The Department of Work and Pensions has announced changes to regulations on who can legally certify fit notes. Fit notes provide evidence to employers about an employee’s absence from work due to ill health, along with any relevant advice on how to offer support for an individual to remain in or return to work. These new laws apply to pharmacists, nurses, occupational therapists, and physiotherapists.
Fit notes cannot be issued on request or via over-the-counter services and therefore pharmacists working in a community pharmacy are not expected to be impacted by this change but may face queries from the public.
The purpose of the change is designed around managing the workload in GP practices by freeing up time for patient consultations. The PDA believes that the transfer of tasks from one professional to another should not be seen in such basic terms around reducing the administrative and bureaucratic burden. It should, however, be implemented in the context of professionals working as part of a multi-disciplinary team, each bringing their specific training and expertise to patient care and working within the scope of their competence.
The PDA has long called for a more joined-up and multi-disciplinary approach to the delivery of healthcare, and for pharmacists to be enabled to deliver pharmaceutical care to patients through having the necessary skills and training which support conversations with patients. This could include discussions about their general health and the effects of their treatment/s on their condition, which may include their ability to work, or activities that may need to be taken into account around their employment, such as driving and operating machinery whilst taking certain medication.
However, this change has been introduced in a very short timeframe and with a two-week period between the announcement and the new law coming into effect. There are concerns about how this will be effectively and safely implemented.
The PDA is already aware of pharmacists working in GP practices being asked to batch sign fit notes, ahead of any change in regulations.
The PDA understands that Health Education England will be designing mandatory training for those who wish to sign fit notes. The union will be seeking urgent clarification around the rollout of guidance and timescales of when this will be available to PDA members working in primary care and hospitals, who will undoubtedly be at the forefront of the implementation. As with any activity, regulated health professionals will be expected to ensure they have received adequate training and guidance before taking on new elements of practice and to ensure they are acting within the limits of their professional competency.
Completing a fit note may have an impact on the income received by the patient and therefore the consequences of supplying the document could mean a direct financial consequence for them, such as eligibility for sick pay or insurance claims, as well as a health outcome. The PDA expects the mandatory training to cover any factors which will need to be considered in this regard so that pharmacists understand any limitations on when, how, and for who they might complete the fit notes.
Any PDA members with questions about their individual circumstances should contact the PDA Service Centre.
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