A qualitative exploration of the perceptions and experiences of UK nurses, occupational therapists, pharmacists and physiotherapists certifying ‘fit notes’

Objectives (1) To explore the knowledge, experiences and perspectives of UK nurses, occupational therapists, pharmacists and physiotherapists around certifying fit notes. (2) To identify barriers/facilitators that might affect fit note completion and identify training needs. Design Qualitative. Setting Primary and secondary care and community settings in the United Kingdom. Participants Total ( n = 25): occupational therapists ( n = 12, 48%), physiotherapists ( n = 9, 36%), nurses ( n = 3, 12%) and pharmacists ( n = 1, 4%). Participants were recruited through an associated survey and snowball sampling. Intervention Semi-structured interviews and focus groups were conducted online. Data were thematically analysed using framework analysis, informed by the Theoretical Domains Framework. Themes were agreed between research team members. Patient/public representatives were involved throughout the research. Results Eighteen participants were interviewed individually; seven participated in a focus group. Two-thirds of participants ( n = 17, 68%) were experienced in certifying fit notes. Participants with fit note experience were enthusiastic about the legislation change. They valued the opportunity to use their skills and knowledge to enable patients to return-to-work and enhance their professional role. Participants without fit note experience reported barriers including lack of policies/guidelines, poor communication about the legislation change and available training, concerns about legal implications and time pressures. Online training was considered adequate, but participants suggested improvements, for example, interactive training sessions. Conclusions Many nurses, occupational therapists, pharmacists and physiotherapists potentially have the knowledge and skills to undertake fit note certification in their areas of expertise. Our findings suggest that consistent guidelines on fit note certification may help clinicians overcome organisational barriers.