Legislation to let nurses write fit notes could ease GP workload

Proposed legislation to allow a wider range of health professionals to sign fit notes could significantly reduce GP workload, an NHS official has said.

Professor Gina Radford deputy chief medical officer for England (Photo: Pete Hill)

Speaking at the RCGP annual conference 2018 on Thursday, deputy chief medical officer for England Professor Gina Radford said that following advice from GPs and other healthcare professionals who felt that fit notes ‘really needed to be reviewed’, NHS England is ‘taking forward work to legislate an extension of fit note certification to other healthcare professionals.’

GP practices issued around one fit note per 49 patients per month in the first quarter of 2017/18, figures from NHS Digital reveal.

The data suggest that practices across England may issue around 10m fit notes per year - contributing significantly to already soaring levels of primary care workload.

Fit notes

However, Professor Radford said this workload fell on GPs despite practices often not having the ‘tools or knowledge’ to deal with them effectively.

Although new legislation could take time to move through parliament, it could allow medical professionals such as nurses and occupational health therapists to sign fit notes as well as doctors.

She told the conference that NHS England had been working with Health Education England to develop e-learning tools to support GPs on the issue of work and health. These tools could be made public as soon as this autumn, she said.

The deputy CMO added that building work and health into medical education at both undergraduate and postgraduate level was vital - and that efforts were underway to develop materials for the undergraduate curriculum and 'build out from there'.

Professor Radford added: ‘If we haven’t got a system that is supporting you then quite honestly we’ve got a huge challenge… The system at the moment is far too binary - its far too black and white - and we need to change things at all levels.’

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