Talking to patients about sickness absence

A person’s 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 during your discussions. 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 patients might believe that working will make their health problems 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 attitudes.

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

Making an assessment

By talking to your patients, 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 patients’ ability to work.

You should assess if your patients are ‘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 have they had these health conditions and have they lessened, or got more severe, over time?
  • What clinical management has already been started and what impact has this had on their ability to work?

This assessment will give you a good idea whether your patients can work or if their health condition will worsen as a result. Need advice about completing the fit note?

E-learning resources

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