Dr Rachel Birch, MPS medicolegal adviser and sessional GP, presents two case scenarios highlighting fit note GP guidance on how to handle patient requests for fit notes (GANFYD) and letters
Fit note scenario 1
You are doing a one-day locum. You see Mr H, a 32-year-old patient with a six-week history of low back pain. It is worse with movement but there is no radiation and there are no red flag symptoms. He tells you that he works as a postman but has not been to work for six weeks due to the pain.
Examination reveals slight tenderness across the lower lumbar muscles but no bony tenderness. He has full range of movement and straight leg raising, together with an neurological examination, are normal.