Short answer: Fit notes are not being scrapped nationally. From July 2026 the Government is piloting new approaches in four areas of England for up to a year, testing personalised stay in work and return to work plans, in some cases without a GP fit note. Employers outside the pilots should carry on using the current fit note system and prepare for earlier, more structured conversations about absence.
The headline “fit notes to be scrapped” has caused confusion. The announcement is a pilot, not a change in the law, and it affects a relatively small number of patients for now. But it signals where policy is heading, and employers can prepare for it at low cost.
On 20 May 2026 the Government announced four pilots through existing NHS WorkWell sites, to run for up to a year and cover up to 100,000 appointments. The areas and models are:
|
Area
|
Model tested
|
|
Birmingham and Solihull
|
GP issues the first fit note where needed, then all patients referred to a support service led mainly by non-clinical staff
|
|
Coventry and Warwickshire
|
GP issues the first fit note, with referral to a mixed clinical and non-clinical support service
|
|
Cornwall and the Isles of Scilly
|
GP refers to a non-clinical support service without issuing a fit note
|
|
Lancashire and South Cumbria
|
GP refers to a mixed support service without issuing a fit note
|
The pilots will test personalised stay in work and return to work plans in place of the current tick-box approach. Support may include three-way conversations between the patient, the employer and a trained professional, covering reasonable adjustments and keeping the person connected to work from the first day of absence. The plans will be available for use for Statutory Sick Pay. Occupational therapists can sign fit notes as well as provide clinical supervision. Alongside this, a group of “Keep Britain Working” vanguard employers will work on how to prevent absence and support safe, swift returns.
People who need time off to recover will still get it. Statutory Sick Pay now starts from day one of absence, following the removal of the waiting period and lower earnings limit on 6 April 2026. Nothing in the announcement changes your obligations under the Equality Act 2010, your duty to consider reasonable adjustments, or the fair process you need before dismissing for capability.
If the pilots lead to national change, employers can expect:
- earlier, more structured engagement during absence, including joining three-way conversations
- a stronger expectation that you will consider adjustments and phased returns early
- more scrutiny of decisions to refuse adjustments or to hold a person off work
- the need to accept plans in place of, or alongside, fit notes for SSP and absence management
It is too early to say how strongly any of this will change absence rates, and the pilots may be changed in light of results.
1. Update your sickness absence policy to make contact normal. Agree contact from day one in a way that suits the employee, not just a chase for a return date. Explain who will be in touch and how often.
2. Prepare a simple stay in work conversation. Use a short template: what is making work difficult, what could help, what the employee can do now, what you can offer and when you will review. It gives you a head start and records that you considered adjustments.
3. Know your adjustment options. Phased returns, changed hours, altered duties, temporary home working, equipment, redeployment. Decide in advance what is realistic by role.
4. Check your SSP processes. Make sure payroll and managers know that SSP applies from day one, that evidence requirements are in your policy and that you accept alternative forms of evidence where the policy and the law allow.
5. Use occupational health earlier. If the pilots expand, occupational health reports will sit alongside plans. A relationship with a provider is easier to set up before it is urgent.
6. Brief managers. They should know that the fit note is not the end of the process. It is the start of a conversation.
Is your absence policy built for early contact and adjustments? We update sickness policies, templates and manager training for a fixed fee. [Review your sickness absence policy]
Are fit notes being scrapped? Not nationally. The Government has announced pilots from July 2026 in four areas of England for up to a year. In some pilot areas, patients will be referred to a support service and receive a plan without a GP fit note. Elsewhere, the current system applies.
Which areas are in the fit note pilot? Birmingham and Solihull, Coventry and Warwickshire, Cornwall and the Isles of Scilly, and Lancashire and South Cumbria.
What are stay in work and return to work plans? They are personalised plans, produced with support from trained professionals, that set out what an employee can do, what adjustments could help and how they will stay connected to work. They replace the tick-box approach in the pilots and will be usable for Statutory Sick Pay.
Do I still have to pay SSP? Yes. SSP starts from the first day of sickness absence for eligible employees, following the changes on 6 April 2026, and the pilot plans are intended to be usable as evidence for SSP.
What should employers do now? Keep using the current fit note system, improve early contact and adjustment conversations, prepare a simple stay in work template and review your sickness absence policy.
Our advisers help employers manage absence fairly and consistently, from policy design to individual case support, on a fixed monthly fee. Get a quote or Speak to one of our experts.
Reviewed 8 October 2026. This article is general guidance and not legal advice.
