The UK Government has taken a step towards overhauling the current sick note system by launching four pilot programmes designed to improve how sickness absence is managed. This follows growing concerns that the existing system is no longer fit for purpose and isn't aligned to the needs of doctors, employers or employees. In response, the new pilots aim to create a more flexible and effective approach that is more personalised. 

The current sick note system

Currently, it's up to GPs to issue sick notes (now usually known, and referred to by the NHS) as fit notes). Around 11 million fit notes are issued each year, with more than 90% stating that individuals are “not fit for work.” The system is quite black-and-white, and doesn't always explore whether employees could continue working in some capacity with the right support or adjustments.

Research suggests that 30% of clinicians view fit notes as a poor use of GP time, while 60% believe the system doesn't adequately support the health and work needs of patients. This has placed unnecessary pressure on already stretched GP services while missing opportunities to keep people engaged with their workplaces.

Against this backdrop, the new pilot programmes aim to address these shortcomings and modernise the system.

How the new sick note pilot programmes will work

The four pilots will test a new way of managing sickness absence by shifting the focus away from simply declaring someone unfit for work. Instead, the emphasis will be on creating tailored “stay in work” and “return to work” plans.

These plans are designed to be more collaborative and involve:

  • The employee
  • Their employer
  • Trained professionals, including both clinical and non-clinical practitioners

The goal is to identify realistic, reasonable workplace adjustments and ensure that employees remain connected to their job from the earliest stage of absence. This approach recognises that, in many cases, staying engaged with work can support recovery and improve long-term outcomes.

Increased flexibility

One of the most significant changes being tested is how employees access support. Under the new pilots, patients will have two potential routes:

  1. They may receive an initial fit note from a GP and then be referred to a community health worker for ongoing support.
  2. Alternatively, they may bypass the GP entirely and access a separate service offering guidance from a mix of trained professionals.

This dual approach aims to reduce the administrative burden on GPs while ensuring individuals receive more tailored and timely support.

Size and scale of the pilots

Over the next year, up to 100,000 appointments will be used to test and refine these approaches. This large-scale trial will allow the Government to assess what works best in real-world settings, gathering data and feedback from all those involved.

Continuous testing will ensure the pilots evolve over time, adapting to findings and improving the support offered.

Planned benefits

The new system is designed to help: 

  • Employees, by providing more personalised support, better health outcomes, and a smoother transition back to work
  • Employers, through reduced long-term absence, improved productivity, and stronger workforce retention
  • GPs, by reducing administrative workload, allowing more time to focus on clinical care

Ultimately, the aim is to create a system that better recognises the complex relationship between health and work.

The future

These pilot programmes represent the first phase of a wider ambition to reform the fit note system. The insights from the pilots will play a crucial role in shaping future legislation and policy changes.

By moving towards a more proactive and supportive model, the Government hopes to build a system that not only responds to illness but actively helps people stay in work where possible and return more quickly when they are ready.

As the pilots progress, employers, healthcare providers, and employees alike will be watching closely. If successful, this could mark a significant shift in how workplace health is managed across the UK.

Questions

If you have any questions about fit notes, please contact our Payroll team via payroll@ct.me.