Ethics Guidance for Occupational Health Practice 9th Edition - Book - Page 82
Certification of sickness absence (fit note)
4.56. A Statement of Fitness for Work (fit note) provides medical evidence to support
a worker's entitlement to Statutory Sick Pay or other health-related benefits. It
is required after seven days of sickness absence, with shorter absences
ordinarily covered by self-certification. Traditionally, these are issued by a
General Practitioner. Since July 2022, fit notes may be certified by a broader
range of appropriately trained NHS healthcare professionals, including nurses,
occupational therapists, pharmacists, and physiotherapists.
4.57. The fit note may state that the worker is ‘not fit for work’, or that they ‘may be
fit with specified adjustments’. Employers are expected to consider the advice
provided and to explore how adjustments may support an effective return to
work.
4.58. Employers may seek occupational health advice to understand the
recommendations contained in a fit note, to determine if the suggested
adjustments are appropriate, or to recommend adjustments if none
are advised.
4.59. The opinion of the occupational health professional may differ from that of the
worker’s treating clinician regarding fitness for work. With the worker’s consent,
the occupational health professional may consider communicating with the
treating clinician to explain the rationale for their opinion, particularly where the
treating clinician may not have full understanding of the work context. Case law
has established that employers are entitled to prefer the advice of occupational
health professionals, recognising their specific expertise in work and health.
Capability and assessment of fitness to attend a disciplinary interview
or meeting
4.60. Occupational health professionals rarely have direct involvement in the
termination of workers’ employment, but they do often provide information
critical to the process. Where there is management concern about attendance,
occupational health input usually centres on outlook, either in relation to a
single extended absence or with regard to the impact of an underlying
condition on repeated absences.
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