Last week, the prime minister, Rishi Sunak, announced his plans to change the country’s “sick note culture” by launching a review of the fit note system, which could see responsibility taken away from GPs and directed towards specialist health professionals with dedicated time and expertise.
According to the government, the idea is to move away from a system where people are ‘not fit to work’ by default and pivot instead to an approach where each fit not conversation centres around what people can do with the right support in place.
In response, director of the NHS Confederation’s primary care network, Ruth Rankine, said any initiative that could help to reduce demand on general practice was welcome.
“But the deeper problem isn’t the system – it’s that people are sicker than they were, and they have more complex healthcare needs,” said Ruth.
“This is why it is vital the government starts treating investment in the NHS as an explicit tool of economic development and also, that the Prime Minister should lead a national mission for health improvement to shift the focus from simply treating illness to promoting health and wellbeing.”
A call for evidence has been jointly published by the Department of Health and Social Care, as well as the Department for Work and Pensions.
The Royal College of General Practitioners has already outlined its intention to respond to the call and have said that it is open to the possibility of removing some of the responsibility from GPs, but whoever its falls on must be focused on patients – not meeting targets.
The organisation’s chair, Professor Kamila Hawthorne, said: “It is vital that if others become involved in this process that the best interests of the patient remains the priority for anyone involved in assessing someone’s ability to work – and that they are trained accordingly, with safeguards in place to ensure appropriate decisions are being made.
“Any initiative should be piloted, and subject to rigorous evaluation in terms of its benefit for patients, especially the most vulnerable, and identifying unintended consequences, before any wider roll out is considered.”
Assistant director at the Health Foundation, David Finch, said that for any government reform to show results, it should be a part of a wider, more comprehensive plan that strikes at the heart of the issue.
He said: “Helping to keep people in good work and health for longer is an important part of supporting a thriving working-age population.
“Key to this is getting support to people quickly as their health starts to affect their ability to work. However, reforms to fit notes, as outlined in the Prime Minister’s speech today, won’t help the 2.8 million people currently out of work due to their long-term health conditions.”
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