Pennygate Resident Knowledgebase

fit-notes

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📝 Fit Notes

Fit notes (previously called Sick notes, Med3, eMed3, Signing off) can be completed digitally if you have a smartcard or by hand. They can be given to a patient, or sent via SMS using accurx or SystmOne.

IMPORTANT

Confusingly, a ‘Fit Note’ means that you are not fit for work, although it can be more complicated than that - see below.

It is a recommendation to the employer that the person be allowed to abstain from work, and in return they can seek some financial benefit from the government to help pay for the period of sickness. As such they are important documents and you must be truthful with what you write.

📅 When does a patient need a Fit Note?

Self-Certification Period

Patients can self certify for 7 days, and a Fit note will start on the 8th day.

If you are seeing a patient before this period has expired (eg: on day 4 or 5), then you can start the note today, and they can use a self certification to cover the first days.

⏪ Can I backdate a Fit note?

A fit note can be backdated if the clinician is happy to. It can be backdated as far as there is evidence available that the illness was ongoing. This might be in the form of:

  • Consultation notes
  • The date the appointment was booked (eg: if booked 4 weeks ago for leg pains, then this corroborates history)
  • A&E attendances

Advise Patients

If a patient does ask for a backdated note, it is worth mentioning that they should seek notes contemporaneously, else should a GP refuse in the future as they feel there isn’t enough evidence, the patient will be left with periods of unauthorised absence.

🔄 Does someone need to be signed back on to work?

No, a patient can return at any point, and similarly an employer can insist that a patient returns at any point.

TIP

If you are asked for a note to say someone can return to work before their note has expired, signpost them to: https://www.nhs.uk/common-health-questions/caring-carers-and-long-term-conditions/can-i-go-back-to-work-before-the-end-date-on-my-fit-note/

✍️ Does a Fit note need to be signed?

Not any more.

👤 What about people who are unemployed?

If you are unemployed you must actively search for jobs to received jobseekers allowance. A Fit note allows the job centre to place patients on ESA (Employment and Support Allowance) meaning they receive money without having to look for a job.

🔄 How does a patient have a phased return to work?

Ask the patient to liase with their employer or occupational health department to discuss what this will look like, and for how long it will be initially planned. Examples include:

  • Reduced days per week for a month
  • Reduced hours per day
  • Amended duties such as desk based work

Steps for Phased Return

  • Ask patient to discuss with employer/occupational health
  • Get details of the phased arrangement (hours, duties, duration)
  • Patient informs us of the information and start date
  • Produce a note with ‘May be fit for work’ ticked
  • Include details and ticks in the right place on the form

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