Certification - Sickness

GP Fit Certificates - Statement of Fitness to Work (Med 3)

The fit note was introduced to replace the old sick note in 2010. Doctors issue fit notes to individuals to provide evidence of the advice the doctor has given about the individual’s fitness for work. The fit note allows doctors to advise that individuals “may be fit for work” taking into account the doctor’s advice, or that they are “not fit for work”.

Doctors use fit notes to record details of the functional effects of their patient’s condition so that individuals and employers can consider ways to help the individual return to work. Fit notes can be hand-written or computer-generated and printed out. Fit notes should be issued by hospital doctors if someone is receiving treatment in hospital, or otherwise by GPs.

There is no need for a back to work certificate and there is the ability to make an assessment by telephone consultation, face to face encounter or report from another health professional. The certificate has space to recommend whether or not you need to see the patient again at the end of the statement period. There is a reduction in the maximum duration of statement during the first 6 months of illness to 3 months and the form has space for comments and some tick boxes to indicate simple adjustments or adaptations that could aid the patients return to work.

This is not to suggest that we should suddenly become occupational health doctors, but that it may facilitate a discussion around returning to work, and we can use our clinical judgement on what we feel may be done to achieve this. This advice is not binding for employers and if they cannot implement the advice then the certificate is valid for the patient to remain off work without need for a further consultation.

Here is some further information you may find useful:

Occupational Health Guide to Operation Recovery Times

Extending Fit Note Certification

From 1 July 2022, new legislation comes into force which allows nurses, occupational therapists, pharmacists, and physiotherapists to legally certify fit notes, in addition to doctors. To support this, the government has published guidance to help individuals and employers identify the knowledge, skills and experience required to certify fit notes. A new training package is also available and should be completed before taking up this task - this is freely accessible for all healthcare professionals. There is a rollout period from 1st July 2022 where GP IT systems will also be updated to reflect the change.

Sickness of Less Than 7 days

You are not obliged to provide a 'sick certificate' for your patients for periods of less than seven days. In these circumstances patients should self certify as below. We have produced a letter for your patient to take to his/her employer to explain this. However, you may of course issue a private certificate you wish.

Click here to access guidance from Acas on managing absence from work.

Employees Statement of Sickness Forms (Self certificate or SC2)

Individuals may make a statement of sickness for the first week of sick leave, and GPs are not required to issue certification for periods of less than 7 days. You can download a copy of the HMRC SC2 Self Certificate Form from here

Sending Fit Notes Electronically

It is possible to send Fit Notes, electronically via email to patients to avoid them having to attend your practice to collect it. Ardens have produced an article and video of a step-by-step guide on how to do this.

TPP SystmOne guide to sending Fit Notes electronically

EMIS Web guide to sending Fit Notes electronically

Hospitals and Sick Certification

Hospital Doctors have also been issued with guidance on Fit Certificates which can be accessed here .

Sick certification will be integrated into the hospital discharge process so that hospital doctors and consultants will not refer patients to a GP solely for the purpose of obtaining a sickness certificate."

The target date for this was July 2001! Hospital staff should therefore provide their patients with an adequate certificate to cover the expected period of disability. If the patient has unexpected complications that necessitate a GP consultation, it is appropriate for the GP to provide any necessary treatment and/or specialist referral and to provide any additional certification that is required. Similarly if the patient's recovery is delayed beyond the expected period then the GP is obliged to provide further certification.

Whenever a patient is discharged without adequate certification it is worth personalising the letter to the Chief Executive of the hospital to draw the matter to his or her attention. Please let the office or your local Committee representative know if this is a frequent problem.

Fit To Return To Work Note – When A Fit Note Ends

You are not obliged to provide a fit to return to work note when a fit note has ended. We have produced a letter for your patient to take to his/her employer to explain this.