The 'fit note' has replaced the sick note, and employees seem to like it better. But without better guidance for employers , it could just prove to be old medicine in a new bottle
New research by the National Institute of Economic and Social Research has found that the fit note can reduce sickness absence - but that employers need more guidance from GPs to help employees who may be fit for work.
As all HR professionals will know, the fit note was intended to shift the sickness absence mindset towards what an employee can do, rather than simply signing them off from work. Employees have welcomed the new fit note, finding that it has increased their leverage in negotiations about adjustments to their job and that it has meant they could return to work earlier.
This is a key finding of an evaluation of the fit note by NIESR for the Department for Work and Pensions, published today. Contrary to the popular myth that employees are too ready to 'pull a sickie' and manipulate their GPs to get extra time off work, the research found that many employees were keen to return to work as soon as they could.
The main benefits for employees of an earlier return to work relate to their well-being more generally, rather than to their health. Far from enjoying a life of leisure, many employees complained at the boredom at being off work. They missed the contact with colleagues, with clients or the work itself. A number of respondents referred to the mental lethargy induced by watching daytime television. One commented: ‘I would much rather be able to work than just be signed off and have to watch Jeremy Kyle and Flog It all day long.... For me it was just about being able to do something and still use my brain.’
While escaping from Bargain Hunt and Cash in the Attic is a good reason for going back to work, employees identified more pressing reasons for their impatience to return to work. Many expressed fears about job security in the current economic climate and the consequences of having too much sick leave for their career progression. This was a particular worry for employees in organisations with rigid sickness absence policies, that use Bradford scores.
GPs' recommendations for adjustments to enable an earlier return were not always taken up by employers. In some cases, employees found they were expected to continue their usual duties, even though their GP had recommended lighter work, reduced hours or other adjustments. In some cases, this delayed their recovery from operations and illness.
We know that work is good for health, particularly for mental health and wellbeing. As well as money, work gives us a sense of purpose, self-esteem and personal fulfilment. Research with unemployed people shows time and again that, far from enjoying life on the dole, benefit claimants are miserable and desperate to work. Try to find an employee of Jobcentre Plus who will tell you otherwise. As a Jobcentre Plus adviser interviewed for other recent research by the NIESR told us: ‘Before I started working here I had a pre-conceived idea about anti-establishment people claiming benefits and not wanting to work but I found I was wrong and 99 per cent are looking for work’
Sick leave can also lead to dismissal. Our research has found that the longer an employee stays off work with stress, a major cause of sickness absence, the more likely it is that they will lose their job. As contact between the employer and employee diminishes, what starts out as welfare, eventually becomes farewell.
Early intervention to address mild mental health conditions can hasten return to work, as the findings of the Fit for Work pilots have found. And the fit note can help, through guidance from GPs to employers about adjustments.
But has the fit note been a complete success? The answer is, not yet. Employers said they wanted clearer guidance from GPs about an employees' fitness to work and on appropriate adjustments. GPs' recommendations were often too vague and sometimes unrealistic. Without this guidance from GPs, employers argued the fit note is much the same as the sick note it replaced – old medicine in a new bottle.
Heather Rolfe is a senior research fellow at the National Institute of Economic and Social Research
