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Pharmacists, nurses and physios to be able to sign fit notes from July

by Emma Wilkinson
17 June 2022

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A wider range of health professionals will be able to sign off fit notes from July to ease pressure on GPs.

New legislation will enable nurses, occupational therapists, pharmacists, and physiotherapists to legally certify fit notes, the Department for Work and Pensions has confirmed.

It is the biggest change to the rules around fit notes since they were introduced in 2010 and part of a planned overhaul of reforms that has included scrapping ink only signatures and providing more ‘interactive’ advice on workplace adaptations and support.

The change in law, which will apply across England, Scotland and Wales from 1 July follows moves in April to allow for fit notes to be certified and issued digitally.

In a bulletin, the BMA, who has long been in favour of a wider variety of healthcare professionals being able to sign fit notes, said not everybody working within these professions should issue them but should be ‘working in a suitable environment and have the necessary skills and training to have work and health conversations with patients’.

Issuing fit notes also needs to be within their professional ‘scope of practice’, the BMA said, and that new guidance and training had been developed to advise on this.

The changes follow a consultation last summer about reducing ill-health related job loss to which many respondents expressed views on the current fit note system despite it not being part of the original scope of the consultation.

Outlining its plans at the time, the Government said it would also move to embed electronic fit notes in hospital systems to encourage hospital doctors to issue them reducing the burden on GPs.

Maria Caulfield, minister for patient safety and primary care said that improving access to GP services and reducing unnecessary bureaucracy was ‘vitally important as we tackle the Covid backlog’.

‘Extending powers to provide fit notes to other healthcare professions will relieve further pressures on GPs and is another step towards helping to deliver an extra 50 million appointments in general practice a year by 2024.’

Chloe Smith, minister for disabled people, health and work said the changes would make it easier for patients to get the support and advice they need from the right place, ensuring where possible that they are able to remain in work.

‘These latest fit note changes recognise the valuable role other professions play in helping manage people’s health and I hope this will also help reduce unnecessary bureaucracy for doctors and general practice more widely.’

‘This is just another way in which we’re supporting GPs in primary care, and we remain on track to deliver 26,000 more primary care staff by 2024 to help improve patient access to appointments.’

BMA England GP committee deputy chair Dr Kieran Sharrock said: ‘This announcement is a positive step and we hope that it will go some way to both improving the process for people who need confirmation that they are too unwell to work, and free-up GPs’ time to care for patients who need their expertise.

‘The BMA has been clear for many years that it may not always be necessary or appropriate for a GP to issue a fit note, especially where a patient has seen a different member of the practice team for their condition, such as a nurse or physiotherapist.

‘At a time when the entire NHS is under pressure, reducing unnecessary administration and bureaucracy, while taking a more flexible and pragmatic approach to patient services is absolutely vital.’

RCGP vice chair Dr Gary Howsam said: ‘Allowing other healthcare professionals working in general practice, where appropriate, to issue fit notes is something the College has called for and would support.

‘Such a move should help free up GPs’ time to deliver patient care to those who need their medical expertise at a time when the profession is working under intense workload and workforce pressures. It would also recognise the role of some members of the wider practice team in giving patients advice about health and work – as such it’s important that appropriate guidance and training is put in place to support them to do this safely and effectively.

‘Whilst this would be a positive step in helping to reduce the bureaucratic burden GPs face on a daily basis, ultimately the Government must take further action to address escalating workload in general practice and chronic workforce shortages.’

This story was initially published on our sister title Pulse.

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