Employment scheme aiming to reduce GP fit notes being rolled out nationally

A Government scheme which aims to reduce demand for GP fit notes will be rolled out nationally, the Department of Work and Pensions has announced. 

The WorkWell programme is set to be rolled out across England, following a £64m pilot across 15 ICB areas which began in 2024.

The scheme will now receive £259m funding over three years and will help 250,000 people with health conditions stay in or return to work, the Government estimated.

It provides ‘personalised’ and ‘early’ help for people struggling with their health, connecting them to local services such as physiotherapy, counselling and workplace adjustments.

The national rollout is expected to reduce demand for GP appointments by ‘ensuring more people get the health and work support they need’ through WorkWell, the DPW added.

Participants do not need to be claiming any Government benefits to take part and will receive support from a coach to understand their current health and social barriers.

They will be able to access services through multiple routes including GP referrals, employer referrals, Jobcentre Plus, local services or self-referral.

Services provided through the programme vary locally, as the scheme will be delivered through ICBs working with local authorities, JobCentre Plus and community organisations, but can include:

• Physiotherapy for back pain and mobility issues
• Mental health interventions including counselling and psychological support
• Workplace adjustment advice to help employers accommodate health conditions
• Ongoing health condition management

The pilots have supported more than 25,000 people to stay in or re-enter work, according to the Government.

Health secretary Wes Streeting said said: ‘We’re issuing millions of fit notes a year dismissing people as simply “not fit for work”. By combining health support with employment support in local communities, WorkWell can give people back their confidence, their purpose and their wellbeing. 

‘Crucially, it also eases pressure on GPs and cuts waiting lists so we can build an NHS fit for the future.’ 

An estimated 11 million fit notes were issued last year, around 40,000 per working day – the vast majority by GPs. 

The Government has already extended its scheme to embed job coaches in GP practices to provide intensive employment advice to 40,000 more sick or disabled people.

Sir Charlie Mayfield’s review into health-based economic activity, published last year, found 93% of fit notes in England deem the patient ‘not fit for work’ and are ‘often extended without further consultation’. 

It recommended adopting a Workplace Health Provision (WHP) service ‘to take the pressure off our GPs and healthcare professionals, freeing up their valuable time to be spent on diagnosing and treating patients’. 

This is despite the Government introducing legislation in 2022 which expanded fit note certification to other professionals such as nurses, physiotherapists, and occupational therapists.  

Last year, Government-commissioned research found limited take up of healthcare professionals other than GPs writing fit notes since the 2022 reforms.