Hundreds of GPs have confessed they have never refused to sign someone off work for mental health issues.
More than 5,000 GPs in England were questioned whether they had ever denied a patient a fit note, more commonly known as a sick note.
Just 752 responded to the BBC, with 540 saying they had never denied a patient asking for a sick note linked to mental health.
Meanwhile, 162 said they had refused at least one person a fit note, with 50 not wanting to disclose a response.
It comes as nearly 850,000 more fit notes were doled out in the most recent year, when compared to six years prior.
A damning Government study also recently revealed millions of sick notes were being handed out without patients seeing a GP or a nurse in person.
And today it was revealed patients needing mental health treatment has surged to the highest level on record.
Fit notes are a piece of official medical evidence, and are approved when someone is too sick or is unable to work for more than seven days.
They do not have to disclose why an individual is being signed off, with NHS data indicating 72 per cent of the slips do not provide a reason.
Last year, more than 956,000 notes mentioned behavioural disorder and mental health as an underlying reason.
Hundreds of GPs have confessed they have never refused to sign someone off work for mental health issues, a BBC report found
Most sick notes are handed out by GPs, but pharmacists, physiotherapists, nurses and occupational therapists can issue them.
Fit notes give guidance on how a patients’ health issues may affect their ability to go to work and can also help with a patients’ eligbility for sick pay as well as certain benefits.
And while some fit notes can sign people off entirely, some patients can be categorised as ‘not fit for work’ or ‘maybe fit for work’.
It is not known if all GPs who replied to the questionnaire submitted by the publication represent all of those in the profession.
However, many who did respond aired their frustration towards the current system, saying issuing sick notes should not be part of their role.
‘It is hard to be patient’s advocate and a judge,’ one said, echoing a theme felt amongst those who responded that issuing fit notes was a difficult task for GPs.
Another told the BBC: ‘Patients come for support – not to be dismissed,’ while one noted that they ‘should not be gatekeepers of fitness to work’.
Most of GPs pointed out that they often handed out sick notes for shorter periods and did not always sign off patients for as long as they requested.
Others said patients sometimes became aggressive if they were not given a fit note, signing them off work, with one GP saying a patient refused to leave without one.
And while some GPs were trusting of their patients’ honesty, others felt it was ‘not worth the grief’ or ‘hassle’ to disagree with those they were treating.
Several also noted that it was both quicker and easier to give a patient a sick note rather than deal with their complaints if they were not handed one.
Fit notes were labelled as ‘often problematic’ by a government-commissioned report into the role of employers in health and disability last year.
The report titled, Keep Britain Working, said GPs sometimes lack the occupational health training or do not have the time to evaluate if a person can work or not.
The review also found that the longer an individual was signed off, the likelihood of them returning to work dropped significantly.
The Royal College of GPs (RCGP) also stated that GPs are not always ‘the most appropriate professionals’ to help people return to work or to provide long-term support.
The Government said it was assessing new approaches as clear change was required with the current sick note system.
Tina McKenzie, Policy Chair, Federation of Small Businesses (FSB) said: ‘Sickness absence costs small businesses billions of pounds each year, with the cost set to rise as of this April with the introduction of Statutory Sick Pay from day one of illness.
‘Proposals to make small businesses pay for a service to provide occupational health advice, as well as fit notes, would add to these costs as well as piling on extra bureaucracy.
‘The Government is funding 5,000 occupational health training places for small businesses, to help them improve the overall health and resilience of their staff, through a scheme working in partnership with FSB.
‘We would like to see this scheme made permanent, along with a reintroduction of the small business rebate for Statutory Sick Pay, to help small firms reduce the cost and impact of sickness absence.’
Tom Pollard, Head of Policy and Campaigns for the mental health charity Mind, said: ‘The current fit note system is not working for people with mental health problems.
‘Many people will have exhausted all other options before going to their GP to request a fit note, like seeking additional support or reasonable adjustments which haven’t been made.
‘For others, particularly those who might underreport mental health difficulties due to stigma, a period of time away from work can be helpful to support their mental health.
‘At the same time, we also know that many GPs – in a challenging backdrop of increased demand and squeezed resources – simply don’t have the time or expertise to assess the nuances of the interactions between someone’s mental health and their work.
‘However, any move towards an alternative system needs to be approached with caution and built around trusting and compassionate relationships.
‘It is essential that people do not feel they are being forced to work when they don’t feel able to, and that any plans to support someone to stay in or return to work are co-produced and consensual.
‘Ultimately, if we want to help more employees stay well and thrive in the workplace, we need a reimagined approach that reflects the changing nature of people’s lives at work.
‘We need to see a joined-up model where workplaces, health services and government all play an equal role in delivering compassionate, person-centred reforms that tackle systemic inequalities faced by those in lower paid or insecure roles. And we need to embed a deeper appreciation of the importance of delivering mentally healthy workplaces through positive and open cultures, early intervention, and upskilling manager capability.’
The Daily Mail has approached NHS England for comment.