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Fit notes

Specialties > General practice

Introduction to Fit Notes 📝

What is a Fit Note?

  • A Fit Note (also known as a Med3 form) is a medical statement provided by a doctor that gives advice on a person’s fitness for work.
  • It is used when a patient’s health condition affects their ability to work.
  • Fit Notes replaced the old ‘sick notes’ in 2010 in the UK.
  • Fit Notes can be issued by GPs, hospital doctors, and other approved healthcare professionals.
  • They are legally required for employers if an employee is off work for more than 7 days due to illness.

Components of a Fit Note 📄

Statement of Fitness for Work

  • ‘Not fit for work’: The doctor assesses that the patient’s health condition prevents them from working at all.
  • ‘May be fit for work’: The doctor believes that the patient could work if suitable adjustments are made, such as altered hours, amended duties, or workplace adaptations.
  • If the ‘may be fit for work’ box is ticked, the doctor should provide recommendations on what changes could help the patient return to work.
  • The duration for which the Fit Note is applicable should be clearly stated.
  • There is also space for additional comments where the doctor can provide more detailed advice.
  • The Fit Note does not need to be signed at every follow-up if the patient’s condition remains the same.

Key Points in History 🥼

Understanding the Condition

  • Onset and Duration: When did the symptoms start, and how long have they persisted? This helps in determining the appropriate duration of the Fit Note.
  • Severity and Impact: Assess how the condition impacts the patient’s ability to perform their job, including both physical and mental aspects.
  • Previous Episodes: Has the patient experienced similar issues before? This could influence the advice given on the Fit Note.
  • Response to Treatment: Consider whether the patient is improving with current treatment, which could affect their fitness for work.
  • Workplace Factors: Are there specific aspects of the patient’s job that exacerbate their condition? This might be relevant for recommending workplace adjustments.

Background

  • Past Medical History: Chronic conditions like diabetes or mental health issues can influence fitness for work and the need for a Fit Note.
  • Drug History: Consider whether the patient’s medication affects their ability to work, such as sedative effects from certain drugs.
  • Social History: Take into account factors such as the patient’s living situation, support network, and other responsibilities that may impact their ability to return to work.
  • Work History: Understand the patient’s role, duties, and whether they have had difficulties in the past managing their condition at work.

Possible Investigations 🌡️

Assessing Fitness for Work

  • Physical Examination: A general assessment to evaluate the patient’s physical ability to perform their job tasks.
  • Mental Health Assessment: Important for patients with mental health conditions, evaluating their ability to cope with work-related stress and demands.
  • Functional Assessment: Specific tests or assessments may be used to evaluate the patient’s ability to carry out particular job functions.
  • Review of Medical Records: Previous health records may provide insight into the patient’s condition and its impact on their work ability.
  • Specialist Referral: In some cases, referral to occupational health or a specialist may be necessary to provide a more detailed assessment of work fitness.

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General practice