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Government names 15 ICBs which will pilot fit note reform

by Eliza Parr
9 May 2024

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The Government has announced a £64m pilot for a new work and health service across 15 ICB areas that will test changes to how fit notes are issued.

A small number of the pilot sites will explore how a new service would take responsibility for issuing fit notes away from GPs.

Last month, Prime Minister Rishi Sunak said the ‘sick note culture’ needs to change, so that the system ‘recognises’ and ‘encourages’ the benefits of work. He also announced that responsibility for fit notes may move away from ‘already stretched’ GPs .

A call for evidence is currently underway proposing fit note reforms and seeking views from clinical and non-clinical professionals, patients and employers on how the system can ‘better support people to start, stay, and succeed in work’. 

The Department of Health and Social Care (DHSC), along with the Department for Work and Pensions (DWP) have now confirmed plans for ‘WorkWell’ pilots, which were first announced in November last year.

From October, the pilots will ‘connect 59,000 people to local support services’ to help them stay in or return to work. 

According to the announcement, the Government plans to explore how the fit note process can ‘be integrated’ with WorkWell. 

DHSC and DWP said: ‘As part of the call for evidence, we are also testing reforms of the fit note process to integrate it more closely with WorkWell, enabling the people who need it to have a work and health conversation with a single, joined-up assessment and gateway into local employment support services.’

In some of the pilot areas, the Government will roll out ‘fit note trailblazers’.

The Goverment departments said: ‘The trailblazers will trial better ways of triaging, signposting, and supporting people looking to receive a fit note and will be used to test a transformed process to help prevent people with long term health conditions falling out of work, including referral to support through their local WorkWell service.’

The call for evidence on fit note reform, published last month, said that trailblazers will recruit both clinical and non-clinical professionals who will have additional training.

‘This new delivery model being tested will explore how the wider health system can take responsibility for issuing the fit note, and situate it within a new service in WorkWell vanguard sites,’ the Government said.

It also said this service will ‘allow primary care teams to use their valuable time more efficiently’.

The DHSC confirmed that these trailblazers, along with the call for evidence, will inform a more detailed consultation later this year with more specific policy proposals.

In the 15 areas (see box below), covering over a third of ICBs, GPs will be able to refer patients to the WorkWell service, which provides links to physiotherapy and counselling for mental health conditions, or facilitates discussions with employers about workplace adjustments.

The Government highlighted that some of the pilots are taking place in areas with the highest number of fit notes issued last year, such as Greater Manchester and the Black Country.

The success of the pilot will inform wider rollout of the WorkWell service across the country.

Health secretary Victoria Atkins said that ‘too often’ people with disabilities or health problems ‘fall out of work with no support’. 

She said: ‘We have a plan to change that and improve lives so everyone has the opportunity to find fulfilling work. 

‘This service will help tens of thousands of people, who will receive joined-up work and health support, tailored to their individual needs.’

ICBs testing the WorkWell service are:

  1. Birmingham and Solihull
  2. Black Country
  3. Bristol, North Somerset and South Gloucestershire 
  4. Cambridgeshire and Peterborough
  5. Cornwall and the Isles of Scilly
  6.  Coventry and Warwickshire
  7. Frimley
  8. Herefordshire and Worcestershire
  9. Greater Manchester
  10. Lancashire and South Cumbria
  11. Leicester, Leicestershire and Rutland
  12. North Central London
  13. North West London
  14. South Yorkshire
  15. Surrey Heartlands

A version of this story was first published on our sister title Pulse