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Over three quarters of GPs feel obliged to issue sick notes

More than three-quarters of GPs are feeling under pressure to issue sick notes to patients even if there is no clear clinical need, a Department for Work and Pensions (DWP) survey has found.

The DWP survey of more than 4,000 GPs found that 77.4% feel obliged to issue sickness certificates, renamed fit notes in 2010, for reasons that were ‘not strictly medical’, a situation that has not improved since last year when the figure was 77.2%.

The GPC said that GPs are not equipped to deal with work issues and their time would be better spent keeping people healthy.

The survey asked a random sample of 4,179 GPs from England, Wales and Scotland 19 questions about their attitudes to health and work between September and November 2012 and the results were compared to a similar survey from the previous year.

The report said: ‘In 2012 as in 2010, the vast majority of GPs felt that a patient did not have to be fully recovered from their condition before they were able to recommend a return to work.

‘However, the vast majority felt obliged to issue sickness certificates for reasons that were not strictly medical.’

The survey also revealed that some GPs did not feel equipped to deal with patients’ work issues. Almost two fifths (37.6%) disagreed that they felt confident in dealing with patient issues around a return to work, though the vast majority (98.4%) agreed that work was generally beneficial for people’s health.

The DWP said that GPs knowledge of the benefits system and knowledge of local services to help patients get work-related advice could be improved, as only 27.6% agreed that their knowledge of the benefits system was up to date and less than one in five GPs (18.6%) agreed that there were good services locally to which they could refer their patients for advice about a return to work.

They added they could also improve training in health and work, after 89.6% of GPs reported they had not received training in health and work within the past 12 months.

Dr John Canning, chair of the GPC’s Professional Fees and Regulation committee and a GP in Middlesbrough said GPs often issue sick notes for people going through difficult periods as there is no other way for them to take time off work.

He said: ‘It comes down to the question ‘what is illness?’. An awful lot of people that you see with bereavement or family problems cannot work. In practice, it might not be illness, it might be an emotional reaction to a situation. There are better ways of taking sick leave, but most employers don’t see it that way so GPs will issue a sick note. If you think about it, it’s not a safe situation if you’re worrying about your child or your wife so you can’t work.’

He added that GPs were not the right professional to give work advice, and should stick to giving advice on health: ‘The reason that GPs don’t feel equipped to deal with work issues is that most of us have chosen to be GPs , we’re not occupational physicians. Providing more training on work isses is all very well, but where do I find the time to do it? There’s a person at the job centre who provides advice on work and they’d be much better at it than me, my time would be better spent keeping people fit and well rather than giving work advice.’