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Dr David Church describes several situations familiar to most GPs (Letters, August 20). Individual GPs can and should do something about this, especially the hospital requests for sicknotes. Hospitals can, and should, issue sicknotes.

This was part of a drive to reduce unnecessary paperwork in the NHS. However, some hospitals or doctors seem unaware of the guidance.

When one of my patients requests a sicknote that should have been issued by the hospital I will issue a note but I write a letter to the chief executive and the consultant in charge of their hospital care with copies to the LMC and the patient. This letter is dictated in front of the patient.

It reminds the hospital they should issue the sicknote and several reasons why, including the convenience of the patient. In some cases the hospital doctor is the only one who knows the correct reason for the sick leave as the discharge note is either absent or incomprehensible.

For GPs who prefer a standardised letter, this is available from our LMC which has been very active in discussions with local hospitals. These actions mean a hospital-generated request for a sicknote is very rare and one hospital increased the maximum sick leave duration from one to the six weeks that had become the local standard.

We get few requests from Jobcentres as, fortunately, we practise in an area of high employment. Where these have seemed inappropriate I also write to the manager and the employee making the request. I tend not to get a reply but I haven't had a request of this nature for more than a year.

We are all susceptible to behaviour training. If we continue to issue sicknotes and silently grumble, the requests will keep coming.

If we create a fuss the requests will stop and, more importantly, the patient will get the right service from the right person. That person is not the GP.

Dr Patrick Craig-McFeely

Salisbury, Wilts

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