More clinicians issuing fit notes

Fit note occupational health news

More professionals can issue fit notes

The government has introduced new laws to extend the number of healthcare professionals that can issue fit notes. The change is intended to ease pressure on GPs.

Currently only doctors can issue fit notes. This sometimes causes delays in certifying absences from work. From July 1st a much greater range of healthcare professionals will be able to issue the notes.

The Department of Work and Pensions says the change, the biggest update to fit notes since they were introduced in 2010, will relieve pressure on doctors, hospitals and employers.

Changes were made earlier this year in response to the pandemic which temporarily extended the period before a fit note could be requested from 7 to 28 days. The notes were also updated to be issued digitally in April this year.

Who can issue fit notes from July?

From July 1st the number of healthcare professionals who can issue fit notes has been extended to include:

  • Nurses
  • Occupational therapists
  • Pharmacists
  • Physiotherapists

What controls are in place?

Fit notes can only be used after an assessment of a person’s fitness for work. They cannot be issued on demand or via over-the-counter services. Not every registered professional will be able to issue the notes.

Guidance from the General Pharmaceutical Council, which regulates Pharmacists, say that only those who are working in multi-disciplinary teams in general practices or hospitals can issue the notes. This excludes many High Street pharmacists.

Furthermore, certain conditions must also be in place. Pharmacists must have the necessary skills and training to hold work and health conversations. Issuing the notes must fall within individual ‘scope of practice’, which means pharmacists must complete training to identify if it is a suitable task.

Many fit notes are for five weeks or more

The Society of Occupational Medicine notes that over a third of fit notes are issued for five weeks or longer, when about 20% of those signed off will never return to work. The Society believes that fit notes are rarely used to their full potential, with most focussing on the ‘not fit’ option, rather than the ‘may be fit for work’ choice.

The Society is calling for comprehensive training in use of the fit note, in undergraduate and post-graduate programmes, across all the relevant disciplines.

Where can I find more information?

The government has published a series of useful guides for patients, employees, employers and healthcare professionals. They can be access directly on the government website.

The Society of Occupational Medicine also has a free webinar on Making the Most of the Fit Note Changes on July 11th (9am to 10am) and anyone can register online on their website.

What does it mean for my business?

Whilst it may take some time for the changes to settle into normal business practices, the benefit of improved access may be off-set by (probably well intentioned) unclear advice from the professional on the fit notes.

For example, vague suggestions on a fit note (e.g. “reduce stress”) to facilitate a return to work may have noble intentions, yet specific guidance is often needed by most employers.

If you are ever in doubt about the relevance of the guidance contained within a fit note, most occupational health professionals will be pleased to offer guidance and support.




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