Posted By akm I was under the opinion that any health professional could sign them back, otherwise why have an occupational health specialist who is employed to give advice on all things occupatonally related? Theeretically the individual is being signed back to work by someone who has a greater understanding of the work/ill health interaction than the GP (who will probably sign anyone off for as long as they like) - sorry to any GPs out there!

Posted By nspencer Without taking offence to previous posting and in response to GP Med 3, as I occupational health specialist (yes I was a nurse in a previous life bit now days do not adminstered medication or apply plasters) do not forget that Med 3 or 'sick notes' are only acknowlegedemnt that that person is entitled to Statutory Sick Pay. Anyone can challenge a sick note. At the end of the day who knows what the employee is telling their GP their job requirements and the average GP has only 7 minutes to assess their fitness to work. This link specifies the GP responsibilities http://www.dwp.gov.uk/me...4/ib204-june04/ib204.pdf which are specified below. Medical statements record the advice which you give to patients regarding the need to refrain from their usual occupation. Such advice is an everyday part of the management of clinical problems and you should always consider carefully whether advice to refrain from work represents the most appropriate clinical management. Doctors can often best help a patient of working age by taking action which will encourage and support work retention and rehabilitation. When providing advice to a patient about fitness for work you may wish to consider the following factors: • the nature of the patient’s medical condition and how long the condition is expected to last • the functional limitations which result from the patient’s condition, particularly in relation to the type of task they actually perform at work • any reasonable adjustments which might enable the patient to continue working. In relation to the workplace it is worth noting that under the Disability Discrimination Act 1995 an employer may be required to make adjustments for an employee with a long term disability • any appropriate clinical guidelines - for example the Royal College of General Practitioners has produced clinical guidelines on the management of acute low back pain6 • Clinical management of the condition which is in the patient’s best interest regarding work fitness As a certifying doctor you will also need to consider and manage your patient’s expectations in relation to their ability to continue working. In summary, you should always bear in mind that a patient may not be well served in the longer term by medical advice to refrain from work,

Posted By GARYS All Many thanks for the responses. Not sure if I'm any the wiser. I'll try and be a bit more specific if I can. We currently have a very generous company sick scheme, as part of the scheme if an employee is found to be absent due to an LTA they will be on full pay for up to 72 weeks (Depending on length of employment). I joined the company just under a year ago and was stunned by the amount of LTA's and F2508's that we had and continue to have, allot of these are slightly dubious (in my humble opinion), we are fortunate that we have occupational health resources available so I am in the middle of revising the absence management policy, what I am finding now is that when we make appointments for employees to come and see either the nurse or physio asap following the accident the first thing they do when they arrive on site is issue the nurse with a sick note for 1-2 weeks ranging from "soft tissue damage", "sore knee, leg, foot" etc. On assessment the nurse and physio (off the record) believe this person to be fit of for, therefore I have asked them to start challenging employees, the nurse then suggested that even if the GP has signed them off we can still insist they returned to work as she has found nothing wrong with them without them being signed fit again by the GP who issued the sick note. To be fair to the Nurse she is very fair with her judgement and under no circumstances would she suggest should be brought in against the advice of a GP just to keep LTA figures down, and this is not the reasoning behind the query, it is to try and manage employees are clearly exploiting our sick pay, so we don't allow a minority of employees spoil that sick pay we have in place.

Posted By GARYS Thanks for the helpful comments Locksley. Obviuolsy I wasn't clear when I stated that currently a large majority of these accidents are dubiuos (we have some very clever employees who know how to abuse our current scheme), but hey I could pretent they didn't happen and under report... I am adressing the issue, but when someone claims to have had an accident with no witnessess and goes and get's signed off by their GP it doesn't help. Yes by good accident investigations we can try to show that we believe the accident didn't happen as claimed or at all if possible, which may help when and if an EL claim comes in, but that doesn't help me try to stop employees taken 2 weeks off, when there are no obviuos signs of any injury. If I can find out whether or not our Occupational Health department are in a postion to sign employees who in their opinion are fit for work back in, then I will be in a postion to reduced LTA's and F2508's, and yes I take your point, that through good risk management if we reduce overall accident figures we would therefore have less accident to becomes reportable, but our total accident rate is reasonably low in comprison to number of employees and industry standard. I apologise if my postings sound pedantic but I was looking for helpful advice on Sick notes, not how to do my job. And I thank all of those who made every effort to help me.

Posted By Paul Duell That's a bit unfair John. I know that in the company I worked for up until three months ago, there was definitely a culture of: a) people going sick for a genuine reason, then reporting an accident when they came back to work. On investigation there was no evidence that the accident had ever happened. b)People having what most of us would consider a minor accident and taking three days. The union involved were telling people that as long as a workplace accident caused three days off work, they could claim. We know that's not the truth, but people believed the union rather than the company. It's all very well saying "report it and let the HSE decide if it's genuine", but treating accidents as more serious than they are diverts investigation and prevention resources away from the genuine serious accidents; it naffs up one important way of measuring the effectiveness of accident prevention measures and if people claim, it forces insurance premiums up as well as wasting investigators's time. I know that most accident reports are genuine: I know that most people want to work and will get back as soon as they can. But it's naive to assume there are no false claimants out there.

Posted By Paul Duell I think the culture of that company is summed up by its making all its H&S people redundant. But as far as "skivers" / "management" etc - ever heard of a thing called the compensation culture? Still, as you yourself said John... Of course, like all H&S professionals, you'll assume your opinion is paramount.

Posted By GARYS Clare Many thanks for your response it was extremely helpful. Thanks Again Gary

Posted By Clare Gabriel It would appear that the last writer works in a very unusual situation, where most of his claims are justified. How lucky is he? I do not believe I have ever seen a MED3 where the nature of the illness or condition has not been listed by the GP - or otherwise why write out a MED3? One of the issues we all suffer from is GPs who sign individual off for weeks and weeks having no understanding of their work environment - it seems many just feel work is BAD, again the value of a good OH doctor who can override such a decision. Occupational Health, when you have a good provider is essential for both parties - employers and employees, and we are fortunate enough to have an excellent provider who is well received by our employees and works hard for the employer bringing back the LTAs who have been all but written off by their GPs. The feedback we have received from these people that they come back is met with relief, and often very small adjustments need to be made for a short time. Many of you will have read that for many, work is actually therapy and with a well organised programme in place employees can return to work - happily - and contribute both economically and socially - which for many is one of the most important things as the isolation they feel stuck at home is crippling. I am sure there will be some readers who feel that this is a capitalist view - but it should not be get them back at any cost (some employers)but the majority of us work in industry where without the employee we would not have a job. I cannot imagine there are many out there who do not sympathise with those who are genuinely made ill or injured at work. Having a good OH provider then ensures we look after those people and those who have illness not attributed to work - properly. Individual views on the EEF are not that interesting as they do appear to be a hugely successful and useful organisation who lobby very hard for employers rights. Equally the quality of the publications and training courses they produce also are hugely popular, which one would assume if they were not any good would not have that level of success.

Posted By Clare Gabriel Bizarrely I come from Worcester but our provider comes from the South East. Our OH do not 'do' risk assessments but assist if required. where is the information on this issue - is there a website link as it would be worth a read?

Posted By Pete48 Oh John, much as I enjoy your contributions, methinks you have set out an extreme position in this one. For example, it is self evident that your final statement about diagnosis is unlikely to occur and if it does would be investigated by the GMC if a complaint was made against that medic. Now whether all OH services are as good as they should or could be is debatable. Objective of an employers OH service is to provide the employer with medical guidance on matters arising from their undertaking. Since it is the employer who ultimately decides fitness for work, there are clear occasions where they might need that advice. The GP as you quite vociferously point out is the agent of their patient and not the employer. The OH support will have specific and specialised knowledge of the workplace that is not available to the GP other than from their patient. That may or may not be accurate or in sufficient detail for the GP to accurately diagnose the best approach for the patient. So mutual working including informed consent of the employee is usually the best approach. Sadly, in this 'orrible world that we live in , many other motivations get in the way of this happening as a positive support for the injured person. However I do not see that as a reason to dismiss the process out of hand.