Starting in April this year the traditional ‘sick note’ is to be replaced by a new system which will see GPs completing a ‘fit note’ instead. Under the new arrangement GPs must decide whether a patient is ‘not fit for work’ or ‘fit for some work’. If the GP selects the latter, they must then choose from a list of four actions to assist with the return to the workplace: phased return, amended duties, altered hours or workplace adaptations. The change was a recommendation made in Dame Carol Black’s report ‘Working for a Healthier Tomorrow’ – based on research showing that a return to work is beneficial to both employer, employee and also the wider economy. But the big question is whether this particular approach is likely to be successful?
The key to the success or failure of the new ‘fit note’ scheme is the quality and effectiveness of a tripartite relationship – between the GP, the employee and the employer. Each has a responsibility and a part to play in making the new system work. Pressure points will occur when GPs fail to understand what’s possible in the workplace; when employers fail to be sufficiently supportive or flexible with returning staff; and if employees don’t really want to return to work and end up ‘playing’ the system. However, if all play their parts positively the new system has the right ethos and components to make a big difference. My hunch is that GPs are the ones who will need the most support because this way of seeing patients and their jobs will be completely new to them and many will be set in their ways after years of issuing sick notes on request.
However, it’s good to see that the government has thought about this aspect of the new system and is taking action to help GPs make the right judgements. The ‘options’ on the new form are a good idea because they will cause GPs to think actively about the advice they dispense regarding return to work. The ‘fit note’ represents a major paradigm shift in terms how we think about illness and work – any process that encourages the ‘operators’ of the system to consider and discuss a range of options for the patient and employer is a positive thing. The absence of an option for ‘occupational assessment’ is also to be welcomed as it places the emphasis firmly on getting people back to work, rather than further diagnosis that could prolong absence. More diagnostic tests may still be required, but they are not seen as a substitute for re-engagement with work – in this sense, the goal of the system is clear.
So the new scheme carries much promise, but in the end two factors that have always been key in absence management will be critical if this culture change is to be successful: trust and communication. All staff need to know the organisation’s expectations regarding attendance and return to work – and this includes the consequences of failing to meet them, plus the support that is available. It’s no good amending your policy, announcing the change and expecting staff and managers to work the rest out for themselves. You will have a head start if a culture of trust already exists to support the change – if not, it’s almost certainly an underlying area that needs development.
Finally, don’t forget the strategic angle. Absence management processes are important, but they are no substitute for creating a business culture that is characterised by high levels of well-being and employee engagement. Over the long-term this is your insurance policy against high levels of absenteeism because if staff are happy and committed they will do their best to perform for the business and are unlikely to betray the trust you invest in them. When your staff actually want to return to work because they enjoy it absence management becomes a whole lot easier.
This post is adapted from a contribution that my university spin-off company, Robertson Cooper made to a People Management article on the subject: http://www.peoplemanagement.co.uk/pm/articles/2010/02/employers-wary-of-new-fit-notes.htm
Have you seen any impact from this just yet? Have there been any changes in workplace behavior, decrease in sick days…anything along those lines?