GP fit note decisions need not always be the definitive last word

This article was written recently by Health for Work Adviceline. The Health for Work Adviceline service is provided by NHS occupational health services. It is a key part of Health, Work and Wellbeing, a Government-led initiative to improve the health and wellbeing of working age people in the UK.

A change included in new guidance on the fit note published by the Government in March 2013 (see our blog on the revised fit note guidance for more information) could allow employers to favour the views of an occupational health practitioner over those of a GP. In the guidance (under the headline ‘Is the fit note binding on me?’) the Government has confirmed that the answer could be ‘no’, GP fit note decisions need not always be the definitive last word. The relevant section from the fit note guidance reads as follows:

“No. The assessment about whether your employee is not fit for work or may be fit for work (and any other advice in the fit note) is classed as advice, and it is for employers to determine whether or not to accept it. Occasionally, you may be believe that your employee is not fit for work when they have been assessed as fit for work by their doctor, or you may think that your employee could do some work when they have been assessed as ‘not fit for work’ by their doctor.

 “In situations like this you are within your rights to gather other evidence about your employee’s fitness for work from other doctors or healthcare professionals. You can choose to give this other evidence precedence over the advice in the fit note. Your employee may disagree with you, and you may need to demonstrate to an employment tribunal why the alternative source of evidence was more acceptable to you than the fit note.”

This change was intended to cover situations in which, based on the knowledge of a workplace and the work an employee does, an employer/occupational health professional may have a different view to a GP on the person’s ability to work. For example, an employer may consider that a person isn’t fit to return to work based on the nature of the workplace, despite having been judged by the GP to be ready to return. Or, alternatively, an employer may be of the view that an employee who has been assessed as not fit for work could return to carry out alternative work functions instead.

This change is good news from the perspective of occupational health practitioners who are often better placed than GPs to decide whether or not a person is fit enough to return to the workplace, and which particular roles the person could carry out. However, GPs will be keen to ensure that they make the best judgement call, where possible.

Since the introduction of the fit note, the interaction between GPs and employers regarding occupational health considerations has changed. In order for GPs to make informed judgements on the fit note about their patients’ ability to carry out particular tasks in the workplace, they are increasingly required to have some knowledge of the nature of their patients’ employment and whether it poses any particular health risks. This is why GPs are invited to use the Health for Work Adviceline’s free services (0800 0 77 88 44) for guidance on the effect their patients’ health issues may or may not have on their ability to work.

(Article written by the Health for Work Adviceline– Original article available on their blog)