OTs to issue fit notes

Government plans to enable occupational therapists to issue fit notes

Published on 8th December 2017

Occupational therapists will be able to issue fit notes under government proposals.

In the recent Department for Work and Pensions Green Paper, ‘Improving Lives: The Future of Work, Health and Disability’, the government stated that it had started development work to legislate for the extension of fit note certification powers to other health care professionals, along with the design and development of a set of competencies for those completing fit notes.

Karin Bishop at the Royal College of Occupational Therapists and expert on the impact of work on individual’s health and wellbeing said: “The Royal College of Occupational Therapists welcomes the announcement of the inclusion of occupational therapists in the proposals for the extension of certification for fit notes.

“Occupational therapists are well placed to be involved in making a judgment about fitness for work and providing sickness certification. They can identify the in-depth support required for individuals, for example: defining amended hours and identifying any reasonable adjustments required; analysing particular job tasks and the demands on the worker in carrying out these tasks and the impact of the illness or injury for the person,” she added.

In the consultation for the green paper, the government said that employers and GPs said they support the idea of helping people to return to work when they can. However, recently published fit note statistics shows that only 6.6% of fit notes used the ‘may be fit for work’ option.

Respondents said that the fit note process itself could be improved by more detailed information - from employers on their workplace and the patient’s job role, and from specialists involved in the patient’s care, such as physiotherapists, occupational therapists or psychiatrists.

The review concluded that the fit note remains an important tool, but it is not always used effectively across the system to support people staying in or returning to work. It is still the case that too many fit notes say ‘not fit for work’ when people ‘may be fit for work’ as long as appropriate workplace adjustments are made.

As a result, the government said it was starting development work to legislate for the extension of fit note certification powers to other healthcare professionals, integrating fit note training into GP undergraduate and postgraduate education and exploring whether changes to the way GPs complete fit notes could support better return to work conversations.

Karin Bishop added: “Our GP colleagues are extremely busy and do not always have the time to carry out these assessments in the necessary detail, so it makes absolute sense for occupational therapists to be included in proposals to the extension in certification powers.

“Having the skills and competencies to assess the person, their environment, and their occupations, occupational therapists have for some time now been using the Allied Health Professions Advisory Fitness for Work Report, which is similar to the current GP statutory documentation. The AHP report is more detailed and specifically identifies issues and potential solutions for return to work. Adapting to the more formal role of issuing fit notes would be a smooth transition for occupational therapists who make judgments on individual’s ability to perform specific tasks, and the support they need based on that judgment, on a daily basis,” she added.

In the green paper, the government reaffirms its commitment to realising the vision and to see one million more disabled people in work over the next 10 years.

Improving Lives The Future of Work, Health and Disability



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