Identification of UK sickness certification rates, standardised for age and sex

Abstract

BackgroundThere is growing interest in tackling the perceived 'sick note' culture in the UK. AimThe aim of this paper was to report the rates of sickness certification in a UK population, using sick certification rates as a precursor to addressing fitness for work. MethodElectronic records from all 14 practices included in the Keele GP Research Network were reviewed; all sickness certification records from 2005 were retrieved and corresponding consultation records were examined. Participants were 148 176 patients registered during 2005, including 6398 patients who received at least one sickness certificate during the same year. ResultsThe rate of sickness certification was 101.67 certificates per 1000 person years (95% confidence interval [CI] = 100.13 to 103.21). This rate was significantly higher in women, at 109.76 certificates per 1000 person years (95% CI = 107.550 to 112.02), compared to men who had a rate of 93.68 certificates per 1000 person years (95% CI = 91.59 to 95.78; P<0.001). The rate of sickness certification was greatest for mental health conditions, followed closely by musculoskeletal conditions. ConclusionOn average, one in 10 patients will receive a sickness certificate each year, with the highest rates occurring around 50 years of age, in women. Mental health and musculoskeletal conditions were associated with the highest rates of certification. These results provide important information to underpin the national 'Fit for Work' scheme, by providing targets for intervention and a benchmark against which the impact of public health initiatives to reduce certified sickness absence due to health conditions can be evaluated and monitored.

Sickness certification of workers compensation claimants by general practitioners in Victoria, 2003–2010

“…The highest proportion of unfit‐for‐work certificates were written for workers with a MHC, followed by fractures, other traumatic injuries, back pain and strains, musculoskeletal injuries and diseases, and other diseases. Recent studies in the United Kingdom have also shown that GPs are more likely to issue unfit‐for‐work certificates for patients with MHCs than other conditions 9 , 10 . Conversely, GPs in our study were more likely to certify workers with other diseases as suitable for alternative duties than those in other categories.…”

“…Evidence that GP sickness certification practices vary according to worker characteristics is growing. A common finding is that GPs are more likely to certify workers with mental health conditions (MHCs) as unfit for work than those with physical conditions 9 , 10 . Risk factors for longer duration of work incapacity include older age, social deprivation, and presence of mild and severe MHCs 11 .…”

Certified sickness absence: does the ‘fit-note’ work?

“…As described in the authors’ previous work and in results from other studies, cases of mental ill-health were responsible for the highest proportion of fit-notes issued, followed by musculoskeletal disorders 4 5 6. ‘May be fit’ advice was less frequently included on fit-notes issued to patients with psychological diagnoses, and this is consistent with results examining the fit-note advice offered to patients in other work.…”

“…Many studies report on the rate of certification but are unable to collect information on the length of absence 6 7. Research on the length of sickness absence in the UK has been difficult largely due to the lack of routinely collected data at general practice level 4.…”

Age differences in the associations between sick leave and aspects of health, psychosocial workload and family life: a cross-sectional study

“…The analyses were controlled for sex, employment category and hours worked weekly. 12 19 To gain more insight into the impact of chronic disease on sick leave, the analyses were additionally controlled for this factor.…”