The Statement of Fitness for Work (known as a ‘fit note’) was introduced in April 2010 across England, Wales and Scotland, replacing the previous medical statement (known as a ‘sick note’). This was intended to help more people return to work from sickness absence as soon as they are able to. The fit note has the option to record that an individual ‘may be fit for work’ and to indicate basic adjustments or adaptations that could aid return to work.
As part of the fit note evaluation programme, the Department for Work and Pensions (DWP) commissioned the Institute for Employment Studies and the University of Liverpool to conduct a quantitative assessment of the fit note to strengthen the evidence base on sickness certification and sickness absence. To achieve this, 49 GP practices in five areas of Great Britain collected data for 12 months from 58,695 fit notes distributed to 25,000 patients. Data collection took place between October 2011 and January 2013.
This report presents the findings from the analysis of this fit note data. It explores the common characteristics of patients who are more likely to receive a fit note for a sickness absence and the types of advice provided. It looks at the characteristics of GPs issuing fit notes and the types of advice given about possible return to work. The report considers the factors associated with the type and length of sickness absence episodes involving one or more continuous fit notes. It also compares the role of the fit note in long-term sickness absence certification with that of the sick note.
A DWP research report to be published on the same day as this report concludes the fit note evaluation programme. The ”survey of employees” was conducted by the Office of National Statistics and looks at how helpful the fit note has been from the employee’s perspective and the interaction with their GP and employer.
A repeat survey on GPs’ attitudes towards health and work was published in April 2013. Many of the findings of the 2012 survey re-iterated those of the baseline survey conducted in 2010. Generally, GPs see themselves as having an important role in promoting the health benefits of work and fit notes increasingly help them to fulfil this role.
This research programme has informed our understanding of sickness absence and will help in the design of the new health and work assessment and advisory service (which will provide expert help to people on sickness absence). It has also contributed to the revised fit note guidance for GPs, employers and patients published in March 2013.