The Department of Social Protection is rolling-out certification guidelines to all GPs in Ireland this week. This follows a six-month research study carried out by the DSP’s Medical Review and Assessment Service and led by Dr. Clement Leech, Chief Medical Officer. The study demonstrated that participating GPs considered the guidelines helpful in their interactions with patients and that they resulted in better outcomes for patients.
The research was approved by the Irish College of General Practitioners (ICGP) Quality in Practice and Ethical Standards Committees and was conducted in consultation with the Irish Medical Organisation (IMO) and the National Association of General Practitioners (NAGP).
The aim of the new guidelines is to prevent people with common health problems progressing to a state of chronic disability by assisting GPs in their role as certifiers to
- provide patients with a clear expectation of duration of recovery from acute medical conditions and common surgical procedures,
- ensure a better health outcome for patients,
- encourage an expectation of an early return to work,
- reduce the number of people progressing to an avoidable state of chronic disability and
- help to prevent resulting job loss.
The DSP has developed these guidelines to assist GPs in certifying patients. The guidelines are evidence-based and provide defined periods of expected recovery and return to work for common medical conditions and common surgical procedures.
When certifying a patient’s absence from work it is most important, in the patient’s interests, to consider whether certification and advice to stay off work for a prolonged period is the most appropriate way to manage a patient’s care.
Prolonged absence from work may cause deterioration in the patient’s health and wellbeing and threaten job security. For the most common health problems, such as back pain and mild to moderate anxiety and depression, advice to stay at work or return to work early is recommended for a better clinical outcome.
There is a wealth of evidence to show that generally employment is good for one’s mental and physical health and wellbeing and, conversely, that unemployment is damaging.
The longer a patient is off work the lower their chances of returning to work and early intervention in the acute stage is essential with GPs’ input being crucial.
The guidelines are not prescriptive. There will, undoubtedly, be individual variations, some patients recovering and returning to work earlier than expected, others later. Ultimately, the clinical judgement of the treating GP should prevail.
Implementation of the guidelines should benefit the GPs, their patients and employers.
The guidelines won the award in the 2014 Irish Healthcare Awards in the ‘Best Education Project—GP/Pharmacy’ category.
Department of Social Protection 22nd September 2015