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England Starts Four Pilots to Replace Fit Notes with Return-to-Work Support

Ministers say the trials will reduce GP paperwork by routing patients to tailored support that improves recovery and job retention.

Overview

  • The Labour government and NHS launched four regional pilots in July to test alternatives to the current fit-note system by shifting care toward personalised 'stay in work' and 'return to work' plans.
  • The pilots use different local models so evaluators can compare approaches: Birmingham and Solihull keep an initial GP fit note then refer to mainly non-clinical teams, Coventry and Warwickshire pair a GP note with mixed clinical and non-clinical support, Cornwall and the Isles of Scilly bypass fit notes and send patients straight to non-clinical services, and Lancashire and South Cumbria refer to mixed teams without issuing fit notes.
  • The programme will be evaluated over about a year and cover up to 100,000 appointments to see which model best frees GPs from admin and helps people return to work.
  • Ministers framed the change as a fix for a system that issues millions of fit notes with little follow-up, saying the pilots will give tailored help through social prescribers and work or health coaches and let GPs focus on clinical care.
  • If the trials show better recovery and job retention, the NHS could scale the winning models nationally, a change that could reduce GP workload, keep more people in work, and alter how employers and services handle short-term illness.