Request a Fitness for Work Form

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The fit note focuses on what patients are able to do in relation to their work. This brings together clinical aspects of illness and how it affects function and ability to work.

Fit notes are issued as part of a “package” of care plan to facilitate the return-to-work agenda of the government. This is the basis on which the Practice deals with any requests for fit/sick notes

Patient who are issued fit notes must have a clear agreed management and treatment plan with clinician.

Example of management plans including taking prescribed medication, ensure engagement with care plan as demonstrated by regular attendance with appointments (specialist, counsellors, and GP), clear evidence of engagement with their employer’s occupational health plan and social prescriber’s advice etc.

When health professionals are asked to issue fit/sick notes or sign any paperwork, they have to use their professional judgement to whether the requested statement is true and an appropriate one for them to make.

Health professionals also have a responsibility to the public bodies (e.g. GMC and NMC) that oversee their regulations in the UK and can only provide statements they can justify on clinical grounds.

A fit note must be issued by a healthcare professional, which could be a doctor, nurse, pharmacist, physiotherapist or occupational therapist.

What is a fit note?

'Fit note' is the informal name for a Statement of Fitness for Work. This is also referred to as a sick note, med cert, med 3 or doctor's note.
It provides evidence of the advice patients have been given about their fitness to work.
A fit note explains details of your condition. This will also assist you and your employer to think about steps to help you return to work.

Who can issue a fit note?

Previously Fit notes were issued by GPs and Hospital doctors only.
From 1 July 2022, in addition to GPs and hospital doctors, it was widened to include other health care professionals including nurses, occupational therapists, pharmacists and physiotherapists.
All GPs, nurses, occupational therapists, pharmacists, and physiotherapists can provide simple fitness for work advice. This can help patients return to work and aid their recovery. It is then up to a patient and their employer to discuss this advice and consider possible changes.

What is the purpose of a fit note?

The fit note focuses on what patients are able to do in relation to their work.

There is a consensus that it is good practice for GPs and other healthcare professionals to:

play a role in advising patients about (return to) work
agree that (return to) work is an important health outcome for clinical management
Help patients develop a return-to-work plan (for example patients may be required to take medications, attend specialist’s appointments etc. in support of their return to work plan)
Help return to work through shared decision-making Enable patients to effectively communicate with their employers (for example patients may be advised to speak with their employers, line managers and occupational health departments).

What is the relationship between work and the fit note?

The fit note focuses on what patients are able to do in relation to their work.

The assessment about whether a patient is fit for work is about their fitness for work in general and is not job specific.
The fit note focuses on what patients are able to do in relation to their work. This brings together clinical aspects of illness and how it affects function and ability to work,

Further information about health, work and wellbing - evidence and research

When do I need a fit note?

7 days off sick or less

If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. Instead they can ask you to confirm that you've been ill.

You can self-certify by filling in a form yourself when you return to work.

Complete a self certification

More than 7 days off sick

If you're off work sick for more than 7 days, your employer will usually ask for a fit note from a healthcare professional.

How can I request a fit note?

You can request a fit note by any of the following methods listed below

Alternatively you can request one from the Surgery reception

What happens after I submit my fit note request?

The issuance of a fit note is an administrative task and may take up to 10 working days (2 weeks).
In view of this, do not request emergency or urgent appointment for the purposes of requesting fit notes, as it will be declined.
Should you have a health concern, you view to be urgent please book an appointment for this independent of your fit note request.
Please note, when deemed appropriate by the healthcare professional, a fit note can be backdated.
All fit notes requests are reviewed every week at the Fit Note Clinic. The Fit note clinic comprises a team including Doctors, nurses, the Practice manager and sometimes wider health professionals such as the mental health nurses and social prescribers.

How do I get assessed after submitting my fit note request?

Patients do not always need to see a health professional in person to be assessed for a fit note.
The assessment for sick notes can be based on your records and the health professional does not need to speak with you if they think there is enough evidence from your records to either issue or refuse to issue you with a fit note.
An assessment of your fitness to work can be done by a variety of methods including
- A review of your clinical records
- A face to face appointment
- A telephone consultation
If you are off work due to a hospital admission, a fit note can be issued by the hospital to cover the period of time you were in the Hospital. Once discharged, your GP can issue a fit note, based on your hospital discharge letter without necessarily needing to see you.

Can I specify the duration I would like my fit note to last for?

The length of time requested is a clinical decision made by the health professional, based on a thorough assessment of your health condition and how long (s) he thinks is appropriate for you to be off work.
If the health professional deems you not fit to work, the health professional will ascertain how much time is required (backed by clinical evidence based guidelines) for you to be fit for work.

Can my fit note request be declined?

The issuance of a fit note is discretionary and based on a full assessment of the patient’s fitness to work by the health professional.
If you are deemed fit to work, following a full assessment of your fitness to work, your fit note request can be declined.
The healthcare professional may choose the "may be fit for work" option if they think that you are able to do some work. This may not be your usual job. They may also advise that you get some extra support from your employer.
You should discuss this advice with your employer to see if you can return to work. For example, your healthcare professional may suggest possible changes, like:
- returning to work gradually, for example, by starting part time
- temporarily working different hours
- performing different duties or tasks
- having other support to do your job - for example, if you have back pain, avoiding heavy lifting

Can I request a back dated fit note?

We may issue back dated fit notes, if
- There is documented evidence of consultation with a health professional for the condition for which the patient is requesting a fit note. e.g. recent attendance at A and E consultation with an Out of Hours doctor.
- Following an assessment of the patient, the health professional has determined that it is appropriate to issue a fit note.
We will not issue fit notes for any condition for which there is no documented evidence on our notes of the illness in question. e.g. A&E letter or GP consultation.
If you are off work, due to a Hospital admission, a fit note should be issued by the Hospital to cover the period of time you were in the Hospital
Once discharged, your GP can issue a Sick Note, based on your hospital discharge letter. If you think this is your situation, our Reception Team will assist you.

Can I request a fit note in advance (for a date in the future)?

Sometimes patients have requested a fit note to commence at a future date e.g. in anticipation of an operation/intervention or procedure.
Unfortunately we are unable to issue fit notes for dates in the future and can only issue fit notes for already established illnesses/health concerns.

What happens if I can’t get a fit note?

An employer can accept alternative evidence of sickness (for example evidence of admission to hospital) and can decide to pay SSP if the employee has a good reason for not supplying a fit note

Don’t I need to be fully recovered before I return to work?

You do not need to be fully recovered to go back to work.

For example:

your employer may agree to make some changes to help you return
if your health condition no longer affects your ability to do your normal duties, you may be able to return, even though you have only partly recovered

Do I need a note, saying I’m fit for work?

No, you do not need to see a healthcare professional again to go back to work.
Some employers have their own policy that requires employees to obtain medical evidence that they are fit for work. If this is the case, your employer should help you arrange this privately with a healthcare professional or occupational health specialist.
A healthcare professional cannot issue a fit note for this purpose.

Can I request a fit note for my child for the school?

It should be noted that GP practices do not provide sick notes for school children. Parents/guardians are responsible for excusing their children from school
GPs cannot provide retrospective sickness certification.

My child has missed an examination, can I request a fit note?

Children who have missed exams due to illness are frequently told by schools that a note from a doctor is required;
But this cannot be provided by a GP.
When a child suffers from a long-term condition, any certification will be provided by the responsible specialist.
General Practitioners Committee (GPC) has sought and received confirmation from the Office of the Qualifications and Examinations Regulator that Awarding Organisations make no requirement for pupils to obtain a medical certificate in support of their application for special consideration.
Students are asked for information in support of their application, but this may take the form of a statement by the school.
The Joint Council for Qualifications has confirmed that as far as they are concerned, if a student was absent from an examination as a result of illness and has the support of the school or centre to be absent, special consideration will be granted on that basis.
Awarding organisations do not insist that medical proof is provided.

Do I need to pay for a fit note?

There is usually no charge for providing a fit note if you are off sick for more than seven days.
Some employers may request a fit note (e.g., from employees who repeatedly take time off sick) even if they are off work for seven days or less. This is a private non-NHS medical certificate.
Fit notes, requested for a period less than seven days are classed as private, Non NHS fit notes and will incur a charge payable to the surgery.
If you are off work due to a hospital admission, a fit note can be issued by the hospital to cover the period of time you were in the Hospital. Once discharged, your GP can issue a further fit note, based on the assessment of your hospital discharge letter.

What about Private Consultations and fit note?

The private healthcare practitioner who you have seen, is responsible for issuing you a sick note.
Issuing a fit note, is discretionary and we are under no obligation to convert your private fit note to an NHS fit note

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