Gp Fit Notes Overhaul Trial Covers Four English Areas

The government is starting a gp fit notes overhaul that will replace some GP-issued fit notes with support to help people stay in work. In two areas, doctors will still issue fit notes where needed but also refer patients for help; in two more, they will send patients straight to support services.

The four pilot schemes will run for up to a year, cover up to 100,000 appointments and are backed by £3m. The government described the current system as “broken” and said too many people are signed off work with no help to return.

Birmingham And Solihull

In Birmingham and Solihull, and in Coventry and Warwickshire, GPs will initially issue a fit note where needed and then refer patients for support alongside it. The pilots will test whether that support should be led by healthcare professionals or by non-clinical staff such as work coaches and social prescribers.

Fit notes are normally used when someone is unwell or cannot work for more than seven days. They can say a patient is “not fit for work” or “maybe fit for work” with adjustments, and they can affect access to certain benefits and sick pay.

Cornwall And Lancashire

In Cornwall and the Isles of Scilly, and in Lancashire and South Cumbria, GPs will refer patients directly to support services without issuing a fit note. That is the clearest break from the current system in the pilot and the part most likely to change what a patient receives at the appointment desk.

The government said more than 11 million fit notes are issued every year, and that number has risen since the Covid pandemic. It also said more than nine-in-10 fit notes sign people off work entirely.

Fit Notes And Support

Earlier this year, hundreds of GPs told the they had never refused to sign a patient off work for mental health issues and said issuing fit notes should not be part of a GP’s job. That criticism sits alongside the government’s plan to use healthcare professionals, work coaches and social prescribers differently in the pilot areas.

For patients in the four areas, the immediate change is not a national ban but a test of two different routes into help: a fit note plus referral in some places, and direct referral in others. The pilot will show which approach the government wants to scale if it decides the current system should be replaced more widely.