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One in three fit notes issued by GPs are for mental health conditions

Mental health conditions account for close to a third of all fit notes issued, according to new data extracted by NHS Digital from GP practices.

In all, 31% of fit notes written in England between December 2014 and March 2017 gave mental health as a reason, making it the most common condition for issuing the notes where a reason was known. A fifth of those fit notes were issued for a period of absence of more than 12 weeks.

Stress and anxiety was one of the biggest causes of fit notes issued for mental health reasons. The number of fit notes known to have been written for anxiety and stress-related conditions from included practices increased by around 14% from 503,000 in 2015/16 to 573,000 in 2016/17.

Musculoskeletal conditions were the second most common reason given for issuing fit notes.

Women accounted for more than half of the total number of fit notes issued in the reporting period, from a low of 53.8% in August 2015 to a high of 57.8% in January 2017, according to the experimental report.

NHS Digital said that this was the first time that anonymised data covering GP practices has been collected for the first time.

These practices are responsible for around two-thirds of working age patients registered with a GP in England.

The fit note - or Medical Statement of Fitness to Work - was introduced in 2010 in response to the Black report on ill health among working age people, so GPs could give advice how a patient might return to work depending on workplace adjustments and support, rather than simply stating they were too sick to work.

Manufacturing bosses previously blamed GPs for the failure of fit notes to help people back into work earlier and called for them to have better training in the fit note process.

The Government said last year that it would look at plans to allow non-GPs to sign off fit notes, amid a wider review of the Fitness to Work scheme.

NHS Digital said other findings in the data included:

  • January 2017 saw the highest number of fit notes written from the included practices (556,000).
  • Of those CCGs where at least two GP practices returned information, NHS Knowsley CCG recorded the highest number of fit notes written per 100,000 working age registered patients in March 2017, with 4,123 fit notes issued per 100,000 people.
  • NHS Richmond CCG recorded the fewest number of fit notes written per 100,000 working age registered patients in March 2017, with 977 fit notes issued per 100,000 people.
  • At national level the number of fit notes written in March 2017 was 2,334 per 100,000 working age registered patients.
  • Women continually accounted for more than half of the total number of fit notes issued in the reporting period, from a low of 53.8% in August 2015 to a high of 57.8% in January 2017.

Readers' comments (4)

  • Public has learned to play the game. How can you prove that they are not stressed/ depressed/ anxious?

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  • Rogue1

    I suggest getting rid of fit/notes sick notes all together.
    What do we sign anyway? Pt has x/y/z, the patient can state that. And is off for how long, I have no way of knowing the recovery and patients are often much longer than the 'text book' surgery times?
    Having worked abroad, they don't have them. If a patient is off sick, that is simply an issue between the employee and employer. It is upto the patient to get better quicker to get back on full pay, puts the onus back on the patient. If the employer doesn't trust what the patient says, that's an issue for them and not drag us into the middle of it to 'certify' they are still sick!

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  • a good percentage of my musculoskeletal sicknotes are also more to do with the mental health or resilience of the patient to toxic workplace experiences than the severity of the musculoskeletal complaint...not that i have any simple solutions to suggest

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  • Cobblers

    So a deprived Liverpool area (Knowsley) has four times the sick note rate as a affluent farming area (Richmond) in North Yorks?

    Again Pope wearing a funnyhat and a constipated Bear spring to mind.

    The Mental Health bit is no surprise. I would have put it higher.

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