http://www.bbc.co.uk/news/uk-scotland-11001149





Yes helping keep people in work is the most important of all. As long as this aspect is the objective I cannot see many problems with this. It will certainly save money in the long run. It might pay to concentrate efforts on those who have just started seeing the GP more so that they can be assisted to stay in work.

Oh FFS! In a ten-minute consultation, a GP has too look for: depression, gambling, alcoholism, smoking cessation, diet and lifestyle, encourage breast/testicular self-examinations and deal with "benefit dependency" too. TBH, unless someone's had surgery or some acute illness, sick notes should not be given. Instead, occupational therapists need to assess what patients can/can't do and then report back to their employer. GPs aren't qualified to be able to give this kind of assessment hence should not have to use "fit notes".

I think that the increased appearances at the GP are what identifies the person as at risk. Which does not involve the GP making an assessment. GP's should not be responsible assessing if a person is fit for work. If the person has a serious relapse as a result the doctor could be legally liable for any and all costs. I dread to think what impact a few substantial lawsuits will have on their insurance and the impact it will have on the numbers of GP's.

They are not qualified to judge mental health, they should only be the judges of whether they should be referred to a Clinical Psychologist.

Exactly it should be referred to a specialist but they are busy enough as it is even before they have to start assessing benefit claims.

Why not? GPs do get training in mental health. Clinical psychologists? What the hell man?1?!?!? If a patient needs a referral, they'll usually get referred to a Psychiatrist. Psychiatrists will refer a small proportion of patients to Psychologists, specifically those not suitable or failing medical therapy.

From the information given it does not need to involve doctors. They could identify people at risk from attendance records and then get the doctors to organise specific help for those that can be helped. It does not need doctors to do much more than that.

Have a read of my first post in this thread. I specifically state that the best way to conquer this sick note culture is to involve occupational departments.

My comment was aimed directly at adidan's comment that GPs aren't qualified to judge mental health and that clinical psychologists are. About 20-33% of a GP's workload will involve mental health. Hence they are perfectly well placed for this. However, I don't believe GPs should be entirely responsible for "fit notes" - you would need to know every type of employment, the level of work (physical, mental) involved or required to be able to determine whether the patient is suitable. It is entirely appropriate to involve the occupational department who would be able to determine whether a patient is suitable for returning to work once declared medically fit.