The Department for Work and Pensions (DWP) has confirmed a significant change to the sick note system, effective from July, under the leadership of Prime Minister Andy Burnham. The new Labour government, succeeding Sir Keir Starmer, is overseeing the overhaul aimed at transforming the current 'tick-box exercise' into personalised support for workers.
Pilots to Test New Approach
From July, four pilot programmes across different areas in England will explore the best ways to replace the existing fit note system. These pilots, covering up to 100,000 appointments and lasting up to a year, will test two models: one where patients receive an initial fit note from a GP and are then referred to community health workers, and another where patients bypass the GP fit note entirely and receive support from a separate service staffed by clinical and non-clinical practitioners.
Government and Expert Reactions
Work and Pensions Secretary Pat McFadden stated: "Fit notes are too often a dead end - a piece of paper that tells people they can’t work but does nothing to help them get better. We’re changing that. By bringing employers, the NHS, and patients together we can help people recover faster, stay connected to their jobs, and get the economy firing on all cylinders. That’s what these pilots are about, and that’s what this Government is committed to – fixing what is broken."
Professor Victoria Tzortziou Brown, President of the Royal College of GPs, commented: "GPs take our responsibility to appropriately issue fit notes seriously, but the current system can involve significant administrative work that takes time away from patient care. We are open to exploring evidence-based reforms that could help improve outcomes for patients. However, any reform of the fit note process must put the health and wellbeing of patients first, be fully resourced and avoid creating additional workload for general practice. As such we look forward to seeing a comprehensive evaluation of this pilot."
Ministerial Support for Reform
Minister of State for Care Stephen Kinnock added: "Ever since I was appointed Minister of State for Care in July 2024, NHS staff have been telling me that the current fit note system isn’t working – not for patients, and not for the clinicians who sign them off. These pilots mark the beginning of the end for that broken system, giving people personalised support to get back into work and freeing up GPs from unnecessary admin so they can focus on what they do best: caring for their patients. This is what our 10 Year Health Plan is all about – earlier support, from the right people, in the right place."
Impact on Workers
The new rule aims to provide tailored 'stay in work' and 'return to work' plans for employees who fall ill, moving away from the current system which critics say offers no support or guidance. The pilots will assess the effectiveness of these personalised plans in helping workers recover and remain employed, with the potential for nationwide rollout if successful.
