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Revamp of GP sick note system 'not realistic'

By Nigel Praities

GPs need considerably more training and support if they are to play a role in the drive to get patients on long-term sick leave back to work, according to a new study published online by the journal Family Medicine.

A survey of 441 GPs from Nottinghamshire found GPs lacked the necessary experience and were reluctant to advise employers about how to ensure a patient kept working.

The study comes as the latest blow to controversial plans from the Department for Work and Pensions for GPs to send thousands back to work by issuing ‘fit notes' offering suggestions about what the patient is capable to do at work.

The GPC has criticised the proposed changes as ‘open to manipulation' and potentially a risk to health and safety, and another recent study showed GPs required more training on the use of sick notes as their use varied widely.

The survey published this week found 77% did not accept responsibility for managing the work problems of patients with low back pain, and only 2.5% initiated communication with a patient's employer about managing back pain at work.

A third provided written information for patients about managing health problems and back pain at work, but 71% of GPs said they lacked up-to-date information that may provide help to patients with work problems due to back pain.

The study authors concluded the Government's plans for GPs to take on this role ‘may be unrealistic' and that a sea-change in the training and perception of GP would be needed.

Mrs Carol Coole, research occupational therapist at the University of Nottingham and lead author of the study, said the study showed how difficult it was for GPs to get involved with providing advice about employment.

‘They see themselves as the patient advocate and they want to protect that and build up trust and confidentiality.'

‘They need more support and training. The training they are offered is a half day, but we don't know if that will change practice,' she said.

The survey raises questions about the Government's proposed revamp of sick notes

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