Mental health and behavioural conditions account for nearly one-in-three known fit notes

NHS Digital must be quoted as the source of these figures

*Regional data are available within this report

31 August 2017: Mental health and behavioural conditions have accounted for 31% of all fit notes², where the diagnosis was known³, written in England between December 2014 and March 2017.

This was the most common known reason for issuing a fit note, new experimental figures from NHS Digital have revealed.

Anonymised⁴ information covering GP practices has been collected for the first time. These practices are responsible for around two-thirds of working age patients⁵ registered with a GP in England.

Information from more than 12 million fit notes⁶ over a 28 month period have been analysed, of which around 5.8 million had a known diagnosis.

From the information analysed, almost 1.8 million⁷ fit notes were issued where the diagnosis was known to be mental health and behavioural conditions, according to the Fit Notes Issued by GP Practices, which is based on analysis of fit notes written in England.

Of episodes for mental health and behavioural conditions, around one in five were issued for a period of absence of more than 12 weeks.

There were around 1.1 million⁸ fit notes known to relate to diseases of the musculoskeletal system and connective tissue, which was the second most common known reason for which a fit note was issued.

The statistics, which were produced in conjunction with The Work and Health Unit⁹, are broken down to CCG level and show the number of fit notes issued per 100,000 working age registered patients¹⁰ in each CCG.

Other findings in the report include:

• the number of fit notes known to have been written for anxiety and stress related conditions from included practices, increased by around 14 percent from 503,000 to 573,000 between 2015-16 and 2016-17
• January 2017 saw the highest number of fit notes written from the included practices, with 556,000 issued during that month

Of those CCGs where at least two GP practices returned information:

• NHS Knowsley CCG¹¹ recorded the highest number of fit notes written per 100,000 working age registered patients in March 2017, with 4,123 fit notes issued per 100,000 people
• NHS Richmond CCG recorded the fewest number of fit notes written per 100,000  working age registered patients in March 2017, with 977 fit notes issued per 100,000 people
• at national level the number of fit notes written in March 2017 was 2,334 per 100,000 working age registered patients¹²
• women continually accounted for more than half of the total number of fit notes issued in the reporting period, from a low of 53.8 per cent in August 2015 to a high of 57.8 per cent in January 2017

Read the full report.

ENDS

1.  NHS Digital is the national information and technology provider for the health and care system.  Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals depend.  During the 2015/16 financial year, NHS Digital published 294 statistical reports. Our vision is to harness the power of information and technology to make health and care better. NHS Digital is the new trading name for the Health and Social Care Information Centre (HSCIC). We provide 'Information and Technology for better health and care'. Find out more about our role and remit at www.digital.nhs.uk

2.     Doctors issue fit notes to people to provide evidence of the advice they have given about their fitness for work. They record details of the functional effects of their patient's condition so the patient and their employer can consider ways to help them return to work.

3.     A total of 6,859,576 out of 12,671,880 fit notes analysed between April 2015 and March 2017 were not mapped to ICD-10 medical codes and therefore have no known diagnosis.

4.     Data was collected at individual fit note level (one record per fit note) but no identifiable data were collected (such as NHS number, date of birth, postcode). More information about the anonymised data collection can be found by reading the Data Provision Notice and here: https://understandingpatientdata.org.uk/

5.     Working age registered patients are patients aged between 18 and 65, registered with a GP in England.

6.     From the submitted data, a total of 12,671,880 fit notes were written across England between December 2014 and March 2017.

7.     From the submitted data,1,789,116 fit notes were issued for mental health and behavioural conditions. This is described in the International Classification of Diseases (ICD10) as mental health and behavioural disorders.

8.     From the submitted data,1,054,043 fit notes were issued for diseases of the musculoskeletal system and connective tissue.

9.     The Work and Health Unit is jointly sponsored by the Department for Work and Pensions and the Department of Health and works to improve the health and employment outcomes for working age people who have, or may acquire, a disability or health condition.

10. Data from the report has been collected from up to 62.5% of all 18 to 65 year olds registered with a GP in England. 

11. No data are included for 23 CCGs for fit notes issued during the reporting period

12. The data shows the number of fit notes issued and not patient numbers.

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