What the Fit Note Overhaul Means for Employers and Payroll

The UK Government’s pilots to replace the traditional “tick-box” fit note with personalised stay-in-work and return-to-work plans (launched in May 2026) are designed to get employers involved much earlier in an employee’s sickness absence. This is part of the same broader package that already introduced Statutory Sick Pay (SSP) from day one on 6 April 2026.

Here’s what it means in practice for employers and payroll teams:

For Employers (HR, Line Managers & Absence Management)

• Early three-way conversations become the norm From the first day of absence, employers are expected to take part in discussions with the employee and a trained professional (e.g. work & health coach or social prescriber) from the new support services. These conversations focus on:
  • What the employee can still do
  • Reasonable adjustments or phased returns
  • Maintaining workplace connections
• Shift from “off sick” to “how can we support you back?” The old binary “not fit for work” note is being replaced by more nuanced plans. Employers will be asked to engage constructively on adjustments rather than simply accepting a note and waiting for the employee to return.
• Regional pilots first (not nationwide yet) The new approach is currently being tested in four areas only:
  • Birmingham & Solihull
  • Coventry & Warwickshire
  • Cornwall & Isles of Scilly
  • Lancashire & South Cumbria

If your organisation operates in these areas (especially if you’re linked to WorkWell sites), you may start seeing referrals or invitations to three-way conversations soon.

• Longer-term benefits The goal is to reduce long-term sickness absence by intervening earlier. This should ultimately lower absence costs and improve retention, but it requires managers to be more proactive.

For Payroll Teams

• SSP from day one is already live (since 6 April 2026) You should already be paying SSP from the first qualifying day of sickness (no more 3 waiting days). The lower earnings limit has also been removed, so more employees now qualify.
• New documentation for SSP claims The personalised stay/return-to-work plans being tested in the pilots can be used as evidence for SSP. Payroll may start receiving these plans instead of (or alongside) traditional fit notes. Self-certification still covers the first 7 days; from day 8 onwards, some form of medical evidence or plan will normally be required.
• Increased record-keeping You will likely need to keep more detailed records of:
  • Three-way conversation outcomes
  • Adjustments offered or agreed
  • Return-to-work plans

These records could become important for SSP disputes, audits, or Employment Tribunal cases.

• System and process updates
  • Ensure your payroll/HR software can handle new plan formats when they become standard.
  • Update absence management procedures and manager guidance.
  • Train payroll staff on the new evidence requirements