GPs to stop issuing fit notes in new pilot – what it means for UK workers
Key Points
- The UK government has launched four pilots in England to overhaul the fit note system from July 2026
- In Cornwall, the Isles of Scilly, Lancashire, and South Cumbria, GPs will stop issuing initial fit notes entirely
- In Birmingham, Solihull, Coventry, and Warwickshire, GPs will issue an initial fit note before referring patients to dedicated work and health teams
- The reforms target a system producing 11 million fit notes a year, with more than 90% declaring workers 'not fit for work'
- Pilots are backed by £3 million in the first year and form part of a wider £3.5 billion employment support package
GPs will stop issuing initial fit notes in two English regions from July, under a four-pilot government programme to overhaul the system.
The Department for Work and Pensions announced on Wednesday (20 May) that GPs in Cornwall and the Isles of Scilly, and Lancashire and South Cumbria, will no longer sign off the initial fit note.
Patients in those areas will go directly to a separate support service staffed by clinical or non-clinical practitioners. In Birmingham and Solihull, and Coventry and Warwickshire, GPs will still issue the first fit note before referring patients on to dedicated work and health teams.
The current system declares more than nine in 10 of those 11 million annual notes ‘not fit for work’, with no accompanying support plan.
A Call for Evidence published alongside the pilots found just 29% of primary care staff consider fit notes a good use of GP time, while six in 10 employers say the process fails to support staff’s work and health needs.
The pilots are the first stage of a wider reform plan, with legislation to follow based on findings shaped by patients, healthcare staff, and employers.
The pilots will last up to a year and cover up to 100,000 appointments, with £3 million of funding for the first year.
Community health workers, social prescribers, and work and health coaches will support patients, with three-way conversations between employers, employees, and trained professionals starting on the first day of absence.
The aim is to replace the current sign-off with personalised ‘stay in work’ and ‘return to work’ plans.
“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,” said Pat McFadden, Work and Pensions Secretary.
“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.”
The reforms follow the Keep Britain Working Review by former John Lewis chairman Sir Charlie Mayfield, which found the fit note system was “not working as intended” and had become a barrier to contact with employers.
The pilots form part of a wider £3.5 billion employment support package, alongside Statutory Sick Pay reforms that pay employees from day one of sickness absence and add £400 million a year to workers’ pockets.
WorkWell, the NHS-led health and employment service delivering the pilots, is also expanding nationally to support up to 250,000 people with a disability or health condition into or back into work.
EDF Energy is among the Keep Britain Working Vanguard employers that will develop approaches to preventing absence and supporting returns to work over the next three years.
Total WorkWell funding allocations range from £21.60 million in the South West to £47.10 million in the Midlands, with the programme covering every English region.
