Fit for work certification: A new government service to help GP workload

Blog by Dr Anna Cantlay

Certification for fitness to work is a huge part of GP workload. In 2013, 131 million days were lost to sickness absence and 815,000 employees have absence of 4 weeks or more.

The average UK worker will have 9 “sick” days in a year, higher than a lot of our global counterparts. It's hardly a surprise that a GP will currently issue about 20 certificates a week.  That’s a hefty chunk of GP resources, at a time where the workforce is being pushed to the brink and capacity is stretched.

In the 2016 BMA annual conference, motions were debated to remove the sickness certification completely from GP responsibilities and instead put this back into the hands of the Department of Work and Pensions (DWP). A proposal was also made to extend self-certification of employees to 14 days from the current 7, easing pressures on GPs.

But as it stands, fit for work certification still predominitanty lies with GPs and although it may not feel like a top priority, it is still a hugely important role for GPs and one that must be done well. So why does it matter?

Firstly, for the economy. Sickness absence comes with huge costs to businesses, with 2013 statistics showing total UK sickness costs coming in at £28 billion.  It goes without saying that the health of the economy correlates closely with the funding available for NHS care.

Secondly, its importance for the patient. Research shows that employees who are off work for 4 weeks or more will struggle to return to work without adequate support. In addition, unemployment has been related to higher mortality and poorer physical and mental health.

Work not only gives the economic means for an improved material well-being, but has also been shown to improve self esteem, provide social status and allow a full participation in today's society.  Despite the clear importance of getting patients back to work, only 31% of businesses in the UK have access to an occupational health service.

To help GPs facilitate their patients with a return to work, the government launched a new “Fit for work” service in July 2015. This free and confidential service provides support for GPs, employers and the employees themselves.

Patients who have been off work for 4 weeks or more are eligible to be referred. With the patient’s consent, a GP can refer a patient into the service and within 2 days will be contacted by an occupational health advisor for an in-depth consultation with the aim to identify and assist with any barriers in returning to work.

The employee will be given a “Return to work plan” and be signposted to local services that may also help them. This plan provides evidence of fitness or lack of fitness to work and therefore also removes the need for ongoing notes from the GP.

With the patient’s permission, the service can also liaise with their employer to provide maximum possible support for a return to work. For more complex cases, a face to face assessment may also be offered within 5 days of referral. The service provides ongoing support for 3 months.

In a 2012 DWP survey of more than 4000 GPs, 37.6% reported they did not feel confident in  dealing with patient issues around a return to work.  Could the Fit for Work provide us with  the support both GPs and employees need?

For more information on the Fit for Work service go to fitforwork.org or call 08000326235.