Medical Certificates: General Practitioners
The question
To ask the Secretary of State for Health and Social Care, in the context of fit notes, what clinical evidence supports removing or reducing GP involvement in decisions that NICE states require long term clinical understanding.
Answered by Mrs Sharon Hodgson
In May 2026, the Government announced that it would test reform of the fit note, beginning with pilots across four integrated care boards in England.
The pilots will test a fundamentally different approach, exploring replacing the traditional general practice (GP) led fit note process with newly designed plans, and new work and health teams, that provide better support for people who fall ill at work.
Clear clinical oversight and escalation routes are built into the pilots, which have been designed through close engagement with GP leaders and the health system. GPs will retain a meaningful role in complex cases, including providing clinical evidence where appropriate.
The Government is taking a test and learn approach to design and delivery, and any future rollout or reform will be informed by learnings from the pilots. The current fit note system, where fit notes can be certified by healthcare professionals including GPs following clinical assessment, will continue in non-pilot areas during the pilot period.
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