College responds to DWP Keep Britain Working review

The Royal College of General Practitioners (RCGP) has responded to Sir Charlie Mayfield’s Keep Britain Working review, which proposes changes to the fit note process as part of efforts to support people living with ill-health and disabled people to remain in or return to work.

Professor Kamila Hawthorne, Chair of the RCGP, said: "The College recognises work as a health outcome, and that good work can be beneficial for patients’ health. As such GPs routinely encourage patients to stay in or return to work when it is safe and appropriate to do so. We do also see many patients in general practice where it is in the best interests of their health to be issued a fit note, whilst acknowledging the current system needs to be improved, for patients, as well as those involved in issuing fit notes.

"We support, in principle, efforts to reform systems surrounding health and work, and to support patients to remain in or return to ‘good work’ that is appropriate and beneficial for their wellbeing. It may well be that one part of this could be the transfer of responsibility for longer-term fit notes from GPs to more specialised professionals. With workforce and workload pressures across general practice, the responsibility associated with the issuing and management of long-term certification can consume valuable GP time, and we are not always best placed to provide the wider care, including occupational health support and communication with employers, that patients often need, so this move makes sense.

“However, it is the College’s view that GPs and our teams should still have the option to continue to issue short-term (up to 3 weeks) fit notes and retain some involvement in longer-term care and oversight of patients’ overall health, where appropriate. This would avoid associated bureaucracy and duplication that would be in nobody’s best interests.

“The College also urges Government to ensure that reforms are developed and evaluated carefully, with input from healthcare professionals, occupational health experts, and patients, to ensure that the system supports recovery, protects patient safety, and helps make best use of GP time. We stand ready to work with the Government to ensure that any future reforms to the fit note system work for GPs and patients.

“Ultimately, any reform to the current system must be in the best interests of patients. Whichever professionals take on the responsibility for issuing long-term fit notes must be properly resourced and trained, and reforms must be consistently evaluated and prioritise the health and wellbeing of patients over economic or political targets. This process should never be punitive in nature.”

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.