Evaluation of the Statement of Fitness for Work (fit note): quantitative survey of fit notes

The Statement of Fitness for Work (known as a ‘fit note’), was introduced on 6 April 2010 across England, Wales and Scotland. Fit notes are issued by doctors as evidence of their advice about an individual’s fitness for work. They are the normal method for employees to provide evidence of sickness to employers after the seventh day of absence.

Doctors use fit notes to assess whether their patient ‘may be fit for work’ or is ‘not fit for work’. If a patient ‘may be fit for work’, the doctor should tick at least one of four boxes outlining common return-to-work approaches to help their patient. There is also space for the GP to give further advice.

The fit note was introduced to improve back-to-work advice for individuals on sickness absence and communication between individuals, doctors and employers on what a patient could do at work, thereby reducing sickness absence levels.

As part of the wider fit note evaluation programme, the Department for Work and Pensions (DWP) commissioned the Institute for Employment Studies (IES) and the University of Liverpool to conduct a quantitative assessment of the fit note to strengthen the evidence base on sickness certification.

To achieve this 49 GP practices in five areas of Great Britain collected these data for 12 months, resulting in 58,700 fit notes distributed to 25,000 patients. Data collection took place between October 2011 and January 2013.