The ‘Statement of Fitness for Work’, or the ‘fit note’ as it is affectionately known, came into effect on 6 April, as introduced in my previous blog dated 18 February. One month on, what impact has it had so far?
Few people would argue that sickness absence costs employers financially. It also costs other employees, who may face an increased workload as they cover for absent colleagues. When the same person is off work for several weeks or months, then the costs to employers and employees are exacerbated. In addition to the primary illness, there can be other secondary effects for the individual concerned. For example, not working may lead to lower self esteem – which will have a negative impact on overall psychological well-being.
To help address longer-term sickness absence, the ‘fit note’ was introduced to support people to return to work as quickly as possible. Have you encountered any situations where the ‘fit note’ has helped or hindered employers or employees? For example, has the ‘fit note’ helped someone you know with a fractured wrist return to work whilst in plaster, to perform amended duties, when they might otherwise have been signed off from work if the old ‘sick note’ system was still in place? Similarly, has anyone you know been offered more flexible working hours or phased their return to work following illness – and benefitted from doing so? Or, do you think that someone you know has already misused the system and been able to ‘cherry pick’ the duties and responsibilities that suit them, leaving other colleagues to cover the more arduous tasks? Finally, are you a GP who has had to write these notes and, if so, how is the new system affecting you?
Real-case examples will be vital to evaluating the success of the system for everyone involved, and I look forward to hearing your experiences.
For more information about the ‘fit note’ you can read the following:
http://www.nhs.uk/chq/Pages/2584.aspx
http://www.direct.gov.uk/en/Nl1/Newsroom/DG_184645
I’ve seen a side-effect, one which I’m sure was unintended—some people who were producing forged notes have been caught out as they were not aware of the changes.
As there is more space for a GP to make comments these may be expected more frequently and misuse perhaps made a little more difficult. But the main benefits might be in allowing earlier return to work, and also light duties for longer rather than facing a full workload on the first day back.
We run a Pay as you go HR advice line for SMEs and have had several calls already from employers unsure how the forms work. The nature of the queries suggests the GPs themselves don’t yet know what the forms are or how to use them.
Hopefully this is just teething troubles. On the whole, I suspect the fit note will help employees on long-term sick into a phased return. Hopefully, it will also help the long-term sick back to work when what they need is additional support from their employer.
A lot will of course depend on the co-operation of the employee in wanting to return to work once they are beginning to make a recovery. It will also be critical how you reassure them that appropriate support will be given during this transitional period.
In our organisation we already have a sophisticated trigger-based attendance management process which enables individuals to return on recuperative duties on the advice of our OH professionals. We were therefore concerned about how the new “fit note” process would integrate with our own.
Thus far, anecdotal evidence suggests GP’s are considering whether individuals are fit for some form of modified duties and we have received fit notes completed on this basis.
It would be great, though, if they were completed electronically and emailed to employers to improve efficiency and help save the planet!!!
Nic Austin
Kent Police
I’ve just come across this request for experiences regarding ‘Fit Notes’. I work for a large media organisation where many of the most experienced staff are subjected to institutional bullying by inadequate managers in the hope that we will leave – or maybe die.
After being one of only three people interviewed for the management role to which my present manager (a formerly equal colleague) was appointed, my new manager’s first act was to demote me and begin to bully and undermine me. I gained a ‘respite’ from this when I fell seriously ill with double pneumonia and was signed off for two months.
Not long after I returned to work, my manager demoted me still further, to the most junior possible duties my new role will allow – which also happen to be the most physically taxing. Suffering extreme exhaustion, I consulted my doctor. He is an OH specialist as well as a GP, and believes the crash in my immune system which allowed the pneumonia to take hold was due to negative stress from the bullying. He issued me with a Fit Note, citing ‘post infective fatigue’ and requesting that I be returned to a less physically exhausting role until I had regained my previously high level of strength and fitness.
As soon as I produced the Fit Note, panic reigned! Neither my line manager nor the HR Manager had any understanding of what the note entailed. They fired off e-mails to me saying that ‘I should have told them I was still ill’, and ‘shouldn’t be in the office if I was still ill’. I patiently explained that there was no question of my being ‘still ill’; the note was to ensure that they had the benefit of my services in some capacity whilst I was able to recuperate fully. I reminded them that I had flagged up the fact that I didn’t feel up to the strenuous aspects of this new role, yet had been placed contrary to my request in the one team where these would be the ONLY duties I would be required to undertake.
My employer then sent me to an OH doctor. He was furious that he had been asked to comment on whether I was fit enough to perform my job, without my employers having given him any job description for the role. As we awaited his report, rather than adjust my duties as recommended by the Fit Note, I was given NOTHING to do at work.
In summary, the Fit Note looks like the businesslike solution to issues – but it’s open to being misunderstood, abused, and its medical opinions are unenforceable!
The fit note was designed to initiate a dialogue between employer and employee, to allow the sick/healthy, inactive/active black and white thinking about recovery to be overcome. The fit note will only be as good as this dialogue. Just as the success rests upon how co-operative the employee is, organisational culture, I also feel has a part to play in its success or failure. Dysfunctional cultures may not always be capable of tolerating dialogue. The fit note has an in-built function which is protective of employees. This prevents exploitative manoeuvering by dysfunctional cultures especially in cost cutting times, when companies are driven to do more with less. Also the emphasis on how much absence management can save companies can also be one-sided. Presenteeism can cost companies just as much, if not more.