What do GPs feel about sickness certification? A systematic search and narrative review

Wynne‐Jones, Gwenllian; Mallen, Christian; Main, Chris J.; Dunn, Kate M.

doi:10.3109/02813431003696189

Cited by 91 publications

(80 citation statements)

References 22 publications

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“…In general, the guidelines have fulfilled positive expectations put on them. Results from studies on GPs sickness certification practices in different countries are surprisingly alike which might mean that equivalent guidelines might be found useful also in other countries 1 8…”

Section: Discussionmentioning

confidence: 99%

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

et al. 2011

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ObjectivesDiagnoses-specific sickness certification guidelines were recently introduced in Sweden. The aim of this study was to investigate to which extent general practitioners (GPs) used these guidelines and how useful they found them, 1 year after introduction.DesignA cross-sectional questionnaire study. A comprehensive questionnaire about sickness certification practices in 2008 was sent to all physicians living and working in Sweden (n=36 898, response rate 60.6%). In all, 19.7% (n=4394) of the responders worked as GPs.SettingPrimary healthcare in all Sweden.ParticipantsThe participating GPs who had consultations concerning sickness certification at least a few times a year (n=4278, 97%).Main outcome measuresDescriptive statistics and prevalence ratios for the 11 questionnaire items about the use and usefulness of the sickness certification guidelines.ResultsA majority (76.2%) of the GPs reported that they used the guidelines. In addition, 65.4% and 43.5% of those GPs reported that the guidelines had facilitated their contacts with patients and social insurance officers, respectively. The guidelines also helped nearly one-third (31.5%) of the GPs to develop their competence and improve the quality of their management of sickness certification consultations (33.5%). About half experienced some problems when using the guidelines and 43.7% wanted better competence in using them. A larger proportion of non-specialists and of GPs with fewer sickness certification consultations had benefitted from the guidelines.ConclusionsThe national sickness certification guidelines implemented in Sweden were widely used by GPs already a year after introduction. Also, the GPs consider the guidelines useful in several respects, for example, in patient contacts and for competence development.

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Section: Discussionmentioning

confidence: 99%

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

et al. 2011

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“…The role of health professionals in supporting patients on sickness absence to return to work requires further research. [92][93][94][95] There may be a need to examine incentives, and disincentives, to enter return-to-work schemes where there is evidence that interventions are effective in supporting return to work.…”

Section: Research Recommendationsmentioning

confidence: 99%

Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

et al. 2018

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BackgroundDespite high levels of employment among working-age adults in the UK, there is still a significant minority who are off work with ill health at any one time (so-called ‘sickness absence’). Long-term sickness absence results in significant costs to the individual, to the employer and to wider society.ObjectiveThe overall objective of the intervention was to improve employee well-being with a view to aiding return to work. To meet this aim, a collaborative case management intervention was adapted to the needs of UK employees who were entering or experiencing long-term sickness absence.DesignA pilot randomised controlled trial, using permuted block randomisation. Recruitment of patients with long-term conditions in settings such as primary care was achieved by screening of routine records, followed by mass mailing of invitations to participants. However, the proportion of patients responding to such invitations can be low, raising concerns about external validity. Recruitment in the Case Management to Enhance Occupational Support (CAMEOS) study used this method to test whether or not it would transfer to a population with long-term sickness absence in the context of occupational health (OH).ParticipantsEmployed people on long-term sickness absence (between 4 weeks and 12 months). The pilot was run with two different collaborators: a large organisation that provided OH services for a number of clients and a non-profit community-based organisation.InterventionCollaborative case management was delivered by specially trained case managers from the host organisations. Sessions were delivered by telephone and supported use of a self-help handbook. The comparator was usual care as provided by participants’ general practitioner (GP) or OH provider. This varied for participants according to the services available to them. Neither participants nor the research team were blind to randomisation.Main outcome measuresRecruitment rates, intervention delivery and acceptability to participants were the main outcomes. Well-being, as measured by the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and return-to-work rates were also recorded.ResultsIn total, over 1000 potentially eligible participants were identified across the sites and invited to participate. However, responses were received from just 61 of those invited (5.5%), of whom 16 (1.5%) were randomised to the trial (seven to treatment, nine to control). Detailed information on recruitment methods, intervention delivery, engagement and acceptability is presented. No harms were reported in either group.ConclusionsThis pilot study faced a number of barriers, particularly in terms of recruitment of employers to host the research. Our ability to respond to these challenges faced several barriers related to the OH context and the study set up. The intervention seemed feasible and acceptable when delivered, although caution is required because of the small number of randomised participants. However, employees’ lack of engagement in the research might imply that they did not see the intervention as valuable.Future workDeveloping effective and acceptable ways of reducing sickness absence remains a high priority. We discuss possible ways of overcoming these challenges in the future, including incentives for employers, alternative study designs and further modifications to recruitment methods.Trial registrationCurrent Controlled Trials ISRCTN33560198.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 6, No. 2. See the NIHR Journals Library website for further project information.

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“…Many GPs would also welcome a change in legislation allowing physiotherapists to handle sickness certification (Wynne-Jones et al, 2010).…”

Section: Physiotherapists Have the Right Skills Expertise And Interestmentioning

confidence: 99%

SAPC hot topic: is it a dangerous idea to make physiotherapists the gatekeepers of frontline primary care for all patients with musculoskeletal problems?

Bishop

Foster

Croft

2013

Prim Health Care Res Dev

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What do GPs feel about sickness certification? A systematic search and narrative review

Cited by 91 publications

References 22 publications

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

Use and usefulness of guidelines for sickness certification: results from a national survey of all general practitioners in Sweden

Collaborative case management to aid return to work after long-term sickness absence: a pilot randomised controlled trial

SAPC hot topic: is it a dangerous idea to make physiotherapists the gatekeepers of frontline primary care for all patients with musculoskeletal problems?

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