The role of the GP in keeping people in work

The annual costs to the UK economy of sickness absence and worklessness associated with working age ill health are estimated to be >£100 billion [1,2]. It is also recognized that work is generally good for health. Long-term absence from work can cause job loss with resulting isolation, confidence loss and social exclusion as well as worsening health [2]. Of those people who are off work for 6 months, 80% will remain off work for 5 years [3] and so getting people back to work quickly after a period of illness is crucial in preventing a slide into long-term incapacity for work. Substantial economic and health benefits might, therefore, be expected if the amount of sickness absence, and particularly long-term sickness absence, could be significantly reduced and both the previous and the current UK governments have developed policy on this basis. General practitioners (GPs) are the immediate gatekeepers to the sickness benefit system in the UK. When someone is ill and unable to work for more than a week, they visit their GP who will issue a statement of fitness for work for social security or statutory sick pay—also called a Med 3. This enables them to stay off work for up to 13 weeks without losing income until a work capability assessment can be conducted [4].