UK Government Trials Changes to Fit Note System in Parts of England

The UK government is preparing to trial changes to the fit note system in parts of England. Under the pilot, GPs in some areas will stop issuing fit notes and instead refer patients to support services that include both clinical and non-clinical staff.

These services will develop personalized return-to-work plans. The government states the changes are intended to move away from a tick-box system and help more people remain connected to work while recovering.

Many readers expressed concern that removing doctors from the process could leave seriously ill people without proper medical support. Several described using fit notes while recovering from heart conditions, cancer treatment, mental health issues, and chronic illnesses.

Readers said employers relied on fit notes to approve workplace adjustments or phased returns. Some warned that non-clinical staff might lack the training to assess health needs safely.

One reader recovering from a heart condition stated that a fit note helped them stay employed by allowing adjustments for strenuous tasks. Another said sick notes enabled access to Universal Credit and income protection insurance after a workplace injury, preventing homelessness.

A reader who had emergency surgery last weekend noted that their current fit note allows access to statutory sick pay after seven days. They questioned how a work consultant could speed recovery when rest is medically required. A former bus driver described returning to work only after nearly four months off following severe sciatica, saying pain prevented an earlier return.

A cancer survivor warned that non-clinical staff could pressure patients to return despite fatigue and sickness.