Certifying fitness to work

Abstract

Around 131 million days of work were lost to sickness in the UK in 2011, an average of 4.5 days per worker. Although there has been a decrease in sickness absence in the UK over recent years, there is still a perception that illness is incompatible with work. Conversely, a substantial body of evidence suggests that earlier return to work results in better outcomes. One of the many roles of GPs is to act as gatekeepers to sickness-related benefits through the issuing of certificates confirming incapacity to work or ‘sick notes’. With this comes a responsibility to enable and assist patients to return to work at the earliest possibility. However, many GPs have received little or no training in sickness certification and occupational health and find this a difficult area of practice fraught with perceived conflicts and ethical dilemmas. This article outlines the evidence in support of early return to work and overviews the sickness certification system in the UK, providing signposts for GPs to make their task easier.