From July 2026, the sick note system in England is undergoing a major overhaul, with four pilot schemes launching across the country, including in Birmingham and Solihull, as well as Coventry and Warwickshire. The Labour government and NHS are replacing the traditional tick-box fit note with personalised 'stay in work' and 'return to work' plans for workers who fall ill.
What the Pilots Involve
The pilots will cover up to 100,000 appointments over a year of testing. In Birmingham and Solihull, GPs will issue initial fit notes before referring patients to new support services led by non-clinical staff, including social prescribers and work coaches. Other regions will test different approaches, with some bypassing fit notes entirely.
Government and Ministerial Statements
Cabinet minister Pat McFadden said: '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.' Minister Stephen Kinnock added that the 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.'
Impact on Workers and GPs
The changes aim to tackle the steep increase in fit notes issued whilst helping people recover faster and stay connected to their jobs. By shifting away from a tick-box exercise, the new system is designed to provide more meaningful support for employees and reduce the administrative burden on GPs.
