Category Archives: occupational health

New Government Sickness Absence Support Service – The Benefits of Occupational Health

The government has recently announced the implementation of a new independent assessment and advisory service to get long term sick employees back to work.  In effect this will be a government run occupational health service.
It has long been recognised that employees who go off sick for longer than four weeks can end up being off work for a huge length of time; occupational health can help manage the situation providing much needed advice and a defence to employers should ultimately they be faced with a possible employment tribunal if the employee is dismissed. 
In my work as an HR consultant, I have always recommended to my clients that when they receive a fit note that indicates the employee requires more than two weeks off sick that they seek occupational health support asap with the agreement of the employee.  The quicker the situation is dealt with in this manner the quicker the employee can be brought back to work in my experience. The worst thing to do is to ignore the problem as it will only escalate.
The first step would be to set up a meeting with the employee which could be in their home, in the company office or in a neutral venue.  They should have the opportunity to be accompanied and should they choose a family member or friend, this should not be discouraged.  They may feel they need that extra support if they are truly experiencing difficulties.
The employee should cooperate with the company requirements to find out more information about their health with the support of occupational health.  If the employee refuses to sign the consent form required under the Access to Medical Records Act 1988 that will allow the occupational health advisor to contact their GP then they need to be made clearly aware that their persistent absence could result in their termination.  Employers should beware of conducting hasty terminations in such circumstances and should wait until sick pay has been exhausted otherwise could be faced with a breach of contract claim.
Occupational health can be used to determine whether the employee is covered by the Equality Act 2010 in terms of disability and whether any reasonable adjustments need to be made.   They can provide an assessment on the prognosis of the likelihood of return to work perhaps recommending a phased return.  They will produce a written report, that is shared with the employee, which will provide the basis of a next meeting with the employee with a view to getting them back to work.

Their service can also be invaluable with cases of intermittent absences eg Monday/Friday syndrome.  They can help decide whether an employee is “swinging the lead” or may have a genuine underlying problem. 

An independent occupational health advisor is more preferable than an employer contacting an employee’s GP with their agreement.  Whereas occupational health will act in the interests of the employer, the GP will act only in the interests of their patient; the GP might not be forthcoming with information requested of them.
According to the government only 50% of large companies and 10% of small companies have access to an occupational health service, however, there are many independent occupational health advisors in the UK who provide an excellent service to help employers with managing difficult sickness absence cases. Many HR consultants work closely with preferred occupational health providers who they trust.  For a minimal cost their services are invaluable compared to managing a costly employment tribunal case due to badly managed sickness absence. Employers can terminate employees who have been experiencing severe sickness absence under capability, but the process must be managed fairly and legally.

If you need advice on sickness absence issues call Sandra Beale on 07762 771290.

Role of the Fit Note in Managing Absence

On 6 April 2010 the fit note replaced the doctor’s sick note that had been in existence for sixty years.  It was intended that this new system will enable employees to get back to work more quickly and reduce absence costs, which cost the UK economy 17.3 billion annually.   The fit note system focuses on what employees can do rather than what they can’t do focusing on positives rather than negatives. 


The fit note, a copy of which can be downloaded from, has advice options for completion and no need for the employee to return to the GP to be confirmed fit; the fit note merely expires. 

The fit note is still required after seven consecutive days sickness and there are obligataions under the Equality Act 2010 so that any advice in that respect could be binding. 


The first fit note issued by the GP can last for a maximum period of three months when hopefully the employee will be back at work.  However a subsequent fit not can be issued for a longer period eg six months.  There is no need for a GP to have a face to face assessment of their patient to issue a fit note, it can be done over the telephone.  
The GP’s advice on the fit note is not binding; it is meant to lead to a discussion between employee and employer.  If an employee or an employer do not agree with the fit note’s reasonable adjustments due to impracticalities in the workplace either can choose not to accept these and the employee can remain off sick until the expiry of the fit note.   
Likewise if an employee wishes to return to work earlier than the fit note states, they may do so provided the employer is in agreement.  However, in such cases, employers need to be wary of employees wishing to return to work for financial reasons and not being fully fit.  To overcome potential liabilities, employers could implement a risk
assessment, discuss concerns, ask the employee to go back to the GP or use occupational health advice to back up a decision. 
The role of the line manager is key in the successful operation of the fit note system.  They will need to be proactive and develop a whole new set of skills with clear guidance and training provided by the organisation.  Managers need to understand what they have to do.  
Organisations need to develop a clear procedure for the fit note process to be incorporated into an existing absence policy.   Any changes should be consulted over and clearly communicated to all members of staff.

The procedure should detail obligations for both manager and employee and how the process will work in practice.  For example, the requirement for a face to face meeting called in writing to discuss suggested reasonable adjustments, if appropriate, should ideally be necessary.  The discussion should include whether the adjustments are
viable, how they will work and how long they will last.  

The possible use of occupational health should also be discussed and if appropriate an appointment set up, which would delay a proposed return.  Also there might need to be a simple risk assessment to ensure safety on return.  The impact on colleagues in relation to the employee’s reasonable adjustments could also be an issue for
discussion.  A clear date should be set for the employee to return to work with hours and duties confirmed and any restrictions.  
The subject of pay may need to be included particularly where there is no contractual sick pay.  The procedure may need to incorporate an enhanced SSP supplement for a phased return to work for example so that it is worthwhile for the employee.  Any issue related to this should be discussed with HMRC on 08457 143143.
Likewise if an employee can not be allowed back to work for impracticality reasons, they need to have these clearly explained.
Extra care should be taken with certain types of workers – home workers, shift workers, safety critical employees and those who work at heights for example.
The meeting should be documented and confirmed in writing with a copy for the employee to sign to show agreement to a proposal.  To standardise company practice a pro forma for meetings could be created or a check list drawn up to help managers cover the appropriate areas.  
The return to work should be monitored on a regular basis to ensure the employee and manager is both happy with the situation.  This can be done by weekly 1:1s which are documented and take place until the employee is back to work as previously.  
Use occupational health or an independent GP to investigate long term or difficult areas of absence for protection against any possible disability discrimination claims.


Key Points to Remember

ƒ Discuss the advice on the fit note

ƒ Consider how it affects the job

ƒ Consider the return to work options

ƒ Discuss the options with employees

ƒ Is a return to work possible?