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How do GPs complete fit note comments?

C Coole¹, P J Watson, L Thomson

¹School of Health Sciences, A Floor, South Block link, Medical School, Queens Medical Centre, University of Nottingham, Nottingham NG7 2HA, UK.

Occupational Medicine (Oxford, England)

|November 12, 2013

Summary

This summary is machine-generated.

General practitioners (GPs) in the UK rarely detailed functional effects in fit notes, hindering return to work (RTW) guidance. Improvements are needed for employers to effectively use fit note comments.

Keywords:

Fit note general practitioner occupational medicine sickness certification work.

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Area of Science:

Occupational Medicine
General Practice
Health Services Research

Background:

The UK's 'fit note' system, implemented in April 2010, aims to support employees' return to work (RTW).
Current research has not explored how general practitioners (GPs) utilize the comments section of the fit note.
Understanding GP commentary is crucial for optimizing RTW processes.

Purpose of the Study:

To analyze the content and characteristics of comments provided by GPs in a sample of fit notes.
To identify patterns and variations in how GPs complete the fit note comments section.
To assess the utility of GP comments for facilitating employee RTW.

Main Methods:

A content analysis was performed on 1212 fit notes.
Data were sourced from a general practice and a Fit for Work Service (FFWS).
GPs in the FFWS had specialized training in occupational medicine.

Main Results:

Fit notes from the FFWS had significantly higher comment rates (98% for 'may be fit,' 90% for 'not fit') compared to general practice (72% and 12%).
Fourteen comment categories were identified, with most referencing RTW but few detailing functional capacity.
Comments often served multiple purposes and varied widely in completion.

Conclusions:

GPs' completion of the fit note comments section varied significantly and did not align with intended use.
The current information in fit note comments may be insufficient for effective employer use.
Enhancements to the fit note comments are recommended to improve RTW support.