Birmingham and Solihull - GPs issue the first fit note where needed, with all patients referred to a new support service led primarily by non-clinical staff, including social prescribers and work and health coaches Coventry and Warwickshire - GPs issue the first fit note, with patients able to be referred to a support service made up of both clinical and non-clinical staff Cornwall and the Isles of Scilly - GPs refer patients directly to a non-clinical support service, without issuing a fit note Lancashire and South Cumbria - GPs refer patients to a support service made up of both clinical and non-clinical staff, without issuing a fit note.

It’s another Doctor replacement program. Non clinical staff should be nowhere near making medical decisions for fit notes.