Regulations to introduce 'fit notes' laid before Parliament

The Social Security (Medical Evidence) and the Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2010 have been laid before Parliament and will come into force on 6 April 2010. Under the regulations, 'fit notes' will replace sick notes (also known as medical certificates, medical statements or doctor's statements). The regulations contain new rules concerning the completion of a medical statement and prescribe the format of the medical statement to which those rules relate. The medical statement will help employees claim statutory sick pay (SSP), as well as certain health-related social security benefits. 

Medical statements are issued by GPs and other doctors to provide advice on fitness for work to their patients who have a health condition. Employees are normally required to provide medical statements to their employers from the eighth calendar day of sickness absence in order to support their claim for SSP or contractual sick pay. At the moment, medical statements simply require the doctor to describe, in brief terms, their patient's medical condition and indicate whether or not they should refrain from work. The new rules will allow a doctor to consider not only whether their patient is unfit for work but also whether their patient may be able to work with appropriate support if available. Where a doctor states their patient may be able to work, the doctor must provide general information to support that statement. This could include advice about changes that could be made by the employer in agreement with the employee that would assist a return to work. There will be a single medical statement form available for use in all cases.

The new medical statement provides information on:

• The date a doctor assessed their patient's case.
• The health condition of their patient.
• Whether their patient is 'not fit for work' or 'may be fit for work taking account of the following advice'.
• Where the doctor considers their patient 'may be fit for work taking account of the following advice', the doctor must provide further information/comments to support this. If the doctor considers it appropriate that their patient may benefit from workplace adaptations or adjustments (such as a phased return to work, altered hours or amended duties), they should also tick the relevant box.
• The period for which the doctor considers their patient is 'not fit for work' or 'may be fit for work taking account of the following advice'.
• Whether or not they need to assess their patient's fitness for work again on the expiry of the medical statement.

There is no longer a 'fit for work' option, which was proposed in the original consultation, as doctors were felt not to have the appropriate knowledge about individuals' roles and the risks involved to be able to assess this.

If an employer is not able to facilitate a change or an adjustment, a revised medical statement is not necessary; the existing medical statement is evidence that an individual has a health condition preventing them carrying out their current role.

The maximum period a medical statement can be issued for will be three months during the first six months of incapacity.

The Government intends that separate guidance for individuals, employers and healthcare professionals will be available shortly. The guidance for individuals will be made available via a fact sheet which GPs can print and provide to patients. Guidance for employers will be available through the internet.

The regulations apply to Great Britain. Separate regulations are to be made in Northern Ireland.