Guidance for employers

  1. How will an assessment help?
  2. Eligibility
  3. When to make a referral?
  4. Completing a referral
  1. After referring an employee
  2. Return to work plan
  3. Tax exemption and sick pay
  4. Feedback

1. How will an assessment help?

As an employer, you're instrumental in forming conversations and assisting in providing support and reasonable adjustments to help an employee return to work as quickly as possible.

We provide employers with a referral route to access a supportive work-focussed assessment for employees who are absent from work for four weeks or more. 

Our assessments are:

  • Free — assessments are free for you and your employees. You can also claim a tax exemption of up to £500 per employee to pay for medical treatments recommended by Fit for Work Scotland.
  • Quick — a telephone assessment will be conducted within two working days, a face to face assessment will be conducted within five working days.
  • Supportive — we complement any existing occupational health assistance you may already have in place.

If you refer an employee, a case manager will contact them within two working days of a referral and they will receive:

  • an assessment by a qualified health professional.
  • a tailored return to work plan that's specific to their needs.

If your employee has requested a face-to-face assessment, this will happen after five working days of the initial referral.

This return to work plan will reflect the assessment, advice and recommendations that your employee has agreed with their case manager. This can be sent to you or your employee's GP, but only if they give consent.

2. Eligibility

To be eligible for an assessment, your employee should:

  • be in paid employment
  • have been absent from work for four weeks or more
  • agree to being referred for an assessment.

An employee will not be eligible for referral to Fit for Work Scotland if they:

  • don't live in Scotland — employees that live and work in England or Wales should be referred to the English and Welsh Fit for Work service
  • have been absent from work for less than four weeks
  • are either self-employed or unemployed
  • have received an assessment and return to work plan from Fit for Work within the last 12 months.

3. When to make a referral?

Employers can refer their employee subject to them providing consent. However, if the GP has not done so, employers can refer their employee for an assessment providing the employee consents.

You can refer an employee for an assessment if:

  • their GP has not already done so after four weeks sickness absence
  • an employee has reached four weeks absence and they are likely to be able to return to work within a 12 week period.

Can I refer someone earlier or later than four weeks?

Employers can't refer an employee earlier than four weeks.

However, a referral can be made after four weeks if it's not appropriate at four weeks, but could be suitable at six weeks — for example, if they're recovering from hip replacement surgery.

When is a referral unnecessary?

You shouldn't refer an individual for an assessment if:

  • they're self-employed or unemployed
  • in the GP's clinical judgement, they don't have a realistic prospect of returning to work
  • they're a hospital inpatient
  • they're at an acute phase of a medical condition
  • they have received an assessment and return to work plan from Fit for Work in the last 12 months
  • they've been absent prior to the launch of Fit for Work Scotland.

4. Completing a referral

If your employee is eligible for the service, you can refer them using our online referral form

Please make sure you have your employee's consent, and have the following information:

Employer details

  • Company name
  • Your name
  • Your email
  • Details of occupational health already provided

Employee details

  • Name
  • Address
  • Date of birth
  • Contact telephone number
  • Email

Conditions and requirements

  • Their reason for being off work as noted on their fit note
  • When did their absence start?
  • When does your employee’s current fit note end?
  • Does your employee have any additional support requirements?
  • What are your employee’s top five daily activities?
  • What are your employee’s normal working hours?
  • Do you have any specific occupational health questions relating to the employee?

Should I contact my employee’s GP when making a referral?

No, you aren't required to contact your employee’s GP when making a referral, unless the employee has given their explicit consent.

5. Consent

Your employee must give consent to be referred. If consent isn't given, you shouldn't refer them for an assessment.

Consent must be explicit, informed and freely given:

  • before they're referred for an assessment
  • when they're enrolled in the service
  • before and during the assessment.

Your employee can withdraw consent at any point during the process.

6. After referring an employee

After making a referral, a case manager will contact your employee to conduct a telephone assessment at a convenient time for them — usually within two working days of receipt of referral or five working days for face-to-face, if this has been requested.

During the assessment

The assessment is carried out by health professionals who act as case managers through to the end of the process. They will be the single point of contact for you (if you have made the referral) and your employee.

It might be necessary to contact you if your employee has been referred by their GP. Your employee must give their consent for you to be contacted if this is the case.

During the assessment, the case manager will:

  • try to identify the obstacles preventing the employee from returning to work
  • agree a plan designed to address each obstacle to enable a safe and sustained return to work.

We have access to specialist musculoskeletal and mental health advice and, where necessary, we will engage with these services before developing your employee's return to work plan.

If your employee's case is complex, we may need to complete further assessments before a plan can be developed.

After the assessment

After the assessment, the health professional will share the return to work plan with you, your employee and their GP subject to your employee’s consent.

This plan will detail steps appropriate for your employee in order to support them back to work. These are recommendations and don't change their GP's clinical judgement. It's up to you to make reasonable adjustments for your employee.


Employees will automatically complete using our service once they have:

  • returned to work
  • started a phased return to work
  • Fit for Work Scotland is no longer appropriate
  • reached 12 weeks of engagement.

Change to circumstances

If there's a change to your employee’s health condition, their GP should address this based on their clinical judgement.

If there's a change in relation to any other factor, their case manager will help to address this.

In these situations, the GP or case manager will decide whether they can continue with, or be withdrawn from, the service.

Is it mandatory for employees to engage with Fit for Work?

Fit for Work Scotland is not a mandatory service. We would however recommend that you consider referring all employees who meet the eligibility criteria.

7. Return to work plan

Following an assessment, responsibility for applying recommendations lies with you, your employee and their GP. It is not mandatory to make the changes we recommend in your employees return to work plan.

Fit note

When making a referral, your employee, and their GP, should ensure there is a valid fit note to cover the referral and initial assessment timeA two week period is usually sufficient.

In the absence of a fit note, you can accept any other form of evidence as you see fit to cover a sickness absence in line with your sickness policy (attendance management policy).

The return to work plan that we develop with your employee can be used in place of a fit note.

More about the fit note

Evidence of sickness absence

You can accept the return to work plan as evidence of sickness absence in exactly the same way as a fit note, so your employee's GP won't need to issue repeat fit notes during the time they're engaged with us (up to 12 weeks).

If an employee is still engaged with us after two weeks, they can use their return to work plan as evidence of sickness absence instead of a fit note.

8. Tax exemption and sick pay

If your employee requires medical treatment as part of their return to work plan, you may be entitled to a tax exemption of up to £500 per year.

This sum can help fund treatments recommended by the Fit for Work Scotland case manager or employer-arranged occupational health service.

Sick pay

Your employee's choice to use, or not use, our service doesn't affect their Statutory Sick Pay entitlement.

Find out what sick pay your employee might be entitled to 

Access to Work

If your employee meets the criteria for Access to Work, they can apply for financial support to help pay for items, such as:

  • adaptations to equipment, or specialist equipment to help them do their work
  • expenses for appropriate transportation
  • a support worker or job coach to help in the workplace.

There is no set amount for an Access to Work grant. How much your employee will get depends on their circumstances.

Find out more about Access to Work through GOV.UK. 

9. Feedback

Fit for Work is audited by independent, authorised auditors, who will review a proportion of the case records, so that they can monitor the service. They may also contact you as part of the customer satisfaction audit.

The service is being independently evaluated for quality and efficiency. You may be contacted in the future by a third party who is working on the Fit for Work evaluation.

Fit for Work Guidance

To support Fit for Work, the Department of Work and Pensions has produced guidance to help employees, employers and GPs to make the best use of the service.

Read the guidance on GOV.UK