Ministers have labelled the fit note system “broken” — but it’s worth remembering that the current form already allows GPs to recommend phased returns, altered duties and workplace adjustments. The tools to support people to stay in work already exist; the issue is how they’re used in practice, not a lack of options.
The UK Government has announced plans to overhaul the current fit note system, describing it as ineffective and overly focused on simply signing people off work rather than supporting recovery.
Around 11 million fit notes are issued each year, with more than 90% stating that the person is “not fit for work”, and there is growing concern that this approach does not help people stay in or return to employment.
To address this, new pilot schemes are being rolled out across selected areas in England. These will test a shift away from the traditional “tick‑box” model towards more personalised support, including “stay in work” and “return to work” plans tailored to the individual.
Under the pilots, some claimants may be referred to wider health and employment support services, potentially without needing a GP-issued fit note at all. The new approach will involve collaboration between the NHS, employers, and trained support staff, with an emphasis on early intervention, workplace adjustments, and maintaining a connection to employment during periods of ill health.
For advisers, this signals a potential shift in how sickness absence and capability are evidenced and managed. There may be less reliance on fit notes alone and more emphasis on functional support needs and work-related planning. The outcomes of these pilots are expected to inform future legislative changes.
Key takeaway: the system is moving away from “not fit for work” towards a model focused on what support someone needs to remain in, or return to, work.