Sickness certification shift will fail without more staff

Plans to shift sickness certification from GPs to occupational health
practitioners could be a chance for OH to take centre stage on workplace
health, but will only work if hundreds more can be encouraged into the
profession, OH staff have warned.

The British Medical Association (BMA) has agreed with the Government that
GPs should give up sickness certification from 1 April 2006, as part of their
new contract designed to reduce hours and workload.

The scheme was due to be formally launched in December, but because of
delays in agreeing initial funding with the Department of Health for pilot
schemes, it is now not expected to be up and running until the new year.

Six pilot projects will be set up to determine the fine detail of the
scheme, including the role of OH, the continuing input of GPs and how small
firms might cope with buying in specialist certification services.

Sheila Tilley, an OH adviser with Interact Health Management, warned there
would need to be very effective firewalls between HR and OH to ensure there was
no conflict of interest or breach of confidentiality, and that patients could
feel able to trust OH with their medical problems.

Dr Jackie Senior, occupational physician with Interact Health Management for
North Yorkshire County Council and Arriva Trains Northern, said the system as
it stood was not working.

OH specialists might be better placed than hard-pressed GPs to spend time
with patients, discussing alternatives to taking to time off work. Line
managers also needed better training in how to manage short-term absence.

But she added: "At our current levels of staffing, we probably would
not be able to do it. There would need to be mass recruitment of OH
advisers."

Dr Anne Price, head of occupational health at Marks & Spencer, said
there could also be a difficulty in managing expectations, as patients might
expect treatment as well as a diagnosis – something that OH will not be
qualified to dispense.

Extending self-certification from seven to 14 days might help, as would better
educating GPs on how to fill in sick notes, she added.

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