Following the introduction of digital certifying of fit notes in April, the UK government has now extended the list of healthcare professionals able to issue fit notes to simplify the process and ease pressure on GPs.

As the latest changes bed in,  People Management takes a look at the possible impact they could have across the HR industry.

What do the changes entail?

The government has introduced new legislation that allows a wider range of healthcare professionals – nurses, occupational therapists, pharmacists and physiotherapists – to certify fit notes, as opposed to just GPs being able to do so.

If a worker has been off with illness for more than seven days, a fit note is issued to provide evidence to the employer about the absence and any relevant advice on how to support the worker to remain in or return to work.

The latest legislation change, announced in June, came into effect across England, Scotland, and Wales on 1 July 2022 and it aims to help ease pressure on GPs, simplify the process, enable patients to see the most relevant healthcare professional, and allow for better conversations about work and health.

How might the update affect absence planning and presenteeism?

Commenting on the fit note policy change, which is the most significant since fit notes were introduced in 2010, director of practice and innovation at The Royal College of Occupational Therapists, Karin Orman, said that this change could “open new opportunities for occupational therapists”.

“Workers and employers are crying out for more help to support people to stay in work, where they are able to do so. These new changes mean occupational therapists are directly able to provide that advice,” Orman said.

As the policy update is also aiming to cut bureaucracy for employers and the NHS, Gill McAteer, director of employment law at Citation, said that the new rules could make it easier for employees to obtain a fit note. 

“This means employees could be back in work much quicker due to less waiting around. Employers will also get a quicker response on how long the member of staff is likely to be off, meaning more time to plan for the absence,” she said.

While pointing out that the changes are also welcome for employees who may not be comfortable going to other healthcare practitioners about a particular issue, McAteer highlighted that health professionals other than GPs “are often in a better position to comment on an individual’s state of health and provide informed advice on any measures which may assist in getting the employee back into work”.

McAteer added that all of this “will help alleviate the burden of long-term sickness absence within the business, especially as businesses, particularly SMEs, are trying to get back to pre-pandemic levels of staffing.”

Echoing the advantages of the policy, Idris Arshad, people and inclusion partner at St Christopher’s Hospice, added that the changes could translate into quicker reporting of absences, as waiting for GPs is seen as a common delay in the process.

While acknowledging that more information is needed about how other healthcare professionals will administer fit notes and how long it will take to book appointments with them, Arshad said that as a result of the changes, “presenteeism may decrease and absenteeism increase as the burden of having to chase for a GP appointment may be less.”

Considerations for employers

While McAteer said that concerns had been raised among employers that the update would result in the inappropriate issue of fit notes to employees, she said “it seems likely that more employers may want to obtain their own medical advice on their employees’ health.” However, she cautioned that this “would need the employee’s consent and would come at a cost”.

Addressing fears of possible misuse of fit notes by workers, Arshad advised that managers and HR “act on a ‘trust first’ basis and only question when having really strong grounds to do so, for example [where] someone states they have broken their leg, but you see them playing football,” he said.

As well as this, Arshad cautioned that the policy update “will put employers’ empathy and trust to the test” as many will question whether “a note from a pharmacist has less value than a GP’s.” 

Regarding the specialist knowledge that other health professionals can bring to the table, Katie Hodson, partner and head of employment at SAS Daniels, said that following the changes, employers may see more fit notes containing “suggestions for adjustments or support for the employer to consider in assisting with any return to work.”  

She added that this should not be viewed as concerning since “physiotherapists, nurses, and occupational health would be dealing with a specific issue with the employee and potentially would have more specialist knowledge.” 

“This can therefore be considered by the employer at an early stage of the employee’s absence, which could result in more employees returning to the workplace at an earlier date,” Hodson added.