Medical Certificates: Reform
The question
To ask the Secretary of State for Work and Pensions, with reference to the Department for Work and Pensions’ press release entitled Broken fit note system to be overhauled, published on 20 May 2026, what assessment he has made of the implications of the reforms for small and medium-sized employers.
Answered by Dame Diana Johnson
As announced on 20 May 2026, the Government is testing reform of the fit note through pilots in four ICB areas in England.
The pilots will support more effective conversations on workplace adjustments by replacing the traditional fit note with a voluntary service in which Community Work and Health Teams will work with individuals to develop personalised workability plans. These plans will set out work capacity, recommended workplace adjustments and any additional support needed to help people remain in or return to work sustainably. Employers will be encouraged to engage in the process, including through direct dialogue with the individual and their case coordinator where appropriate, helping to ensure that any adjustments are reasonable, proportionate and practical. Employers will retain responsibility for all employment decisions, and the service will not replace existing occupational health provision or override workplace policies.
Officials are working with a wide range of employer groups, including representatives for small and medium-sized employers such as the Federation of Small Businesses to shape design and delivery of the pilots. Evidence gathered through the pilots, including qualitative research, will capture the experiences and views of a range of stakeholders, including small and medium‑sized employers, to assess the viability and deliverability of the models being tested.
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