What does the new fit note mean to me in practice?

Legislation came into effect on 1 July that allows physiotherapists to legally certify fit notes (Med 3 forms) to patients in England, Scotland and Wales (at the time of Frontline going to print, it had not yet been confirmed if this change will also apply to physiotherapists working in Northern Ireland, but members will be informed about any updates regarding this). Prior to this change of legislation only medical doctors were able to issue fit notes.

This change of law recognises the valuable role physiotherapists have in providing health and work advice and supporting people to stay in work where possible. However, while the legislation covers all qualified physiotherapists from the point of registration with the Health and Care Professions Council (HCPC), we do not envisage that all physiotherapists will be in a position to do so.

You should be working in a suitable environment and have the necessary education, training and capability to have work and health conversations with patients. To support you to identify if this is the case, guidance and training has been developed for you and your employer. While non-statutory, the CSP expects its members to complete the training and follow the guidance.

At present, the majority of fit notes are issued to patients in primary care settings, therefore this legislative change will naturally have most impact on members working in this setting. In these circumstances it will simplify the process of issuing a fit note for patients and reduce the burden on GPs. However, it may also be appropriate to issue a fit note in other settings; for instance, the acute and secondary care sectors are particularly being encouraged to provide more fit notes to ease the burden on primary care.

Fit notes will be completed by physiotherapists either digitally or in paper format. But private practitioners will have to write a letter, as doctors in the private sector currently do.

It is up to you to determine if it is appropriate for you issue fit notes within your setting and according to the specific context of your individual patients.