GP information: how anonymous fit note data is collected and published
Updated 12 October 2018
Applies to England
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Why we collect fit note data
We’ve collected data on the use of fit notes since the computer-generated fit note (eMED3) was introduced. This allows the Department for Work and Pensions (DWP) to get national data on sickness absence to inform policy development.
Research suggests that:
- being out of work for long periods of time is damaging to health, social and financial wellbeing
- the longer someone is off sick, the harder it is for them to get back to work
Wider evidence suggests that work can:
- provide important economic, social and psychological benefits for individuals
- help individuals avoid the considerable mental and physical health risks associated with unemployment
What data we collect and publish
We use aggregated statistics derived from computer-generated fit notes to gain a better understanding of sickness absence across England. We do this to develop policy to provide support where it’s needed most, helping people with health conditions to return to work earlier. The data is completely anonymous to protect patient privacy.
The data includes:
- how many computer-generated fit notes are issued
- how many patients are recorded as ‘unfit’ or ‘maybe fit’ for work
- fit note duration
- gender
- health condition type, aggregated to a high level diagnosis code
- location, including Clinical Commissioning Group (CCG) areas
- whether workplace adaptations were recommended
We cannot identify individual patients at any stage.
Who collects the data
DWP funded a project in 2012 to provide GPs with the ability to generate fit notes by computer. This included software to collect data.
NHS Digital, the national information and technology partner to the health and care system, extracts this data on behalf of DWP. They do this we can begin to understand what is working and where services can be improved.
When data collection started
We started to collect fit note data from GP systems across England in March 2017. The data was first published in August 2017.
The first data collection included fit notes issued from December 2014. It did not include data about patients who objected to their data leaving the GP practice for purposes beyond their direct care before the time of the first collection.
Since then, the data of any patient with an objection has been excluded from the point their objection is registered.
What you need to do before data is collected
As data controllers, GPs are required to tell patients that the data collection is taking place. This can be:
- in person when a patient comes in for a fit note
- on your practice website
- on a practice notice board
We sent a briefing pack and data provision notice to all GP practices in January 2016. This included information and suggested wording that practices could use to inform patients.
The eMED3 (fit notes) data provision notice was updated in July 2018.
How the anonymous statistics are produced
The eMED3 data provision notice issued by NHS Digital explains how they collect the data. The process for collection does not create any extra work for GP practices.
Where we publish the data
Fit note data is published on the NHS Digital website.
This includes data tables to allow people to conduct their own analysis. The data is published at CCG level and above. A small number of DWP analysts have secure password access to the anonymous aggregated data at GP practice level.
How we ensure patient confidentiality
The data published at CCG level is aggregated and fully anonymised. No patient-level information is extracted and individual patients cannot be identified.
DWP analysts who have access to anonymous statistics at the level of a GP practice do not have any information that could identify a patient. As an extra security measure, NHS Digital applies ‘small numbers suppression’ to the data – any numbers less than 5 are replaced by an asterisk (*).
NHS Digital groups diagnosed conditions recorded in the fit note into high-level general conditions using the ICD-10 classification. This is to ensure that any rare conditions are part of an aggregate higher level diagnostic grouping.
Who we consulted about this data collection
DWP consulted with the professional medical bodies:
- the Royal College of General Practitioners
- the British Medical Association General Practitioners Committee
- the Joint GP IT Committee
They are aware of that:
- we collect this data
- we advised GPs about their responsibilities as part of this data collection