Fit notes should only cite ‘general advice’ warns medical body MDDUS

Doctors are being urged to give only the most general advice when making workplace recommendations on medical fit notes and should ensure against unwarranted disclosures of patient details.

Guidance issued by The Medical and Dental Defence Union of Scotland (MDDUS) advised GPs to exercise a degree of caution, not give opinions out, and work within the limits of their clinical competence.

“GPs are not experts in occupational health medicine and we would caution against giving anything other than the most general recommendations for alteration to workplace conditions,” the guidance stated.

The recommendations come as national director for health and work Dame Carol Black – the creator of the fit note – warned the initiative would amount to little more than a sick note if GPs failed to volunteer information about the activities workers could carry out.

Paul Nicholson, chairman of the British Medical Association’s Occupational Medicine Committee, agreed and said in most cases only simple and general ‘off-the-rack’ advice should be required about phased return to work and amended duties.

“Clearly GPs have no knowledge of their patients’ workplaces and most have no occupational medicine training, so it would be inappropriate for them to provide bespoke tailored advice,” he told Personnel Today.

“Where a GP believes that a more detailed assessment would help, they should write in the comments box ‘recommend occupational health opinion, if available’.”

Lord McKenzie, minister for the Department for Work and Pensions, said: “We don’t expect GPs to be experts in occupational health, but they are experts in their patient’s health, just as employers are best placed to understand their own workplaces. The advice on the fit note will help employers to work with their employees to support them back to work more quickly.”

Black said work plays a significant role in determining a person’s health. “The fit note is a hugely important development which means that GPs will be encouraged to think about their patient’s ability to work and provide more helpful information to patients to discuss with their employer. This is why the fit note is a win-win for both employees and employers.”

In addition to new online guidance, a half-day course is being run by the Royal College of GPs with funding from the DWP to help GPs increase their knowledge, skills and confidence in dealing with clinical issues relating to work and health.

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