Fit note gains public approval but requires GP guidance

The response to the government’s consultation on its plans for a ‘fit note’ to reform the Med3 sick note is broadly positive about the creation of a ‘fit for some work’ option in the new certificate.

Guidance for GPs and OH practitioners will be vital if the fit note is to be adopted successfully by GPs, Dr Bill Gunnyeon, chief medical adviser at the Department for Work and Pensions, told delegates at a conference of the Commercial Occupational Health Providers Association (COHPA) last month.

The guidance has been developed in co-operation with professional bodies including the Royal College of Nursing and the Royal College of General Practitioners as well as employers’ groups.

GPs will take part in a national education programme which will include health and work e-learning modules, and the guidance will be provided in the government’s OH Helpline pilot for smaller companies. There may also be a web-based information resource.

Gunnyeon acknowledged that there had been resistance to the reform from GP leaders in the British Medical Association. The Employment Lawyers’ Association also warned that the new statement could lead to GPs making decisions about partial fitness to return to work without proper knowledge of what an employee’s job entailed and could lead to an “increased potential for conflict” between employers, employees and GPs.

However Gunnyeon denied that GPs would be taking on the work of OH practitioners.

“They [GPs] don’t have to be aware of the individual’s job, they merely have to list any potential functional limitations. It is for the employer to address this with the individual employee,” he said.

The response to the consultation, which ended in August, is being assessed and the medical statement will be launched in April 2010.

Gunnyeon said the government was looking at whether it would be possible for the fit note to be available by the April launch in a computer-generated format, following a successful pilot in Wales which finished last month. It will be possible for the fit note to be sent by e-mail between GPs, employers and other stakeholders at the outset.

He added that GPs would be able to audit the quality of their practice regarding fit notes by benchmarking with other practices.

The pilot fit for work teams proposed by Dame Carol Black’s workplace health review will be announced this month.

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