Taking time off
We all need to look after our mental health like we need to take care of our physical health. You are entitled to take time off to do this and we support your right to do so.
There is widespread fear of fitness to practice consequences for stating you are having mental health difficulties. We want to dispel these misconceptions. It's important that you feel safe to ask for help without worrying about any negative consequences. The thresholds for GMC (General Medical Council) involvement are high and so the likeliness of the need for referral or self-referral to the GMC is low.
Mental health problems are common. They affect one in four people at some point in their life and account for over 30% of sickness absences in the NHS.
Taking time off for your wellbeing can help you to better look after your patients and avoid burnout. You should feel able to take time off without worrying that it will raise concerns about your ability to do your job. We want you to feel able to take time away from work to address any and all mental health difficulties you are having.
What your contract says
The 2016 junior doctor contract states that you can take time off work for your mental health in the same way you would for physical illness. In the UK, there is no legal difference between taking a mental health sick day and a day off for a physical problem.
For instance, there's no legal difference between a migraine disrupting your concentration and a family issue impacting your mood and ability to focus. Both are valid reasons to take time off. It is equally important to take time off to look after your mental health and wellbeing.
If you decide to take time off, you can self-certify sickness absence for the first seven days (this includes any non-working days). You are not responsible for organising cover for or paying any costs relating to your absence.
Check your contract to find out about your right to statutory sick pay and any other allowances.
The fitness to practice thresholds for doctors with mental health issues set by the GMC are higher than you may think. These guidelines set a high bar to ensure no doctor is prevented from seeking support when they need it.
You should feel able to seek support for their mental health as soon as you feel the need to. The system is designed to help you and to protect patients in the rare instances this is needed.
The vast majority of doctors with mental health conditions are not a risk to patients, so it is highly unlikely that a referral or self-referral to the GMC will be necessary. The GMC’s online guidance explains when it needs to know about a doctor’s health condition. The guidance tells you what you can expect if you are referred or self-refer because of your health and signposts to specific support that may help you.
To emphasise this, the GMC provides the following information:
- Having a mental health issue (including diagnosed mental health conditions) does not on its own raise concern about your fitness to practice.
- Most health conditions can be appropriately managed from a medical and occupational perspective without ever meeting the threshold to become a health concern as defined by the GMC.
- As investigations can have a significant impact on a doctor’s wellbeing, the GMC advise managing health conditions that do not cross this threshold locally.
- In the rare event of a referral, the GMC will only ask for more information if it is needed to assess if there is any risk to patients.
- The GMC aims to resolve all cases as quickly as possible.
If you are subject to an investigation, we offer confidential support via the doctor support service.
It is important that you take action and seek support if you are struggling with your mental health. If you or your employer have concerns, you will be referred to your occupational health department.
You can refer yourself to occupational health if you have a recently diagnosed mental health condition and need support. You can also do this if your mental health condition meets the definition of disability (as defined in the Equality Act 2010).
Your employer may refer you if you are absent for a longer period (typically over two weeks), or if there is a particular pattern to your absences. This can include missing particular shifts on a repeated basis, or short-term absences that increase in frequency.
You can also take a look at our sources of support resource to find out about additional ways of getting help with your mental health.
Meeting occupational health
Occupational health will work with you to understand your needs. Following a consultation, they may make advisory recommendations to your employer. This can include changes to your working practices to support your wellbeing.
The nature of your medical issue will determine what recommendations are made. The recommendations will seek to provide support for you to overcome any disadvantage you experience. These measures have to be practical for your employer to put in place. The decision on what is workable rests with them. An example might be giving you protected time to attend therapeutic appointments.
You will also be assessed to find out if you are likely to meet the legal definition of having a disability. This lets your employer know whether they have a legal duty to make any reasonable adjustments. There are a small number of conditions that are protected under the Equality Act. These include HIV, cancer, multiple sclerosis, and visual loss/impairment.
Your right to confidentiality
The information you share with occupational health will be treated confidentially. It can only be shared with your informed consent. This means you will get to see the report beforehand before you agree to sharing it. It does not need to include clinical details about diagnosis, treatment or symptoms.
Your report would typically be shared with you and the person who is responsible for putting in places any adjustments to your working pattern or practices. You can specify if you do not want your report shared although this may make it more difficult to get appropriate support.