GPs are being explicitly told not to issue fit notes to patients by the Department of Work and Pensions, even if there is still a chance that the decision could be appealed.
The changes to the letters sent to GPs by the DWP remove the section warning that they may still need to issue fit notes – for example if a patient is appealing a decision or their condition gets significantly worse.
This means that GPs may have been put off from issuing a fit note, even if they believed one was needed.
Charities say this has put patients at risk of becoming homeless or ‘reliant on foodbank vouchers and loans’.
The RCGP said GPs should not be treated as ‘benefits assessors’ and should be encouraged to advocate for their patients to receive benefits where needed, and not be put off making such a decision.
The ESA65B letter is automatically sent to GPs whose patients fail their capability assessment (WCA) and are deemed fit to work.
Originally the letter clearly stated that GPs may have to give their patient ‘new medical statements if they decide to appeal against our decision, their condition gets significantly worse, or they have a new medical condition.’
However, following a review, the new letters now say: ‘As a result of this decision, [Title] [Surname] is not entitled to ESA from and you do not need to provide any more fit notes to [select] relating to [select] disability/health condition for ESA purposes.’
Advice charity Z2K, which take benefits appeals to tribunals on behalf of patients, told our sister publication Pulse, where this article was first published, that they have had cases where GPs have received these letters while patients are going through the appeals process.
The charity gave one example of a client who had previously been given a fit note due to her arthritis in her knees, but was then told she would not be able to get another note due to the ESA65B letter her GP received from the DWP, even though the case was pending appeal.
Chief executive of Z2K Raji Hunjan said: ‘It is not for the DWP to interfere with the GP and their patient. Sending these letters directly to the GP, without even informing the patient, is putting doctors in a position which both undermines their role and puts their patients at risk.
‘The impact of these letters can be devastating. We have seen how they lead to our clients who are seriously ill, suddenly have zero income, other benefits are comprised, become reliant on foodbank vouchers and loans, and face a very real threat of homelessness.’
RCGP chair Professor Helen Stokes-Lampard said: ‘We are concerned about letters being sent to GPs suggesting that we do not need to provide fit notes to patients who have been found to be ineligible for the Employment and Support Allowance, without making clear that there are exceptions, for example, if a patient is appealing against the decision.
‘It is crucial that any document or correspondence relating to fit notes reflects the often-complex reality of the situation and ensures that GPs are still able to issue fit notes for patients when they feel it is necessary and when our patients need them.
‘Patients who are appealing a decision require a fit note to be able to continue to receive benefits – without this document, their finances and ultimately their health are potentially at risk. No GP wants that, and it only serves to threaten the long-standing trust that patients have in their family doctor.
‘GPs are doctors, and our concern is the health and wellbeing of our patients. We are not benefits assessors and must never be used as barriers for patients to receive benefits when they are entitled to them, as ultimately, this can have a detrimental impact on their health.’
A DWP spokesperson said: ‘These letters simply inform GPs when a claimant has been found fit for work and are not intended to dissuade them from issuing fit notes for ESA appeal purposes, to claim otherwise is inaccurate.
They added: ‘We are committed to ensuring our communication is clear, which is why the wording of this letter was cleared by both the BMA and the RCGP. However, we will of course consider feedback when revising the letter.’
Earlier this month, the DWP announced it was developing a new IT system which would allow access to GP patient data to determine benefits assessments.
In October, a petition was launched calling for professions other than GPs to be able to sign fit notes, saving GP time.
A version of this story was originally published on our sister publication Pulse.