British doctors say 40% or 9 million sick notes are suspect each year

British doctors get 22 million requests for sick-notes every year - and they estimate that nine million of these are suspect, according to a new report.

Norwich Union Healthcare's latest 'Health of the Nation Index' found that doctors think almost a quarter of the 577 requests for sick-notes they each get yearly are questionable, at best, and nearly a fifth of them are invalid.

And nearly three million workers across the country admit they'd consider asking their GP for a bogus sick-note - with twice as many men than women saying they'd cheat the system.

Over a fifth of the GP panel interviewed as part of Norwich Union Healthcare's 'Health of the Nation Index' say that up to 20 per cent of their patients are unable to work due to health reasons.

But many GPs think that the numbers of people on sick-leave could be reduced if it wasn't for delays in treatment, and if organisations arranged to have their employee back to work in a different capacity.

Dr Ann Robinson, one of the GPs who took part in the Norwich Union Healthcare research says: "GPs want to treat genuinely ill patients and don't want to act as policemen, identifying those who are claiming bogus sick notes.

Employers need to be more flexible with their workforce and hospital services need to provide fast track diagnostic and treatment centres so people can get back to work as quickly as possible. It's well known that the longer you're off work, the harder it is to get back."

And four in 10 of the GP panel, interviewed by independent medical research specialists Dr Foster for Norwich Union Healthcare, think more than a third of their patients who are unable to work, could actually work a few hours a day, or in a slightly different role, but that employers just aren't encouraging them to return to work.

The most frequent causes for sick-note requests are:

1. Back pain
2. Depression
3. Work-place stress
4. Other stress related problems
5. Flu

The findings are part of Norwich Union Healthcare's third 'Health of the Nation Index', now entering its second year, which looks at GPs' views of the health service. The Index also reveals:

• Patients in Scotland outdo the rest of the country by 2:1 - Scottish GPs receive 1,013 requests for sick-notes a year on average
• Doctors in East Anglia receive the least requests in the UK, at 286 per year
• Over-eating is seen as the most damaging dietary habit affecting patients' health
• The GP panel thinks better public education about the impact of poor diet on health would be most effective in reducing this impact
• Nearly half (48%) of GPs say at least a third of their time is spent on social, rather than medical issues - 70% of those questioned don't think the profession is adequately equipped to deal with these.

Research amongst workers also revealed the top five reasons they'd give to get a sick note:

1. Embarrassment ie. personal crisis they couldn't tell their employer about
2. Workplace is too stressful
3. Holiday request refused or didn't want to use their holiday entitlement
4. Fatigue
5. Gave me a legitimate excuse to skive off work

Dr Doug Wright, clinical development manager at Norwich Union Healthcare adds: "One of the main themes of the report is how much time doctors devote to matters other than medical ones in their surgery, and that they're not feeling adequately equipped to deal with these issues.

"Their view is that if patients were to educate themselves more about their condition, as well as the other forms of support available, this could not only reduce the numbers attending their surgery, but will actually benefit patients' health, long-term. And of course, the added benefit of this is that GPs will be free to spend more time with patients who genuinely need their medical attention."

Roger Taylor, research director at Dr Foster said: "More work is needed to understand how social support could help people cope better with the stresses of life, improve their health and lifestyle and reduce unnecessary burdens on the health service".

Full details of the Health of the Nation Index report can be accessed at www.healthofthenation.com