Fit for purpose? Using the fit note with chronic pain patients: a qualitative study

E Wainwright, D Wainwright, E Keogh, C Eccleston

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Background: Staying in work may benefit patients with chronic pain, but can be difficult for GPs to negotiate with patients and their employers. The new fitnoteis designed to help this process, but little is known of how it is operating.

Aim: To explore GPs’ views on the fit note, with particular reference to sickness certification for patients with chronic pain.

Design and setting: Qualitative study using semi-structured interviews in eight primary care trusts in south-west England.

Method: In-depth interviews with 13 GPs.

Results: GPs reported that the rationale behind the fit note is sound and that it may help patients with chronic pain to return to work earlier. However, GPs also reported barriers to successful fit note use, including the need to preserve
doctor–patient relationships, inconsistent engagement from employers, GPs’ lack of specialist occupational health knowledge, issues with fit note training,and whether a new form can achieve cultural shift.

Conclusion: While doctors agree that good work improves health outcomes, they do not think that fit notes will greatly alter sickness-certification rates without more concerted initiatives to manage the tripartite negotiation between doctor, patient, and employer
Original languageEnglish
Pages (from-to)794-800
Number of pages7
JournalBritish Journal of General Practice
Issue number593
Publication statusPublished - Dec 2011

Bibliographical note

Acknowledgments: We thank the GPs who participated in this study. We also thank Dr Rachael Gooberman-Hill, who provided many useful comments on an earlier draft of this article.

Funding: The study was funded by an unrestricted grant from the University of Bath (EA–FH1005).


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