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Completion of fit notes by GPs: a mixed methods study

Coole, Carol; Nouri, Fiona; Potgieter, Iskra; Drummond, Avril E.R.

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Carol Coole

Fiona Nouri

Iskra Potgieter

Professor of Healthcare Research


Aims: The aim of this study was to investigate the completion of fit notes by UK general practitioners (GPs). A series of actual fit notes issued to employed patients were examined, and their GPs’ reflections and experiences of fit note completion explored.

Methods: A mixed-methods design was used. Data were collected from copies of 94 fit notes issued to employed patients by 11 GPs, and from 86 questionnaires completed by these GPs reflecting on the fit notes they had issued. Face-to-face interviews were then conducted with each GP.

Results: Fit note completion is not meeting expectations for a number of reasons. These include the following: limited knowledge and awareness of the guidance in fit note completion; problems with the fit note format; lack of mandatory training in completing fit notes; lack of incentive to change practice; incomplete implementation of the electronic fit note; GPs’ lack of confidence in, and doubts about the appropriateness of performing this role.

Conclusion: If UK GPs are to continue their contractual responsibility for completing fit notes, further consideration of their education and training needs is urgently required. Weaknesses in the design and format of the fit note and the availability of the electronic version also need to be addressed.

Journal Article Type Article
Acceptance Date Apr 17, 2015
Online Publication Date Jul 20, 2015
Publication Date Sep 9, 2015
Deposit Date Jul 27, 2016
Publicly Available Date Jul 27, 2016
Journal Perspectives in Public Health
Print ISSN 1757-9139
Electronic ISSN 1757-9147
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 135
Issue 5
Keywords General practitioner, Employees, Fit note, Sickness certification
Public URL
Publisher URL
Additional Information Copyright 2016 by Royal Society for Public Health


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