A&E sick notes could save 42,000 GP hours

GPs are issuing hundreds of thousands of sick notes a year that should have been given by emergency departments, according to research in Emergency Medicine.

Emergency departments are not following government guidelines asking them to write sick notes, particularly for fracture patients and it has resulted in increasing waiting lists and wasted hours.

The research follows up a 2001 DoH report, ‘Making a difference: reducing general practitioner paperwork’, that found that many patients discharged from hospitals and outpatient clinics visited their GP for the sole purpose of obtaining a sick note.

The report estimated that 518,000 appointments, or 42,000 GP hours a year, could be saved by ensuring that these patients were issued with a sick note by the hospital rather than being referred to their GP. This practice was supposed to be adopted from July 2001.

But the research found that, of the 25 Scottish emergency hospitals contacted, just 16 per cent of A&E departments and 32 per cent of fracture clinics issued sick notes at all. This was compared with 20 per cent of the A&E departments and 48 per cent of the fracture clinics in England.

Dr Craig Walker, orthopaedics and trauma specialist from Hairmyres Hospital in Glasgow and lead author of the study, concludes: ‘The 2001 guidance from the joint Cabinet Office and the DoH has not been fully incorporated into standard practice in Scotland and England. If all emergency departments and fracture clinics were to issue sick notes to patients requiring more than seven days’ absence from work, this could reduce GP consultations and improve waiting times.’

Meanwhile, national newspapers quoted a ‘source close to John Hutton’, the work and pensions secretary and former health minister, as saying that the Department of Work and Pensions (DWP) was considering a crack down on GPs signing too many people off work.

The DWP denied that ‘naming and shaming’ was policy but a spokeswoman confirmed that it ‘was looking more at working with GPs on this and they are being consulted’.

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