Occupational Health and Wellbeing, Buckinghamshire Healthcare NHS Trust, Stoke Mandeville Hospital, HP21 8AL, UK.
Department of Physiotherapy and Paramedicine, Glasgow Caledonian University, Glasgow, G4 0BA, UK. Electronic address: https://twitter.com/@ShivSivaram.
Physiotherapy. 2022 Sep;116:79-89. doi: 10.1016/j.physio.2022.02.001. Epub 2022 Feb 11.
As yet, the benefit of the Fit Note has not been convincingly demonstrated, although a limited body of research suggests that provision of fitness for work advice and sickness absence certification may be improved with training and case-specific direction. The role of certifying sickness absence in the UK has traditionally been conducted by General Practitioners, but this role has now been extended to First Contact Practitioner (FCP) Physiotherapists in primary care. Therefore, FCPs may offer an ideal solution to the current challenges faced within primary care for those with a musculoskeletal (MSK) condition at risk of sickness absence from their work environment.
The main aim of this study was to identify the challenges and key learning and development needs of FCPs in response to providing Occupational Health (OH) information in the form of fitness for work advice and sickness certification for patients with MSK conditions within primary care.
Consensus was generated using an online modified version of the Nominal Group Technique (NGT) method. A priori consensus threshold of 60% was used in the voting stage.
NGT participants included clinicians with experience in managing MSK conditions in primary care within the FCP model of care. All participants generated, voted, and ranked the items using an online platform.
This research adds new evidence regarding the challenges and learning and development needs identified by a group of FCPs working within primary care in consideration of sickness absence certification and fitness for work advice. The items highlighted provide evidence to complement Health Education England's FCP A Roadmap to Practice educational pathway and informs on professional development needs in this area.
尽管有限的研究表明，通过培训和针对具体病例的指导，提供工作能力建议和病假证明的服务质量可能会得到改善，但 Fit Note 的益处尚未得到令人信服的证明。在英国，开具病假证明的传统角色由全科医生承担，但现在这一角色已扩展到初级保健中的初级保健联络医生（FCP）物理治疗师。因此，对于那些在工作环境中因肌肉骨骼（MSK）问题而有患病风险的人来说，FCP 可能是解决初级保健中当前面临的挑战的理想选择。
本研究的主要目的是确定 FCP 在提供职业健康（OH）信息方面（以工作能力建议和病假证明的形式）的挑战和主要学习及发展需求，这些信息针对的是在初级保健中患有 MSK 疾病的患者。
使用在线修改后的名义群体技术（NGT）方法生成共识。投票阶段使用了 60%的预设共识阈值。
NGT 参与者包括在 FCP 护理模式下具有管理 MSK 疾病经验的临床医生。所有参与者都使用在线平台生成、投票和对项目进行排名。
这项研究增加了新的证据，说明了一组在初级保健中工作的 FCP 所面临的挑战和学习及发展需求，这些需求涉及病假证明和工作能力建议。强调的项目提供了证据，补充了英格兰卫生教育署（HEE）FCP 实践路线图教育途径，并阐明了该领域的专业发展需求。
