Doctor’s call for change to fit note regime

• play a key role in advising patients about (return to) work;
• agree that (return to) work is an important health outcome for clinical management;
• help patients develop a return-to-work plan;
• facilitate return to work through shared decision making
• enable patients to effectively communicate with their employers.

Bogged down with demand and reduced resources, GP’s have last week asked that their role in signing fit notes be changed so that they will not have to sign this paperwork before 4 weeks. At this stage this is just a demand from the British Medical Association and there has, as yet, been no Government response to this proposal.

If the change were implemented what would the implications be? Employers would potentially be in a situation where employees were self-certifying for a 4 week period. They would have potentially less information about the health position of an employee, reliant purely on what the employee did or didn’t chose to tell them.

Given that GPs aren’t encouraged to refer anyone to the Fit for Work Service until the 4 week point has passed, employers would be left either making an early referral themselves (employers can request the use of the service) or referring to their own occupational health service with the associated costs of doing so.

Perhaps if the government agreed to a change, they would shift responsibility away from GPs to the Fit for Work Service instead? Could that service automatically kick in after 7 days? It might have to change fundamentally away from e.g. a telephone service staffed by Occupational Health nurses to one with the option for face to face assessments and Occupational Health doctors input. Presumably that service would need information from GP’s surgeries about someone’s medical history so it would only work with significant investment. For that reason I can’t see it happening.

I’m a glass half-full type of girl so I can also see that there might be benefits of these proposed changes: employees wouldn’t be able to get signed off work for ‘stress’ at the drop of a hat or obtain a GP note to e.g.:- avoid a disciplinary hearing so easily. If occupational health is engaged earlier or the Fit for Work service which is tasked with getting people back to work quickly is engaged sooner, I’d hope this might rebalance the feeling we all get the GP’s had out sick notes willy nilly, mindful of their role in society not really being to get engaged between an employer and employee.

Let’s watch this space…….