Number of fit notes issued hits record high

Analysis finds more than 10 million sickness certificates were given out in the last 12 months, including more than 800,000 for stress

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The number of fit notes issued to workers on sick leave has hit an all-time high, analysis has found, with the number given out jumping more than 20 per cent in the last year.

Research conducted by law firm GQ|Littler, based on NHS data for the year-ending March 2022, showed a 21 per cent yearly increase in the number of fit notes – up to 10.4 million from the 8.6 million issued in 2020/21.

The analysis also found a 7 per cent increase in stress-related fit notes – up from 755,000 in 2020/21 to 808,000 in 2021/22.


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GQ|Littler suggested the increase in stress-related fit notes was likely caused by the impact of the pandemic on mental health, as lockdowns took their toll on workers. 

The firm also cautioned that the cost of living crisis could possibly exacerbate the mental health crisis leading to a further increase in stress-related fit notes being issued.

Sophie Vanhegan, partner at GQ|Littler, advised that employers have processes in place to support employees who appear to be suffering from stress or mental-health related issues. 

“Supporting employees through their mental health issues is extremely important, not just for productivity and morale. In today’s competitive jobs market, organisations that are viewed as unsupportive may have difficulty attracting and retaining talent,” she said.

Vanhegan also suggested actions that employers can take ranging from scheduling regular catch-ups and arranging mental health awareness training to appointing mental health ambassadors.

Echoing this, Gemma Bullivant, HR consultant and grief and bereavement specialist, also warned that it was less well understood that “adjusting back after a long period of building a new normal, such as lockdown, is also stressful”. 

“Added to which, stress is both dynamic and cumulative, in that it rises and falls frequently and needs regular support to maintain good mental health and wellbeing,” she said.

She suggested it would be key for businesses to give managers the tools to have genuinely supportive conversations (such as mental health first aid training); consider how other aspects of the individual's work life blend might be impacting mental health; and give employees the tools to better understand their own mental health.”

In addition, “normalising the conversation around mental health and enhancing and/or promoting the mental health support services offered by your organisation” might go a long way, Bullivant added.

As there were 7.3 million Covid cases between April and December 2021, compared to 2 million in the same period in 2020, GQ|Littler also suggested the rise in fit notes may partially be attributed to the higher numbers of Covid infections, as some employees returned to the office and overseas travel resumed.

However, the firm said that during lockdown, it is likely that some people continued to work from home while unwell and many employees in sectors such as hospitality and tourism were furloughed for long periods, so did not seek fit notes if they were unwell.

Commenting on the findings, Idris Arshad, people and inclusion partner at St Christopher’s Hospice, said there was further work for organisations to do in not only treating absences related to mental health, but taking more proactive and preventative action in creating a working environment that reduces mental health. 

At the same time, he acknowledged that there had been a “shift in the right direction” spurred by more conversations about mental health amid the pandemic.

For this reason, he suggested that “momentum needed to be kept up by developing line managers, leaders, and HR departments in ensuring they promote a culture where presenteeism is not encouraged and employees feel comfortable being absent because they are not fit to work,” he added.

The data shows the number of fit notes issued dropped during 2020/21, having been steadily climbing until that point: the figure stood at 10.2 million in 2019/20; 9.5 million in 2018/19; and 9.2 million in 2017/18.

Until recently, fit notes could only be issued by GPs, but with a change brought in to issuing fit notes from 1 July in a bid to mitigate pressure on primary care services, nurses, occupational therapists, pharmacists and physiotherapists are now also able to issue them.