The new Fit Note regime ushers in a real headache for employers, employees and GPs alike. However, the system offers opportunities for advisers, says Phil Taylor
For years organisations have considered how they might manage absence more effectively in order to drive greater efficiency, increase productivity and reduce costs. It is absolutely clear that the system of getting a sick note from a general practitioner (GP) is no longer reflective of modern society and social dynamics – it is simply too blunt an instrument.
The answer, it would appear, is the introduction of the ‘Fit Note’. These notes are intended to encourage a dialogue between the employer and employee, in order to identify ways in which the employee can be supported back to work. Nobody could deny that this attempt to reduce the crippling impact of long-term absence on corporate UK is anything other than commendable.
An adequate solution?
However, there are some questioning whether the system in its newly revised format will actually achieve this, and whether it has been effectively communicated to the parties involved. So, is the new Fit Note system an adequate solution, or is it fraught with challenges?
There are positive repercussions for the employee benefit market, not least in simplifying previously difficult sales. All in the benefits market are aware that the biggest single objection relating to purchasing outsourced Occupational Health and Absence Management solutions has simply been a demand from the purchasing firms for advisers to ‘Prove it’.
For many organisations, particularly small to medium enterprises (SMEs) the outsourcing of absence management is perceived as an additional cost and a theoretical exercise, which rarely achieves sign off. This is because little, if any, evidence exists to support the external ‘expert’ intervention.
With the change from sick note to Fit Note, it is reasonable to predict that organisations of all sizes and across all industry types will now require far more occupational health intervention in order to manage potential liabilities under the Disability Discrimination Act (DDA), and to clarify the nature of any suggested adjustment.
There are a number of observations that can be made about the new Fit Note regime which will impact on a company’s attempt to control their employee absence rates.
- The GP will remain the advocate of the patient – this is simply engrained into the psyche of the GP. This is not necessarily a bad thing, but it is a simple fact of life.
- GPs are under enormous pressure already to manage patient lists and appointments efficiently – most consultations last no more than three minutes. How is it then possible for a GP to conceivably review the patient’s job description, gain a full understanding of the job functionality in the context of the presenting medical condition (and in doing so consider that a return to work, with adjustments is achievable)?
- Most GPs have only very limited specialist training in Occupational Health and with the RCGP planning to offer half day training courses for around 4,500 of the 35,000 GPs over the next two years, this does present somewhat of a knowledge gap.
There are some real banana skins associated with the Fit Note implementation. While the GP’s recommendations are not binding for the employer, it will be fascinating to see what happens when an employee presents the note as evidence in a DDA claim, where an employer has failed to make necessary adjustments which would have facilitated a return to work.
Conversely, if the GP, with limited Occupational Health experience, states that an employee is fit to return to work with adjustments, but the employee remains adamant that they are simply not well enough, what will the employer do? For some there will be a temptation to stop Statutory Sick Pay and follow the disciplinary process – Specialist Occupational Health Intervention, we would hope will be the widely adopted approach.
For a great number of employers, across all industry sectors and sizes, the solution to maximising the benefits of the Fit Note while minimising the inherent litigation risk will be to engage with Occupational Health providers in order to obtain specialist input and advice at the earliest opportunity.
Health Assured has found that more and more clients are seeking to integrate Occupational Health and Absence Management benefits, using objective Absence Triggers to facilitate a referral into Occupational Health. This approach works well with the new system, as qualified Occupational Health clinicians can generate a phased return to work schedule, and propose reasonable adjustments, based on a thorough understanding of the job functionality in the context of the work place.
Most SMEs simply do not know how to access Occupational Health Services and it is evident that a significant market opportunity exists for intermediaries who are able to understand the dynamics of the market, and offer a holistic approach.
It is possible for intermediaries to put highly cost effective and joined up protection in place for clients, incorporating all of the above within single products. Health Assured, amongst others, offers this ‘integrated solution’.
The transition to Fit Notes represents a massive opportunity for informed and forward thinking intermediaries, who are able to demonstrate remarkable added value and clarity in a changing market.
Phil Taylor is managing director of employee benefit specialists Health Assured
