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GPs' use of sick notes under scrutiny

By Lilian Anekwe

GPs take widely varying approaches to sickness certification with few having received any formal training on how long people should be signed off work, a new study reveals.

A questionnaire survey of 113 GPs found only 36% were aware of Department of Work and Pensions' guidelines on sickness certification, and only 20% had ever used them.

Researchers asked questions on three case vignettes in the DWP's guidance: a 28-year-old computer technician who had undergone an uncomplicated laparoscopic hernia repair, a 42-year-old female who had undergone an uncomplicated hysterectomy and a 49-year-old man who had experienced a myocardial infarction.

Just 43% of GPs assigned the correct period of one or two weeks sick leave for hernia, 18% gave the recommended period of seven weeks absence following hysterectomy and 52% of GPs correctly recommended four to six weeks sick leave following an MI.

Only just over a third of GPs had ever received any formal training in sickness certification, and of those that had, the average length of training was a mere four hours and only six hours in occupational health medicine.

Dame Carol Black's review of sickness certification in November last year recommended GPs offer patients ‘fit notes', stating whether or not they are fit to work and which kinds of tasks they are able to perform.

But a Londonwide LMCs poll last week found few GPs had been offered training on how to award fit notes.

Dr Richard Roope, a GP in Fareham, Hampshire who led the new study, said closer monitoring of fit notes through GP computer systems could improve standards.

‘It would not be a huge burden to set a new QOF target to record the patient's occupation, which would have the advantage of encouraging GPs to start thinking about the interactions between work and health.'

The study is published online the journal Occupational Medicine.

The survey questions GPs' use of sick notes The survey questions GPs' use of sick notes

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