The government's department for work and pensions (DWP) is sending doctors premature and misleading letters suggesting ill patients no longer need a “fit note” (medical note) after being found fit for work, an influential charity claimed today. 

The letter leaves claimants including those with mental illnesses unable to obtain Employment and Support Allowance (ESA) to which they are entitled, pending appeal.

Anti-poverty charity Zacchaeus 2000 Trust say this threatens doctor – patient relationship, puts patients at risk of damaging their health further, and leaves them in serious financial difficulties.


Like thousands of others, Louis* was too ill to work and needed the vital income ESA provides – but his claim was refused. Louis was blocked from claiming ESA as he awaited his hearing, due to a misleading letter sent from the DWP to his doctor without Louis’ knowledge. Louis had to rely on food-bank vouchers, went into debt, accrued rent arrears and faced an increased risk of eviction.

Louis is not alone. The Zacchaeus 2000 Trust say such letters are sent to the GP of every claimant after they have been refused ESA - before they've finished the appeal process. 88 percent of the charity's clients win their appeal and are declared entitled to ESA again.

“It is not for the DWP to interfere with the GP and their patient," said Raji Hunjan, Zacchaeus 2000 Trust Chief Executive. "Sending these letters directly to the GP, without even informing the patient, is putting doctors in a position which both undermines their role and puts their patients at risk."

"The impact of these letters can be devastating. We have seen how they lead to our clients who are seriously ill, suddenly have zero income, other benefits are comprised, become reliant on foodbank vouchers and loans, and face a very real threat of homelessness."

Ella Abraham, Policy and Campaigns Officer at Trust added: “We have launched a petition to ensure that these backdoor policies are brought to light. Different government departments attempt time and again to force doctors into positions where they must act as benefits assessors or border guards. The DWP must withdraw the letters."

A DWP spokesperson told Mental Health Today: "These letters simply inform GPs when a claimant has been found fit for work and are not intended to dissuade them from issuing fit notes for ESA appeal purposes, to claim otherwise is inaccurate."

"We are committed to ensuring our communication is clear, which is why the wording of this letter was cleared by both the British Medical Association and the Royal College of General Practitioners. However, we will of course consider feedback when revising the letter."

* Name changed to protect identity.