Family doctors issued nearly one million sick notes signing people off work with mental health issues last year, NHS data shows.
There are calls to reform the “fit note” system, which means GPs are responsible for deciding if people should be off work, with the majority saying they have never refused a mental health request.
Analysis of NHS data shows the number of fit notes has soared in recent years. Last year 11.2 million fit notes were issued, up from 5.3 million in 2015. They enable people to stay off work, claim sick pay, and in some cases qualify for welfare payments.
They are usually issued by a GP, although some other health professionals including nurses and pharmacists are able to issue them.
While most fit notes do not cite a reason for people being off sick, the most common reason cited is mental health. Last year 956,000 notes were issued for mental health reasons such as stress or depression.
An investigation by BBC News found that GPs feel they cannot refuse requests from patients. In a survey of 752 GPs, 540 said they had never refused a request to sign somebody off work with mental health issues.
Some GPs said patients become aggressive if they are not signed off, with one describing how “they argue and fight, we end up having to give in for our own safety”.
Several GPs reported that younger adults were more likely to ask for time off work. One said: “We sign off legions of young patients with anxiety and depression who are quite clearly not ill.”
Data from the Office for National Statistics shows that 2.8 million people are off work with long-term sickness. There has been a significant rise in young people out of work or education, with mental health problems driving this increase.
Professor Victoria Tzortziou BrownRCGP/Grainge Photography/PA
Professor Victoria Tzortziou Brown, chair of the Royal College of GPs, said that the “amount of time spent on the administrative process around fit notes can take away valuable time with patients”.
She added: “The current system needs to be improved, for patients as well as those issuing fit notes. As a college, we have long called for improvements as evidence-based and patient-centred reform could help reduce GP workload and improve outcomes for patients.
“Any reform of the fit note process must put the health and wellbeing of patients first, rather than being driven primarily by economic considerations or policy targets.”
Sir Mel StrideHouse of Commons
Sir Mel Stride, the shadow chancellor, called for the government to move fit notes away from GPs. He said: “The number of people getting signed off sick for mental health problems is soaring, and the government is doing nothing.
“Making GPs the gatekeepers for the benefits system puts them in an impossible position. It undermines the doctor-patient relationship. Some say patients get aggressive if they try to refuse a fit note and they worry for their safety.
“We had started reforming the fit note, then Labour came in and halted it. They even refused to publish a response to the consultation we ran. Last year the Labour government said they had ‘no current plans to reform the fit note’. No wonder the benefits bill is soaring.”
Meanwhile, monthly data shows that the NHS hospital waiting list has fallen for the third month in a row. It stood at 7.25 million at the end of January, down from 7.29 million in December, and the lowest level since February 2023.
The figures showed that a record 9.1 million people attended A&E this winter. Some 73.6 per cent were seen within four hours, the highest figure since the winter of 2021-22. Meanwhile ambulance response times this winter were the fastest they have been for five years.