Requests for certification of absence from the workplace relating to Covid-19 may fall into five categories:
1. Symptomatic so isolating for seven days
Patients can and should self-certify for the first seven days as normal if they are unfit to work. They do not need to contact their GP.
2. Symptomatic and remaining unwell for over seven days
If they remain unwell and unfit to work after seven days, the current advice is to visit www.111.nhs.uk where there is an online self-assessment tool which should be up and running soon. They do not need to contact their GP for a certificate but you can advise patients to use the template form below.
3. Household contact symptoms so isolating for fourteen days as per government advice
GPs cannot and are not the gatekeeper of the statutory sick pay system and can only provide certificates for the purpose of illness, not in relation to government advice regarding self-isolation. Employers are responsible for putting in place arrangements for home/remote working where this is possible. Where it is not, the employee may self-certify and return to work following the relevant absence which their employer may authorise as per government advice.
4. At risk group so following government advice
Where they do become unwell during or after this time, point 1 and 2 applies. They do not need to contact their GP.
5. Those in full time education who are symptomatic or requiring self-isolation.
There is no NHS requirement to issue certification to schools or colleges to confirm absence. These organisations must work with parents and students to ensure that any absence is appropriately recorded, obviating the need for a ‘doctor’s note’. They do not need to contact their GP.
The current Government Guidance for employers and businesses on coronavirus (COVID-19) states:
“By law, medical evidence is not required for the first 7 days of sickness. After 7 days, employers may use their discretion around the need for medical evidence if an employee is staying at home.
We strongly suggest that employers use their discretion around the need for medical evidence for a period of absence where an employee is advised to stay at home either as they are unwell themselves, or live with someone who is, in accordance with the public health advices issued by the government.”
Until further guidance is available, Londonwide LMCs would suggest that practices upload the ATTACHED LETTER to their website and requests that if needed by patients they use this letter as the practice will not provide a medical certificate for patients requiring self-isolation for coronavirus.
For Illnesses lasting less upto 7 days
If you have an illness lasting seven days or less you do not require a doctor's sickness certificate. Your employer may require you to complete a self-certification form called an SC2 which is available from the HMRC website or you can click on the link below to download a form.
If you require a sick certificate during this self-certification period we are able to provide a private sick certificate but there is a fee payable for this service. The issuing of a private sick certificate is at the discretion of the doctor at the time of assessment for a fixed period (please enquire at reception for the current fee payable). Please kindly refer to the section below 'Optional Occupational Pay Schemes' for more details.
For Illnesses lasting more than 7 days
If you are off work for more than seven days due to illness, your employer can ask you to give them some form of medical evidence to support payment of SSP (statutory sick pay) or other sickness benefit. This type of form is referred to as ‘fit note’, which is a legal medical statement made by the doctor at time if they feel you are not able to undertake any work. The issuing of the ‘fit note’ is at the discretion of the doctor at the time of assessment for a fixed period.
To request a sick certificate or ‘fit note’ please speak to reception. Please note- it may take 48 hours to process the request and it may be necessary to have an appointment if we have not seen you recently regarding the illness. When you receive the ‘fit note’ please make a note of the expiry date and if you require a further certificate request it in good time- the DWP only write once the existing certificate has expired and we are unable to provide "same day" sick certificates apart from in exceptional circumstances.
For illnesses where you are deemed able to do some work
Alternatively, under certain circumstances a doctor may issue a ‘may be fit note’. This has four iterations:
- A phased return to work: a gradual increase in work duties or hours
- Altered hours: changing their work times or total hours
- Amended duties: changing their work duties
- Workplace adaptations: changing aspects of the workplace
A doctor may also use the comments box to give you more detailed advice about what your type work you can do. This advice will be about their general fitness for work, not just related to your current role. If there are certain parts of your role that may be affecting their health, these will be mentioned in the comments box.
In most cases, people do not need to be 100% fit to return to work. This may not mean doing their normal job. People with health conditions may have limits on what they can do at work, but these will not always mean they cannot do any work. Additionally, an ‘Amended fit note’ becomes a ‘fit note’ if the employer is unable accommodate/fulfil the conditions set out by the doctor.
Please refer to the following government link for more information and guidance. (https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/578032/fit-note-guidance-for-employers-and-line-managers.pdf)
Please note once a ‘fit note’ or ‘amended sick note’ expires, if the employer feels that the employee requires further assessment to consider them fit to go back to work, this is up to the employer to make the necessary assessments i.e. by instructing an occupational health assessment or human resources return to work interview.
Optional Occupational Sick Pay Schemes
A number of employers operate occupational sick pay schemes which, while offering employees more benefits than that prescribed under SSP (Statutory Sick Pay) legislation, require more in the way of certification in that they require a Doctor’s certificate for illnesses of less than 7 days’ duration. Since the advent of self-certification for statutory sick pay purposes in 1983, as has been mentioned GPs are not required to issue certificates for periods of sickness of less than 7 days duration. It is clearly not a GP’s role to supervise an employers’ enhanced occupational sick pay scheme. If employers require additional certification it is up to them to make their own arrangements, on a private basis, with a Doctor, be it the patient’s own GP or an occupational health Doctor to examine and verify the genuineness of the patient’s illness. For this reason when GPs are asked to carry out this work and provide a sickness certificate within the first 7 days of illness it is classed as un-commissioned private work and attracts a fee (charged in accordance with national BMA guidance).
Please note that our members of staff including reception and clinicians have a right to work in a safe environment, without fear of bullying, aggression, intimidation or harassment. The NHS Zero Tolerance Policy applies at all times as such any behaviour deemed in breach of this will not be tolerated. Please refer to Zero Tolerance page for further information.