Doctors should assess patients' ability to work generally when issuing fit note

Doctors should consider a patient's ability to work generally when issuing a fit note not just focus on their capacity to carry out a specific job, a government-commissioned review has recommended.

A review into long-term sickness absence found many employers are ‘frustrated’ with the fit note as they believe patients are often signed off as ‘unfit for work’ when they could be supported to remain in or return to work.

The review highlighted a recent Department for Work and Pensions survey which found only 10% to 15% of fit notes issued include the ‘may be fit’ assessment.

It suggested one reason why doctors issue relatively few ‘may be fit’ certificates is that they think about a patient’s specific job when they make a judgment on their ability to return to work.

It therefore recommends that doctors should consider a patient’s capacity to work generally, rather than carry out a specific job.  

It said: ‘We therefore recommend that the government revise fit note guidance to ensure that judgements about fitness to work move away from only job-specific assessments.

‘Such an approach would help employers to make sound judgements about whether an early return to work can be facilitated, but the certifying doctor would not be required to have extensive occupational heath knowledge about specific jobs.’

The review also recommended that GPs no longer take responsibility for signing-off patients on long-term sick.

It said the government should fund a new Independent Assessment Service (IAS) that GPs can refer long-term sickness absence cases to for advice. GPs would refer a patient to the IAS after they have been off work for around four weeks, the review said.

It said: ‘The IAS would provide an in-depth assessment of an individual’s physical and/or mental function. It would also provide advice about how an individual on sickness absence could be supported to return to work.

‘The assessment could be used by employers to help support a return to work, and by doctors to inform their advice to patients.’

Visit the GPonline.com Fit Note Resource Centre

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in


Just published

Clinical trials: Microscope in a lab

GPs could be incentivised to recruit patients onto commercial clinical trials

GPs could be offered incentives to recruit patients onto commercial clinical trials...

Talking General Practice logo

Podcast: How many GPs do we need for safe general practice, pay restoration, the state of premises

Talking General Practice looks at safe working limits and the number of GPs we need...

Stethoscope and a computer

EMIS to keep panic button after outcry from GPs

EMIS, one of the main GP IT system providers, has backtracked on plans to phase out...

Health minister Lord Markham

Health minister Lord Markham: How we will support GPs to offer patients greater choice

Health minister Lord Markham explains what the government's plans for using the NHS...

Patient receives the flu vaccine

Flu vaccination campaign to return to pre-pandemic cohorts this year

This year's flu vaccination campaign is set to be reduced after it was expanded during...

Plant-based diet

Vegan and vegetarian diets can play key role in reducing cardiovascular risk, study finds

Plant-based diets can play a significant role in lowering the risk of stroke and...