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The Business Disability Forum has said the Government must address the Access to Work backlog if new plans to overhaul the ‘broken’ fit note system are to succeed.
This week, the Government announced several pilots to reform the fit note system for workers who fall ill, with the aim of offering better support or guidance. These will be trialled at selected NHS WorkWell sites and with major employers.
The WorkWell programme will expand nationally to support up to 250,000 people with a disability or health condition to get into or stay in work.
Trials of a new approach were recommended by the former John Lewis chairman, Sir Charlie Mayfield, in his Keep Britain Working Review into economic inactivity. The Review noted that the fit note system is “not working as intended” and has become a barrier to contact with employers.
How will the fit note pilots work?
The pilots will cover up to 100,000 appointments and last up to a year, with continuous testing, to narrow down the most effective approach to tackle the number of fit notes issued.
Patients will be offered either an initial fit note from a GP, followed by a referral to community health workers, or they will go through the whole process without an initial fit note from a GP and will instead be supported by a separate service staffed by clinical and non-clinical practitioners.
They will provide a range of work and health support, including three-way conversations between patients, employers, and trained professionals, covering reasonable adjustments and helping to keep people connected to their workplace from the first day of absence, supporting more people to stay in work.
Work and Pensions Secretary Pat McFadden said: “Fit notes are too often a dead end – a piece of paper that tells people they can’t work but does nothing to help them get better. We’re changing that. By bringing employers, the NHS, and patients together, we can help people recover faster, stay connected to their jobs, and get the economy firing on all cylinders. That’s what these pilots are about, and that’s what this Government is committed to – fixing what is broken.”
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The launch comes as the Government publishes the Fit Note Call for Evidence, which shows that only three in 10 Healthcare Professionals in Primary Care consider fit notes a good use of GPs’ time, while six in 10 employers think the current process is ineffective in supporting their employees’ work and health needs.
Wider workplace inclusion issues need to be addressed
The Business Disability Forum said that although it supports plans to pilot a more flexible system with multiple routes for individuals, as well as more practical and tailored support for employees and their employers, these changes will have a limited impact unless wider workplace inclusion issues are also addressed.
It added that the Government must reduce NHS waiting times, as Fit Notes often have to be extended because people are still waiting for a diagnosis or for access to the NHS treatment they need to be well enough to return to work.
Angela Matthews, Director of Public Policy and Research, said: “The current Fit Note system is not working for anyone. People using the system find it difficult to access and it places too much responsibility on time-poor GPs who cannot be expected to know someone’s job or the workplace adjustments that they would need.
“We are unsure about the practicalities of the three-way conversation between employee, employer and trained professional being proposed. We support this approach, but in our experience, this could be complicated to organise logistically and could make the return-to-work process longer. We will be feeding back on this.
“We also need the Government to end the current uncertainty around the funding of workplace adjustments through Access to Work, recognising that people may need adjustments to make the return to work possible. The Government announced plans to address the Access to Work backlog earlier in the week, but employers and disabled people are still waiting to hear about additional funding for the scheme itself.”
