Fit notes record details of the effects of the patient’s condition so that the patient and employee can consider ways to facilitate a return to work where appropriate.
You must provide a fit note, sometimes referred to as a sick note, after being off sick for more than seven days in a row (including non-working days). Hospital doctors or GPs can complete the fit note.
There are two options: that you are ‘not fit for work’; or that you ‘may be fit for work, taking account of the following advice’.
There are four types of alterations from which the GP/hospital doctor can choose:
There is space on the form for the doctor to provide more information on the condition and how it may affect what the employee can do.
In some cases, there will be nothing to recommend and, as previously, you will go back to work once the GP feels you are ready. If you are fit for work, the GP does not issue a new medical certificate. In such cases, you are deemed fit for work once the existing certificate expires (even if this is during a period of school closure).
The doctor should only recommend a return to work with adjustments if you are not fully recovered, after discussing it with you and making sure you are fully aware of, and happy with, what is being suggested.
The doctor is likely to propose a phased return to work where you are suffering from an illness that has left you fatigued, or if you have been away for a long period of time and are not confident about returning full-time. It may also be used if you have an injury where the doctor believes that your strength has to be built up gradually. Often a phased return to work may be proposed along with other changes such as amended duties.
Here the doctor may recommend that the pattern of working hours is changed. This may be recommended if the GP feels, for example, that you may not be able to travel on rush-hour public transport, or need time to build up to a full day’s work.
The GP should recommend amended duties where they believe that you cannot fully fulfil your duties, but may be able to do your job if some duties are temporarily avoided or changed. This could include not attending after school meetings or not undertaking playground duties.
These may be recommended if the GP believes that some physical adaptations are needed to help you return to work. An example of this could be ensuring that you can work on the ground floor of a building if you have trouble with stairs.
In each of these cases, the GP should base the recommendations on what you have told them about the workplace and they should discuss the proposals and the implications fully with you.
If you are disabled and protected by the Equality Act, this procedure does not alter the duty on the employer to make reasonable adjustments regardless of what a GP recommends. If you are disabled within the meaning of the Act, the GP may be able to argue that proposals in a fit note are reasonable adjustments and should be implemented by the employer.
The medical statement is given to you and you should send it to the school. It is good practice for the head teacher to discuss the proposals with you and agree what changes will be made. If there is disagreement, the head teacher may not require you to come back until you feel comfortable with the changes proposed. If it is not possible to implement the recommendations, you should not return to work.
The employer/school management does not have to accept the advice on the medical statement, but if it does not do so the statement should be treated as though the doctor has advised ‘not fit for work’. Some schools may try to argue that you are ready to come back and are no longer signed off. This is not the case and the Government advice on this is clear.