Update
New “Fit note” launched
Fit notes have now replaced sick notes in England, Scotland and Wales.
The Med 3 and Med 5 medical statements have been replaced with the new “fit note”, or “Statement of Fitness for Work”, which intends to advise patients who are on sick leave for more than seven days on whether, with extra support from their employer, they could return to work.
The Statement allows GPs to provide more information about the effects of a patient’s illness or injury. GPs will be able to document that the patient:
- “Is not fit for work”, or
- “May be fit for work taking account of the following advice”.
There is space to add more general advice about the impact of an illness or injury, or the functional effects of a patient’s condition. A tick-boxing system has been added, to suggest common ways in which the employer could make simple changes to the patient’s job to support an earlier return to work. Examples of extra support needed in order to return to work could include:
- A phased return to work
- Temporarily working different hours
- Amended duties or tasks
- Additional practical support, eg, exemption from heavy lifting for patients with a back problem.
The Department for Work and Pensions states in its guide on the new requirements: “The advice you give is on the functional effects of the condition within the limits of your knowledge and expertise. This advice will help your patient’s employer to make a more active contribution to your patient’s recovery.”
But Dr Laurence Buckman, Chairman of the BMA’s GP Committee, said GPs need to be careful not to get drawn into making comments they are not qualified to make. “Unlike occupational health doctors, GPs are not often in a position to know the details of the patient’s working conditions, neither do they have specialist knowledge of workplace hazards.
"Occupational health doctors have a central role in helping people back to work, but, unfortunately, only one worker in eight has access to an occupational health doctor."
The rules for issuing a Statement have changed, so that during the first six months of sickness, the new Statement can be issued for no longer than three months.
Sources:
Practices struggle to introduce new complaints system
Some practices are struggling to follow the new complaints procedures, according to MPS.
Last year, since the introduction of the new system, MPS received more than 2,000 enquiries about how to handle complaints.
A number of common themes were identified around the challenges faced by practices:
- Insufficient information and confusion about the changes to the process.
- Feeling excluded from the process, eg, the PCT taking control of the complaint, where a doctor is working as a locum or for an out-of-hours agency.
- Having limited time and staff resources to implement and manage a patient-focused procedure, even though spending time in planning how a complaint is handled at the outset can prevent the matter from escalating.
Dr Stephanie Bown, MPS Director of Policy and Communications, said: “Whilst some practices have embraced the new process and have dealt with complaints appropriately by being open, outcomes focused and drawing up a resolution plan, many are still following the old procedures and are therefore struggling.”
According to the NHS Information Centre, 38,453 complaints were made against 8,228 practices in 2008-9.
Northern Ireland: GPs welcome free prescriptions for all
Doctors welcomed the start of free prescriptions for all in Northern Ireland, which began on 1 April.
Larne GP Dr Brian Dunn, who heads up the BMA’s Northern Ireland GP Committee, said: “GPs have seen first hand how patients had to contend with the inequalities of the previous charging system. I will now be able to write prescriptions in the knowledge that cost won’t be a factor in preventing patients from taking their medicines.”
Dr Paul Darragh, Chairman of the BMA’s Council in Northern Ireland, described it as a momentous event in the history of healthcare, as patients with chronic and life-threatening illnesses will now be able to get their medicines without worrying about cost.
The move follows the announcement by Health Minister Michael McGimpsey in 2008, to introduce free prescriptions and end the tax on illness.
Charging for prescriptions has already been abolished in Wales and is being phased out of the Scottish health system.
England has abolished charges for cancer patients.
In your practice
Campaigns
The Health and Safety Executive (HSE) has launched a campaign on slips, trips and falls in the workplace as part of its "Shattered Lives" initiative. Last year, in addition to 40 fatalities, there were over 15,000 minor injuries to workers, as well as more than 30,000 workers having to take over three days off work. The campaign is targeted at those sectors where there is a high number of incidents; health and social care is one of them.
Take action
You have until 28 May to respond to the Department of Health’s consultation on plans to abolish practice boundaries and allow patients to register with a GP practice of their choice. The consultation is seeking views from healthcare professionals and the public on different options for organising healthcare for patients and the potential implications of removing the existing system, which would remove practice boundaries.
Guidance
The National Patient Safety Agency (NPSA) has developed new guidelines to help NHS staff with health problems receive prompt treatment. “Invisible Patients” has been developed to remove any stigma NHS staff may feel in asking for medical help. The document suggests ways in which healthcare organisations can support their employees and demonstrate the help that is available.
Useful links
A new mental health resource has been developed for relatives, by the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry. The resource provides carers, families and friends suffering any form of psychosis with information on different aspects of treatment and care.