Recommendations to facilitate the ideal fit note: are they achievable in practice?

Background: Although the UK fit note has been broadly welcomed as a tool to facilitate return to work, difficulties and uncertainties have resulted in wide variation in its use. Agreement on what constitutes the ‘ideal’ fit note from the perspective of all stakeholders is needed to inform best pract...

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Main Authors: Coole, Carol, Nouri, Fiona, Potgieter, Iskra, Watson, Paul J., Thomson, Louise, Hampton, Rob, Drummond, Avril
Format: Article
Published: BioMed Central 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/35254/
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author Coole, Carol
Nouri, Fiona
Potgieter, Iskra
Watson, Paul J.
Thomson, Louise
Hampton, Rob
Drummond, Avril
author_facet Coole, Carol
Nouri, Fiona
Potgieter, Iskra
Watson, Paul J.
Thomson, Louise
Hampton, Rob
Drummond, Avril
author_sort Coole, Carol
building Nottingham Research Data Repository
collection Online Access
description Background: Although the UK fit note has been broadly welcomed as a tool to facilitate return to work, difficulties and uncertainties have resulted in wide variation in its use. Agreement on what constitutes the ‘ideal’ fit note from the perspective of all stakeholders is needed to inform best practice. A recent Delphi study conducted by the authors reached consensus on 67 recommendations for best practice in fit note use for employed patients. However, such recommendations are not necessarily followed in practice. The purpose of this study was therefore to investigate the perceived achievability of implementing these Delphi recommendations with a further reference panel of stakeholders. Methods: Potential participants were identified by the research team and study steering group. These included representatives of employers, government departments, trades unions, patient organisations, general and medical practitioners and occupational health organisations who were believed to have the knowledge and experience to comment on the recommendations. The consensus Delphi statements were presented to the participants on-line. Participants were invited to comment on whether the recommendations were achievable, and what might hinder or facilitate their use in practice. Free text comments were combined with comments made in the Delphi study that referred to issues of feasibility or practicality. These were synthesised and analysed thematically. Results: Twelve individuals representing a range of stakeholder groups participated. Many of the recommendations were considered achievable, such as improved format and use of the electronic fit note, completion of all fields, better application and revision of guidance and education in fit note use. However a number of obstacles to implementation were identified. These included: legislation governing the fit note and GP contracts; the costs and complexity of IT systems and software; the limitations of the GP consultation; unclear roles and responsibilities for the funding and delivery of education, guidance and training for all stakeholders, and the evaluation of practice. Conclusions: This study demonstrated that although many recommendations for the ideal fit note are considered achievable, there are considerable financial, legal, organisational and professional obstacles to be overcome in order for the recommendations to be implemented successfully.
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spelling nottingham-352542020-05-04T17:19:42Z https://eprints.nottingham.ac.uk/35254/ Recommendations to facilitate the ideal fit note: are they achievable in practice? Coole, Carol Nouri, Fiona Potgieter, Iskra Watson, Paul J. Thomson, Louise Hampton, Rob Drummond, Avril Background: Although the UK fit note has been broadly welcomed as a tool to facilitate return to work, difficulties and uncertainties have resulted in wide variation in its use. Agreement on what constitutes the ‘ideal’ fit note from the perspective of all stakeholders is needed to inform best practice. A recent Delphi study conducted by the authors reached consensus on 67 recommendations for best practice in fit note use for employed patients. However, such recommendations are not necessarily followed in practice. The purpose of this study was therefore to investigate the perceived achievability of implementing these Delphi recommendations with a further reference panel of stakeholders. Methods: Potential participants were identified by the research team and study steering group. These included representatives of employers, government departments, trades unions, patient organisations, general and medical practitioners and occupational health organisations who were believed to have the knowledge and experience to comment on the recommendations. The consensus Delphi statements were presented to the participants on-line. Participants were invited to comment on whether the recommendations were achievable, and what might hinder or facilitate their use in practice. Free text comments were combined with comments made in the Delphi study that referred to issues of feasibility or practicality. These were synthesised and analysed thematically. Results: Twelve individuals representing a range of stakeholder groups participated. Many of the recommendations were considered achievable, such as improved format and use of the electronic fit note, completion of all fields, better application and revision of guidance and education in fit note use. However a number of obstacles to implementation were identified. These included: legislation governing the fit note and GP contracts; the costs and complexity of IT systems and software; the limitations of the GP consultation; unclear roles and responsibilities for the funding and delivery of education, guidance and training for all stakeholders, and the evaluation of practice. Conclusions: This study demonstrated that although many recommendations for the ideal fit note are considered achievable, there are considerable financial, legal, organisational and professional obstacles to be overcome in order for the recommendations to be implemented successfully. BioMed Central 2015-10-13 Article PeerReviewed Coole, Carol, Nouri, Fiona, Potgieter, Iskra, Watson, Paul J., Thomson, Louise, Hampton, Rob and Drummond, Avril (2015) Recommendations to facilitate the ideal fit note: are they achievable in practice? BMC Family Practice, 16 (138). 138/1-138/12. ISSN 1471-2296 Fit note Sickness certification Statement of fitness for work Recommendations Achievability Implementation http://bmcfampract.biomedcentral.com/articles/10.1186/s12875-015-0360-4 doi:10.1186/s12875-015-0360-4 doi:10.1186/s12875-015-0360-4
spellingShingle Fit note
Sickness certification
Statement of fitness for work
Recommendations
Achievability
Implementation
Coole, Carol
Nouri, Fiona
Potgieter, Iskra
Watson, Paul J.
Thomson, Louise
Hampton, Rob
Drummond, Avril
Recommendations to facilitate the ideal fit note: are they achievable in practice?
title Recommendations to facilitate the ideal fit note: are they achievable in practice?
title_full Recommendations to facilitate the ideal fit note: are they achievable in practice?
title_fullStr Recommendations to facilitate the ideal fit note: are they achievable in practice?
title_full_unstemmed Recommendations to facilitate the ideal fit note: are they achievable in practice?
title_short Recommendations to facilitate the ideal fit note: are they achievable in practice?
title_sort recommendations to facilitate the ideal fit note: are they achievable in practice?
topic Fit note
Sickness certification
Statement of fitness for work
Recommendations
Achievability
Implementation
url https://eprints.nottingham.ac.uk/35254/
https://eprints.nottingham.ac.uk/35254/
https://eprints.nottingham.ac.uk/35254/