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Fit for Purpose? Unpacking the Proposed Changes To Fit Notes For Individuals With Mental Health Issues

The government have recently proposed a change to how individuals in the UK will be treated when visiting their GP for mental health issues. But do the proposals have any merit and will the changes ever see the light of day?

I am drafting this article for Mental Health Week 2024. The timing is important for two reasons. The first is that this week, above all others, it is vitally important in maintaining the messaging around mental health and reducing stigma. The second is, at the time of writing anyway, we still have a Conservative government. More on that later.

Recent statistics have shown a worrying increase in the number of employees taking leave due to mental health issues with 53% of the 2.8 million people on long term sick leave being diagnosed with depression or anxiety. This trend not only impacts the well-being of individuals but also affects the operational efficiency of organisations. It is clear that something needs to change, however, there is a great debate amongst medical professionals, politicians and business owners about what change is needed. 

There have been numerous column inches devoted to addressing the rise of mental health related absences in the UK, however a recent announcement by Prime Minister has caught many by surprise.

The speech, given on 19 April 2024, and available to watch on Youtube here https://www.youtube.com/watch?v=peA_yCqQE0Y&t=42s sets out the government’s “moral mission of reforming welfare”, and attempts to address the £69bn cost per year for government and businesses relating to individuals of working age with a disability or health condition. Buried deep into the speech, the Prime Minister did not pull any punches on the rise of mental health absences, stating that we need to be “more honest about the risk of over-medicalising the everyday challenges and worries of life”. In summary, it is clear that government believe that individuals are being signed off with mental health issues for normal day to day stresses of life. I do not have enough column inches to explore that position here, however I would be very interested in your comments once this article hits social media.

So, what is the government’s plan for reducing mental health absences? For those who guessed better access to counselling services or campaigns to increase awareness and education, you would be wrong. Instead, government propose transferring the responsibility of issuing fit notes from GP’s to other qualified health professionals, no doubt in the private sector.

The proposal marks a significant shift in managing workplace health. No longer will individuals be signed off as unfit to work after a quick 10 minute appointment with a GP. Instead, following a wait for a referral to a third party, the individual will need to be assessed to ascertain whether they are able to carry out any work at all, before being signed off. For those with genuine mental health issues, this creates an additional barrier to getting the support required.

The Prime Minister's announcement about the reform of fit notes follows a broader initiative in July 2022 to streamline health services and reduce the burden on GPs. Under the changes already in place, other health professionals such as nurses, occupational therapists, and physiotherapists are empowered to issue fit notes. This change aimed to facilitate quicker access to necessary documentation, reduce waiting times, and allow GPs to focus on more critical health care needs. How this fits in with the new proposals is unknown at this time.

So will the proposed changes to fit notes actually come to fruition and will it address the increase in mental health related absences? The honest answer is, at this stage we simply don’t know. From purely a processing point of view, it is difficult to see how specialist work and health professionals will manage to review the estimated 11 million fit note cases currently given out per year. In addition, will the current government have time to push through any such changes?

If you believe the latest opinion polls, 2024 will most likely see Labour government come into power. Historically Labour tend to be on the side of the worker and indeed, they have promised an overhaul of employment rights in the first 100 days which will likely see an increase in employment rights for individuals, ironically including SSP being paid from the first day of absence. Their green paper, entitled “A new deal for working people” was likely drafted before the Prime Minister’s statement, however it is likely that any such proposal will be repealed by a Labour government.

It is evident that the coming six months will mark a significant shift in the treatment of individuals with mental health issues in the UK workplace. The nature of these changes, however, will hinge on the outcome of the forthcoming general election. Whether it is Labour's approach or the Conservatives' policies that prevail, the impact on mental health support at work is poised to be profound. As voters head to the polls, the future of mental health advocacy and workplace accommodation rests in the balance, underscoring the importance of this election in shaping progressive workplace health policies.

As HR professionals navigate these changes, it is essential to stay informed about the legal implications. The reform of fit notes must be aligned with existing employment laws and regulations regarding employee rights and employer responsibilities. Regular consultations with legal experts specialising in employment law are advisable to ensure compliance and mitigate potential legal risks.

These notes have been prepared for the purpose of articles only. They should not be regarded as a substitute for taking legal advice.


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