College response to BBC research on fit notes

The College responds to BBC research with GPs on how and when fit notes for mental health are issued.

Professor Victoria Tzortziou Brown, Chair of the Royal College of GPs, said:

“GPs recognise the many benefits that being in work can have on our patients’ health, including their mental health, and will use their clinical judgement when considering whether a fit note is appropriate. Fit notes are not issued lightly, but where there is a genuine health-related impact on someone’s ability to work. However, it also important that GPs are able to have sensitive conversations and build trust with patients when they are reporting a health issue that may impact their ability to work. 

“We recognise some of the frustrations reflected in this research – the amount of time spent on the administrative process around fit notes can take away valuable time with patients, and GPs might not be always the most appropriate professionals to provide the long-term occupational support some of our patients need when returning to work. 

“The current system needs to be improved, for patients as well as those issuing fit notes. As a College, we have long called for improvements as evidence-based and patient-centred reform could help reduce GP workload and improve outcomes for patients. 

“We are open, in principle, to exploring whether responsibility for longer-term fit notes could sit with other suitably trained professionals, particularly where occupational health expertise is required, and where this is clinically appropriate, with GP input as needed. This could help ensure patients receive more tailored and personalised work-specific support, and free up valuable GP time.  

“However, GPs should retain the ability to issue short-term fit notes - for example, up to three weeks - where appropriate. This would avoid patients being sent to multiple professionals unnecessarily, and reduce the risk of additional bureaucracy or duplication of assessments.

“Any reform of the fit note process must put the health and wellbeing of patients first, rather than being driven primarily by economic considerations or policy targets. It would need to be fully resourced and thoroughly evaluated, with safeguards in place to ensure reforms do not create further administrative burden, and that people are properly supported to return to, and remain in, appropriate work.”  

Further information

RCGP press office: 0203 188 7659

press@rcgp.org.uk

Notes to editors

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.