GP research into effects of fit note

On 6 April 2010, the Government implemented a new Statement of Fitness for Work (‘fit note’) across England, Wales and Scotland to replace the ‘sick note’. The new medical statement aims to:

  • improve back-to-work advice for individuals on a period of sickness absence;
  • improve communication between individuals, GPs, and employers on what a patient can do and how a patient’s condition could be facilitated in work;
  • reduce sickness absence;
  • support people with health conditions to stay in work or return to work more quickly;
  • contribute to creating new perspectives on the link between work and health, and improve awareness and understanding of the importance of work for good health.

Between February and May 2011, 45 in-depth, semi-structured interviews were carried out with a non-random, selected sample of GPs in England, Scotland and Wales in order to find out about:

  • GPs’ experiences of using the fit note;
  • what role GPs feel they play in giving return-to-work advice;
  • how the fit note has influenced their role perceptions.

The findings of the report (‘An evaluation of the Statement of Fitness for Work: qualitative research with General Practitioners’) show that:

  • the fit note has become a consultation tool that GPs use to initiate and guide negotiations with patients about returning to, or starting, work;
  • many GPs believe their patients return to work earlier than previously because work has become more of a focus in their consultations;
  • barriers to the successful use of the fit note include GPs’ confidence in dealing with conflict, and unwillingness to damage relationships with patients.

The Black/Frost independent review of sickness absence, which was published on 21 November 2011, acknowledges the difficulties some GPs face when making decisions about signing people off on long-term sickness absence, and has recommended the use of an independent assessment service to make this decision, in place of GPs.

One of the recommendations of the research was for the creation of a simple guide to the benefit system for GPs. Based on requests from GPs, the Department for Work and Pensions (DWP) had already begun work on such a guide before the report’s findings became available and it is available on the DWP website.

The Health for Work Adviceline is not only available to help employers deal with employee health issues, but can also offer guidance to GPs who are unsure about how a person’s health problems may affect their ability to work. Call 0800 0 77 88 44 for free, professional advice.

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