This site is intended for health professionals only

Government pilot of sick note revamp sends three quarters back to work

 A Government pilot of radical proposals to strip GPs of responsibility for signing patients off on long-term sick leave has found three quarters of patients are being sent back to or staying in work, Pulse can reveal.

A report due out this week recommends a huge overhaul of the rules on sickness absence, with independent assessors ruling on sicknesses absences of longer than a month rather than GPs, who it says have ‘no incentive’ to refuse to sign sick notes.

The Independent Review of Sickness Absence, commissioned from Dame Carol Black, the Government´s director for health and work, and David Frost, former director of the British Chambers of Commerce, recommends that a new government-funded service be set up to rule on longer-term sickness to which GPs can refer.

The service will concentrate on assessing what work an employee is capable of and develop strategies to reintroduce those on long-term sick leave back into employment.

The report says employers stand to gain around £100m a year from reductions to sick pay bills from using this service. It also calls a new job brokering service for employees on long-term sickness absence who are unable to return to their current employer, which could save a further £300 million a year.

A PCT-commissioned pilot informing the report showed some 77% of people returned to or stayed at work. The pilot, running in Leicestershire since 2010, was one of six case studies set up by the Department of Work and Pensions.

The service, which uses two GPs to assess cases, and only accepts referrals from GPs, has received 820 referrals and 80% of 154 practices in Leicestershire have made referrals to it.

Some 62% of referred patients had mental health problems and 27% musculoskeletal problems.

The pilot found 78% of people returning to work cited ‘non-medical interventions’, such as mediation/negotiation, personal support and help with new employment as the key factor.

Healthcare interventions were only cited by 22% of people.

Dr Rob Hampton, clinical lead for the Leicestershire Fit for Work Service and a GP in Wigston, said there was a high satisfaction rate among GPs and patients: ‘We’ve had good buy-in from GPs. Some practices referred an awful lot of patients and some very few.’

Dr Hampton said the service employed four case managers apart from the GPs whose job it was to ‘deconstruct the complexity’ of cases. GPs using the service had to sign a ‘memorandum of understanding’ handing the Fit for Work service responsibility for managing their return to work.

The service in Leicestershire was voluntary and had a 5 to 10% drop-out rate among patients.