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Independents' Day

GPs will not have to sign fit notes for hospital patients under new contract

GPs will not be required to write fit notes for patients if they are seen in hospital, under the new hospital standard contract.

The new two-year contract, which will come into effect from April this year, makes it mandatory for hospitals to write fit notes for patients that were admitted by hospital staff, discharged or attended an outpatient clinic.

The contract said the fit note must be valid until the patient is recovered or until a clinical review is needed.

Last year, the Government began consulting on whether healthcare professionals besides 'doctors in primary care and other settings' should be able to certify fit notes because the Fitness to Work scheme was not achieving what it was set up to do.

Dr Farah Jameel, workload management lead for the GPC, described the new obligation for hospitals as ‘a win’ for GPs.

Speaking at Pulse Live in London today, she said: ‘If a patient is seen in hospital, it’s up to the hospital to write that fit note. If they’ve had general hip replacement they can sign that patient off, thank you very much.’

She advised GPs in the audience that if a hospital asks them to write a fit note, ‘make sure you say no, and bounce that back to the hospital’, adding that the BMA will be releasing more templates through their ‘Quality First’ guidance website to help GPs respond.

The BMA's Urgent Prescription for General Practice has previously called for self-certification of illness to be extended from seven days to 14 days to cut down on GP workload.

The new contract will also ask hospitals to send a letter to a GP within 10 days of their patient visiting an outpatient clinic. This deadline will shorten to seven days after April 2018, and by October 2018 all letters must be sent electronically.

Readers' comments (8)

  • 1. Isn't this already the case re med certs?
    2. Getting a typed letter quickly is IMHO part of the problem, as everyone is hospital is happy to dump informing patients they need follow up for abnormal results on you as it's 'in a letter'. So timely work and liability dump box ticked and GP to stay until 9pm each night clearing the 50+ letters from each day which are full of clinical risk the patient has no idea from as apparently hospital phones can't connect to patients and postmen don't deliver from hospitals to private houses.

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  • National Hopeless Service

    Today I have been asked to re-refer a patient because the hospital cancelled an OPD but forgot to send out a replacement appointment. And an irate father wanted his sons hospital initiated test results because the consultant told him to phone the GP. If the 2016-2017 Hospital Trust changes cant be implemented there is no hope that anything else will change.

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  • This is nothing new! The regulation for them to do this has been in place for over 20 years. However many GP's and hospitals are unaware of this, or too apathetic to enforce it

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  • The only way I can see this changing both hospital clinicians and patients requesting behaviour is if the above is changed from'gps will not have to' to 'gps are not able/allowed to' -I suspect this is the only way busy hospital clinicians wd accept the job, and in our area the only way a patient will not continue to ask us for notes as we are nearer.It won't stop us being asked to override/extend hosp notes if the pts sickness absence is biopsychosocial/multifactorial ,which will be far beyond hospital to deal with.

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  • Difficult to see how anything extra will be achieved given that the following guidance has been available to hospital doctors for the last 7 years:

    Unfortunately the 'Can't do' attitude is so ingrained in some healthcaredroids' psyches all we can do is print off the booklet and beat them over the head with it.

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  • Cobblers

    As previous have said the current status quo means that Hospitals are required to issue a sick note so no chage there then.

    Fitness to Work scheme not achieving what is was set out to do? Hahaha! It was set out to get GPs to give Occupation Health advice on the cheap. Sensibly most have declined to do so. By all means extend the sick note signing to Uncle Tom Cobbly (no relative) and remove it from GPs.

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  • Hospitals can do/ should do this already.
    Is this just more spin?
    I assume they will continue to do as before

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  • there is nothing new. it has always be the case that hospital need to supply med3 . patient just turn up in surgery and ask for med3. in 10 minutes with lots of patients waiting, we don't have time to chase it up and send patients back to 7 miles to fetch med3. it take 1 minute to do note. why should poor patient suffer for hospital mistake. charge £30 payable by secondary care to us for mistake and all will be sorted out.

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