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December 9, 2009

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Sickness sign-off is a lottery, research shows

Vast inconsistency in how long people are signed off ill by GPs is revealed in new research.

A study of 113 GPs in a primary care trust asked doctors how long patients should be absent from work after being signed off with specific illnesses. In one example, the researchers asked how long a woman recovering from a hysterectomy should remain off work. In this case, more than three-quarters of GPs advised a period of sick leave that did not correlate with government guidelines, and the suggested length of time off sick ranged from two weeks to more than 13.

The research, published in scientific journal Occupational Medicine, found that almost two-thirds of doctors have not received any training in sickness certification, and for those who had, their training amounted to just four hours. Only a third of GPs surveyed were aware of the existence of government guidelines on sickness certification, while just one in five said they actually use them.

Occupational-health doctors are currently helping the Royal College of General Practitioners (RCGP) to roll out training days for GPs, however the Society of Occupational Medicine believes the findings vindicate the need for occupational medicine to be embedded in doctors’ training curriculum at the outset.

Professor Steve Field, chair of the RCGP, said: “We would like GPs to have quicker access to refer patients on to specialist occupational-health consultants. We would like to see some provision for occupational medicine in the GP training curriculum but feel this could only realistically be achieved if GP training were increased to five years, as we have previously recommended.”

Dr Tony Stevens, president of the Society of Occupational Medicine, commented: “We need to get the message out to everyone that, in general, work is good for you; being off work is depressing and isolating.

“There needs to be a culture shift among employers and patients, and more support for GPs so that we can offer a more flexible approach that facilitates early rehabilitation to work. This can stop people being signed off unnecessarily, so that they don’t find themselves on a downward spiral into long-term worklessness, social isolation and dependency.”

Mark Baylis, deputy chair at the UK Rehabilitation Council, echoed Dr Stevens remarks, saying: “GPs have a vital role to play in helping to improve rehabilitation and return-to-work rates, but first there needs to be a change of approach in some doctors’ surgeries. The emphasis should move away from what patients cannot do towards what they might, with help, be able to achieve.”

The Government is preparing to replace the current sick-note system with electronic fit notes, expected in the spring.

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