Has the fit note reduced general practice sickness certification rates?

Area of Science:

• Occupational Health
• General Practice
• Public Health Policy

Background:

• The fit note replaced the sick note in 2010, shifting focus from incapacity to employee capability.
• This change aimed to improve management of work-related ill-health and sickness absence.

Purpose of the Study:

• To compare sickness certification rates for work-related ill-health before and after the fit note's introduction.
• To analyze trends in sickness absence and certification over time.

Main Methods:

• Data on work-related ill-health and sickness certification were collected from General Practitioners (GPs) via The Health and Occupation Research network in General Practice.
• Proportions of sickness certification were compared for 4 years pre-fit note and 3 years post-fit note.
• Changes in certification incidence rate ratios were measured.

Main Results:

• Out of 5517 reported cases, 50% were certified sick pre-fit note.
• In the first year post-fit note, certification rates did not change, with 13% classified as 'maybe fit'.
• By the second year, sickness certification significantly reduced to 41%, with 19% advised on workplace adjustments. A slight rise occurred in the third year, resulting in a non-significant annual decrease of 2% in certification rates.

Conclusions:

• The fit note facilitated recommendations for workplace modifications for employees previously certified as unfit.
• A slight decrease in overall certification rates suggests GPs are becoming more adept at advising on workplace adjustments.
• The study indicates a gradual shift in managing work-related ill-health towards facilitating return-to-work and workplace accommodations.