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November 4, 2010

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Fit-note system a flop, say GPs

Awareness among GPs about the new ‘fit note’ is still limited, seven months after its introduction, and there is widespread lack of belief among doctors in the ability of the new system to meet its objectives.

This is one of the key findings of the fourth annual Health of the Workplace report from Aviva, which surveyed GPs, employers and workers on topical employment issues and challenges in workplace health.

The main aim of the fit note, which came into force in April this year, is to encourage GPs and employers to work together to help employees with a medical condition to return to work faster. However, with more than 50 per cent of the GPs questioned for the Aviva survey saying they now have less time than ever to spend with their patients and thus provide a detailed diagnosis, or offer wider lifestyle and work-related advice, this aim is proving difficult to achieve.

In all, 65 per cent of GPs said they feel “ill-equipped” to provide fit notes, and 68 per cent don’t believe that the new system will cut absence levels (compared with 54 per cent of those surveyed last year – prior to the introduction of fit notes).

Other research carried out by Aviva earlier this year found that employers and employees are equally sceptical about the effectiveness of the system. Of 500 employers questioned, just 5 per cent said they would reduce absence rates. On the employee side, 57 per cent of respondents didn’t believe their doctor would be in a position to say whether or not they were fit for work.

According to Aviva UK Health’s principal clinical consultant, Dr Doug Wright, the Government is “missing a trick” in making fit notes work by ignoring the role occupational-health services and income-protection providers can play. He said: “Currently, occupational-health practitioners are the missing piece of the jigsaw but can perform a potentially crucial support role in bridging the knowledge gap between employers, HR, managers, GPs and workers. Without this engagement, the introduction of fit notes may cause more problems than it solves.”

The British Medical Association agreed but said OH provision is still too patchy. A spokesperson told SHP: “This study broadly reflects how GPs feel about the new fit notes. The bigger problem is that only one in eight workers has access to an occupational-health doctor – this situation must improve if the overall plan to help more people back to work is to be truly effective.”

The Aviva survey also found that business leaders are still prioritising profit and productivity over staff motivation and work-life balance. Of those questioned, 31 per cent want maximum profitability for head count, and 39 per cent demand highly productive, flexible teams.

Small companies were found to have a better approach to work-life balance and well-being initiatives, although, in general, business leaders do recognise the important role that both can play in terms of employees’ health, productivity and morale.

However, the recession and the recently announced spending cuts have led to an increase in stress in the workplace, as well as a reduction in the number of morale-boosting initiatives and employee ‘perks’ provided by employers (nearly half of companies don’t provide any health or group-risk benefits for their employees).

According to the report, this is a mistake as people who are happy and motivated at work will be loyal and more likely to take ownership of their work. Understanding the significance of work in a person’s life, therefore, can lead to more successful leadership and, consequently, improve staff motivation, morale, productivity, and well-being.

Commented Doug Wright: “It is clear to everyone that the economy has been struggling for the last few years. These tougher conditions have led to difficult decisions having to be made, reflected in the recent spending review. The scale of the reforms has led to considerable debate and, while important, we hope the focus on patients and health outcomes will not be lost, and continue to drive the reform process.

“It is also important that the wellness agenda is maintained – as well as empowering individuals and businesses to look after their employees and to be accountable for it, there are far-reaching societal benefits, and it will also help control central costs.”

A PDF of the report can be downloaded here.

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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13 years ago

In theory, use of Occupational Health Practitioners is obvious – but what if the OH department answers to for example HR. Ethically, OH should put the health and interestd of the patient first. If the OH is directly employed and answerable to the HR department, they cannot be independant. There is a high risk that their remit will be to get staff back to work ASAP regardless of their health and/or provide evidence for dismissal. It’s not all cosy and fluffy out there