SOM calls for fit note training for health workers

Health workers should be trained in how to use the fit note to its full potential, the Society of Occupational Medicine has said after the government gave more professions the power to certify notes.

The change, announced late last week by the Department for Work and Pensions, means more health professionals including nurses, physiotherapists and occupational therapists will be able to certify notes that declare a workers’ fitness to work, which the government claimed would relieve pressure on stretched GP services.

The move has been welcomed by SOM, but it has called for more training to be put in place to ensure fit notes are having the greatest impact impact work and health, as their use should go beyond certifying sickness absence.

“The fit note acts as an important backstop to occupational health in GP practices, ensuring contact with a healthcare professional relatively early in a period of sickness absence,” said chief executive Nick Pahl.

“However, the fit note is rarely used to its full potential, with fit notes generally focusing on the ‘not fit’ for work option, rather than the ‘maybe for work’ section. Over a third of fit notes are also often issued for five weeks or longer, by which time around 20% of people will never return to work.”

SOM has suggested that undergraduate and postgraduate curricula in health professions should include modules on occupational health, as well as training around what fit notes could be used for – including on the “maybe fit for work” section.

It believes that this would enable health professionals to offer tailored advice around fitness to work.

According to an Imperial College London article published in the British Journal of General Practice last year, almost 95% of over six million fit notes issued by GPs in 2020 advised that the patient was “not fit for work” without suggesting adjustments or advice.