18 November 2011
The Department for Work and Pensions (DWP) has published a research report about GPs’ views on the Statement of Fitness for Work (fit note), which mentions M.E.
The fit note replaced the doctor’s sick note on 6 April 2010. It means GPs can say if they think patients are ‘not fit for work’ or ‘may be fit for work taking account of the following advice’ with tick boxes for a phased return to work, altered hours, amended duties and/or workplace adaptations.
The new report, An evaluation of the Statement of Fitness for Work: qualitative research with General Practitioners, says:
“Many GPs discussed how patients with conditions such as myalgic encephalomyelitis or M.E. (often referred to as chronic fatigue syndrome), common mental health conditions and musculoskeletal problems had experienced the most benefit from the introduction of the new note.
“These conditions are perceived to be highly compatible with amended working hours, tasks and phased returns and the fit note can lead to positive health outcomes for these patients through having the opportunity to work.”
Our response
Action for M.E.’s Sir Peter Spencer says, “The researchers are presumably talking about people who have mild to moderate M.E., not the severely affected. This should have been made clearer, as it was for other conditions.
“While we support intelligently planned, phased returns to work for those who are well enough to go back, many primary healthcare professionals - and employers - still don’t realise that M.E. often requires a more gradual return than many other conditions and the plan needs to cater for the very real possibility of relapse.
“The latest Aviva Health of the Nation study showed that 60% of GPs can’t refer M.E./CFS patients for specialist treatment because there isn’t any available locally.
“More M.E. training for GPs is needed, as are more specialist M.E./CFS services comprised of multi-disciplinary teams including occupational therapists.”
Other findings
The DWP press release about the report, issued 17 November, says:
“The fit note has become a consultation tool that GPs use to initiate and guide negotiations with patients about returning to or commencing work. GPs use the fit note to justify why they have initiated discussion about work and to prompt them through the process of questioning patients about their work-related capabilities.
“GPs are less confident in using particular options on the fit note, like the amended duties and workplace adaptations tick boxes. Some reported difficulty in understanding and distinguishing between the four return-to-work tick boxes and confusion over date fields.
“Barriers to the successful use of the fit note include GPs’ confidence in dealing with conflict and their perception that it could damage their relationship with their patients. GPs are also less likely to drive for a return to work if they perceive the patient’s job to contribute to their health condition.
“Many GPs believe that motivating their patients to return to work is an integral part of their role and that the fit note has helped them to do this. It has also helped some GPs to adopt a stricter role with their patients.”
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