Moran et al1 report the uptake and practice of issuing Electronic Fit Notes (e- Fit Notes) in a secondary care setting in the NHS highlighting several issues including lack of doctors’ training on e–fit notes, variation in the practice of issuance of e-fit notes and technological issues supporting e-fit notes.
This study is timely and important as it reveals the lack of full embeddedness of e-Fit Notes in the NHS secondary care despite introduction of e-fit notes (eMed3) in 2012 initially in the primary care.2 While there are no precise statistics on e-Fit Notes issued in the secondary care, 12,671,880 e-fit notes were issued in the primary care from December 2014 to March 2017.3 Nevertheless, the number of e-fit notes issued in secondary care is expected to be less than in the primary care (general practice) because e-fit notes issued in the secondary care will relate to patients attending A&E, hospital in patients such as those admitted for an elective surgery / procedure, patients with mental health issues requiring regular review and some patients attending hospital out-patients, for these types of patients issuance of e-fit notes is the responsibility of hospital doctors attending the patients.4
Medical doctors working in the NHS include doctors who have been trained in the UK, other EU member countries and non-EU countries such as India where the practice of Fit Notes could be different from the UK. In addition, medical doctors either trained in the U...
Moran et al1 report the uptake and practice of issuing Electronic Fit Notes (e- Fit Notes) in a secondary care setting in the NHS highlighting several issues including lack of doctors’ training on e–fit notes, variation in the practice of issuance of e-fit notes and technological issues supporting e-fit notes.
This study is timely and important as it reveals the lack of full embeddedness of e-Fit Notes in the NHS secondary care despite introduction of e-fit notes (eMed3) in 2012 initially in the primary care.2 While there are no precise statistics on e-Fit Notes issued in the secondary care, 12,671,880 e-fit notes were issued in the primary care from December 2014 to March 2017.3 Nevertheless, the number of e-fit notes issued in secondary care is expected to be less than in the primary care (general practice) because e-fit notes issued in the secondary care will relate to patients attending A&E, hospital in patients such as those admitted for an elective surgery / procedure, patients with mental health issues requiring regular review and some patients attending hospital out-patients, for these types of patients issuance of e-fit notes is the responsibility of hospital doctors attending the patients.4
Medical doctors working in the NHS include doctors who have been trained in the UK, other EU member countries and non-EU countries such as India where the practice of Fit Notes could be different from the UK. In addition, medical doctors either trained in the UK or outside may or may not have training in dealing with Fit Notes especially e-fit notes.
It is therefore imperative to support medical doctors working in secondary care in regards to e-Fit Notes. For example, providing a free training course on e-Fit Notes with CPD credits for NHS medical doctors, working in both the secondary and the primary care, who have had no experience or training in e-Fit Notes. In addition, as highlighted by Moran et al1, introduction of occupational health focusing on fitness to work and occupational functioning of patients of working age (18-65 years) would be useful for secondary care doctors; thus helping in the integration and adoption of e-Fit Notes in the secondary care, which could be helpful not only for patients requiring Fit Notes but will also reduce unnecessary burden on GPs who provide nearly 15 million appointments related to Fit notes and associated issues.
1. Moran A, Mainwaring C, Keane O, et al. Sick Note to Fit Note: one trust’s project to improve usage by hospital clinicians. BMJ Open Quality 2018;7(1) doi: 10.1136/bmjoq-2017-000220
2. NHS Digital. eMED3 (fit notes). Information Standards Notice SCCI2118 Amd 65/2015. Leeds, 2015.
3. NHS Digital. Fit notes issued by GP practices, England. December 2014 - March 2017. Leeds, 2017.
4. Department for Work and Pensions. Statement of Fitness for Work. A guide for hospital doctors. London, 2010.
5. British Medical Association. Primary and secondary care interface guidance 2017 [updated 04 July 2017. Available from: https://www.bma.org.uk/collective-voice/committees/general-practitioners....
Acknowledgements:
The views expressed in this letter are my personal views and my organisation bears no responsibility for these comments.
Moran et al1 report the uptake and practice of issuing Electronic Fit Notes (e- Fit Notes) in a secondary care setting in the NHS highlighting several issues including lack of doctors’ training on e–fit notes, variation in the practice of issuance of e-fit notes and technological issues supporting e-fit notes.
Show MoreThis study is timely and important as it reveals the lack of full embeddedness of e-Fit Notes in the NHS secondary care despite introduction of e-fit notes (eMed3) in 2012 initially in the primary care.2 While there are no precise statistics on e-Fit Notes issued in the secondary care, 12,671,880 e-fit notes were issued in the primary care from December 2014 to March 2017.3 Nevertheless, the number of e-fit notes issued in secondary care is expected to be less than in the primary care (general practice) because e-fit notes issued in the secondary care will relate to patients attending A&E, hospital in patients such as those admitted for an elective surgery / procedure, patients with mental health issues requiring regular review and some patients attending hospital out-patients, for these types of patients issuance of e-fit notes is the responsibility of hospital doctors attending the patients.4
Medical doctors working in the NHS include doctors who have been trained in the UK, other EU member countries and non-EU countries such as India where the practice of Fit Notes could be different from the UK. In addition, medical doctors either trained in the U...
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