Illness-related benefits cost the Irish taxpayer over 2.7 billion euro in 2010. It has been suggested that the Irish system of sick certification focuses excessively on disability. An alternative sick certification system may be preferable to GPs and help patients to return to work earlier.
Remaining in the workplace is beneficial for a person’s physical and mental health.and, conversely, unemployment leads to a decline in health. Irish GPs have reported challenges with sick certification including an adverse impact on the therapeutic relationship with patients and a lack of communication with employers.
Fitness to work (FTW) certification focuses on facilitating a return to work after illness and aims to improve communication between GPs, employers and patients. It is possible that FTW certification would be preferable to Irish GPs than the existing system of sick certification.
Objectives:
Examine current sick certification practices of GPs in Ireland.
Ascertain difficulties encountered by GPs with the current sick certification practice.
Establish whether GPs would favour a FTW certification system instead of the current system.
Investigate variables associated with GP preferences for the FTW system
Methods:
A postal survey conducted in a representative sample of Irish GPs. A questionnaire was developed, piloted and posted to 305 GPs who were included by systematic sampling and using a sample size calculation. Statistical analysis included descriptive data, Chi-Squared tests and binary logistic regression.
Methodology:
A postal survey conducted in a representative sample of Irish GPs. A questionnaire was developed, piloted and posted to 305 GPs who were included by systematic sampling and using a sample size calculation. Statistical analysis included descriptive data, Chi-Squared tests and binary logistic regression.
Results:
A completed response rate of 64.3% was achieved (n=196). 45% of GPS reported to have a practice policy for sick certification. Challenges associated with sick certification were: 1) lack of rehabilitation services (>90%), 2) excessive focus on disability (86%) and 3) difficulty in balancing the gatekeeper role when issuing sick certificates (83%). 75.5% felt that employers should be involved in the decision regarding patient/employee return to work. 53% of GPs indicated a preference for the FTW certification system described in our survey and 36% were undecided. Preference for FTW certification was associated with the view that: 1) sick certification focuses excessively on disability (P< 0.005), 2) communication between primary care and employers is poor (P<0.005), 3) GPs lack familiarity with patients’ roles at work (P<0.05) and 4) GPs lack training in sick certification (P<0.005). The only variable to significantly predict a preference for FTW on regression was the view that the current system focuses excessively on disability.
Conclusion:
The current system of sick certification is unpopular with Irish GPs for a number of reasons relating to doctor/patient therapeutic relationship, lack of collaboration with employers and a lack of rehabilitation options enabling patients to return to work. A little over half of GPs voice a preference for a FTW system, a view that was strongly associated with the opinion that sick certification focuses excessively on disability.
| Categories: | ICGP Resources,Irish Content,Any |
|---|---|
| Status | Current |
| Description | Illness-related benefits cost the Irish taxpayer over 2.7 billion euro in 2010. It has been suggested that the Irish system of sick certification focuses excessively on disability. An alternative sick certification system may be preferable to GPs and help patients to return to work earlier. Remaining in the workplace is beneficial for a person’s physical and mental health.and, conversely, unemployment leads to a decline in health. Irish GPs have reported challenges with sick certification including an adverse impact on the therapeutic relationship with patients and a lack of communication with employers. Fitness to work (FTW) certification focuses on facilitating a return to work after illness and aims to improve communication between GPs, employers and patients. It is possible that FTW certification would be preferable to Irish GPs than the existing system of sick certification. |
| Publication Year | 2014 |
| Location | ICGP Main Library |
| Publication Status | · Report published · |
| Data Available to other researchers? | Yes |
| Completion Date | 05/01/2015 |
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