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GPs expected to send thousands back to work under fit notes

By Nigel Praities

GPs will be expected to turn down far more requests for patients to be signed off from work through illness from next year under sweeping Government reforms that will consign the sick note to history.

As many as three times as many patients with conditions such as back pain are set to be assessed as fit for at least some work under the new ‘fit notes' system, results of a Government pilot reveal.

A consultation document on the plans shows for the first time the dramatic impact of the new system, which is set to hand GPs a say not only over whether patients are fit for work, but also over what kind of work they might be able to do.

The Med 3 statement will become entirely computerised and GPs will have to indicate if patients are fit to work, unfit to work or able to go back to work under certain conditions, such as with reduced hours or with a modified working environment.

The Med 4 and Med 5 statements will not be used and the Government is looking at removing the requirement for GPs to issue a medical statement once a patient is fit to work.

A pilot of the ‘fit note' scheme involving 583 GPs showed the proportion of patients with back pain or depression receiving a ‘not fit for work' assessment fell from 88% to 58%.

Under the new system, 38% of patients were assessed as fit for some work and a further 4% as fully fit for work – compared with 12% of patients assessed as fit for work under the current system.

The Department of Work and Pensions estimated there would be huge administrative

savings for GPs under the new scheme, of as much as £110m over 10 years, through the scrapping of the paper sick-note

system. ‘It is believed the computerised aspect of the Form Med 3 statement could be quicker for GPs to complete, especially as they become familiar with the system,' the document reads.

But the DWP admitted GPs in the pilot study had to provide ‘a longer discussion with patients considered fit for some work'. GPs were required to identify patients who could return to work and initiate discussion ‘on what adjustments could facilitate an early and continuous period of return to work'.

An impact assessment estimated a net saving to the economy of £1.2bn over 10 years, if 10% of people signed off sick returned to work a week earlier, although it insisted the benefits ‘are likely to be substantially greater'.

But GPC negotiator Dr Chaand Nagpaul criticised the figures as ‘crude statistics', saying the real issue was not time, but protecting the independent position of GPs.

‘This is a point of principle. We need to ensure the role of the GP and the trust patients have in their GP is not in any way compromised.

GPs should not be faced with being occupational health advisers. That is not their role – that is for their patient and employer.'

Dr Nagpaul said the GPC was looking at the proposed changes and would issue a formal response to the consultation.

The DWP said: ‘The new medical statement is a means to support GPs to give the best possible advice about when it is appropriate to return to work and the adjustments that they might need to make to help facilitate a return.'

It said 350,000 people missed work on sick benefit each year.

GPs will be expected to assess what kind of work patients could do GPs will be expected to assess what kind of work patients could do

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