Docs say fit notes plan is 'unrealistic'
Docs say fit notes plan is 'unrealistic'
Government plans to introduce GP 'fit notes' instead of sick notes may be unrealistic, say researchers. A survey of 440 GPs in Nottinghamshire found few currently took any responsibility for managing the work issues of patients with back problems. Considerable training and a change in culture will be needed for GPs to take on a role where they advise on the work a patient can do, the paper in the journal Family Practice concluded.
The researchers from Nottingham University send a postal questionnaire to 441 GPs, and received responses from 54.7 per cent. The majority of GPs responding (76.8 per cent) reported that they did not take overall responsibility for managing the work problems of patients arising from low back pain. Few 'mainly agreed' that they initiated communication with employers (2.5 per cent) and/or therapists (10.4 per cent) regarding their patients' work. Two-thirds said therapy and rehabilitation to help patients with low back pain with work problems should be provided by local authorities. The paper concludes: 'The results of this study demonstrate that most GPs do not readily engage in vocational rehabilitation and do not initiate contact with employers or other health care practitioners regarding patients' work problems. Thus the current government expectation that GPs are able to successfully manage this role may be unrealistic; considerable training and a change in the GPs' perception of their role will be required.' Study leader Carolyn Coole, a research occupational therapist, said: 'It is going to be difficult for them in terms of the amount of knowledge they will need about a person's job and to give advice that the employer understands.' A Department of Health spokesperson commented: 'We believe that GPs are well placed to provide appropriate advice, which the employer, who understands the demands of their workplace, can then use to decide whether or not they can safely facilitate the employee's return to work.' This suggests the one person left of the discussion will be the patient themselves. Research published this year found workers off sick with back pain and who were involved in identifying potential barriers to their return to work get back on the job much quicker (Risks 415).
Carol Coole, Paul J Watson, and Avril Drummond. Work problems due to low back pain: what do GPs do? A questionnaire survey, Family Practice Advance Access, published on 26 October 2009, doi:10.1093/fampra/cmp074 [Abstract]. BBC News Online.
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