Hundreds of family doctors told the BBC they have never refused a mental‑health fit note. Of 752 GPs who replied to its questionnaire, 540 said they had never declined a request, 162 had refused at least one, and 50 preferred not to say. The BBC also notes the sample may not be representative of all GPs. The immediate takeaway for employers is simple: more staff are being signed off for mental‑health reasons, and that carries real‑world cost, culture and productivity consequences for businesses of every size.

Scale matters here. NHS England data point to roughly 11 million fit notes issued in England last year, with 93% marked “not fit for work” – a signal that work is still being treated as binary rather than adaptable. Separate analysis suggests around seven in ten fit notes contain no diagnosis, making it harder for line managers to plan reasonable adjustments. And mental and behavioural disorders remain the leading known reason for certification, with analysis indicating around one million notes a year tied to mental ill‑health. (gov.uk)

The certification rules have widened since 2022 – nurses, pharmacists, physiotherapists and occupational therapists can now issue fit notes alongside doctors – but GPs still sign the vast majority. For employers, that means the clinical gateway into absence often sits outside the workplace context in which support or adjustments must actually be delivered. (gov.uk)

A government‑commissioned Keep Britain Working review describes the fit note as “often problematic” and backs ‘stay‑in‑work’ and ‘return‑to‑work’ plans co‑designed with employers and occupational health. The evidence case is stark: the chance of returning to work is about 96% after a 4–6 week absence, but falls below 50% once someone has been off for a year. Early, structured engagement clearly matters for outcomes – and for payroll. (gov.uk)

Policy is already edging this way. Ministers are scaling up the WorkWell model, which brings health, adjustments and job support together and is expected to help up to 56,000 people by spring 2026. In parallel, government has convened more than 60 large employers and providers as early adopters of the review’s ‘Healthy Working Lifecycle’ standard – Jaguar Land Rover among them. (gov.uk)

For a sense of what employer‑led support can look like, JLR has established six on‑site Centres for Wellbeing in the UK, blending prevention with access to physiotherapy, counselling and occupational health. Independent recognition has highlighted strong return‑to‑work outcomes from its rehabilitation programmes, pointing to the commercial logic of investing in workforce health. (wellbeing.jlr.com)

Costs will also shift in law. From 6 April 2026, Statutory Sick Pay becomes payable from the first full day of absence and the lower earnings limit is removed. SSP will be paid at 80% of normal weekly earnings (capped at the statutory flat rate, uprated to £123.25 a week). Finance directors should expect more short‑duration SSP liabilities to hit cash flow and update payroll systems ahead of April. (gov.uk)

Small firms are worried. The Federation of Small Businesses has warned that higher SSP costs are arriving without matching support, and told MPs that many SMEs lack in‑house HR or occupational health to manage complex absences. Any future move to shift more certification or OH costs onto employers will need to reflect that capacity gap. (yourharlow.com)

What can employers do now? First, make “maybe fit” a default conversation, not an afterthought. Line‑manager scripts, early adjustments and phased returns reduce the odds of a long absence that becomes permanent. Second, buy or pool access to occupational health; the Keep Britain Working review cites robust returns on investment – from about £4.70 back for every £1 spent on mental‑health initiatives to around £8 for Employee Assistance Programmes. (gov.uk)

Third, align HR, finance and clinical input. Use week‑two check‑ins to co‑create a simple return‑to‑work plan; record adjustments; and integrate EAPs with primary care where possible. Where the diagnosis is unclear on the fit note, focus on function: what tasks can be done safely now and what changes help? NICE and academic commentary both underline that better use of “may be fit” can improve outcomes. (academic.oup.com)

Caution still matters. Charities have warned that reforms must not push people to work when they are too unwell, and have highlighted how low sick pay can undermine recovery. Building trust and pacing returns appropriately is as important as reducing absence days on a spreadsheet. (hansard.parliament.uk)

The direction of travel is clear: more early intervention, clearer roles for employers, and a legal shift that makes SSP a day‑one right from 6 April 2026. For SMEs in particular, the planning window is now. Update sickness policies, budget for day‑one SSP, train line managers on “maybe fit”, and – if in doubt – borrow from those who have already built the playbook. JLR’s example shows this is possible at scale. (gov.uk)