Starting this July, a significant overhaul of sick note procedures will be introduced in England under the new leadership of Andy Burnham and the Labour government. This reform, announced by the Department for Work and Pensions (DWP), aims to move away from the traditional fit note system that often serves as a mere formality without offering real support to sick workers.
The initiative will launch four pilot programs across different regions in England, each designed to test more effective ways of assisting employees during illness. These pilots, covering up to 100,000 appointments and lasting for one year, will explore replacing the standard tick-box fit notes with personalised “stay in work” and “return to work” plans tailored to each worker’s needs.
Under the new system, patients may either receive an initial fit note from their GP and then be referred to community health workers, or bypass the GP’s fit note entirely and access a dedicated service staffed by both clinical and non-clinical experts. The goal is to provide better guidance and support to help patients recover, remain connected to their jobs, and return to work sooner.
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Work and Pensions Secretary Pat McFadden emphasized the limitations of the current fit note system: “Fit notes are too often a dead end — a piece of paper that tells people they can’t work but does nothing to help them get better. We’re changing that. 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. That’s what these pilots are about, and that’s what this Government is committed to – fixing what is broken.”
Professor Victoria Tzortziou Brown, President of the Royal College of GPs, acknowledged the strain that the current fit note process places on GPs and expressed cautious optimism about reform. “GPs take our responsibility to appropriately issue fit notes seriously, but the current system involves significant administrative work that takes time away from patient care. We are open to exploring evidence-based reforms that could help improve outcomes for patients. However, any reform must prioritise patient health and wellbeing, be fully resourced, and avoid adding extra workload for GPs. We look forward to a comprehensive evaluation of these pilots.”
Minister of State for Care Stephen Kinnock added: “Since my appointment in July 2024, NHS staff have been clear that the current fit note system isn’t working — for patients or clinicians. These pilots mark the beginning of the end for that broken system, providing personalised support to get people back into work and freeing up GPs from unnecessary administration so they can focus on what they do best: caring for their patients. This aligns perfectly with our 10 Year Health Plan—providing earlier, targeted support from the right professionals, at the right time and place.”