Under a new pilot launched in May, GPs in four selected areas of the UK moved away from simply signing people off sick. Fit notes (traditionally known as sick notes) have been replaced by personalised “stay in work” or “return to work” plans. The aim is to reduce long-term absence, take pressure off GPs and stop fit notes becoming a “dead end” (as described by Work and Pensions Secretary Pat McFadden).

More than 11 million fit notes were issued last year, with around 93% stating that the employee was “not fit for work” rather than setting out what support might help them stay connected to work. In 44% of cases, people were signed off for five weeks or longer. (BBC, 2026)

This fit note reform is a sensible shift. Most employers know the frustration of receiving a vague fit note that does not provide:

• a practical steer on timescales,
• indication of any adjustments needed, or
• advice about whether a phased return is realistic.

The government’s reform pilots are designed to create more meaningful conversations between the employee, healthcare professionals and employers. The results are expected to inform future legislation.

‘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,’ says Mr McFadden.

One employer’s costly mistake

While the Government is looking at reforming fit notes, employers need to handle absence management correctly. Both sides need to act, although it’s too late to save one employer from a costly mistake …

A disabled glass maker, who was unfairly dismissed while on sick leave and spied on by his bosses, has been awarded £329,000 in compensation.

The surveillance company provided footage of the employee on a friend’s farm accompanying him on a delivery. The company treated this as evidence that its employee had been working while on sick leave and questioned whether the physical activity was consistent with his condition.

The tribunal found the company had relied on assumptions rather than medical evidence, changed the nature of the allegations during the process and failed to handle the matter fairly. (CIPD)

It’s a stark reminder to all employers: process matters and assumptions are dangerous. The judge’s criticism was clear: the employer had a legitimate concern but did not investigate proportionately or properly test what the surveillance footage actually showed before moving to dismissal. The more intrusive the monitoring, the greater the legal risk.

It’s plausible that a “stay in work” or “return to work” would have helped to resolve this situation more fairly and cheaply.

Action for employers

Employers need to:

• get medical evidence,
• define the allegation clearly,
• separate welfare concerns from disciplinary action, and
• remember that where disability is involved, Equality Act risk is never far behind.

‘It’s fair to say reforming the fit note system could eventually improve the way absence is managed,’ says Emma Clack, founder of Heneom HR based in Stevenage and Welwyn in Herts. ‘If employers are expected to play a bigger role in supporting people back to work, they need clarity about what that role actually looks like in practice.’

Where to start

There’s a simple stance that works for employers: treat fit notes as the start of a conversation, not the end of one. It’s important to:

• Ask sensible questions.
• Get occupational health input where appropriate.
• Explore reasonable adjustments.
• Keep your process straightforward.
• Stop guessing and start evidencing … especially if you are dealing with an employee with special needs.

Whether the fit note system changes or not, tribunals will still expect employers to act reasonably, fairly and with actual facts. They definitely won’t favour decisions informed by suspicion, assumption and an inconclusive surveillance file.

Are you confident in your absence management policy?

Check whether your company is being fair and compliant. Please don’t wait for the fit note system to be reformed. It’s important to know that you’re handling sickness and absence correctly, now. The first step is to seek professional HR advice.

Contact us for an initial chat without obligation or explore our HR audit. We’ll get your HR ducks in a row.