Employee absenteeism has a great deal of impact on the economy, in fact, £100 billion a year. Lost man hours can cost large companies thousands of pounds  and can be crippling for smaller companies. Employees cannot sack people for being sick but replacing staff that are away for long periods of time is expensive.

It is the above facts that led to the change from the old ’sick note’ to the new ‘fit note’ in April of this year. The new note is intended to help employees return to work and do what they are physically capable of doing rather than staying away until they are able to do everything within their job description. Unfortunately the latest statistics show that the new method is not really working.

Study results from the Department for Work and Pensions (DWP) show that the new fit note has not improved things greatly for places of work. The old sick notes declared an average of 85% of people as being unfit for work. The new ‘fit note’ has only decreased this by 5%.

Ironically line managers reported what where GPs had recommended adjustments in the work place this did help people to return to work more quickly.

One of the problems is that in some cases, depending on the job and the health problem, it can be very difficult to provide measured returns to normality at work. It is particularly important to note that GPs cannot possibly understand what is required of an employee in their jobs unless they spend time with their patients ascertaining exactly what their job requirements are. This takes time that GPs do not have and also entails that the GP place high degree of trust in the patient.

The most common reason for health related absenteeism are mental health issues. This is a difficult thing for GPs to accurately asses and also a difficult area to monitor and help with at work, so perhaps it is easier to either sign people off or keep them at home.

Gareth Williams, head of health, disability and work at the Department for Work and Pensions said that people tend to see the issue as a dichotomy. He said:

‘Too often there is an on/off switch ­ if someone is ill they can’t work, and if they are well they can.’

GPs have been criticised for being too quick to sign a person off without taking into account the possibility of encouraging their staged return to work. Currently there is discussion about whether GPs should be released from making ‘return to work decisions’ in favour of nurses in occupational health roles. However this could lead to abuse both by patients and employers. Inexperienced nurses could be duped by unscrupulous employees who do not want to return to work and there could be pressure on nurses from employers to sign people back to work before they are ready.

In terms of the individual there is substantial evidence that returning to work can aid a person in their recovery as long as their return is managed well. The emotional support of colleagues and the extra self-esteem and contact that work can provide can be a challenge that is definately worth exploring.