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Self-certification and SSP and OSP payments

 i) How long will people with swine flu be ill and off work for?

Current UK data shows that while swine flu can be a serious illness, the majority of people experience mild symptoms. The best current estimate of the length of illness is that around half of people who become ill recover within about 7 calendar days without needing to see a doctor. Approximately another 25% may need up to 10 calendar days to recover, but should not need to see a doctor. The remaining 25% could have symptoms for more than 10 calendar days. Anyone whose health is not improving by day 7 is strongly advised to seek further medical advice. More information on swine flu-specific Planning Assumptions can be found at the Cabinet office website

ii) How does swine flu affect Statutory Sick Pay (SSP) payments?

No changes have been made to the rules for payment of SSP during the outbreak of swine flu. The normal rules continue to apply.

iii) How does swine flu affect payments of SSP to agency or temporary workers?

Again, there are no changes. Agency workers or temporary workers like other employees are entitled to SSP from the first day of their contract provided they satisfy all the other conditions for entitlement. However, they must have undertaken some work under that contract to become entitled. More information about the qualifying conditions and the payment of SSP are available from the businesslink website or from the E14 Helpbook  provided annually by HMRC.

iv) Have changes been made to the arrangements for self certification and/or medical certificates?

No changes have been made to existing arrangements for medical certificates and self-certification.

v) What evidence of illness can an employer ask for from their employee?

Employers are entitled to ask for reasonable evidence of their employee’s incapacity to work in order to decide whether to pay SSP. The employer is free to decide what evidence is acceptable. However, a doctor will not normally issue a medical certificate for the first 7 calendar days. During this period the normal practice is that employees self-certify (although there may be some legitimate exceptions where there are already established attendance issues and the employer has stipulated that medical certificates will be required for all absences).

We recognise that it is normal practice for employers to ask for a doctor's certificate after the self-certification period. However, other forms of medical evidence are equally acceptable. The decision on whether evidence is required and, if so, what evidence is acceptable, ultimately rests with the employer.

vi) What flexibilities are open to employers around self-certification and medical evidence?

To reduce the burden on GPs the government suggests (and LGE encourages) employers to consider using other arrangements (instead of a doctor’s certificate) for gathering evidence of employee illness during the current swine flu pandemic.

Some suggested flexibilities employers might want to consider are:

• Decide whether to extend the self-certification period for your employees if you feel this is appropriate. This could, for example, be an extension to 10 calendar days of self-certification for those with flu-like symptoms.

• Authorities with access to qualified medical staff via an occupational health scheme could use these staff to contact those off sick with flu-like symptoms to satisfy themselves that the employee is ill and unable to work.

Although the government’s suggestion applies primarily to SSP, authorities are encouraged to operate similar measures for Occupational Sick Pay (OSP) (see (viii) below).

vii) Do employers have to ask for a medical certificate when paying SSP for illnesses lasting more then 7 days?

No. There is no requirement for a payment of SSP to be supported by a medical certificate. HMRC do not require medical statements to support claims for the Percentage Threshold Scheme (PTS – see below (xi)) or for compliance checks.

viii) How does this advice work with the advice in the national conditions of service about Occupational Sick Pay?

Most authorities require that employees provide certificates for periods of sickness absence. As a matter of good practice, LGE’s advice to authorities is that they should request certification for any period of absence (whether self-certification or certification by a GP) as proof of the employee’s illness for sick pay purposes and to ensure an accurate sickness absence record.

To qualify for Occupational Sick Pay (OSP) under the national conditions of service, e.g. the Green Book, an employee must submit a doctor’s statement from the eighth day of absence, in order to be eligible for contractual OSP. LGE has no plans to amend that advice in the national conditions of service; however, for those off sick with swine flu-like symptoms we recommend that authorities temporarily amend the requirement for a doctor’s statement from the eighth day to the eleventh day of absence. This is in line with the suggested regime for SSP (see vi).

ix) Do employers have to ask for a medical certificate to show that an employee is fit to return to work?

No. It is not generally necessary for an employee to have a medical certificate to show they are fit to work after any period of illness. However, some national conditions of service, e.g. Green Book do require medical evidence of fitness to return after long absences. This is also an area in which authorities should consider their current practice and may waive the need to provide a medical certificate in such circumstances. However, they should also take into account any necessary evidence of standards of fitness required in safety critical areas.

x) Can doctors refuse to give certificates?

Doctors have a duty to provide a medical certificate for SSP or benefit purposes, to a patient to whom they have clinical responsibility for at that time. A doctor cannot issue a medical certificate unless they have examined a patient on that day or the previous day and are able to make an adequate assessment of the patient’s fitness or non-fitness for work. Where a patient has previously been assessed as having swine flu, either by the National Pandemic Flu Service or their GP and has been advised to stay at home whilst ill, a GP may, at their discretion, issue a medical statement after a telephone consultation. This is for the doctor to decide and depends on their clinical care of the patient.

xi) Is there any government help with the costs of SSP?

Employers may be entitled to some help with the cost of SSP through a government rebate known as the Percentage Threshold Scheme (PTS). This scheme helps employers get back some of the SSP they pay out if they experience high levels of sickness absence in any given month. Swine flu absence is the type of situation that PTS was designed to help with.

If you have a number of staff off sick, you may be entitled to recover some of the SSP you pay out under the Percentage Threshold Scheme. Find out more here 

xii) Possible legislative changes to the period of self-certification

If there is a further widespread wave in this swine flu pandemic (see the Planning Assumptions highlighted at (i) above for more information) the government is considering possible measures to reduce pressures on GPs, protect public health, and minimise the risk of further spread of swine flu. One option being considered is to make a legal change (rather than just a recommendation to employers) to lengthen the period of self-certification beyond the current 7-day period. If this is adopted it would extend the period during which an employer would be prevented from requiring an employee to provide a medical certificate.

Such a measure would only be implemented for a limited time, if absolutely necessary, and the decision would be taken by the government’s Civil Contingencies Committee, based on scientific advice and surveillance data. LGE will continue to monitor the situation and provide early indications if this decision might be made.

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