In efforts to reduce the alarming number of sick notes dished out by UK GPs – sometimes booking off people for months on end – Ministers will radically overhaul the practice, with a more stringent regime in the pipeline for a back-to-work drive to tackle the country’s ballooning welfare bill.
Mel Stride, the Work and Pensions Secretary, and Steve Barclay, the Health Secretary, are working on plans to dramatically shake up the current system in favour of a “treat-them-first” approach, which will slash the number of Britons being routinely signed off for months at a time.
Partly due to time pressures, GPs were currently signing people off “as being unfit for any work whatsoever” in nine out of 10 cases, reports The Telegraph.
Under one option being discussed, GPs could be removed as the first port of call for those seeking a so-called “fit note”. Instead, workers would be “triaged” by a local medic or welfare official working as part of a new national scheme.
Sources said this would amount to a fundamental change to the process for signing people off work, with one warning that the final proposals would not amount to a “quick fix”.
The plan is drawing on an existing pilot scheme, WorkWell, under which the government was expected to trial “work and health hubs” in England involving NHS and Jobcentre staff, to support those at risk of losing jobs because of their health condition.
In its response to a government consultation on reforming the existing system, The Society of Occupational Medicine called for “a locally delivered, but nationally led work and health service” to be responsible for fit notes – describing the type of model now being seriously considered by Ministers.
Under the plans, the triage process would identify the most appropriate clinician or official for an individual to see under the “treat-them-first” principle, if they are seeking a fit note.
Those available could include occupational or mental-health practitioners, physiotherapists, GPs, Jobcentre work coaches, and “life coaches” who could help people with problems such as debt, and with work-related matters, like networking.
Ministers hope the approach will lead to fewer people simply being signed off as unfit to work.
Less radical options
Currently, GPs are asked to classify people as either unfit for work, or possibly fit for work with specific changes, such as adapted hours or duties. A source involved in the discussions said that under the plans being considered, “GPs will absolutely still have a role, but exactly how that functions is still being discussed”.
Less radical options include adding more options to the form, including a referral to a new work and health support service, but keeping GPs as the first port of call.
Last week, Stride warned that of 2.6m people classed as “long-term sick and disabled”, only 1% were “coming out of that group every month”.
“You start by going to your GP, they give you, on average, seven minutes, they have a fit note where 93% of the time they will sign you off as being unfit for any work whatsoever. A medical practitioner has therefore said you cannot work.
“The other box, which is that under certain circumstances with adjustments you might be able to do something, only gets ticked 6% of the time.
“I want to change it so that the person can be helped there and then, and enters into an arrangement where health support, plus work coach support, is brought together at that time to make sure they don’t proceed along that path.”
See more from MedicalBrief archives:
UK pharmacists and therapists now also allowed to issue sick notes
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Why the courts are sceptical about sick notes
Traditional healers want to be able to issue sick notes