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GPs are signing 7% more fit notes than a year ago

The number of fit notes issued by GPs in England has risen by more than 7% in the space of a year, official figures have shown.

NHS Digital statistics show the number of fit notes – previously known as sick notes – authorised by GPs increased from 2,292,182 between July and September 2018, to 2,462,938 during the same period in 2019.

GP leaders said the steep rise could be down to the tendency for hospital doctors to pass on the activity to GPs, in combination with increasing numbers of patients being too ill to work.

There is an ‘urgent need’ to reform the way fit notes are issued, particularly at a time when GPs are already struggling with workload demands, they said.

Fit notes, signed by GPs after a patient has self-certified their ill health for seven days, replaced sick notes in 2010 under the new system of assessing claims for welfare benefits when someone is too ill to work.

Between July and September 2019, mental and behavioural disorders were the most common reason for a patient needing a fit note signed by their GP.

A total of 261,127 notes were signed for mental health conditions – around 11% of all those authorised.

The rise in number of fit notes issued by general practice is partly due to other areas of the NHS passing on the extra workload, according to GP leaders.

Dr Peter Scott, a Birmingham GP and chair of Solihull LMC, said hospitals should be doing more to help.

He said: ‘The hospitals do often throw the workload on to the patient’s GP when they come home. Sick notes could be generated in the hospitals, but they are thrown onto primary care. It’s easier to pass it on.’

Dr Richard Vautrey, chair of the BMA’s GP Committee, highlighted the workload pressures facing GPs and called for a wider range of hospital staff to be able to sign fit notes to ease the burden.

He said: ‘This is yet another indicator of the workload pressures GPs are under, and the growing number of patients who are too ill to work because they are living with conditions like anxiety, stress and depression.’

Dr Vautrey added: ‘It’s clear there is an urgent need to see reform of the fit note arrangements. This must include extending the period of self-certification and enabling more healthcare professionals to issue fit notes, including hospital practitioners.’

A Pulse survey of over 800 GPs taken in 2018, found that a fifth of GPs said the advice they gave on fit notes was ignored by employers.

A Pulse investigation into welfare benefits last year found that among those patients who go on to try and claim employment support allowance, but are told they are fit for work, the majority (68%) win their appeal. GPs warned the system of assessment was not fit for purpose.