Doctors could be told to sign fewer people off sick in an effort to boost Britain’s economy, it has been revealed under plans reported by The Telegraph. Under consideration in Whitehall, people who would currently be considered ill enough to be issued with a sick note would instead be “helped” to remain in work.

Ministers have expressed concerns over the number of people signed off work with long-term conditions. Official figures in the Labour Force Survey show that 2.32 million people were signed off with long-term health conditions last summer, up from 1.95 million before the pandemic in 2019.

In response, the government is considering changing advice to GPs to encourage people to stay in employment.

A government source told The Telegraph:

“The mental health benefits of work are well established. We want to do all we can to encourage as many people as possible to stay in work with the relevant support in place to help them do so.”

However, there are also risks associated with keeping people in work when they are perhaps not fit to do so. The pandemic threw into the mix the issue of presenteeism - people working when unwell – which has implications for both employee and employer.

The Centre for Mental Health calculated that presenteeism from mental ill health alone costs the UK economy £15.1bn per annum, while absenteeism costs £8.4bn. Research shows that presenteeism is hugely costly to employers, but all too often ignored.

Presenteeism is surely likely to increase if GPs are permitted to issue fewer sick notes. This could mean employers need to step up their health and wellbeing support.

New research conducted during January 2023 for GRiD, the industry body for the group risk protection sector, found that over the past 12 months, employees felt that their health and wellbeing had deteriorated mentally, physically, financially and socially, with financial wellbeing being the area most impacted:

• 40% of employees felt that their financial health had deteriorated.
• 29% felt that their mental health had deteriorated.
• 28% felt that their physical health had deteriorated.
• 24% felt that their social health had deteriorated.

However, over the same period, employers themselves felt their responsibility had most increased for supporting the mental and social health of employees:

• 51% of employers felt increased responsibility for their employees’ mental wellbeing.
• 51% felt increased responsibility for employees’ social wellbeing.
• 49% felt increased responsibility for employees’ financial wellbeing.
• 47% felt increased responsibility for employees’ physical wellbeing.

As a result of this increased sense of duty, during the past 12 months, many employers have increased the provision of the health and wellbeing support or employee benefits that they offer their staff.

In total, 80% of businesses have increased their support for health and wellbeing or employee benefits over the past 12 months. However, while GRiD believes that employers are right to adapt to changing circumstances, the industry body feels more could be done.

Katharine Moxham, spokesperson for GRiD, said:

“A crystal ball would be hugely beneficial to help plan ahead for employees’ needs but in the absence of any ability to see into the future, employee benefits must be all encompassing to support all areas of health and wellbeing. This time last year, interest rates were still quite low and the full impact of the current cost of living crisis was not known and so it’s understandable that employers were not as focused on supporting financial wellbeing as they might be now.

“It’s important that employers do not try to second guess what employees need but listen to their current concerns. Many employee benefits, such as group risk products, are all inclusive in terms of the wellbeing support they offer. This means that no matter what happens within a business, or what external factors employees face, support is available across all pillars of health and wellbeing to ensure all staff have access to the comprehensive support they both need and deserve.”

So, in the absence of a crystal ball, what steps could employers take to prepare for the proposed new sick note system?

Speaking to HR Grapevine, Lesley Rennie, principal employment solicitor at WorkNest said:

“Employers have a duty of care to safeguard the health, safety and welfare of their employees so businesses will need to carry out suitable risk assessments where an employee who would previously have been signed off is to remain at work. Depending upon the circumstances, businesses may need to take specific health and safety advice and take into account any potential impact upon their employers’ liability insurance.

“Careful consideration will need to be given to the support recommended by a GP and employers will need to have strong grounds for any decision not to put such support in place. Otherwise, they run the risk of constructive dismissal claims, prejudicing the fairness of any eventual dismissal based on the employee’s fitness and failing in their duty to make reasonable adjustments where the health condition amounts to a disability under the Equality Act 2010.

“The current Fit Note system already provides the opportunity for GPs to state that the employee may be fit for work with adjustments and to go onto provide advice on what those adjustments should look like. This is aimed at encouraging discussion between the employer and the employee to facilitate a return to work, but businesses often find that little practical guidance is given. If there is a move away from certifying employees as unfit to promoting continued working with adjustments, businesses will need clear guidance from individual GPs on what adjustments are needed in a particular case.”