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Return-to-work outcomes and usefulness of actual fit notes received by employers

Coole, Carol; Potgieter, Iskra; Nouri, Fiona; Worthington, Esme; Drummond, Avril

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Authors

Carol Coole

Iskra Potgieter

Fiona Nouri

Esme Worthington

AVRIL DRUMMOND avril.drummond@nottingham.ac.uk
Professor of Healthcare Research



Abstract

Background: GPs can use the fit note to advise that a patient ‘may be fit’ or is ‘not fit’ for work. Previous employer-based research on the fit note is largely qualitative and based on general perceptions and past experience. Knowledge of the return-to-work outcomes and usefulness of actual fit notes is needed to strengthen the evidence-base and inform practice.
Objective: To investigate the return-to-work outcomes of fit notes issued to employed patients, and their employers’ opinions as to the usefulness of each note.
Methods: Participating organizations collecting fit notes were asked to rate the outcome and usefulness of each fit note via postal questionnaires. Quantitative data were analysed descriptively; qualitative data were analysed using thematic content analysis.
Results: Five hundred and sixteen questionnaires were posted, with a 97% return rate (n = 498). More than 80% of employees (n = 44) returned to work after the expiry date of a ‘may be fit’ note compared with 43% (n = 167) of those issued with a ‘not fit’ note. Fit notes were considered more useful if they provided information on the condition and its effect on the employee’s ability to work, if they stated whether or not the employee needed reassessment and if clear advice regarding return-to-work had been provided.
Conclusions: ‘May be fit’ notes are useful in helping employees return to work. However, this option is infrequently used, and the completion and content of many fit notes does not meet employers’ needs. These factors need to be urgently addressed if the fit note is to reach its full potential.

Citation

Coole, C., Potgieter, I., Nouri, F., Worthington, E., & Drummond, A. (in press). Return-to-work outcomes and usefulness of actual fit notes received by employers. Family Practice, 32(5), https://doi.org/10.1093/fampra/cmv050

Journal Article Type Article
Acceptance Date May 29, 2015
Online Publication Date Jun 26, 2015
Deposit Date Jul 25, 2016
Publicly Available Date Mar 28, 2024
Journal Family Practice
Print ISSN 0263-2136
Electronic ISSN 1460-2229
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 32
Issue 5
DOI https://doi.org/10.1093/fampra/cmv050
Keywords consultation, occupational/environmental medicine, primary care, public health, rehabilitation/disabilities
Public URL https://nottingham-repository.worktribe.com/output/753660
Publisher URL http://fampra.oxfordjournals.org/content/32/5/551
Additional Information This is a pre-copyedited, author-produced PDF of an article accepted for publication in Family Practice following peer review. The version of record: Return-to-work outcomes and usefulness of actual fit notes received by employers/ Carol Coole, Iskra Potgieter, Fiona Nouri, Esme Worthington and Avril Drummond. Family Practice (2015), 32 (5): 551-556 is available online at: http://fampra.oxfordjournals.org/content/32/5/551

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