Experiences of certifying fit notes

Background

Employers require a ‘fit note’ from a GP if an employee has more than 7 consecutive days of sick leave. A fit note details whether a person is unable to work (i.e. unfit to work) due to sickness or an ongoing health condition, or if they ‘may be fit’ to work. This means that an individual could return to work if recommended adjustments are made (e.g. reduced hours, different duties).

We know that being in work is good for physical and mental health, therefore it is important to get people back to work as soon as possible. In order to issue a ‘fit note’, GPs need to understand what an individual’s job involves and possible changes that could be made to their role to enable a return to work.

GP practices are under a significant amount of pressure as practices deal with increasing patient demand and patients with increasingly complex medical problems, at the same time as the number of GPs continues to drop. GPs have a limited amount of time to see patients, which makes determining someone’s fitness to work difficult, so this can lead to longer periods of work absence.

Since 1st July 2022, fit notes can be issued by occupational therapists, pharmacists, nurses, and physiotherapists as well as doctors. This change in practice is hoped to reduce pressure on GPs.

However, it is not clear whether the healthcare professionals that are new to issuing fit notes have received relevant training, have the knowledge and skills to assess a person’s ability to work, have an understanding of different job roles and have the confidence to complete fit notes.

Aim

To explore the experiences and opinions of occupational therapists, pharmacists, nurses, and physiotherapists in completing and issuing fit notes, and identify any issues that might affect their completion.

Methods

This study will be split into two parts.

Online survey of occupational therapists, pharmacists, nurses, and physiotherapists (19 participants or more per professional group). The survey will explore what factors might affect healthcare professionals’ ability to complete fit notes (e.g. skills, knowledge, influences) and identify any barriers to their completion.

Interviews with up to 20 occupational therapists, pharmacists, nurses, physiotherapists involved in certifying fit notes. Interviews will be conducted via video call or in person, and will explore barriers to completing fit notes, identify training needs and understand more about healthcare professionals’ experiences of completing fit notes.

Patient and public involvement

Patients with lived experience of injury and absence from work, and expertise in healthcare and human resources have been involved in the development of this application. They will be involved throughout the study and involved in reviewing documents, attending meetings and writing publications.

Amount awarded: £55,827