FCP's challenges and learning and development needs in response to managing fitness for work and sickness absence in primary care

Cameron Black*, Sivaramkumar Shanmugam, Heather Gray

*Corresponding author for this work

Research output: Contribution to conferencePosterpeer-review


Purpose: The UK’s Departments of Health and Work and Pensions, within the White Paper Improving Lives: The Future of Work, Health and Disability, outlines the Legislation for extension of Fit Note sickness absence certification for those patients ill for more than 7 days in a row to other suitably qualified non-medical Allied Health Professionals (AHPs) along with a set of competencies to aid in its certification completion. The Statement of Fitness for Work (known as a ‘Fit Note’) was introduced in the UK in 2010 to allow clinicians to provide their patients with advice on fitness for work and to encourage patients to resume some work as soon as they have recovered sufficiently. Despite this, clinicians seem to not provide fitness advice on most Fit Notes and in 2016 the UK Government reported that the fit not was ‘not fully achieving what it set out to do’. The role of certifying sickness absence in the UK has traditionally been conducted by General Practitioners in Primary Care settings, but this role increasingly is being carried out by AHPs who work within Occupational Health and Primary Care settings. More recently, the 2019 AHP Health and Work report was designed by a working group from the Chartered Society of Physiotherapy, Royal College of Occupational Therapy and College of Podiatry to provide information to the employee and employer on the functional impact of the patient’s reported problem. The role of sickness absence certification and fitness for work advice is potentially amenable within the First Contact Practitioner (FCP) primary care model.
The main aim was to obtain consensus nationally for FCPs training and development needs and challenges in delivering OH focussed consults in primary care, including fitness for work recommendations and sickness absence certification.
Objectives: Conduct a Delphi study to gain consensus on the topic and explore the major parameters of the problem area (fitness for work and sickness absence) as perceived by FCP experts 
Methods: The study used an online modified version of the Delphi Technique, to achieve FCP expert consensus. 
Results: Study results to be finalised March 2021. 
Conclusion(s): This research adds new evidence regarding the challenges and learning and development needs identified by a group of national FCPs working within primary care with regards to sickness absence certification and fitness for work advice.
Impact: OH experts will gain consensus on challenges faced and the learning and development items needed when delivering OH specific advice within primary care.  This study provides evidence to supplement and support frameworks on an important topic and suggests that FCPs are willing to take on this role with adequate support and training. It will be published through the peer review process and disseminated amongst key stakeholders including the CSP, PCNs, GP network and the wider NHS network. 
Original languageEnglish
Publication statusPublished - 6 Nov 2021
EventVirtual Physiotherapy UK 2021 - Online, United Kingdom
Duration: 5 Nov 20216 Nov 2021
https://www.csp.org.uk/professional-clinical/courses-events/physiotherapy-uk (Link to conference website)


ConferenceVirtual Physiotherapy UK 2021
Abbreviated titleVPUK
Country/TerritoryUnited Kingdom
Internet address


  • first contact practitioner
  • primary care
  • fitness for work


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