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A faulty production line

Employers blame GPs for failures in 'fit note' policy

British employers have claimed that the failure of the ‘fit note’ system, designed to get people back to work, is the fault of GPs.

A survey by EEF, the organisation for UK manufacturing companies, found that its members deemed the Government’s flagship ‘fit note’ policy - in which GPs provided advice on whether a patient is suitable for any type of work - to have failed.

But LMC leaders said employers were misguided in their criticisms and it was not the job of GPs to decide what goes on in a workplace.

The survey of 353 companies found that only 26% of employers believe that the fit note has resulted in employees returning to work earlier, compared to 40% who said that they have not. According to the survey, attempts at reducing sickness absence rates have stalled, plateauing at 2.2% and 2.3% for 2011 and 2012 respectively, having previously fallen from 3% in 2007.

Companies reported that the failure of the fit note system was partly down to failures by GPs. They voted GPs and NHS capacity as the joint second greatest barrier in achieving successful rehabilitation of long-term sick employees, behind the employees’ health condition.

They also blamed GPs’ failure to provide useful advice. Almost half of companies (49%) disagree the advice given by GPs about employees’ fitness for work has improved, while only a fifth (20%) agree the advice has improved.

EFF therefore called on increased training for GPs to use the fit note, and for a summit between the Government, employer organisations and doctors’ groups to discuss the problems and come up with solutions.

The report on the survey said: ‘Our survey suggests that medical professionals are still disengaged from the fit note process and need to be better engaged through effective training. ‘

It added: ‘It is essential that government, the RCGP, the BMA and employer organisations meet to identify, clarify and resolve the obstacles that appear to be preventing the fit note certification system from working effectively.’

Dr John Hughes, medical secretary of Manchester LMC, said employers were misguided in their criticism.

He said: ‘There’s a simple solution. Occupational health services. It’s not part of our job to know what goes in the workplace. It’s not part of our training or our contract.’

‘Companies have been trying to save money and cut occupational health services in the last few years and they’re trying to dump this work on GPs. Were certainly not going to take it on because GPs are already working at capacity.’


Readers' comments (13)

  • The majority of gps are not occupational health trained.We are our patients advocates no their employers.The fit note was another ill thought out change where no change was needed.

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  • To be honest the 'fit note' looks much the same as the old sick note, it was hardly a major redesign. What did they expect - the patients to suddenly miraculously get better by redesigning a form?

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  • If you don't do what the patient says or wants, expect a complaint or endless pressurising to re-write the report-been there. We need freedom to be honest without fear of patient reprisals.

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  • still waiting for the training to become an occupational health expert as well as a GP (even some for how to fill the form in properly would be a start)

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  • Perhaps we best just stop providing them then

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  • Having done the Diploma in Occ Med one of the take home messages of it was that in discussing work options you are always likely to p*** off one, other or both the patient and employer.

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  • Everything is our fault, you didnt need to tell us all this, global warming, littering, the banking crisis, you name it its all down to us GPs!!!

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  • Many employers don't even know how the basic system worked in the past, let alone 'The Fit Note' system. Many send their employees to get a Fit for and Back to work note, even to this day. It is ridiculous to think they are in a position to say, it is the GP's fault. All they want the Fit Notes to do is 1) Expect people to get back to work irrespective of what the problem is but want someone to carry the can in case something goes wrong. 2) WAnt to be covered in case they get sued.

    The Buck lies with Occupational Health and the Govt. time you think GP, remember, it is the MP YOU WANT !!!

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  • 1/ GPs are not allowed to state someone is fit for work. We can only say they are not fit, or they might be fit. Only an occupational physician or nurse can determine if someone is fit for work
    2/ GPs are not trained to understand workplace hazards and therefore should provide very generic advice about their patient e.g. ticking the box on the Med3 and doing little else. It is up to the employer to take the responsibility for any action. This could include seeking an OH opinion.

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  • When I've tried to get specialist support to get people back to work after surgery (abdominal hysterectomy fit to work after 3 to 4 weeks - I get told to give them as much as they need, and some are able to string it out for months. But then again I wouldn't want to trigger any complaints from a patient I'd just operated on !

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