Fit notes: what can registered health professionals do?

Big shake up

We previously advised you about key changes to the fit note regime (click here ). In a nutshell, since 1 July 2022, in addition to a medical doctor, such as a GP or hospital consultant, a fit note - or “statement of fitness for work” may be issued by a healthcare professional who is:

• a registered nurse
• a registered occupational therapist
• a registered pharmacist; or
• a registered physiotherapist.

Some examples

For example, if an employee attends a registered pharmacist about an allergic reaction or an illness, they could be issued with a fit note at the pharmacy. Equally, a registered physiotherapist may issue a fit note to an employee who has a bad back or a serious neck problem.

Likewise, a registered nurse, say at a GP’s surgery, could issue a fit note if they see an employee for follow-up care after an operation.

These fit notes could either provide advice to help the employee return to work or sign the employee off work for a period of time.

Outside of their expertise

In the above examples, the registered healthcare professional should be acting within their area of expertise. But can they give advice which is outside of their area of expertise or sign an employee off work for any reason whatsoever, e.g. an occupational therapist signs an employee off work due to a nasty stomach bug?

Matter of insurance

In theory, the answer to both of these questions is “yes”. That’s because, when it comes to issuing fit notes, the four registered healthcare professionals can do exactly the same as medical doctors - there are no restrictions placed on them.

However, whilst any of the four registered health care professionals can and may well sign an employee off work for any reason, it’s unlikely that they would give advice outside of their area of expertise to assist a return to work.

This is due to the fact that their professional insurers may not indemnify them if they do this. Likewise, it may go against the requirements or advice of their professional or regulatory bodies.

Tip. You can’t generally challenge a fit note where an employee is signed off work, regardless of which healthcare professional or doctor has issued it because, in this situation, the employee is deemed incapacitated or “not fit” for work. That said, you can still challenge suspected or fraudulent sickness absence in the usual way.

Tip. Conversely, you don’t have to automatically accept the advice that’s given in any fit note - it’s information for the employee and not binding on you in any way. If you suspect that a fit note has been faked, you can contact the individual who purportedly issued it and ask them for clarification (click here ).