Viewpoint: Fit for Work scheme can ease pressure on GPs, says Dr Sundar Thava

By autumn 2015 GPs across England and Wales should be able to refer patients for advice from the Fit for Work service, which aims to support patients in work who are off sick or at risk of long-term sickness absence. Dr Sundar Thava explains how the scheme can ease pressure on GPs.

Dr Sundar Thava: Fit for Work programme can support GPs
Dr Sundar Thava: Fit for Work programme can support GPs

GPs are facing an unprecedented workload. More and more patients are presenting with long-term conditions, budgets are shrinking and demand for general practice is increasing four-fold, according to the RCGP. So how can we make sure we are doing all we can to provide a service that gives the best possible outcomes for our patients?

We need to think outside of the box. We need to come up with more creative, innovative ways to make sure our patients have access to the best treatments with the best possible outcomes.

Fit for Work is a free and voluntary occupational health assessment service for employed patients. In addition to helping achieve better outcomes for patients, it offers practices the prospect of saving time and precious resources that might otherwise be spent issuing fit notes.

10-minute GP consultation

As a GP, I know that I just don’t have the time to give to my patients who I’ve signed off work. I can only offer them seven to 10 minutes per consultation and that just isn’t enough time to delve into all the obstacles stopping them returning to work. That is where Fit for Work comes in.

Before a patient can be referred to the service they need to meet the eligibility criteria:

  • The patient must be in paid employment but not self-employed.

  • The patient must live in England or Wales. (In Scotland there is a different service)

  • The patient must have been, or be likely to be, off work for four weeks or more.

Once a patient meets the criteria and has given explicit and informed consent to be referred, they will be contacted by a health professional within two working days by phone. The health professional will then carry out a 45-minute biopsychosocial assessment and work with the patient to agree a 'return to work' plan that is centred on their needs.

GP workload

The return to work plan will help to signpost patients to services which empower them to overcome their obstacles. It will also provide recommendations to their employer on how they can help them return to work sooner; for example recommending a phased return to work or counselling. If the patient consents to their plan being shared, then the employer can accept it as sufficient medical information replacing the need for a fit note – meaning the patient doesn’t have to return to their GP, which in turn saves us time.

For the first time, Fit for Work potentially provides the whole working population with access to occupational health support, something currently available only to a minority; mainly those working in larger organisations. The service will be complimentary to the care we provide our patients and will work with in-house occupational health teams, if applicable, to make sure there is joined-up care for the patient.

I have already received lots of good feedback about the service from GPs across the country and it’s showing that the service really is making a difference to people’s lives. If you want to find out more about the service and further benefits that it can provide for you, your practice and your patients’ then visit

Dr Sundar Thava is GP engagement lead at Fit for Work and a London GP.

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