Implementation of electronic fit notes in secondary care

Overview

The Statement of Fitness for Work (“fit note or Med 3 form”) was introduced in April 2010 across England, Wales and Scotland by the Department for Work and Pensions (DWP).

In 2012 the DWP worked with the national General Practice Systems of Choice (GPSoC) programme to successfully introduce a digital version of the fit note into general practice. Since 2017, data about the issue and characteristics of fit notes has been published on the NHS Digital website. Data is broken down by CCG, diagnosis (where known) and date of issue.

As a result of this success, DWP now proposes to extend the use of digital fit notes to secondary care organisations and clinicians replacing the existing manual, clerical system that is reliant on pads of fit notes ordered from DWP. The proposal will remove a barrier to issuing fit notes in secondary care settings improving the responsiveness to patient requirements.

This consultation invites feedback on the proposal.

In addition, over 43 million digital fit notes are known to have been issued by GPs between April 2015 and December 2020. The proposal to introduce digital fit notes into secondary care will also seek to quantify the numbers issued within secondary care and to work with clinicians to achieve a more equitable balance with general practice.

Recognising that implementation in secondary care will be more fragmented than in general practice, DWP is working towards publishing new legal regulations, updating the Social Security (Medical Evidence) Regulations 1976 (as amended), to:

• remove the need for a signature in ink (“wet signature”)
• extend the range of health care professionals who can sign fit notes.

Note that while the first point is likely to achieved from April 2022, the second is subject to confirmation.

To assist with both the evaluation of the success of the secondary care implementation and the monitoring of the balance between general practice and secondary care, data on fit note use in hospitals will be collected. Data flow will be facilitated from version 6.3 of the Commissioning Data Sets (CDS), due to commence submission from April 2022 (utilising SNOMED CT).

This consultation also invites feedback on the collection and submission of this data.

Why your views matter

Data Alliance Partnership Board

Consultation on this proposal is being undertaken as part of the assurance process set by the Data Alliance Partnership Board (DAPB) for subsequent publication as an information standard under section 250 of the Health and Social Care Act 2012. This consultation, and your feedback, forms part of the assurance evidence that is considered as part of the approval process.

Your feedback will be reported back to the DAPB which we anticipate will consider the request at its meeting in March 2022.

This consultation helps to ensure that all interested parties, including clinicians, informatics staff, system suppliers, have an opportunity to provide feedback before the information standard and supporting documents are finalised.

There are 3 draft documents published in the Related Documents section below. Please review before you answer our questions:

• Requirements Specification
  • how the standard is structured and the specific process and system requirements
• Technical Specification
  • the technical details supporting the Requirements Specification
• Implementation Guidance
  • advice to support the implementation of the requirements

There is also a Word version of this consultation in the Related Documents section (below) if you would prefer to prepare an offline consultation. Please return to the DAPB assurance team via email: standards.assurance@nhs.net

What happens next

This proposal has been submitted for approval by the Data Alliance Partnership Board (DAPB) for subsequent publication as an information standard under section 250 of the Health and Social Care Act 2012. This consultation, and your feedback, forms part of the assurance evidence that is considered as part of the approval process.

Your feedback will be reported back to the DAPB which we anticipate will consider the request at its meeting in March 2022.

Enquiries about the progress of this DAPB application may be sent to the Data Standards Assurance Service at NHS Digital which provides the assurance on behalf of the DAPB. Please contact: standards.assurance@nhs.net