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Pharmacists, nurses and physios to ease GP fit note burden from next month

fit notes

A wider range of health professionals will be able to sign off fit notes from next month to ease pressure on GPs.

New legislation being laid down tomorrow will enable nurses, occupational therapists, pharmacists, and physiotherapists to legally certify fit notes, the Department for Work and Pensions has confirmed to Pulse.

It is the biggest change to the rules around fit notes since they were introduced in 2010 and part of a planned overhaul of reforms that has included scrapping ink only signatures and providing more ‘interactive’ advice on workplace adaptations and support.

The change in law, which will apply across England, Scotland and Wales from 1 July follows moves in April to allow for fit notes to be certified and issued digitally.

In a bulletin, the BMA, who has long been in favour of a wider variety of healthcare professionals being able to sign fit notes, said not everybody working within these professions should issue them but should be ‘working in a suitable environment and have the necessary skills and training to have work and health conversations with patients’.

Issuing fit notes also needs to be within their professional ‘scope of practice’, the BMA said, and that new guidance and training had been developed to advise on this.

The changes follow a consultation last summer about reducing ill-health related job loss to which many respondents expressed views on the current fit note system despite it not being part of the original scope of the consultation.

Outlining its plans at the time, the Government said it would also move to embed electronic fit notes in hospital systems to encourage hospital doctors to issue them reducing the burden on GPs.

Maria Caulfield, minister for patient safety and primary care said that improving access to GP services and reducing unnecessary bureaucracy was ‘vitally important as we tackle the Covid backlog’.

‘Extending powers to provide fit notes to other healthcare professions will relieve further pressures on GPs and is another step towards helping to deliver an extra 50 million appointments in general practice a year by 2024.’

Chloe Smith, minister for disabled people, health and work said the changes would make it easier for patients to get the support and advice they need from the right place, ensuring where possible that they are able to remain in work.

‘These latest fit note changes recognise the valuable role other professions play in helping manage people’s health and I hope this will also help reduce unnecessary bureaucracy for doctors and general practice more widely.’

‘This is just another way in which we’re supporting GPs in primary care, and we remain on track to deliver 26,000 more primary care staff by 2024 to help improve patient access to appointments.’

BMA England GP committee deputy chair Dr Kieran Sharrock said: ‘This announcement is a positive step and we hope that it will go some way to both improving the process for people who need confirmation that they are too unwell to work, and free-up GPs’ time to care for patients who need their expertise.

‘The BMA has been clear for many years that it may not always be necessary or appropriate for a GP to issue a fit note, especially where a patient has seen a different member of the practice team for their condition, such as a nurse or physiotherapist.

‘At a time when the entire NHS is under pressure, reducing unnecessary administration and bureaucracy, while taking a more flexible and pragmatic approach to patient services is absolutely vital.’

RCGP vice chair Dr Gary Howsam said: ‘Allowing other healthcare professionals working in general practice, where appropriate, to issue fit notes is something the College has called for and would support.

‘Such a move should help free up GPs’ time to deliver patient care to those who need their medical expertise at a time when the profession is working under intense workload and workforce pressures. It would also recognise the role of some members of the wider practice team in giving patients advice about health and work – as such it’s important that appropriate guidance and training is put in place to support them to do this safely and effectively.

‘Whilst this would be a positive step in helping to reduce the bureaucratic burden GPs face on a daily basis, ultimately the Government must take further action to address escalating workload in general practice and chronic workforce shortages.’

Additional reporting by Caitlin Tilley

READERS' COMMENTS [11]

Rogue 1 9 June, 2022 12:12 pm

Even more revolutionary, why not get rid of them altogether like abroad
Its purely a matter between you and your employer, if you want to get full pay then it encourages you to get back to work.
They don’t mean anything anyway

Emon Farrah Malik 9 June, 2022 12:59 pm

What about prescribing paramedic practitioners? Any reason for the exclusion?

Patrufini Duffy 9 June, 2022 1:14 pm

Wow. 2022 and we’re discussing a Fit Note.

David jenkins 9 June, 2022 3:57 pm

i can see an explosion of queries from the DWP requesting clarification of why people are “off sick” for so long !

i imagine this will still be dumped in our lap – since we are contracted to deal with it !

how are we supposed to provide any meaningful information on people who have been signed off sick by a physio, who has no contractual obligation with the DWP ?

has anyone “at the top” even thought about this ?!!

Patrufini Duffy 9 June, 2022 4:14 pm

PCNs will probably be employing Fit Note specialists. Maybe an Occ Health company. Good value box ticking. Innovation.

Dave Haddock 9 June, 2022 8:44 pm

Will not reduce workload, will create extra confusion and hence extra work.
The whole sick note charade is pointless and needs not tinkering but abolishing.

Slobber Dog 10 June, 2022 7:47 am

Great idea, if the communication between different agencies is effective.

Turn out The Lights 10 June, 2022 8:41 am

Sh** notes , will be a ill thought out mess as always.Should be employer responsibilty.Any old crap can be put on them the employer or the punter isnt that bothered as long as a Dr has signed it.A total waste of time,as all the above coming into the workforce dont seem to have reduced my workload in fact its going up.

John Evans 14 June, 2022 12:42 pm

The “ get lost and let me get on with treating patients “ voucher scheme?

Not quite true because a significant proportion of patients attend for non-medical reasons. The sick pay voucher is just one of the instances that patients visit us for that has nothing to do with concerns related to illness or the management of medical conditions.

Free at the point of abuse. When considered against an ageing population and an understaffed workforce there are negative consequences – stress on the workforce, risk of errors, unmet clinical needs.

The separation between cause and effect, and the fact that consequences do not impact upon those with power, results in perpetuation of a clearly inadvisable situation.

John Evans 14 June, 2022 12:51 pm

I would also expect the chit to be 3-4 days then see your GP (ie someone who knows what they are doing).
The pharmacists will presumably expect an item of service fee.

Keith Greenish 16 June, 2022 8:21 am

But who is going to make sure our secondary care colleagues get the message that there is now no excuse whatsoever for dumping this work on primary care ?