Sick notes have been in the news in the business world as well as the football world this year.  Or rather the new system of fit notes to replace the old sick note system has been. The new system came into effect on 6 April in response to the enormous costs to employers associated with long-term sickness absence which costs the UK economy some £100bn each year, according to a 2008 report by Dame Carol Black, the government's national director for health and work.

Many of the comments made since the new system was announced have been somewhat negative, which is a shame because they are essentially intended to be a positive response to an old and seemingly intransigent problem. Fit notes were launched to encourage people, who are well enough, to return to work before they receive Employment and Support Allowance (ESA) on incapacity grounds. The notes are designed to provide employers with greater information on an employee's medical condition and suitability for work.

The notes have two boxes which allow GPs to certify one of two options:  ‘not fit for work’ or ‘may be fit for work taking into account of the following advice’.  The notes then list four common types of adjustments which employers can introduce to assist a return to work including: ‘a phased return to work’, ‘amended duties’, ‘altered hours’  and ‘workplace adaptation’.

It appears that as a nation we are still having to adapt to the new system as people become more aware of the implications of the legislation. This has caused some comment but in reality it is fairly typical of the way in which new legislation is adopted and developed. For example, it has been claimed that some GPs may fail to understand the nature of the workplace.

Now of course the majority of GPs are not trained in occupational health, have limited knowledge of many types of workplace. This is why one medical defence union has warned GPs to be cautious in their approach to completing the notes. There will need to be a settling in period, but on the plus side fit notes encourage everyone concerned to think about reasonable adjustments at a much earlier stage of the sickness process and may eventually achieve their aim of getting people back to work sooner and making sure they stay there.

At RH we believe that fit notes are a sign of the times. We are shifting from a negative mindset to one that looks for positive actions. For example, ergonomics for office workers has traditionally been seen largely as an issue about eliminating bad posture. This is rooted in the legislative approach and the flawed idea that it is up to employers to provide the right ‘ergonomic’ equipment, carry out the appropriate training and generally mitigate the effects of poor posture. That’s why you see products described as ‘ergonomic’ which is misleading without knowing about the context of their use. It is all pretty negative. No wonder some firms that have carried out risk assessments weighing the cost of all this stuff and training against the likely impact of absenteeism, legal action and so on.

RH has recently been carrying out ongoing research in the UK and across Europe to gauge the positive impact of a broader approach to ergonomics. The Results of this initial study support us in our belief that things are changing. The focus has shifted away from posture towards movement. There are lots of reasons for this, partly to do with new working styles, but also greater awareness of the issue of ‘wellness’, the need for people to take breaks, move around in their seats more. So this is much more of a management issue than a matter of just giving people the right stuff and hoping they don’t come to any harm.

In spite of this encouraging point, there still seem to be a large number of managers who claim not to take this positive view. Why else would this debate be ongoing, particularly in light of the new fit note system? What is encouraging is that one of the four potential adjustments on the new fit notes is ‘workplace adaptation’. This is one area in which we can work with GPs to make them more aware of the potential of the workplace to improve wellbeing and performance, not just through equipment but with new working practices and new attitudes.