Belfast Telegraph

Fit Notes

By Siobhan Harding

Since 6 April 2010 sick notes were replaced by fitness for work medical certificates, known as ‘fit notes’.

The new form allows a doctor to say that an employee may be fit for work, subject to changes at the workplace, rather than saying they are either fit or not fit to do their normal job, as was the case with the old-style sick note.

The new fit note will include an option for the GP to state either that the employee is not fit for work or may be fit for work subject to advice. The intention of the second option is that the employer, in consultation with the employee, can decide whether they can accommodate any necessary changes to facilitate the employee's return to work. This is separate from the employer's duty to make reasonable adjustments under disability discrimination law.

Where a doctor has advised that an employee may be fit for work they will include some comments on their condition and will tick one or more of four tick boxes if they feel it could help the person return to work:

Phased return to work – where the employee may benefit from a gradual increase in intensity of work duties or working hours, for example, following an operation an employee could return to work on reduced hours

Altered hours – where the employee will benefit from a change to the hours they work in order for them to return to work, for example, allowing flexible hours for an employee who is still receiving treatment to attend treatment sessions during the day

Amended duties – where the employee may be able to return to work if their duties are amended to take into account their condition, for example, removing heavy lifting from an employee who has a back injury

Workplace adaptations – where the employee may be able to return to work if the workplace is adapted to take account of their condition, for example, providing a ground floor workstation to an employee who has problems going up and down stairs.

It is for employers and employees to agree between them what these changes should be. If a return to work is possible the employer should agree any temporary changes to the job or hours with the employee and what support the employer will provide and for how long. Employers with sickness absence policies should consider whether they need to amend their policy to include fit notes.

If a doctor certifies that an employee may be fit for work subject to adjustments being made, but the employer does not agree to make appropriate adjustments, then the employee should still be considered as unfit for work for statutory sick pay purposes.

If an employee is off sick for short periods of four to seven days they are not required to give the employer any medical evidence for the purposes of statutory sick pay. However, for contractual sick pay, an employer can require an employee to provide a medical certificate for any period of time off work due to sickness depending on the contract of employment. This may mean providing a medical certificate even if they have had only one day off sick, if they are to receive contractual sick pay for that day.

Further information is available from your local CAB and guidance for employers is available from the Department for Social Development’s website at

Siobhan Harding is an Information and Policy Officer with Citizens Advice

Belfast Telegraph