Keeping people working – new study into the best use of GP ‘fit notes’

Researchers from The University of Nottingham are investigating the best way to use fit notes to facilitate a timely return to work for those with health conditions.

The study — commissioned by the Institution of Occupational Safety and Health (IOSH) — is the first to look at the way the notes are used to consider the views of patients, employers and GPs together.

The GP fit note was introduced three years ago to replace the old sickness certificate. It allows GPs to recommend whether a patient is not fit for work or may be fit for work. GPs can also suggest adjustments that will enable patients to stay at work or return as soon as possible.

Research into long-term work incapacity shows that the longer people are on sick leave, the less likely they are to return to work.

Carol Coole, senior research fellow on the project, said: “There is an indirect link between our research and long-term benefit recipients. Most work is good for our health and often people with health conditions can stay at work — or return to work — through quite simple measures.”

Avril Drummond, Professor of Healthcare Research at the University, is leading the study. She said: “We want to know how fit notes are being used, how useful they are in helping people return to and stay at work, and how they could be used more effectively.”

The researchers are gathering information through questionnaires and interviews with patients, employers and GPs in Nottinghamshire, Derbyshire and Leicestershire. This information will then be used to establish the ‘ideal’ fit note, as well as inform training and how to improve communications between all parties.

Professor Drummond said: “A fit note should consider the patient’s health condition and how this affects them carrying out every day activities and their general fitness for work. It needs to consider both what the patient can do, and what they have difficulty doing.

“We want to establish what an ideal fit note should contain and how it could be best used. This would be from the point of view of the three main groups involved — patients, employers and GPs. There will be other implications from this such as identifying ways of improving communication between the three groups and providing training for GPs and employers in using fit notes.”

Jane White, research and information services manager at IOSH, said: “The first four to six weeks of a person being absent from work is a critical window, and without proactive intervention this could lead to long term sickness absence.

“Therefore the doctor’s fit note is a vital link between a person, their employer, and them going to work with the right support when they are able. So we need to ensure that it works as effectively as it should, and this research plays an important role in doing that.”

For more information about the research, visit the Fit Note webpages.

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