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Government confirms plans to reduce GP fit notes workload


fit note


A planned overhaul to how fit notes are provided include making them fully digital and encouraging hospital doctors to issue them to their patients to take workload pressure off GPs.

Other reforms will include possible changes to the regulations so a wider range of healthcare professionals can sign them and the creation of a new ‘interactive’ fit note advising on suggested workplace adaptations or modifications for different clinical conditions.

The Government spelled out its intention in response to a consultation on proposals to reduce ill-health related job loss earlier this summer.

While fit notes weren’t part of the ‘Health is everyone’s business’ consultation, many respondents expressed their views about them prompting the Government to outline improvements it planned to make.

Plans include to ‘transform’ the fit note for the future include:

  • Removing the requirement for them to be signed in ink, making them fully digital.
  • A new interactive version of the fit note which will provide advice and support for suggested workplace adaptations or modifications, based on clinical conditions, to encourage work and health discussions between patients and employers.
  • Exploring the amendment of regulations to allow a wider range of eligible healthcare professionals to sign fit notes.
  • An e-learning training module this summer to support eligible healthcare professionals with providing fit notes once they are permitted to do so.
  • Promoting the use of allied health professionals Fitness for Work Reports as an alternative to fit notes.
  • Embedding electronic fit notes in hospital systems and encouraging hospital doctors to issue fit notes to patients in their care, reducing the burden on GPs in primary care from spring 2022.

‘Fit Notes associated with the statutory sick pay system are not working and fail to provide specific advice or feedback for employers. This can frustrate more effective returns to work,’ one respondent to the consultation said.

Another pointed out that appropriate healthcare professionals or employment advisers in primary care surgeries should provide the fit note rather than the GP ‘given GPs cannot be expected to know the impact of each condition’.

In its response, the Government said it was ‘committed to improving the fit note to enhance work and health conversations and the support provided to both individuals and employers’.

The BMA said it had long been in favour of a wider variety of healthcare professionals being able to sign fit notes to take the pressure of burdensome admin in general practice.

And RCGP chair Professor Martin Marshall said: ‘The College has been feeding into the Government’s work on fit note reform with an aim to help reduce the bureaucracy involved. This includes allowing a wider range of eligible healthcare professionals, with the appropriate training, to sign fit notes, and updating how fit notes are certified, by removing the current requirement for them to be signed in ink.

‘The College has been calling for some time for these proposed changes to be implemented, and we need to see this done as a matter of urgency. General practice is already under intense workload and workforce pressures, and reducing administrative workload, would give GPs more time to deliver patient care.’ 

READERS' COMMENTS [7]

Bonglim Bong 31 August, 2021 10:37 pm

While I would encourage more healthcare professionals to be able to sign med3s, I’m a bit worried about some of the other suggestions. I am not really trained to decide what workplace adaptions are appropriate. Why should I be charged with writing that.

Dr N 1 September, 2021 6:48 am

Not one ounce of this in all reality will reduce my workload. SystmOne has had the facility to digitally ‘self’ sign for ages so no new work saved there.

Turn out The Lights 1 September, 2021 7:05 am

Sorry a bit part of this is occupational health,GPS are NOT qualified,indemnified or experienced in this area.You would think the RCGP would know that, but then again they don’t seem to know a lot about the front line.

John Glasspool 1 September, 2021 8:03 am

TOTL- you are soooo right. All the senior ones are what I call “Fugitives from the consultation”. Yet they have the cheek to call themselves GPs on the basis of doing one clinical session a week.

Iain Chalmers 1 September, 2021 12:00 pm

Don’t see how this will reduce my work.

A) agree not Occupational Health trained
B) lots of different individuals signing off means lots of different opinions, good news when appealing
C) who does the report?? Guess falls to GP who may never have been involved courtesy of B)

Bernie Hunt 1 September, 2021 1:42 pm

Lots of extra powers for noctors and AHp is fine, as long as they are responsible for the quality of their work. If a sick note is challenged will it go back to the paramedics?or PA or enp/acp/anp? or to the GP? I dont anyone writing sick notes on my behalf if queries come back to me to sort out.

Deborah White 1 September, 2021 3:50 pm

Hospital doctors don’t just need “encouraging”. They need to fulfill their contractual obligations, and be held to account when they don’t.