The GP Fit Note
With almost 60 tips and myth-busters now available on the CQC website there is plenty of information to help GP practices prepare for their inspections based on guidance and best practice. One of the mythbusters I’ve been re-reading recently is about the GP Fit Note (mythbuster number 40). It was introduced 5 years ago for GPs to consider what work a person could do, before advising they are not fit for any work, and the ‘may be fit’ option could be considered.
What do GPs know about the Fit Note?
CQC inspection teams will focus on working-age people and assess GPs on how they give fitness for work advice to assist recovery and help the patient back to work as soon as possible. They will want to know how fit notes are used, whether GPs are aware of the guidance, and whether they understand the implications of the advice they offer to patients.
What does ‘may be fit’ for work mean?
GPs may choose the ‘may be fit’ for work option if they think that returning to work, with support from the patient’s employer, will help them to recover. They are expected to give general advice on the fit note about how the illness or injury may affect the patient’s ability to work and encourage them to discuss this advice with their employer to see if they can return to work. For example, GPs may suggest possible changes, such as:
- Returning to work gradually e.g. initially working part-time;
- Temporarily working different hours;
- Performing different duties or tasks;
- Having other support to do the job e.g. if the patient has back pain they should avoiding heavy lifting.
Guidance for GPs
If Practices are unsure how the fit note can help GPs, patients and their employers the Department for Work and Pensions (DWP) has produced some guidance, see the link below. However, there are some misconceptions about the Fit Note and Prof Nigel Sparrow, CQC’s Senior National GP Advisor answers some common questions in his mythbuster, see the link below. In it he addresses the ‘may be fit’ for work box, claims for Employment Support Allowance (ESA), the expectation of specialist knowledge of workplaces or occupational health, and access to the computer-generated fit note template.
Links
CQC Mythbusters – GP Fit Note
http://www.cqc.org.uk/content/nigels-surgery-40-gp-fit-note
NHS Choices – What are fit notes?
http://www.nhs.uk/chq/Pages/2584.aspx
GOV.UK – Fit Note