On 10 June 2022 the government set out new regulations providing that pharmacists and nurses (as well as other types of healthcare professional) will be given the power to issue sick notes to individuals in England and Wales, with the change in law to take effect from 1 July 2022.

Employees in England and Wales who are unwell or injured and absent from work for more than 7 days are usually required to submit a ‘fit note’ to their employer, certified by a doctor, stating that they are unfit to work, or that they “may not be fit for work” subject to certain adjustments or adaptations in their workplace or duties by their employer. During the first 7 days of sickness absence, employees can ‘self-certify’. Fit notes can be certified by a doctor providing treatment in a hospital, but ordinarily unwell employees will obtain a fit note from their GP.

This new update to the law follows recent changes in April 2022 removing the requirement for fit notes to be signed in ink, and allowing fit notes to be certified and sent to patients digitally. Given the challenges NHS hospitals and GP surgeries presently face, with maximum hospital waiting times at 18 weeks and the average waiting time for a GP appointment at 10 days, this further reform is intended to reduce pressure on public services and make obtaining a fit note easier and quicker.

Under the amended regulations, employees will be able to obtain fit note certification from:

      • Nurses.
      • Occupational therapists.
      • Pharmacists.
      • Physiotherapists.

Fit notes can only be issued by these types of healthcare professional following an assessment of the patient’s fitness to work, and cannot be issued on request or via over-the-counter services. It is not yet clear from the government’s announcement how this is intended to work in practice, particularly where certification is sought from a pharmacist, whose services are almost always provided ‘over the counter’.

The announcement has been welcomed by the British Medical Association, the Chartered Society of Physiotherapy and the Royal College of Occupational Therapists, and is likely to be viewed positively by unwell employees, who will no longer need to navigate their (often bureaucratic and slow) GP appointments process when seeking fit note certification. The government have said that the change (the most significant since the introduction of fit notes in 2010) will “support and empower better conversations about work and health between employers and staff by making it easier to get this advice certified by the most relevant healthcare professional”.

On the other hand, the new rules could also benefit malingerers, as they arguably make it easier for a minority of unscrupulous employees to be signed off work in illegitimate circumstances, meaning lost productivity and the expense of sick pay for companies. Arguably this is a cynical view but one that is likely to be shared by some employers and HR professionals. Equally, many such employers might comment that it is already relatively straightforward for employees to obtain fit note certification and that these changes will make little difference from the perspective of the patient.