Dr. Russell Brown explains that hospital staff have an important role in writing fit notes, also called revised Form Med3s, for patients at discharge. Fit notes replaced old sick notes in 2010 and it is the duty of doctors and nurses to provide them upon request. The presentation provides guidance on when fit notes should be issued (at discharge, same time as discharge letter), how to fill them out properly based on diagnosis and expected time off work, and where to find more information and order additional fit note forms. The key responsibilities are asking all patients if they need a fit note, estimating an appropriate length of time off, and referring to online guidance for correctly completing the fit note.

1. Dr Russell BrownDr Russell Brown
GP, Manor Park Medical Centre, PolegateGP, Manor Park Medical Centre, Polegate

2. Fit notesFit notes
Your role in their writing...Your role in their writing...

3. The Fit note
• Actually called a "revised Form
Med3"
• Replaced the old sick notes in
2010
• It is your duty to provide one on
request, as well as the nurses
providing a yellow Med10, not
instead
• Guidance at:
• http://tinyurl.com/hospitalfitnote

4. Why me?
• If not you, then who?
• Me? Not necessary!
• To be honest, me doing them is a waste of my time
and the patient's
•So: YOU!

5. Ok, when?
• At discharge
• Plan it in to departmental discharge procedures
(please!)
• Maybe even plan it in to admission procedures?
• Logically, at the same time as the discharge letter
• Every patient: even if "retired", may well still be
working

6. But we haven't got any...
• Then get some ordered. Only requirement is headed
paper and a fax machine.
• Hospital faxes/emails request to DWP asking for
however many pads are needed (I would suggest
“lots” and that this is done by admin team)
• Ordering details at http://tinyurl.com/orderfitnotes

7. Ok, found one. How...
• Have you read the guidance documents?
• http://tinyurl.com/hospitalfitnote
• Fill in diagnosis, how long you expect them to be off, sign and
date.
• Slightly more complex if you think they “may be fit”, but only
slightly, wait for the next few slides...

8. So just for 2 weeks then see Gp for longer
if needed?
• No! For as long as you could reasonably expect the
patient to be off work.
• So if your patient has had surgery that is likely to
need 6 weeks off, sign them off for 6 weeks.
• Guidance on post-procedure time off at:
http://tinyurl.com/howmuchtimeoff
• 2 weeks and see Gp is a waste of my patient's time,
please don't do it!

9. What if they MIGHT be fit...
• See the guidance: http://
tinyurl.com/hospitalfitnote
• It is advice, IF employer agrees and can
accommodate it
• If they can't, the fit note still signs them off

10. Summary
• It is your responsibility
• Ask everyone, even if you think they won’t need one
• Timing of note - as long as you expect it to take
• That's it!
• Guidance at http://tinyurl.com/hospitalfitnote

11. • Photo on front screen credit: Tom Hussey/Getty
• Presentation : Dr Russell Brown, GP Polegate, East
Sussex