Sicknotes. Or, perhaps as we are encouraged to think of them - lack of fitness certificates. These are a fact of a jobbing GP's life.... "can I have a note for work doc" which really means, "can I have a note so I don't work, doc". When we see someone with flu, we recommend a week's absence from contact with work colleagues in order to prevent the passage of the infection... not unreasonable. But what happens if you telephone the National Flu Line or obtain help via the internet flu diagnostic service the Government has set up? Yes, you may well get the advice to stay off work but regrettably they don't issue sick notes.

This situation cropped up in surgery this week. A patient had needed to take more than a week away from work and came along wanting me to issue a retrospective sicknote. He informed he had been diagnosed with flu by the telephone flu advice line and had been issued Tamiflu. However (and this is a secondary problem) he was unable to get the Tamiflu for four days and hence ended up being off sick for nearly two weeks. Regrettably I was unable to issue a sick note as legally I required to have consulted with the patient BEFORE the time off work, not afterwards. I did my best by producing a suitably worded letter, but it struck me as a problem which is going to become more commonplace as the weeks go on. The NHS flu line do NOT inform the patient's doctor that medication or advice has been issued.

So if you are a working person and need to take time off with influenza, then at least inform your general practice that you have gone down with influenza at the outset (or next day) so that they can then, if necessary, issue you with a sick note.

Thanks for the suggestions about how to greet people now that kissing is banned. I really think the Royal Wave is probably the best way forward for a one to one scenario and the Mexican Wave for groups.