GPs do not believe that signing sick notes is a good use of their time, according to a poll of delegates at the Pulse Live conference in London today.
GPs attending the Great GP Debate heard arguments for and against the suggestion that sick notes are a waste of GP time.
A show of hands vote indicated that around 65% of the delegates agreed that signing sick notes were a waste of GP time, while around 30% said that they thought it was a role that GPs should fulfil. A number of delegates remained undecided.
Arguing that signing sick notes – or ‘fit notes’ which are used to assess whether patients in employment are well enough to work – is a waste of GP time, Dr Rory McCrea, a GP in Waltham Abbey and national council member of the Family Doctor Association, said that there were many more useful things GPs could be doing with their time than dealing with sick note situations
He said: ‘Are we really serious that it is a good use of general practitioner time? Nurses, social workers, podiatrists, dieticians, health service managers don’t give out fit notes – they all have too much sense. I can see the advantages but I am not sure this needs to be done by GPs.’
Dr McCrea acknowledged however that the impact of being signed off from work could be ‘disastrous’ for patients health and that ‘exercise and the stimulation of work’ would likely to very beneficial to many conditions they might be presenting.
Arguing that signing sick notes was not a waste of GP time, Dr Rob Hampton, a portfolio GP and occupational physician, said that GPs should sign sick notes but only for short periods of time and that there were some circumstances where the signing of sick notes should not be a GPs responsibility.
He said: ‘I would agree that some fit notes are a waste of our time. First where somebody off work has got deeply entrenched in some sort of conflict at work. I think us continuing to sign fit notes is not the right thing to do, this is rarely helpful and in fact that should all be displaced to the workplace.
‘Secondly is those people caught in the benefit system, either applying for or appealing benefits, we are put in an invidious position signing sick notes again and again for these people.’
Dr Hampton said that these scenarios only took up around 20% of GP time, however. GPs overwhelmingly do not feel comfortable about signing sick notes for people in the welfare system, he said, adding that job centres should not send people to GPs for sick notes and that there should be an independent evaluation for people off work for significant periods of time.
But he said that GPs should not underestimate their power to influence patients and that they did have a role in getting people back to work.
He said: ‘The first two or three consultations with GPs is key. Patients really do trust their GPs in this field.’
‘The sickness certificate is a powerful tool but if used incorrectly is a dangerous tool.’