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New ‘Fit Notes’

On 6 April 2010 a number of changes to the medical statement (‘sick note’), which employees get from their GP to certify sickness absence, came into effect in England, Scotland and Wales. The NASUWT explains the change.

Previously, a sick note simply stated whether a doctor believed that a person should or should not be in work.

The new medical statement will either indicate that a person is not fit for work or that they might be fit for work under certain circumstances. The doctor will also be able to suggest changes that would assist a return to work. This addition may, in principle, be helpful, but there is real concern that neither GPs nor employers will have the systems in place to deal with the changes straightaway, particularly the expert advice needed to support changes that would assist a return to work.

Consequently, teachers may find themselves being pressed to return to work before they are fit to do so or may be penalised financially, having to wait for the expert advice through occupational health. There is no requirement for the GP to write anything apart from that the person is not fit for work and how long the person is ‘signed off’ for.

In most cases it is unlikely that the patient and employer will see any change in the information that the medical statement provides. However, it is essential that the situation is closely monitored.

The new process

The new medical statement will still provide evidence that an employee cannot work due to injury or illness and normally will not be required until after the seventh calendar day of sickness.

The main changes are:

1. the form will now have two options: that the patient is ‘not fit for work’ or that the patient ‘may be fit for work taking account of the following advice’;

2. there will be four options listed that the GP can tick: •a phased return to work; •altered hours; •amended duties; •workplace adaptations;

3. there will be space for the doctor to provide more information on the condition and how it may affect what the patient can do.

In most cases there will be nothing to recommend and, as at present, the employee will go back to work once the GP feels they are ready to do so.

The form does not contain an option for the GP to say that a person is ‘fit for work’. In these circumstances no further medical certificate will be issued. A return to work should only be recommended after discussion between the GP and the patient, making sure that the patient is fully aware of what is being suggested in terms of a return to work.

Phased return to work

A phased return to work is usually an option when an employee is suffering from an illness that has left them fatigued or has been absent due to a long illness and is not confident about returning full time to their full duties. A phased return may also be used if a person has an injury, where the doctor believes that their strength has to be built up gradually.

Often a phased return to work may be proposed along with other changes, such as altered hours, amended duties and workplace adaptations. Employers should get advice from an occupational health service in deciding what action to take. NASUWT members should seek advice from the Union about any proposals that will involve a permanent change to their contract of employment or if they are concerned that the proposals for their return are not appropriate.

Risk assessment

The employer must also undertake a risk assessment if they make any adaptations or changes to an employee’s duties to ensure that these do not introduce new risks. In addition, if the employee is disabled and covered by the Disability Discrimination Act (DDA), then the new fit note procedures do not alter the duty on the employer to make adequate adjustments regardless of what a GP may recommend. NASUWT members should seek advice from the Union on their rights and entitlements.

A GP is unlikely to know what the exact demands of the job are and if the employee feels that they are being pressed to return before they are fully fit, they should make their concerns explicit. In addition, the employer will also know the demands of the job and will have a responsibility to ensure that the welfare of the employee and the pupils in their care is paramount, regardless of any recommendation on a medical statement.

Sickness absence policies

The nationally agreed occupational sick pay scheme is set out in the teacher’s contract. Local authorities may have locally agreed occupational sick pay schemes that may provide enhanced provisions. Schools in the local authority may adopt the authority’s scheme or if they are foundation or voluntary aided schools, they may have their own. Academy schools may have developed their own scheme but any staff who transferred to the academy when it was established will have transferred with the provisions of their previous employer’s scheme unless they have signed a new contract of employment with the academy.

The key issues in any revision to the sickness absence policy are:

•no employee should suffer any financial detriment as a result of returning to work on reduced hours or on reduced duties. Any teacher returning to work should receive their substantive pay,

regardless of the hours they work or the work they undertake as part of a phased return to work;

•once an employee returns to work they are no longer absent due to sickness, including on days they do not attend work due to the terms of any phased return; and

•where disputes arise concerning changes to work or working time proposed as a result of a medical certificate that cannot be resolved through dialogue, then the employee should have access to the grievance procedures and the sickness absence policy should make this clear.

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