PM announces review of fit note system

The Prime Minister has announced a review of the fit note system, claiming it should be more based on keeping people in work when they are unwell.

Mental Health


Rishi Sunak has announced a review of the fit note system which he claims is being used to write people off as “not fit for work” by default and says he is considering shifting responsibility for fit notes from GPs to other work and health professionals.

In a speech today, the Prime Minister said he wants to design a new system where “each fit note conversation focuses on what people can do with the right support in place, rather than what they can’t do”.

As part of this, the government will consider shifting the responsibility for issuing the fit note to “specialist work and health professionals who have the dedicated time and expertise to provide an objective assessment of someone’s ability to work and the tailored support they may need”.

A call for evidence has been published to seek responses from a diverse range of perspectives, including those with lived experiences, healthcare professionals and employers, on how the current process works and how it can better support people with health conditions to start, stay in work.

The Prime Minister said:  “We don’t just need to change the sick note, we need to change the sick note culture so the default becomes what work you can do – not what you can’t.

“Building on the pilots we’ve already started we’re going to design a new system where people have easy and rapid access to specialised work and health support to help them back to work from the very first Fit Note conversation.”

Sunak also spoke about the new WorkWell pilot which will provide a single, joined-up assessment and gateway into local employment support services, “to help people manage their health conditions and get back to work sooner”. It has been launched in 15 areas in England.

The speech was greeted with anger by anti-poverty campaigners. Child Poverty Action Group Chief Executive Alison Garnham said: “The Prime Minister must know he can’t scare people into good health, but his words this morning will be chilling for low income families up and down the country who rely on our social security system for help.

“His government needs to address the reasons people can’t go to work – like poor health – rather than make life harder for those who are struggling. The PM should focus on delivering investment in the NHS, improving employment support and providing social security for everyone who needs it, including the record number of children currently living in poverty.”

Meanwhile, Tony Wilson from the Institute for Employment Studies said the speech is more or less a repeat of what was outlined in the Autumn Statement. He said it is likely to cost more than it saves, due to the cost of additional ‘support’ and because it is estimated that very few people will end up having claims closed.

The Chartered Management Institute issued findings which show seven out of 10 UK managers have seen a recent uptick in sick leave and people leaving their jobs due to poor health. Earlier CMI research found that only two-thirds (67%) of British managers say their organisations have a policy in place to help manage and support staff with long-term health conditions who are not considered disabled.

It is keen to focus on what employers can do to help and is proposing a ‘Help to Hire’ short course that would help those doing the hiring and managing of people who have been off sick – especially in smaller businesses that might not have experience with the issues faced by people with health issues.

Anthony Painter, Director of Policy at the Chartered Management Institute (CMI), said: “Employers and government have to work in partnership to achieve higher participation in the workforce and a Help to Hire programme can teach employers how to navigate everything from offering flexible hours to accommodate medical appointments or caring responsibilities to diagnosing a need for improved digital skills in people who have been out of work for longer periods.”

Other benefits reforms aimed at cutting the benefits bill include:

– A consultation on Personal Independence Payment (PIP) on possible changes to the eligibility criteria, assessment process and types of support that can be offered “so the system is better targeted towards individual needs and more closely linked to a person’s condition rather than the current “one size fits all” approach”.
– Legislation in the next parliament to change the rules so that anyone who has been on benefits for 12 months and doesn’t comply with conditions set by their Work Coach – including accepting available work – will have their unemployment claim closed and their benefits removed entirely.
– The Work Capability Assessment will be tightened affecting people with “less severe conditions”.
– Raising the weekly earnings threshold for conditionality from £743 to £892 for individual claimants and £1,189 to £1,437 for couples – or the equivalent of 18 hours at National Living Wage a week for an individual from next month.
– New powers on tackling benefits fraud.

Meanwhile, the Observer reported at the weekend that the Work & Health programme is being scrapped this year. It has helped hundreds of thousands of disabled and vulnerable people into work. The Universal Support programme comes in next summer and aims to help 25,000 of those with the most complex problems into work.

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