DAUK has been working with the Department for Work and Pensions and the Department of Health on the future of fit notes.

Dr Steve Taylor, DAUK GP co-lead, attended the launch event in Birmingham, where details of the four pilot schemes were announced.

Fit notes

He said: “We agree the current system of fit notes isn’t working well for patients, GPs and employers.

“It often lacks the nuance to deal with specific work situations and reasons that people have for not being able to work their full or part of their role. 

“We hope these pilots will give the opportunity to explore a different way for people to engage with periods of ill health and ways to make work more accessible and achievable.

Pilot schemes

“This recognises that GPs aren’t always best equipped to understand the options for work and we hope that active engagement between patients, GPs, employers and this new service will provide a better experience for everyone.”

The small-scale pilots will be held in Coventry and Warwickshire, Birmingham and Solihull, Lancashire and South Cumbria, and Cornwall and the Isles of Scilly.

The Department for Health said the pilots are ‘exploratory and flexible, designed to test and refine different delivery models through a test and learn approach’.

DAUK survey

DAUK’s own GP survey highlighted strong professional support for reform.

Among respondents, 69% said fit notes should no longer remain within GP remit, while 85% supported transferring responsibility to a dedicated new service. Nearly half backed a return to four-week self-certification, and 94% reported that refusing a fit note negatively affected the doctor–patient relationship.

Dr Taylor said: “It is important that no one is forced to work who cannot, but it is also important that those who can, should be encouraged and given options to work.

“This could be a great improvement and we look forward to seeing the outcomes from these four pilots.”

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GP co-lead Dr Steve Taylor highlighted the work of DAUK on fit notes during an interview on national radio.

Dr Taylor was discussing a survey by BBC that found that hundreds of GPs have never refused to sign a patient off work for mental health issues.

Some respondents told the BBC they were frustrated with the current system, saying providing fit notes should not be part a GP’s role.

Fit notes

The Doctors’ Association UK (DAUK) GP co-leads Dr Taylor and Dr Sarah Jacques last year took part in discussions with the Department for Work and Pensions about the future of fit notes.

Ahead of the meeting, DAUK surveyed GPs to ensure their views were represented.

The survey found:

• 69% of GPs said fit notes should not remain part of their remit
• 85% felt a new service should take responsibility for issuing fit notes
• 46% supported a return to four weeks self-certification
• 51% did not favour self-certification by patients
• 94% reported that refusing a fit note negatively affects the doctor/patient relationship

Dr Taylor, speaking to Tom Swarbrick on LBC, said: “The majority of respondents said they didn’t think GPs were the best people to issue fit notes.

Work health

“I wasn’t expecting that many, but the majority did agree with the survey the BBC have done that actually it’s hard for GPs to assess health in work.”

He added: “GPs usually only hear one side of the story.

“The person in front of us says they are struggling to work, but we don’t know the workplace situation or the employer’s perspective.

Self-certify

“What worked well was during the pandemic when people could self-certify for a month.

“And so the conversations were occurring between the employee and the employer.”

Listen to Dr Taylor’s LBC interview on the DAUK Instagram.

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

GP co-leads Dr Sarah Jacques and Dr Steve Taylor attended the meeting on behalf of DAUK.

Ahead of the talks, DAUK surveyed GPs across the UK on the future of fit notes to ensure their views were represented.

Fit notes

We asked for their views on whether fit notes should be the remit of GPs, whether a new service should be responsible for them, and whether there should be a return to the Covid plan of four-weeks self certification, GP input after four weeks.

GPs were also asked if they would prefer patients to fully self certify for any illness, and whether refusing a fit not can impact the doctor/patient relationship.

The survey received 213 responses, which were all anonymised before being shared with the DWP. It found:

• 69% of GPs said fit notes should not remain part of their remit
• 85% felt a new service should take responsibility for issuing fit notes
• 46% supported a return to four weeks self-certification
• 51% did not favour self-certification by patients
• 94% reported that refusing a fit note negatively affects the doctor/patient relationship

Dr Jacques and Dr Taylor said: “We are pleased that the voices of our members and of frontline general practice were heard in this important discussion.

Listening to GPs

“We welcome the DWP’s willingness to listen to GPs as they look at how fit notes could evolve.”

The discussions come as the Government undertakes a new pilot scheme to reform the way fit notes are issued. The WorkWell Primary Care Innovation Fund is backed by £1.5 million across 15 regions.

The Government says the pilot scheme will look to find other ways to help people back into work.

Pilot scheme

DAUK’s GP committee member Dr Rosie Shire spoke on national radio about the scheme when it was launched last month.

Speaking on LBC, Dr Shire challenged assertions GPs ‘immediately write people off with a fit note’.

She said: “We want people to work and people do want to work, and that’s really important.”

DAUK’s GP committee will continue to engage with members and represent their views on this and other issues around general practice.

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