GPs demand right to second opinion on sickness benefit claimants

GPs have called for the reinstatement of a system that allows them to refer patients claiming sickness benefit for a second opinion.

Dr Hampton: ‘The fit note has become more than it was ever meant to be. It can absolve the recipient of having to get involved in support services for months and GPs feel uncomfortable.’
Dr Hampton: ‘The fit note has become more than it was ever meant to be. It can absolve the recipient of having to get involved in support services for months and GPs feel uncomfortable.’

‘Fit notes’ were introduced in 2010 to replace the old Med 3 forms. At the same time, RM7 forms that allowed GPs to refer patients for a second opinion if they were uncomfortable signing them off sick were scrapped.

But GPs say the removal of this mechanism has made it harder to get people back to work and left them signing people off sick when they do not feel comfortable doing so.

An online poll by Leicestershire GP and occupational health expert Dr Rob Hampton found most GPs believe a mechanism similar to the RM7 should be reinstated.

A total of 50 GPs completed the poll. Of these, 39 had heard of the RM7 and all but one (97%) backed the return of ‘a mechanism that allows GPs to refer people claiming sickness benefits for a second opinion when they are uncomfortable signing repeat fit notes’.

A total of 82% said they had used the RM7 when it was available.

Dr Hampton said: ‘For every time you write a letter because you really feel the patient has a valid case to go onto long-term employment support allowance (ESA), there are probably two or three when you feel uncomfortable signing the fit note.’

He said the best option for people in these cases would be to get them into rehabilitation to get them back to work.

But he added: ‘The principle of the fit note works well when someone is in work – you can give advice to their employer about work they can do.

‘But the fit note has become more than it was ever meant to be. It can absolve the recipient of having to get involved in support services for months and GPs feel uncomfortable.’

While people are in the assessment or appeal phase for ESA, Dr Hampton explained, they do not have to be part of the work programme that aims to get people off benefits and back to work.

Because of this, ‘a vital opportunity to help people back to work is lost’, he said.

A total of 63% of respondents to the poll said that the number of people on benefits requesting fit notes was increasing.

Job centres are increasingly asking people claiming ESA to request a fit note from their GP, the poll found - a total of 81% of respondents said this was their experience.

However, 82% felt job centres did not welcome discussions with GPs signing fit notes for people on or appealing ESA.

A recent independent review of sickness absence made recommendations around the fit note, and the government is in the process of developing a response.

A DWP spokeswoman said:  ‘We recognise the importance of ensuring that the certification system of fitness for work and the benefits system work well together, and we are currently looking at how we can improve this taking into account feedback from GPs.’

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