In this episode of the SOM Podcast, host Steve Randall is joined by a panel of leading clinicians and occupational health experts to explore the realities of the UK Fit Note system.

The discussion covers how Fit Notes work in general practice, barriers to meaningful “maybe fit for work” recommendations, international comparisons from Guernsey’s healthcare system, and the growing call for stronger occupational health integration.

The panel reflects on GP workload pressures, patient expectations, policy reform, and the future of work-and-health collaboration.

Guests

• Dr Toni Hazel – GP in North London with a portfolio in education
• Prof Neil Greenberg – Consultant Psychiatrist, President of the Society of Occupational Medicine
• Dr Lara Shemtob – GP and Occupational Health Physician
• Dr Bob Gallagher – GP, Occupational Health Doctor & Medical Advisor for Social Security, Guernsey

Key Topics Discussed

• How Fit Notes currently work in NHS general practice
• The shift from “sick notes” to “fit notes” and the intention behind “maybe fit for work”
• Why over 90% of Fit Notes are still issued as “not fit for work”
• GP time pressures and lack of occupational health training
• The doctor–patient relationship and challenges of difficult Fit Note conversations
• Guernsey’s alternative model for sickness certification and GP training
• The role of occupational health professionals in complex or chronic cases
• Inequality in access to occupational health support
• Policy hopes from the Keep Britain Working review
• What an ideal Fit Note system could look like in the future

Key Takeaways

• Fit Notes are still largely being used like traditional sick notes
• GPs face time, training, and system constraints
• Occupational health expertise is essential for complex work-health decisions
• Better integration between healthcare, employers, and OH services is needed
• Good work is good for health — when supported properly

The SOM podcast is sponsored by Orchid Live - specialist occupational health software used by a number of SOM members to run every aspect of their occupational health operations. They hold healthcare records for over 1 million UK workers and work with both in-house OH teams and OH providers. You can find out more at OrchidLive.com.