The Benefit System, Work Capability Assessment

The role of the Fit Note

DWP report published – the role of fit notes

The Department for Work and Pensions has published a report of findings from qualitative research with General Practitioners (GPs) to examine their views on the Statement of Fitness for Work – the fit note.

The report provides detailed information about how the fit note has influenced GPs’ certification practice, and GPs’ views on their role in sickness certification. It is part of a wider programme of research to evaluate the fit note, including research with employers.

Key findings of the report

  • The fit note has become a consultation tool that GPs use to initiate and guide negotiations with patients about returning to or commencing work. GPs use the fit note to justify why they have initiated discussion about work and to prompt them through the process of questioning patients about their work-related capabilities.


  • GPs perceive that the fit note is most effective for patients with conditions such as ME/chronic fatigue syndrome, mild-to-moderate mental health conditions, and musculoskeletal conditions.


  • GPs are less confident in using particular options on the fit note, like the amended duties and workplace adaptations tick boxes. Some reported difficulty in understanding and distinguishing between the four return-to-work tick boxes and confusion over date fields.


  • Barriers to the successful use of the fit note include GPs’ confidence in dealing with conflict and their perception that it could damage their relationship with their patients. GPs are also less likely to drive for a return to work if they perceive the patient’s job to contribute to their health condition.


  • Many GPs believe that motivating their patients to return to work is an integral part of their role and that the fit note has helped them to do this. It has also helped some GPs to adopt a stricter role with their patients.


Read the report


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