Streeting advises GPs to replace sick notes with gym memberships

A new pilot program by the government will ask GPs to stop signing off sick people from work, and instead refer them either to job coaches or gyms.

In 15 regions, GPs will receive funding for specialist support, along with sick notes, instead of simply signing them off.

The NHS issued over 11 million “fitnotes” last year – an increase from 5.3 millions in 2015. However, most of these notes did not provide any other alternative way to keep patients active or prepare them for work.

Pilot will have doctors working with employment coaches to help patients write CVs and cover letter. Also, gardening classes and gym memberships may be “prescribed”. The patient will be linked with charities that can help with debt management, housing and other issues.

Wes Streeting, the Health Secretary, said that 2.8 million people were out of work because of health conditions. This is bad for patients and the NHS. It’s also bad for the economy. The sick society that we inherited is costing taxpayers huge sums. We can’t keep writing off people.

It was a “bureaucratic dead-end” to issue 11 million fit notes per year.

Streeting said that occupational therapists and work coaches, as well as “social prescribing” professionals would be hired to “help people navigate their way back into employment while managing health conditions.”

Mental health conditions like anxiety and depression and musculoskeletal problems such as back pain or injuries are the most common causes of long-term sick leave.

Ministers plan to expand the pilot nationally. It will also free up time for GPs by allowing NHS staff such as occupational therapists and physiotherapists to provide fit notes and more health and work advice. The WorkWell program, which was launched during the last year of the Conservative administration, will be used to implement the Restart initiative in 2020. The scheme will be implemented in 15 English regions with high unemployment and sickness rates, such as Birmingham, Manchester and Lancashire.

Employees may self-certify their absence for up to seven days. However, if they are ill for a longer period, they will need a note of fitness to continue receiving sick pay.

NHS leaders warned that inactivity was “perpetuating mental health issues” and that finding work for people should be an important “part of treatment plans”.

Claire Murdoch told The Times recently: “As NHS, we are here to help people get or keep a job.” The NHS should, can and will consider itself a contributor to the economy.

In the UK, nearly 11 million adults of working age are unemployed. The number of people who have been signed off for long-term illness is a record. Half of them suffer from depression or anxiety.

These figures show that there are 923,000 young adults in the UK who are not in education or employment.

Legal Comment

Owen Dear, partner at Crossland Employment Solicitors said that the idea is good in theory, but may have practical issues when implemented.

He said: “Any initiative to encourage engagement between employees who cannot work due to illness and their employers should be welcomed. The Government’s proposal is a step in the right direction.” Theoretically, at least, if trained professionals facilitate that engagement, and employees take proactive steps to help them return to work, this could reduce the time an employee is away from work and receiving sick pay.

“But it will work better if the system still recognizes that employers are best placed to determine what steps they can or cannot take to assist an employee to return to work. Health coaches and occupational therapy may not be familiar with the specifics of the company where an employee works, but they can make recommendations to help that employee. If an employer is unable to implement the recommendations made by the fit note, they should not force the employee to refuse to return to work or engage in any activity until the employer has implemented the suggestions.

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