GPs should no longer be responsible for signing people off work on long-term sickness, a government-backed review has said.
The government should instead invest funds in an Independent Assessment Service (IAS) to allow "independent" doctors to assess a person's fitness to work.
The state-funded service aims to provide an "in-depth assessment" of a person's physical and mental health, revealing what type of work they were capable of.
It is estimated employers would save approximately £100m a year in sick pay costs using this service.
The review calls for the abolition of the government's Percentage Threshold Scheme (PTS) – a compensation service for employers who experience high levels of sickness absence costing £50m – as a way of funding the proposed IAS.
Health at work – an independent review of sickness absence was commissioned in February to the government's Director for Health and Work Dame Carol Black and the former Director of the British Chamber of Commerce David Frost CBE.
The Statement of Fitness for Work (fit note) was introduced in April 2010 to replace the traditional sick note.
A survey of 45 UK GPs carried out by the Department of Work and Pensions showed many GPs fear damaging their relationship with their patients by not signing a sick note.
One GP said he was aware negative feedback from "disgruntled" patients could affect his reputation and have a knock-on effect on his income or appraisals.
Low confidence among GPs has a "major effect" on whether they used the fit note to help patients return to work, said the DWP survey.
It claims attending an RCGP workshop increased confidence and called for policy makers to introduce further training.
"GPs have varying opinions about their role as facilitators of a return to work," said the report.
"Some believe motivating people back to work is integral to their role while others believe it is the responsibility of other agencies to prioritise.
"Further training in communication and negotiation skills in the context of patient management would help GPs feel confident raising returning to work with their patients."