Provide clear policies and support for fit note certification by AHPs locally.
Ensure access to training and resources to build confidence and competence.
Improve awareness of legislation among staff and patients to make certification consistent.
Context
To identify facilitators and barriers to fit note certification among AHPs and determine ongoing training needs.
Methods
- Design: Online survey based on the Theoretical Domains Framework (TDF) to explore behavioural barriers and facilitators.
- Participants: UK-based nurses, occupational therapists, pharmacists, and physiotherapists were recruited via professional bodies and social media.
- Survey: 52 TDF-linked statements rated on a 7-point scale, plus free-text responses for barriers, facilitators, and training suggestions.
- Analysis: Descriptive statistics for quantitative data was used and thematic analysis of qualitative comments.
Results
- Participation: 198 respondents (Physiotherapists 33%, OTs 25%, Nurses 22%, Pharmacists 20%).
- Experience & Training: Only 24% had certified fit notes; 37% had attended training (lowest among pharmacists at 15%).
- Most experience and training occurred in general practice settings.
- Barriers: Lack of training and goals associated with FIT notes was a common theme. Memory and decision processes were a challenge as often not routine in practice.
- Qualitative insights: Poor awareness of legislation, unclear organisational policies, IT access issues, and time constraints.
Reference
Kettlewell, J., Trusson, D., Powers, K., Drummond, A., Anderson, C., Phillips, G., Holmes, J., Radford, K., Pahl, N., Martin, S., Timmons, S., & Kendrick, D. (2025). Experiences and knowledge of nurses, occupational therapists, pharmacists and physiotherapists about certifying fit notes: A UK-wide survey. BMJ Open, 15, e092211
