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GPs urged not to consider patient’s job when assessing fitness for work



GPs should consider a patient ‘fit for work’ if they safely able to do some types of work, but not their current job, according to revised Government guidance on fit notes.

The Department of Work and Pensions guidance emphasises that GPs should tick the ‘may be fit for work taking account of the following advice’ box if patients can do some form of work, and that this advice should not be ‘job specific’.

The new guidance – which was written in conjunction with the BMA, the RCGP, also recommended using computer generated fit notes, as they have added benefits including being easy to read, removing the need to issue duplicates, and improving continuity of care.

Released last month, the revised guidance says GPs should give advice about the functional limitations of a patient’s condition on their fitness to work, including stamina, mobility, effects of treatment etc, but are not expected to have specialist knowledge of workplaces or occupational health, and do not need to suggest possible changes to patients’ jobs or workplaces, the guidance says.

It said: ‘Your assessment about whether your patient is fit for work is about their fitness for work in general and is not job-specific. Always consider if your patients could do work of some kind before advising that they are not fit for work.’

‘Remember to consider carefully whether advising your patient that they are not fit for work increases the long-term health risks of worklessness.’

The advice further clarifies previous guidance, released in 2010 when Med 3 and Med 5 notes were combined into the new fit note, in which there was less emphasis on advising that a patient is fit for work if they are able to carry out some form of work.

Dr John Canning, chair of the GPC’s Professional Fees and Regulation committee, said that while the guidance may be more strongly-worded, it ‘did not represent a change in policy’ and was simply a ‘statement of fact’.