Change is on the horizon…

As
our sister publication Personnel Today publishes its exclusive new research
into sicknotes, we look at the implications of the changes for OH
practitioners.  By Nic Paton

Plans
by the Government and the British Medical Association (BMA) for GPs to give up
sick-note certification by 2006 have caused some consternation among
occupational health practitioners.

Concerns
about workload, staffing, patient expectations, confidentiality, trust and the
relationship between OH and HR have all been raised.

But
the latest message to OH from both Government advisers and the medical
profession is ‘don’t panic’. Not only is nothing much likely to happen before
April next year, but it is not even a fait accompli that GPs will give up
writing sicknotes altogether.

One
thing that is clear, though, is the appetite for change within the medical
profession.

A
survey in October by Occupational Health’s sister title Personnel Today and
Doctor magazine found that, in a poll of 300 doctors, more than 80 per cent no
longer wanted responsibility for writing sicknotes, with 77 per cent admitting
they issued sicknotes too easily.

The
study also polled 1,000 HR professionals and reported that 80 per cent said they
were now seeing more staff signed off sick, with 30 per cent saying the numbers
had increased greatly in the past year. A total of 54 per cent of the doctors
and 39 per cent of the HR professionals wanted to see specialist OH centres
established, while 49 per cent and 8 per cent respectively believed in-house
certification was the answer.

According
to Dr Simon Fradd, joint deputy chairman of the BMA’s GPs’ committee, as part
of its agreement on a new GP contract, the Government has allocated £10m over three
years for projects that might take some of the burden off GPs. Part, but by no
means all, of this money has been earmarked to fund the proposed pilots on
sicknote certification, the evaluation process by (probably) the University of
York and, it is hoped, to reimburse smaller companies taking part.

However,
the money only comes on stream from April 2004, so until then the process is
stalled, although preparatory work is continuing.

Who
is taking part is still a closely guarded secret, but Fradd said it is likely
there will be a large motor manufacturer, a police force, an NHS Plus
organisation and at least one other multinational.

Along
with the reimbursement issue for smaller firms, there is also debate about how
any scheme might work in the NHS. Because treatment is so readily available
within the health service, OH has often been more at the advice end of the
spectrum.

“There
are concerns about being seen to be fast-tracking people through the NHS simply
because they are employees of the NHS, and that is something we need to discuss
with the minister,” Fradd explained.

Similarly,
in all the excitement over the proposed change, it has been overlooked that the
new GP contract does not say that GPs are going to give up sickness
certification altogether, stressed Dr Philip Sawney, a principal medical
adviser at the Department for Work and Pensions (DWP).

The
DWP has policy responsibility for the regulation and guidance of sickness
certification, and so is a very interested observer to the process.

The
intention is simply to make “significant progress” towards national coverage by
April 2006, Sawney said. “GPs are not necessarily going to give up the role
completely by 2006. It is pretty clear to me that GPs will continue to have a
role for the foreseeable future.”

There
are serious issues of capacity, as there are already not enough OH
practitioners to go round, he conceded.

“If
employers want to take greater responsibility for this function, fine. But most
people in the labour market do not have access to that sort of enlightened
employer view, and do not have access to the necessary OH service,” he argued.

“OH
is not in a position to take over lock, stock and barrel the clinical care of
people of working age,” he warned.

The
message for the profession, it appears, is that, yes, change is coming, but
there’s a long way to go before it arrives at your workplace.

 

 

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