Talking to patients about work absence

Category: Advice for GPs

A persons health or wellbeing might not always be the sole cause of an absence from work. Problems with debt, homelessness or personal relationships can also cause absenteeism, which is why it's so important to encourage patients to talk openly about their reasons for being off work.

Talking to patients

As you're aware, many people find it difficult to talk about their personal problems with their GP, especially if they think it doesn't concern their health directly.

Being able to communicate effectively with your patient helps to:

  • build trust and nurture relationships
  • encourage disclosure of information
  • make better health decisions
  • manage expectations and reduce the risk of errors.

 When communicating with your patient:

  • be an active listener and ask open ended questions
  • build a rapport with the patient and be sensitive to their needs
  • communicate in plain English and speak slowly, deliberately and clearly
  • use appropriate body language and voice tone
  • repeat key information to be sure you've been understood.

Discussing health and work

How your patient feels about health and work will become apparent as you talk to them. As with other health advice, you should emphasise how working benefits your patients health and wellbeing and encourage them as much as possible.

When discussing health and work:

  • talk about the health benefits of working, and the health risks of not working, and explain that people don't need to be fully fit to work
  • ask about their job and working conditions
  • issue fit notes for shorter periods of time, and use the fit note to encourage your patient to set goals
  • tell your patient about support services if they're having non-health related problems
  • find out if they have access to occupational health services through their work.

Your patient might believe that working will make their health problem worse or delay their recovery. By talking to them about the benefits of working, and how it can improve recovery, you may be able to change these beliefs.

In some situations, your patient's health might not be the primary cause of their absence. They could have money or housing troubles, struggling as a working carer or been recently bereaved. In these circumstances it may be in your patient’s best interest if you refer them to other available support

Making an assessment

By talking to your patient, you will get a good idea of the health and non-health problems that have caused them to be absent from work. However, a deeper assessment is needed to fully understand how these problems affect your patient's ability to work.

You should assess if your patient is 'generally' fit for work independent of the job they do, and consider the following:

  • Does your patient's condition, or treatment, limit them in any way — does it affect their stamina, mobility, cognition or senses?
  • How long they've had this health condition and has it lessened, or got more severe, over time?
  • What clinical management has already been started and the impact of this on their ability to work?

This assessment will give you a good idea whether your patient can work or if their health condition will worsen as a result.

How to record your assessment in a fit note

E-Learning resources

Healthy Working UK provide e-Learning resources that help to explain some of the key aspects of health and work, including making difficult decisions assessing fitness for work and building relationships and trust with patients

A list of health and work learning resources is also available on GOV.UK.