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    Recommendations to facilitate the ideal fit note: Are they achievable in practice?

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    Author
    Thomson, Louise
    Keyword
    General practitioners
    Employment
    Return to work
    Date
    2015
    
    Metadata
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    DOI
    10.1186/s12875-015-0360-4
    Publisher's URL
    https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-015-0360-4
    Abstract
    BACKGROUND: Although the UK fit note has been broadly welcomed as a tool to facilitate return to work, difficulties and uncertainties have resulted in wide variation in its use. Agreement on what constitutes the 'ideal' fit note from the perspective of all stakeholders is needed to inform best practice. A recent Delphi study conducted by the authors reached consensus on 67 recommendations for best practice in fit note use for employed patients. However, such recommendations are not necessarily followed in practice. The purpose of this study was therefore to investigate the perceived achievability of implementing these Delphi recommendations with a further reference panel of stakeholders. METHODS: Potential participants were identified by the research team and study steering group. These included representatives of employers, government departments, trades unions, patient organisations, general and medical practitioners and occupational health organisations who were believed to have the knowledge and experience to comment on the recommendations. The consensus Delphi statements were presented to the participants on-line. Participants were invited to comment on whether the recommendations were achievable, and what might hinder or facilitate their use in practice. Free text comments were combined with comments made in the Delphi study that referred to issues of feasibility or practicality. These were synthesised and analysed thematically. RESULTS: Twelve individuals representing a range of stakeholder groups participated. Many of the recommendations were considered achievable, such as improved format and use of the electronic fit note, completion of all fields, better application and revision of guidance and education in fit note use. However a number of obstacles to implementation were identified. These included: legislation governing the fit note and GP contracts; the costs and complexity of IT systems and software; the limitations of the GP consultation; unclear roles and responsibilities for the funding and delivery of education, guidance and training for all stakeholders, and the evaluation of practice. CONCLUSIONS: This study demonstrated that although many recommendations for the ideal fit note are considered achievable, there are considerable financial, legal, organisational and professional obstacles to be overcome in order for the recommendations to be implemented successfully.
    Citation
    Coole, C., Nouri, F., Potgieter, I., Watson, P. J., Thomson, L., Hampton, R. & Drummond, A. (2015). Recommendations to facilitate the ideal fit note: Are they achievable in practice? BMC Family Practice, 16, pp.138.
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/11057
    Note
    © Coole et al. 2015
    Collections
    General Practice

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