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GPs should consider ‘societal costs’ when signing patients off sick



GPs should consider the wider societal costs of signing someone off sick, relating to the costs of work absenteeism, researchers have concluded.

Researchers at Keele University found that issuing patients a ‘fit note’ for low-back pain so they can take time off work does not necessarily help improve their recovery in terms of their pain, functioning or well-being.

The study included over 800 patients who went to their GP with low-back pain, 14% of whom had a record of sickness certification while the remaining 86% did not.

Six months after their initial consultation, there was little difference in patients’ self-reported pain, functioning or general well-being between those signed off sick and those not, after adjusting for the severity of the problem at baseline, the team reported.

Differences in health costs were small, but people with sickness certification were significantly more likely to take time off work and cost around £2,000 more on average in ‘productivity losses’ over the six months.

The researchers concluded: ‘This study has provided no clear evidence that issuing of sickness certificates confers any major advantages or disadvantages in respect of patient improvements in clinical outcomes or healthcare costs.

‘However, from a broader societal perspective, primary care clinicians and policymakers may wish to consider the higher societal costs as well as the ethical/moral issues of sickness certification within patient care.’

J Occup Rehabil 2015; available online 17 January