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Fit note will replace the sick note

Dr Rob Hampton says that the new medical certificate will aid GPs and help patients return to work.

Dr Rob Hampton (photograph: NTI)
Dr Rob Hampton (photograph: NTI)

Fishing around for the pad of sick notes feels anachronistic when just about every other administrative task that supports patient care can be performed on computer.

Completing a Med 3 still requires pen and paper, but soon we will be printing off new 'fit notes' as part of the government's drive to help patients on sick leave return to work sooner.

A draft of the new certificate has been tested on 500 GPs who broadly welcomed it and an electronic version is being piloted. The government's intention is to launch the fit note this year.

The change is long overdue. The average GP currently writes around 600 Med 3s each year and the wording and process it supports feel antiquated. Sick notes are unpopular with GPs, occupational health professionals (OHPs) and employers.

The impetus for replacing the Med 3 now is in response to the increasing burden of long-term sickness and people receiving incapacity benefit.

While there has been success with getting patients off benefits, the number of people sliding from employment on to benefits remains unchanged with an increasing number with stress- related illness the largest group of new claimants.

The DoH's plan to improve matters includes the fit note and is outlined in 'Improving Health and Work: Changing Lives' that you can download at www.workingforhealth.gov.uk.

GPs will be able to print off the fit note from existing clinical IT systems and hand it to the patient to give to their employer.

The name of the new note has been chosen to encourage GPs, but mostly our patients and their employers, to consider what work that patient can do rather than just consider whether or not patients are 'sick' or not.

In my view the note would be better called the 'absence advice note' to reflect the fact that medical advice is only one aspect to consider when deciding what someone is able to do at work.

As one of three GPs involved with its design, I am sure there is nothing for GPs to fear.

The format is yet to be finalised and there is a process of public consultation under way, but I believe that it encompasses some broad themes that most GPs will welcome.

It will enable you to 'assess' patients without always having to see them so that telephone consultations, advice from colleagues, hospital letters and so on are acceptable evidence to complete the note.

You can record that the patient may be capable of some work rather than the all-or-nothing approach of the Med 3.

This should place emphasis on the patient and employer to discuss workplace adjustments. It should have the benefit of encouraging more employers to seek advice from an OHP.

The GP and employer will be able to identify the potential for long-term absence so that early intervention can be considered to support a return to work.

Lastly, it will facilitate return to work before the period the note is for runs out if symptoms improve.

  • Dr Hampton is a GP and occupational physician in Leicestershire

Benefits of fit notes

  • Assessing the patient will not always involve seeing them.
  • GPs can state that the patient may be capable of some work.
  • Option to provide more detail to enable employer and patient to discuss workplace adjustments.
  • Will enable GPs and employers to identify potential for long-term absence.
  • Will facilitate return to work before the fit note's expiry date.

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