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GPs concerned at plan to replace sick notes with 'fit notes'

By Emma Wilkinson

GPs have raised "grave concerns" over government plans to replace sick notes with "fit notes".

The new forms will be introduced as soon as next year as part of an overhaul of medical certification, the Government has confirmed.

Under proposals announced by Work and Pensions Secretary James Purnell, GPs will be provided with "user-friendly" electronic forms which will inform employers what patients are fit to do at work.

A spokesperson for the Department of Work and Pensions said the revised fit note would enable GPs to indicate what work an individual may be able to do rather than simply stating whether they should work or not.

Giving the example of back pain, she said a GP could indicate that what level of activity would be appropriate, for example suggesting their patient should not bend or lift while they recover.

A draft version of the fit note is being tested by 500 GPs and the revised certificate, which will be in electronic rather than paper form, is due to be introduced in late 2009.

The overhaul of medical certification was announced alongside a range of proposals for getting people back to work including pilots for ‘Fit for Work' services to support people to return to work after ill health and better training for GPs. The proposals come in response to Dame Carol Blacks report on the health of working age Britain.

GPC chair Dr Laurence Buckman said GPs had been calling for a review of the sick note system for over a decade. But he raised concerns about aspects of the plans.

'The new ‘fit note' has potential, but we would like to see the findings of this evaluation because it's crucial GPs can continue to act as the patient's advocate and don't end up policing the system for the Department for Work and Pensions,' he said.

Dr John Canning, a GP in Middlesbrough also agreed reform was needed but it was vital that GPs were not given a "policing role" and that occupational health departments should assess what work people could do.

"I practise in North East England in an area with high levels of unemployment and really we need commitment from employers to see things change.'

Dr George Moncrieff, a GP in Bicester, Oxfordshire, took part in the consultation process carried out by Dame Carol Black but said his views were not listened to.

He said: 'I 100% agree that the system needs to be overhauled as it is a disaster currently – it's a system which encourages people to be off work. But I feel desperately saddened that this is a missed opportunity.'

Asking GPs to fill out "fit notes" was incompatible with their role as doctors, Dr Moncrieff added.

'We should have occupational health nurses in the community who are not the patient's health advisor and not employed by the employer who can act as an interface and help decide what work the patient can do.'

GPs are concerned over plans to replace sick notes with 'fit notes'

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