General practitioner Practice manager England Wales GP practices Scotland

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Fit for Work Scheme - Guidance for GPs

The Government's Fit for Work service was launched in December 2014 and is intended to be a patient referral service for GPs.

The Government is clear that the introduction of the scheme is aimed at tackling the significant number of days lost to sickness every year. However, as the scheme also aims to help support patients to move back into work sooner, one possible benefit to GPs could be that they will be called on less frequently to issue repeat fit notes.

Health Management Limited has been appointed as the supplier to deliver Fit for Work in England and Wales. Fit for Work Scotland will be delivered by the Scottish Government, on behalf of the UK Government.

The Department for Work and Pensions have guidance on the new service aimed at GP, employers and employees

Download the guidance


Fit for Work scheme

The Fit for Work scheme has two elements:


This element is relatively uncontroversial; offering patients or their employers advice to help patients, for example, when their health condition is affecting their job.

This might involve providing help with issue identification, information on the type of adjustments which could help patients stay in or return to work, or more general work related health advice. This will be available online and through a phone service.

The advice service is targeted at employees, employers and GPs.


Referral for an occupational health assessment

This element will provide GPs with a referral route to access a supportive health assessment for patients who they judge could be absent from work for four weeks or more. Patients will be contacted within two working days of a referral by a case manager and they will receive a 'holistic biopsychosocial assessment', which will usually take place over the telephone.

The Fit for Work case manager will seek to identify the obstacles preventing the patient from returning to work and agree a plan designed to address each obstacle to enable a safe and sustained return to work.

This 'Return to Work Plan' will reflect the assessment and provide work-focussed advice and recommendations which have been discussed with the patient to help them return to work more quickly. The Return to Work Plan will be sent via email or post (where appropriate) to the GP, the patient and the patient’s employer, subject to the patient’s consent.

It should be noted that there are likely to be few face to face interviews and that most assessments will take place over the telephone, which may be of concern to some patients.


What does GPC think?

GPC has some concerns about the occupational health referral element. In particular the word 'occupational' appearing in front of health assessment or health advisor as we believe it is potentially misleading.

We have argued strongly that it should just say 'specially trained' health professional and had previously received assurances from the Government that the service would not be presented as a comprehensive occupational health service.

The guidance reflects some of our concerns, but we do not believe it goes far enough to avoid being misinterpreted.



  • Do GPs have to refer patients to this service?

    No - there is no contractual or mandatory requirement for GPs to refer patients to this service, but DWP guidance urges GPs to refer all patients that are eligible for the service.


  • What are the criteria for referring patients?

    • patients of any age in paid employment
    • the patient is likely to be absent from work for four weeks or more
    • the patient has a reasonable prospect of returning to work
    • the patient has not already been referred within the last 12 months and has not received a Return to Work Plan
    • the patient consents to the referral


  • How do GPs refer patients to the service?

    For England and Wales GPs can phone 0800 032 6235   or visit

  • Is it only GPs who can refer?

    • No - employers can refer too, separate guidance has been issued for them by the DWP
    • Employees cannot self refer


  • Why would employers be willing to refer?

    • Not only would their employee be potentially able to return to work more quickly but they also get a financial contribution to addressing any issues identified
    • From 1st January 2015 the Government introduced a tax exemption of up to £500 (per year, per employee) on medical treatments recommended to help their employees return to work. This will be applicable to treatments recommended by health professionals within Fit for Work and health professionals within employer-arranged occupational health services


  • How quickly does the service respond?

    Fit for Work will contact the patient to conduct a telephone assessment at a convenient time for them (within two working days of receipt of referral or five working days for a face to face consultation if it is deemed appropriate).


  • Are DWP going to be monitoring use of the scheme?

    Short contact will be made with patients, employers and GPs to provide feedback about the service; this follow up takes place following discharge of a patient from Fit for Work. This will take the form of a questionnaire conducted via email or telephone. This will help support continuous improvement and evaluation of the assessment service.