Under the new system, GPs will indicate whether the patient is "unfit for work" or "may be fit for work". In the latter case, he will advise of any adjustments to the employee's role or work environment from which the employee may benefit. These might include a phased return, restricted duties, altered hours or even physical adaptations to the workplace.

The objective is to reduce the incidence of long-term absence by facilitating earlier returns.

Will it work?

Some fear the new system will introduce additional vagaries to absence management which will only lead to increased headaches and cost for employers. In particular, it is questioned whether doctors have the time and information to fully appreciate their patients' work situations in order to provide useful recommendations. Government guidance clarifies that GPs should not be too prescriptive in their recommendations, but only time will tell whether there is consistency of approach.

The guidance also encourages doctors to recommend a referral to Occupational Health if felt necessary. This would certainly seem preferable to GPs making ill-informed recommendations on workplace adjustments. But is there a risk that this becomes the 'default' recommendation of doctors who are under time pressure and are wary of foraying into unfamiliar waters? Employers, not the NHS, pick up the tab for such specialist input. Traditionally they have done so at their own election. They may not welcome having this course urged upon them routinely and potentially unnecessarily. 

The guidance emphasises that GPs' recommendations will not "bind" employers. However, employers will ignore them at their peril. Tribunals will be exhorted by Claimants to look closely at any failures by employers to implement recommended adjustments. The most likely context in which these failures will be scrutinised is litigation arising from capability dismissals. The scrutiny will be all the more acute where the Claimant is covered by the Disability Discrimination legislation.  Prudent employers will therefore give careful consideration to implementing recommendations and, if they decide against, will ensure their reasons are robust and fully recorded.

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