Fit for work, with the help of nurses, physios and others

NHS and health and social care partnership colleagues across Grampian have completed a successful pilot project to broaden the range of health professionals able to provide Fit-Notes.

Training is now available to a range of professionals who work in community settings across Grampian – including registered nurses, pharmacists (excluding community pharmacists), occupational therapists and physiotherapists – in a bid to improve the patient experience and lessen the workload of GPs.

Some people may still refer to Fit-Notes as ‘sick lines’, but the emphasis of these has changed over the years to support individuals to consider their plan to return to work and what help they may need. Healthcare professionals who are working closely with an individual know their needs best and are best placed to offer this support and issue their Fit-Note.

The law changed to support the development in the way Fit-Notes are certified, with health providers across Scotland asked to start making changes last year. Work to increase the number of GP practices involved in the expansion is ongoing, with the teams who took part in the test of change saying it makes a big difference to supporting patients in the best way possible for them.

David Cooper, a GP from Old Machar Medical Practice commented: “For the nurses, physiotherapists and others who are working closely with a patient, it makes sense for them to be able to work on Fit-Notes without having to refer back to a GP for sign off. We’ve found it works particularly well for those with chronic, long-term conditions or illness, and it’s a more efficient way for us to work as a practice.  

“The process behind the scenes is also now electronic so it saves paper, time and energy. Another big bonus has been the emphasis on team working for us, the support from NHS Grampian on training and mentorship, and also the relationships it has helped us develop with other practices. This is a step in the right direction for primary care, along with things like advanced prescribing by a range of practitioners, and it will take time to grow and develop.”

First contact physiotherapist Paul Gray, who works with patients from Old Machar as well as other practices, added: “It has been really positive for me to be able to process Fit-Notes directly. It makes the patient journey easier and it’s better for people to access Fit-Notes from those who are assessing your physical capabilities and helping you get stronger. The additional training and team working has been helpful for me and something we can build on by training and mentoring others too.”

Stuart Reary, NHS Grampian’s Clinical Director for Primary Care, who has led the test of change across Grampian added: “The idea is Fit-Notes will be issued by those caring directly for you, rather than you having to make another appointment with your GP. A wider range of health professionals who are providing you with care will be able to issue Fit-Notes, following a full assessment of a person’s fitness for work.”

If you are offered a Fit-Note by your occupational therapist or others who may be caring for you – this is all part of the roll-out of a new process and should simplify who you can go to in future. In time, this expansion will also apply to a range of professionals who may support patients in a hospital setting.

Data is being stored in the same way, with only those caring for an individual being able to see that person’s information. If you have any questions, please refer to your care provider.