Sicknote debate highlights shortfalls in new proposals

‘Fitness for work statements – whose job is it anyway?’ was the subject of a
debate on government proposals to take the responsibility for writing sicknotes
away from GPs, and pass it on to other health professionals – including OH.

It was chaired by Gail Cotton, head of OH and safety services for
Leicestershire Fire and Rescue, and past president of the AOHNP, and involved
three speakers.

Dr Philip Sawney, principal medical adviser at the Department for Work and
Pensions, explained some of the thinking behind the proposals. He said many
health professionals give advice to patients on their fitness for work, but
only GPs can certify them. The new set-up would create a new role for health
professionals to inform the decision that should be made by both staff and
their employers.

He said a joint study is currently underway on the future responsibility for
sicknotes, but no-one in Government has made a decision yet.

OH manager Cathy Harrison, who is currently on secondment to the NHS Plus
team at the Department of Health, said a series of pilots are taking place
looking at fitness for work. She said that OH has always advised on fitness for
work, but questioned how it would manage the role of determining sicknote
provision. "Is it appropriate for us to become gatekeepers?" she

Violet Chidombwe, an OHA for Leicester Prison Service, who also works as a
locum practice nurse in a GP’s surgery, put a different slant on the debate.
"Are we trying to shift the balance onto OH practitioners?" she
asked. "If so, we can only face that challenge if we’ve got the right

During the interactive debate that followed, delegates queried how such a
venture would be resourced, and how it would work for employers without access
to OH.

They voted overwhelmingly against moving fitness for work statements over to
OH, but were in favour of involvement with the pilot schemes.

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