ENGLAND — GP fit notes declaring people unable to work will be replaced with support to help them stay in their job under a government pilot scheme in England. Four pilot schemes will run for up to a year, cover up to 100,000 appointments, and are backed by £3 million of funding.

In Birmingham and Solihull, as well as Coventry and Warwickshire, GPs will initially issue a fit note where needed but patients will also be referred to support services. In Cornwall and the Isles of Scilly, along with Lancashire and South Cumbria, GPs will refer patients directly to support services without issuing a fit note.

The pilots will test whether support should be led by healthcare professionals or non-clinical staff such as work coaches and social prescribers, and will involve conversations with employers about adjustments to help people return to work. They will be delivered through existing NHS WorkWell sites, which connect patients with services such as physiotherapy and counselling.

More than 11 million fit notes are issued every year, with numbers increasing since the Covid pandemic. Fit notes are approved when someone is unwell or cannot work for more than seven days, and advise on how health problems impact on ability to work and can help access certain benefits and sick pay. A patient can be declared "not fit for work" or "maybe fit for work" with some adjustments, but the government says more than nine-in-10 sign people off work entirely.

A review led by former John Lewis chairman Sir Charlie Mayfield found the fit note system was not working as intended, with most GPs lacking the training and time to assess someone's ability to work. The review also found that fit notes were often a barrier to contact between employers and employees.

Announcing the pilots, Work and Pensions Secretary Pat McFadden said: "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." He added: "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."

Prof Victoria Tzortziou Brown, President of the Royal College of GPs, said: "The current system can involve significant administrative work that takes time away from patient care. However, any reform of the fit note process must put the health and wellbeing of patients first, be fully resourced and avoid creating additional workload for general practice."

Mental health charity spokesperson Tom Pollard said: "Giving people the chance to have detailed conversations about the challenges they face and the support they need is a positive step. However, it's vitally important that this is a supportive and collaborative process."