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The number of fit notes that GPs issued last year was the highest on record and may have been driven by a rise in Covid infections, a specialist employment law firm has suggested.
London-based GQ Littler compared NHS data on fit notes for 2020-2021 with 2021-2022 and found that the number had risen from 8.6 million to an unprecedented 10.4 million – a 21% increase.
As part of its research, the law firm also compared the number of Covid infections from 1 April-31 December 2020 with 1 April-30 December 2021 and found that cases had risen from 2 million to 7.3 million.
The law firm suggested the dramatic spike in infections could have been caused by people returning to the office after the easing of lockdown rules and the growing number of people who have travelled overseas since the resumption of air travel.
During the various lockdown periods some employees who tested positive for Covid continued to work from home. At the same time, others who worked in sectors where it wasn’t possible to work from home such as hospitality and tourism were furloughed for an extended period and didn’t require a fit note if they became infected.
With Covid cases once again on the rise, Sophie Vanhegan, partner at GQ Littler has warned employers about the potential impact on staff sickness levels.
‘One legacy from the pandemic is it is now frowned upon to come into the office while visibly unwell,’ she said. ‘This could also have contributed to the increase in notes being issued in roles which cannot be performed from home.’
In July 2021, the Chartered Institute of Personnel and Development (CIPD) urged employers to review their absence management policies, processes and practices to reflect the impact of the COVID-19 pandemic on employee long-term absence.
A potentially more significant long-term trend is the increase in employees who have been issued with ‘stress-related’ fit notes over the past year. The law firm’s analysis of NHS data revealed that the number issued by GPs for stress-related issues has risen from 755,000 in 2020-21 to 808,000 in 2021-2022, a 7% increase.
The lockdowns undoubtedly contributed to mental ill-health. According to the article ‘The Pandemic’s Mental Health Crisis’ in IOSH magazine, data from the mental health charity Mind found that ‘65% of 10,000 UK adults surveyed said that their mental health had got worse since the first lockdown, and 26% said they had experienced mental distress for the first time’.
However, the law firm warned that rising living costs could exacerbate employee mental health further and possibly result in a further spike in stress-related fit notes being issued.
Fit notes are issued when employees have been off work with an illness for more than seven days and provide employers with evidence about the individual’s absence and any relevant advice on how the employer can support them to remain in or return to work.
The government’s introduction of new legislation governing fit notes on 1 July, which expands the range of healthcare professionals who have the powers to certify and issue them to include nurses, occupational therapists, pharmacists and physiotherapists could help to reduce sickness absence.
According to Nottingham-based law firm Actons, there is an argument that specialists are better able to assess an individual’s fitness for work and help facilitate a return to work. However, it also noted that there is a concern that this ‘broadening of options may lead to an increase in fit notes being issued without any “real” assessment being carried out.’
There are also concerns relating to the change to the law in April that allows fit notes to be signed digitally. Actons said that in the future, the fit note will only state the name and title of the person who is issuing it.
Ruth Wilkinson, head of health and safety at IOSH, commented: ‘There are likely to be many reasons for the increase of GP fit notes, including reasons associated with the COVID-19 pandemic. Monitoring and understanding the reasons workers are off sick for more than seven days and requiring a fit note is one form of data that can help us identify trends in sickness and absence. It is worth considering that workers off with Covid itself would have received an isolation note if their employer did request a note of confirmation.’
Fit notes, she added, are very important because they enable organisations to know if their employee is ‘not fit for work’ or ‘may be fit for work’. This advice can support the employee to stay at work or return to work, and determine and support adjustments they might need, she said.
‘It is crucial they are used well and in collaboration with risk assessments where necessary, so they can be as effective as possible.’
Sophie said that it is critical that employers put process in place to support employee’s with their mental health, including scheduling regular catch-ups and providing mental health awareness training.
‘Supporting employees through their mental health issues is extremely important, not just for productivity and morale,’ she said. ‘In today’s competitive jobs market, organisations that are viewed as unsupportive may have difficulty attracting and retaining talent.’
In May this year, employee benefits provider Unum UK launched a new report in parliament that recommended replacing the UK’s current Statutory Sick Pay (SSP) system with Statutory Sickness Support.
According to the report authors, sickness absence costs the UK economy up to £130 billion annually. In addition, Unum UK said the government spends up to £29 billion in foregone tax and National Insurance contributions as a result of people not working as a result of their ill-health.
