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Fit Note Use in UK Clinical Practice 2010–2016: A Systematic Review of Quantitative Research

Published online by Cambridge University Press:  23 March 2020

S. Dorrington
Affiliation:
King's College London, Department of Psychological Medicine, London, United Kingdom
E. Roberts
Affiliation:
King's College London, Department of Psychological Medicine, London, United Kingdom
S. Hatch
Affiliation:
King's College London, Department of Psychological Medicine, London, United Kingdom
I. Madan
Affiliation:
King's College London, Occupational Health, London, United Kingdom
M. Hotopf
Affiliation:
King's College London, Department of Psychological Medicine, London, United Kingdom

Abstract

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Background

The fit note, introduced in England, Wales and Scotland in 2010, was designed to radically change the sickness certification process from advising on individuals’ inability to work to what they could do if adjustments were made available. Our review aimed to evaluate: (1) the percentage of fit notes utilizing the new “may be fit for work” option or advising on work adjustments, (2) the impact of the fit note on sickness absence and return to work, (3) demographic variation in fit note use.

Methods

We systematically searched in Embase, Cochrane CENTRAL, Pub Med, Worldcat, Ovid and PsychInfo from 1 Jan 2010–30 Nov 2016 for studies on working aged adults which included the search terms “fit note” or “fitnote”. Relevant abstracts were extracted and we assessed the quality of the papers and assessed bias using the modified Newcastle Ottawa Scale.

Results

Nine papers met the inclusion criteria, four of which were based on the same cohort. Maybe fit notes made up just 6.6% of all fit notes. Work adjustments were most often recommended for patients who were less deprived, female and patients with physical health problems. Fit note advice for patients with physical health problems increased over time, but the opposite was seen for patients with mental health problems.

Conclusions

Further research needed to evaluate the use, impact and potential of the fit note, especially for patients with mental illness.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster viewing: Mental health policies
Copyright
Copyright © European Psychiatric Association 2017
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