Patients’ Sick Notes Eliminated In Pilot Scheme

GPs will no longer issue sick notes in some places under a new government trial aimed at overhauling the broken system.

Some 11 million “fit notes” are issued each year under the current system, with more than nine in ten declaring the person not fit for work.

The Department for Work and Pensions (DWP) said in four areas of England, the pilot will look at the best way to “end this tick-box exercise” for workers who fall ill.

Some patients affected will be offered an initial fit note from a GP and then referred to community health workers. Others will go through the entire process without an initial fit note from a GP and instead be supported through a separate service staffed by clinical and non-clinical practitioners.

The pilots will be launched in Birmingham and Solihull, Coventry and Warwickshire, Cornwall and the Isles of Scilly and Lancashire and South Cumbria.

The Government said this is the first step of “radical fit note reform”, with patients, healthcare staff and employers providing input ahead of legislation being brought forward for changes to the “broken system”.

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.

“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. That’s what these pilots are about, and that’s what this Government is committed to – fixing what is broken.”

Care minister Stephen Kinnock said NHS staff had repeatedly highlighted that the current fit note system is not working for patients or clinicians who sign them off.

He added: “These pilots mark the beginning of the end for that broken system, giving people personalised support to get back into work and freeing up GPs from unnecessary admin so they can focus on what they do best: caring for their patients. This is what our 10 Year Health Plan is all about – earlier support, from the right people, in the right place.”

National Voices, a coalition of health and social care charities, welcomed the pilots and planned reforms. Chief executive Jacob Lant said: “The current tick-box system for fit notes isn’t working for anyone, particularly patients. It makes people who are unwell jump through unnecessary admin hoops, and yet the process rarely offers people the support they need to get well and manage their conditions long-term.

“The Department for Work and Pensions is absolutely right to test out new ways of supporting those who are signed off, and it is vital that patients are fully involved in that testing process, able to feed back over what works and what doesn’t. This is the only way to reliably avoid unintended consequences and create a system that actually helps both those who can’t work and those who would be able to with the appropriate support.”

I’m not sure if this pilot scheme will work or not. I always say, “If it’s not broken, there is no need to fix it.”

People are frustrated because some believe that people just don’t want to work, but claiming that the majority of people in the UK don’t want to work doesn’t actually hold up because data shows that most people on sickness-related benefits want to work, but are thwarted by health, unstable work conditions, inaccessible systems, and employer discrimination, not by lack of intention, and by saying that the majority of people don’t want to work is a political framing, not a factual one.

Across the UK, most people are on long-term sickness benefits and have numerous chronic illnesses, often fluctuating or poorly managed because of NHS delays.

Over 70 per cent say they want to work if their health allowed it (DWP’s own survey data).

The biggest obstacles are structural, not motivational – lengthy NHS waiting lists, employers refusing adjustments, insecure work that penalises fluctuating conditions, fear of losing all income if a job trial fails, and inaccessible workplaces and transport, and none of this will be solved by shifting sick notes to a new department.

So why does the “majority don’t want to work” narrative persist? It’s because it’s politically convenient. If the problem is framed as individual laziness, then the government doesn’t have to fix NHS backlogs, employers don’t have to improve conditions, no one has to invest in accessibility or proper occupational health, and cuts can be justified as “cracking down” rather than failing to support people. It shifts blame away from systemic failure and onto people harmed by it.

Moving sick notes from GPs to “work and health professionals” doesn’t fix the lack of treatment, the lack of support, the lack of suitable jobs and the lack of employer accountability. It just creates a new gatekeeper whose job is to say “no”. It’s not a reform, it’s a rebranding.

And here’s the painful truth – people who genuinely don’t want to work are a small minority, and they’ve always existed in every society, but they’re politically useful as a scapegoat.

Meanwhile, the people who do want to work but can’t, such as disabled people, people with chronic illnesses, carers, and people stuck in poverty traps, get penalised because of that narrative, and honestly, folks, you’ve lived enough of this system to know the difference between myth and reality.