GPs across England are being ordered to stop issuing millions of sick notes and instead send patients to job coaches or the gym.
Health Secretary Wes Streeting told the Mirror that England was “moving away from a system that just treats illness” after we revealed numbers signed off work sick have finally started to fall after more than doubling in the past decade.
GP surgeries were given funding from last month so that all family doctors can prescribe specialist support from the likes of career coaches, physiotherapists and occupational therapists, rather than simply signing patients off work. The WorkWell scheme rollout will come into force from November in what is the first major change to the “fit note” system since it was introduced in 2010.
View 3 ImagesThe Government wants GPs to prescribe back-to-work support(Image: Getty Images/iStockphoto)
It comes after numbers being signed off work snowballed under the Tories. GPs now issue fit notes 11 million times a year, up from around five million a decade ago. Data suggests GPs in England are already offering more suggested adaptations for staying in, or returning to work, as part of the fit note they issue.
Health Secretary Wes Streeting said: “A piece of paper that closes doors is no substitute for a proper plan. That’s why we are moving away from a system that just treats illness, but also tackles the factors that stop people living fuller, healthier lives at their root. Through our WorkWell initiative, which has just been extended nationwide, people who receive a fit note are being linked up with real, practical support – including physiotherapy, mental health services and advice on workplace adjustments.
“Alongside this, our Health and Growth Accelerators are bringing together NHS teams, occupational therapists and employment advisers in areas with the highest levels of health-related economic inactivity, to help prevent people falling out of work in the first place and reduce pressure on GPs.”
Fit notes need to be written by a healthcare professional, usually a GP, if a person is unwell and cannot work for more than seven days. During the first week workers can self-certify as unwell. They may confirm that a person is ‘not fit for work’ or recommend that they ‘may be fit for work’ with adjustments. Fit notes can be used to claim benefits or statutory sick pay.
The WorkWell scheme to prescribe people back-to-work support was initially launched last year in 15 regions of England with high levels of unemployment and sickness. They included Birmingham, Manchester, Lancashire and Leicester. Its success means GPs now operate the system in all regions of England.
Family doctors will work with employment coaches who can help patients write CVs and covering letters, and social prescribing link workers who refer patients to support such as gym memberships and gardening classes. Patients will also be linked up with charities helping with issues such as debt management and housing.
It comes a day after the Mirror reported that total fit notes signing people off work had soared from around 5.2 million in 2015/16 to over 11 million in 2025 driven by long term sickness and mental health issues. However new analysis of the 2025 data suggests a small uptick in sick notes where GPs have authorised that the patient “may be fit for work” with adjustments.
More recent data for the final three months of 2025 showed 2,853,624 fit notes were issued in the October to December period. This is down 14,935 on the same quarter the previous year. The region issuing the highest rate of fit notes per 100,000 registered patients was the North East, while the lowest was London.
View 3 ImagesNumbers of people signed off work by GPs has doubled(Image: Getty Images)
Mr Streeting added: “After a decade in which fit notes more than doubled, it is encouraging to see these early signs of change. But far too many people are still being quickly signed off without addressing the cause of the absence in the first place or offering any support when they’re ready to come back to work.
“I am not resting on my laurels – there is more to do, which is why we will soon set out further reforms to make sure the fit note system genuinely supports recovery and provides a route back to work.
“Good work is good for people’s health, reduces pressure on the NHS, and is essential for a strong economy. Under our 10 Year Health Plan, the NHS will play its full part in delivering that change.”
Fit notes were launched in 2010 under the Tories to replace the sicknote however critics say they came to be used in the same way.
During the first six months of a workplace absence, fit notes can last up to three months, with a review date. After six months a fit note note can last for a longer or even indefinite period.
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Work and Pensions Secretary Pat McFadden said: “Too often, people with health conditions are signed off sick without the support they need to stay in or return to work—and that doesn’t help anyone. Now we’re rolling WorkWell out nationwide because supporting people to stay healthy and employed benefits individuals, businesses and our economy.”