Is the Government ‘fit note’ still fit for purpose?
The idea was a simple one, instead of your GP signing off because you are completely unfit for work, they will now complete a ‘fit note’ (Statement of Fitness for Work) in cases where you can continue to work taking into account any advice that they may have.
The scheme was intended to get people active and back into work, but five years after its implementation, it appears to be failing in this purpose and seriously hampering the UK’s valiant attempt to improve sickness and absence in the workforce.
The core issue is that GPs just aren’t trained on how to correctly use the government’s flagship ‘fit note’; in particular they lack the formal health and safety advice needed to be able to properly advice patients on improving their working practices to enable them to go back to work. It is a frequent occurrence that GPs don’t complete the fit note correctly, often meaning an employer will have to request the employee to return to the GP to have this completely corrected. Obviously this also has a knock on effect for the GP surgery as they now have to schedule another appointment. So it could be said that the GPs are actually contributing to the strain they are under by failing to complete the fit note correctly.
Michael Lewin’s Head of Employment, Ian Abel, says:
“We know for a fact that only a small percentage of the 20,000 GPs (fully registered and working in an Approved Practice Setting) are using the system correctly; as well as not being fully trained in workplace health and safety issues, we know that it’s quicker and easier for GP’s to simply sign off workers as simply unable to work.”
Ian believes that the problem is getting worse, “Year after year, GPs are under increasing pressure to see patients as quickly as possible, which is leading to ‘sloppy’ working practices, for which I have a lot of sympathy. However it does appear that GPs are taking the line of least resistance and simply signing employees off at their request. I have noticed this particular issue when employees are going to their GPs to complain about issues such as depression, anxiety or stress. It seems to happen far too often that rather than adequately check the person’s actual symptoms – they are just given a fit note as they request. This may be controversial – but in my humble opinion that is simply not good enough and GPs are causing problems for employers with this approach. ”
The Care Quality Commission (CQC) focusses on the care patients get at the Surgery, and doesn’t focus on the ability for the health service to get them back to work.
Ian continued “What we really need is a real joined-up health system where everyone (Health professionals, regulators, employers and employees) are focussed on both the care of the patients and getting them back to work as soon as possible. It’s also vital that the government is focussed on getting GPs fully trained on the efficient and proper use of the fit note as ultimately this will help to reduce the considerable pressure GPs are under.”