The government’s pilots on alternatives to GP sicknote certification have failed miserably due to a combination of union resistance, employee suspicion and lack of business buy-in.
The pilots, which ran from February last year, could not even conclude whether GP workloads had been cut – one of the main reasons they were run in the first place.
The government had been under pressure from both employers and GPs to change the existing sicknote system, but the failure of the pilot schemes means questions remain as to whether any reform will now go ahead.
Where it had been intended to run three pilots – a remote call-centre occupational health (OH) advice service, a remote service for employers, and one using in-house OH advisers – resistance from unions meant only the first two actually took place.
While 72 employers initially expressed an interest in the trials, just 10 carried it through to the end, according to professor Jeremy Dale, director of the Centre of Primary Health Care Studies at Warwick Medical School, which evaluated the project.
Many firms blamed the tight timescale, changing priorities, logistical problems and a lack of resources. Workers were also deeply unhappy with the idea of being signed off work by OH advisers rather than their GP, mistrusting their motives and worried about confidentiality, the pilots concluded.
“Employees were asking: ‘Why is our organisation doing this?’ This led to a climate of suspicion,” Dale said.
Of 544 incidences of more than seven days’ sickness absence recorded, 356 went through the call centre and 188 through the advice service. Of these, 212 staff returned questionnaires, with 58% expressing satisfaction.
The pilots were also met with apathy from GPs. Just 18 staff gave researchers permission to contact their GP, and only 10 GPs bothered to reply.
Med 3 makeover aims to boost its usefulness
The government is to redesign the official sicknote (Med 3) in an effort to encourage GPs and employers to communicate more about how they get sick staff back to work.
“It is very much at the planning stage, but it is something we are thinking about quite widely now,” Cathy Harrison, occupational health (OH) adviser at both the Department of Health and the Department for Work and Pensions, told the In Health and In Work conference in Nottingham last week.
Ministers want the certificate to go further than just saying someone is unable to work, perhaps by including what could be done to help them return to work, she added.
Dame Carol Black, the government’s OH tsar, also revealed she is to have a meeting with the Treasury to discuss the issue of tax breaks or other financial incentives for companies that invest in workplace health.
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