Community pharmacies will be unable to issue NHS fit notes under new legislation, government confirms

Changes to legislation allowing pharmacists to certify fit notes will be aimed at those working in general practice and hospitals, the Department of Health and Social Care (DHSC) has clarified.

The government had previously stated on 9 June 2022 that it planned to amend legislation, expanding the range of healthcare professionals who could issue fit notes to include pharmacists, as well as nurses, occupational therapists and physiotherapists, from 1 July 2022.

These amendments to the Social Security (Medical Evidence) Regulations 1976 were laid before Parliament on 10 June 2022 as a statutory instrument, replacing references to “doctor” in the original regulations with new references to “healthcare professional”, which the statutory instrument says covers doctors and the four other healthcare professionals.

However, when asked whether this would include community pharmacists, a spokesperson for the DHSC told The Pharmaceutical Journal that the policy change “is aimed at pharmacists working within general practices or hospital settings where they are able to assess patient’s fitness for work”.

They added that the intention of the new legislation “is that ‘where’ the fit note is issued will remain the same but ‘who’ issues it will change”.

The spokesperson said that while the legislation names whole professions — meaning that any registered practicing doctor, nurse, occupational therapist, pharmacist or physiotherapist could legally issue a fit note — “fit notes are not part of the NHS-commissioned services which private pharmacies provide”.

“Private providers, such as high street pharmacies, are unable to provide the ‘Med3’,” they continued, explaining that this “is the technical name for a fit note provided for free under NHS provision”.

While fit notes can be obtained from private providers for a fee, they “should only be issued following a full assessment of a patient’s fitness for work, [which] therefore would be an unsuitable service to be provided ‘over the counter’,” the spokesperson said.

The Royal Pharmaceutical Society (RPS) said in a statement on 9 June 2022 that the legislation “should not affect community pharmacists at the current time as community pharmacy has not been commissioned to certify fit-notes and you will not have access to the necessary health records required to support you in this role”.

“Pharmacists in general practice and secondary care may have a role in certifying fit notes as soon as they are ready after 1 July 2022,” it said.

“Pharmacists should be working in a suitable environment and have the necessary skills and training to have work and health conversations with people.”

The RPS added that it would issue further communications on this topic, including national training, RPS policy and pharmacy guidance.