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Safety and Health Practitioner (SHP) is first for independent health and safety news.
May 27, 2009

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Views sought on ‘fit-note’ overhaul

The end of the doctor’s sick note has moved a step closer as the

Government today (Thursday) launched a 12-week consultation on the

design of a new medical ‘fit note’.

The rationale behind the replacement of the sick note with the ‘fit note’ is to improve the advice given to people about staying in work, and, in cases where this is not possible, what their employer can do to make job alterations and help them return to work sooner.

A proposal made by Dame Carol Black in her report into the health of the working-age population, the ‘fit note’ will allow doctors a new option to indicate where a patient ‘may be fit for some work now’.  
If a doctor decides to classify a patient as in this category, they will need to provide general details of the functional effect of that individual’s condition. The consultation paper stresses that, since most medical professionals who issue statements on a regular basis are not experts in occupational health, only generic advice is expected.

The patient’s employer will also not be bound to implement suggestions by a doctor for workplace changes designed to facilitate a return to work. Instead, changes will be provided at the discretion of employers and with the agreement of the employee.

However, concerns still persist among doctors that their unfamiliarity with patients’ work situations will prevent them from making effective work-adjustment suggestions, while they will not be able to carry out their role as patient advocate.

Chair of the British Medical Association’s GPs Committee, Laurence Buckman, told SHP: “Sitting in a consulting room, it’s impossible for me to have knowledge of my patients’ working conditions, so I don’t have the evidence to back up the kind of decision I’m being asked to make. That’s the role of an occupational health doctor.”

He went on: “In its current form this ‘fit note’ is likely to be misunderstood by doctors and patients alike. It also represents a fundamental shift of our responsibilities to our patients. GPs act as their patients’ advocates, but we can’t do that if we’re also expected to be judge and jury, and effectively decide whether or not they get social security payments.”

The Government is nonetheless determined to press ahead with the reforms, and wants a more flexible system that takes account of a changing world of work which is less physically demanding, and the ability of employers to implement low-cost changes to facilitate an individual’s return to work.

Health and safety minister, Lord Bill McKenzie, said: “Employers tell us that managing sickness absence can be a challenge. This is compounded by a ‘sick note’ system that makes sickness absence a black-and-white issue — either you are unfit for work, or you are not.

“We recognise how important it is to help people who are sick to stay in work, or get back to work quickly — the new ‘fit note’ will do just that.”

Health minister, Ben Bradshaw, added: “We know that sickness absence is economically and socially damaging, and makes people more likely to drift into social exclusion and poverty. Getting people back into work quicker is good for their health as well as the country’s finances.”

Due to be rolled out across Britain in the spring of 2010, the ‘fit note’ is expected to be computer-generated in GPs’ surgeries, replacing the current hand-written version.

What makes us susceptible to burnout?

In this episode  of the Safety & Health Podcast, ‘Burnout, stress and being human’, Heather Beach is joined by Stacy Thomson to discuss burnout, perfectionism and how to deal with burnout as an individual, as management and as an organisation.

We provide an insight on how to tackle burnout and why mental health is such a taboo subject, particularly in the workplace.


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