The Fit Note Dilemma: When “Not Fit for Work” means “Not Fit to Talk”

Hundreds of GPs say they have never refused a fit note for mental health. At the same time, there were 850,000 more fit notes issued last year than six years ago.

For those of us working in HR, this aligns exactly with what we’re seeing with clients. But it raises an increasingly difficult issue: GPs are being asked to be both advocate and judge—and that’s not an easy position to be in.

We are increasingly seeing fit notes that effectively translate into:

• Not fit for work
• Not fit to speak to the employer
• Employer advised not to make contact
• Communication to go via the trade union

The intention is clearly to protect wellbeing. But in practice, it can leave organisations stuck, particularly when there are ongoing workplace issues that still need to be addressed.

A Real-World Case Study

We recently supported a client where an employee was off sick with mental health concerns while also being involved in a grievance, disciplinary, and capability process.

The employer was advised the employee was not fit to speak and all contact should go through their union. I received a trade union response obviously using AI, which wasn’t exactly helpful. Meanwhile, the organisation still had responsibilities to:

• Address the grievance
• Manage the disciplinary process
• Deal with capability concerns
• Manage the ongoing absence and duty of care

This is where Occupational Health is increasingly being asked one key question: “Is the employee fit to attend a meeting?”

The Bottom Line

Fit notes play an important role, but they are only one piece of the picture. The real challenge for employers is finding the balance between supporting mental health and progressing legitimate workplace processes.

Because sometimes the absence itself doesn’t resolve the underlying issue. It simply pauses it.

We want to hear from you: Are fit notes becoming more difficult to navigate in practice? Or is the current system working as intended?

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