Management Briefing


A ‘Fit Note’ or Statement of Fitness for Work is issued by a doctor when they believe that either a person is unfit for work, or ‘may be fit for work’ with some help from their employer. This may mean that they can work in some capacity, but may need the role to be altered to suit their needs.

For example: they may need altered hours, changes to the workplace, amended duties or a phased return to work. A doctor may deem a patient ‘unfit for work’ for a certain period. It is important that if an employee wants to return to work before that period ends, that their needs are discussed fully and a risk assessment is undertaken. A patient does not need to be ‘signed back’ to work by a doctor.


Key risk factors for consideration
  • – Employees putting themselves or others at risk by being at work whilst unfit
  • – Employees making an ill health condition worse by coming back to work too soon
  • – Employees who are at work, but on reduced duties, being unable to respond effectively in emergencies
  • – Reducing productivity by not adapting work for those classified as ‘may be fit for work’


Recommendations for employers
  • – Put in place a policy for the management of sickness absence and return to work
  • – Make sure that sick pay arrangements are clear, and avoid encouraging or pressurising staff to return to work before they are appropriately fit for the work they are to do
  • – Ensure that risk assessments are reviewed if an employee is not fully fit for their normal duties
  • – Ensure that managers are trained in the policy and procedures
  • – Provide internal or external human resources expertise to support managers in decision making
  • – Arrange for support from an occupational health provider as necessary, eg to advise on adaptations for more complex ill health cases
  • – Provide information to employees on the procedures to follow if they are given a fit note by their doctor
  • – Ensure that communication is maintained between employees and employer/line manager, with an approachable and honest take on an individual’s situation, always maintaining trust and confidentiality


Specific management actions for a patient deemed ‘unfit for work’ notes
  • – Seek professional advice from human resource advisers on sickness absence management
  • – Be wary of allowing a member of staff to return to work during a period where they are signed off as ‘unfit’. Whilst it is permitted, employers must have good reasons to believe the individual is fit enough to work safely, should have discussed this with the employee and should have undertaken a risk assessment.
  • – Where an employee returns to work after expiry of a Fit Note, hold a return to work interview to check whether there is any ongoing ill health or fitness issue, which you need to take into account. Seek Occupational Health advice if appropriate.


“The contents of the fit note are not binding; the final decision rests with the employer”


Important points
  • – The Fit Note is not required until after the seventh calendar day of sickness
  • – The contents of the Fit Note are not binding; the final decision rests with the employer
  • – There is no need to send an employee back to their GP to be signed off as ‘fit for work’ after they have been off work for a period of time as ‘unfit for work’. In fact, the Fit Note doesn’t include a ‘fit for work’ option
  • – If an employee has a note which states the ‘may be fit for work’ the form can still be used as evidence for why the employee is unable to work and for Statutory Sick Pay claims


Specific management actions for a patient deemed ‘may be fit for work’ notes
  • – Discuss with the employee what types of adaptations might enable them to work safely and confidently
  • – Make sure that the effect of medication is taken into account, eg safety when operating machinery, working at height or driving
  • – If it does not appear to be practical to accommodate changed duties, working hours etc explain this to the employee and then refer to advice for ‘unfit for work’ employees
  • – If in doubt or if you cannot reach an agreement with the employee seek Occupational Health/Human Resource advice
  • – Review risk assessments for activities which the employee is going to carry out whilst they are not fully fit. Note any amendments
  • – When considering the adaptations which may be needed for a temporary physical disability, remember that the employee must be able to safely escape in the event of fire
  • – Make use of home working where this makes the work safer, but ensure that you continue to monitor the employee’s needs and progress by frequent contact
  • – Write down any restrictions on work activities as determined with the employee’s input and ask the employee to sign it
  • – Do not forget that the employee, whilst able to undertake reduced duties, may be unable to carry out their usual role during emergencies, eg acting as a fire warden. Implement alternative arrangements as necessary
  • – Where adaptations have been made to the workplace, work activities or working hours, monitor that the employee is adhering to the plan


Legal duties
  • – The Health and Safety at Work etc Act 1974
  • – The Management of Health and Safety at Work Regulations 1999
  • – The Social Security (Medical Evidence) and Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2010.


Getting in touch

If you have any questions on these issues, please contact Hettle Andrews today.



These example Employee Factsheets are provided by Hettle Andrews & Associates for general guidance on matters of interest. In making these documents available to a general and diverse audience it is not possible to anticipate the requirements or the hazards of any subscriber’s business.  Users are therefore advised to carefully evaluate the contents.

Hettle Andrews & Associates does not accept any liability whatsoever for injury, damage or other losses which may arise from reliance on this information and the use of these documents.

Copyright of these documents remains with Hettle Andrews & Associates and whilst subscribers are permitted to make use of them for their own purposes, permission is not granted for resale of the intellectual property to third parties