Guide to Doctors Notes for Absent Staff
Doctors Note Snapshot:: A fit note is applicable if a person is absent from work due to sickness for more than 7 days. Prior to this, a person can self-certify. This guide explains Doctors notes, the type of Doctors notes you may encounter and how they affect absence management.
What is a (Doctors) Fit Note?
Up until 6th April 2010, General Practitioners (G.P.) and hospital Doctors issued a 'sick note', when they assessed that somebody was unfit for work. However, as part of a national sick management strategy, the 'fit note' was introduced to replace the sick note. A fit note is applicable if a person is absent from work due to sickness for more than 7 days. Prior to this, a person can 'self-certify'.
The fit note is issued by a Doctor in order to provide evidence to an employer of any medical advice that states the individuals fitness for work. The fit note gives Doctors the discretion to declare somebody 'not fit for work' or 'may be fit for work'.
Not fit for work – Employers must accept the fit note as evidence for company sick pay procedures. It advises how long they will be unfit for work and whether a return to work will take place once the fit note expires. Employers may also take a copy, but should return the original to the employee, in case of benefits or other purposes.
If selecting 'may be fit for work', the Doctor can prescribe advisory notes on the document, i.e. advice for the patient to follow.
In addition, the Doctor will state, where necessary, any special requirements in order for the patient (employee) to return to work. There are 4 themes:
- phased return to work
- altered hours
- amended duties
- adapted workplace
This can be extremely helpful to employers and line managers in managing their staff back to work. However, it is worthy of note, that the Doctor cannot force an employer to take somebody back to work if the employer believes that adaptions cannot be made. An example of this maybe a Fireman who has a broken leg. The Doctor may suggest he is fit for work if he can have amended duties. The Station Master may not have a suitable non-physical role for the Fireman and so he cannot return to work at that stage.
Doctors' Return to Work Considerations
An employee may attend work and do normal duties, but not complete their whole commitments or all of their contracted hours.
Example 1: For a Full-Time employed member of staff who would usually work 30 hours over 6 days, you could allow them to concertina the hours into 4 days, if their main problem is mobility and travel is an issue.
This could be reducing hours so that days are shorter, changing days worked, or as above concertina hours to work less days.
Example 2: A shop assistant normally works 8 hours a day on the cash tills, but is having difficulty sitting in one position for any length of time. Reduced hours to 4 per day allows less time in position and may assist a speedy return to work.
This may be difficult to achieve for more physical professions, such as policemen, prison officer, nurse, fireman, soldier, builder, plumber etc. However, it can be useful for all concerned, as it may allow additional support in a different department of the business.
Example 3: A plumber has burned his arm and cannot handle tools. His manager agrees to place him in the administration office, where he can plan workloads for the other plumbers and manage their diaries.
There is an expectation under the Equality Act 2010 and Disability Discrimination Act 2005, that employers will make reasonable adjustments within the workplace to accommodate those with various needs. According to the Equality Act 2010, a person is disabled if they have 'a physical or mental impairment that has a 'substantial' and 'long-term' negative effect on their ability to do daily activities'. This may include some members of staff that have long-term, but not permanent illnesses or injuries. Reasonable adjustments is a broad theme, but should not cause the employer unnecessarily costs or extreme disruptions.
Example 4: A member of staff has been involved in a road traffic accident and has been absent from work for four months, due to a back injury. The Doctor is happy for a return to work, if the employer can make workplace adaptations. The employee is a secretary and an ergonomic chair is the only necessary adaptation to allow usual work to resume. The employer purchases the chair and the employee returns to normal duties and normal working hours.
The Doctors fit note and any advice given by the Doctor regarding 'may be fit' on the note, are designed to be short term measures that will support a person back to fitness and into the workplace environment without unnecessary stress. The return to work process can be emotional and daunting if someone has been absent for a long period. It needs to be managed effectively, with understanding. A good line manager will diary in to their schedule regular update meetings with the employee to track progress. This is also a great time to amend the return to work plan. It is of value to include HR, trade unions and any occupational support staff in discussions and decisions.
Doctors Notes and the Bradford Factor
The Bradford Factor includes all unplanned absence so absence with a Doctors note should still be considered in your Bradford Factor Calculations. A manager should use their discretion when reviewing absence on a 'case by case' basis and, if they feel the absence should not count, discard it from the Bradford Factor calculation. Good examples of this are absence as a result of work related stress, ongoing treatments like chemotherapy and periods following close family bereavement.
Remember: The Bradford Factor Index score should be a guide that supports your absence management strategy, it is not a like-for-like benchmark tool and each absence and staff member should be considered individually (their attitude, situation at work and home and historical absence record).
Bradford Factor Resources
- An introduction to the Bradford Formula
- Absence Management Strategy and the Bradford Factor
- Absence Management Strategy and the Bradford Factor
- Guide to Doctors Notes for Absent Staff
- Absence Management Forms and Supporting Documents
- An introduction to Analysing Staff Information
Additional Bradford Factor Resources
For further information on The Bradford Factor (Use, Implementation and Record Keeping), please review our Bradford Factor guides and management strategy information.