General practitioners' knowledge of notifiable, reportable, and prescribed diseases

BMJ 1995; 310 doi: (Published 20 May 1995) Cite this as: BMJ 1995;310:1299
  1. D Sen, employment medical advisera,
  2. K Osborne, assistant statisticianb
  1. a Merseyside and Cheshire Area Office, Health and Safety Executive, Bootle, Merseyside L20 3PG
  2. b Epidemiology and Medical Statistics Unit, Health and Safety Executive, Bootle, Merseyside L20 3QZ
  1. Correspondence to: Dr Sen.
  • Accepted 9 March 1995

For most patients with an occupationally related illness or injury the family doctor is often the first port of call. With recent estimates suggesting that over 90% of registered patients consult their general practitioners over five years,1 family doctors can play a key part in diagnosing and treating ill health that may be linked with work, in preventing further cases by notifying the right people (reportable diseases),2 and in enabling the patient to claim benefit under the Industrial Injuries Scheme (prescribed diseases).3

Subjects, methods, and results

The Health and Safety Executive recently investigated general practitioners' awareness of health and safety legislation and its relevance to their practices. A survey was carried out by means of a telephone questionnaire on 24 randomly selected practices in each of the 20 areas covered by the Health and Safety Executive in Great Britain. These were prearranged, when possible, with the senior partner at each of the practices. Interviewers were employment medical or nursing advisers from each of the area offices. Respondents were senior partners at the practices, or, if this was not possible on the day, practice managers. Included in the survey were three questions designed to compare knowledge of notifiable, prescribed, and reportable diseases. The interviewer asked respondents whether they knew what was meant by a notifiable disease. Respondents who answered yes and gave an appropriate definition were then asked to give two examples. The same process was repeated for prescribed and reportable diseases. A total of 466 questionnaires were completed and included in the subsequent analysis. This represents a response rate of 97%. In all, 323 of the survey respondents were general practitioners, approximately 1% of all general practitioners in Great Britain.

The table shows the proportion of partners who properly defined each disease category as well as the proportion correctly identifying two diseases (or injuries in the reportable category). Only a third of all partners included in the survey could correctly define a prescribed disease. Of these, approximately a fifth failed to give two relevant examples. Knowledge of reportable diseases and injuries was lower still: only a quarter of partners knew the definition, with less than half of them giving two relevant examples. Almost all partners in the survey correctly defined a notifiable disease, although only two thirds could give two relevant examples.

Knowledge of notifiable, prescribed, and reportable diseases and injuries among 321 general practitioners.* Values are numbers (percentages (95% confidence intervals))

View this table:


While showing that general practitioners knowledge of notifiable diseases is far from complete (already shown by Voss4), these results also highlight the lack of knowledge about diseases that are linked to patients' occupations. Although the identification results are somewhat difficult to interpret, general practitioners' knowledge of the relevant definitions can be seen to be poor. Indeed, such a low degree of knowledge makes any subsequent analysis almost redundant. Improving medical practitioners' awareness of prescribed and reportable diseases and injuries (by increasing doctors' training in recognising work as a cause of illness) would not only help improve the quality of life of people with occupational diseases (through disablement benefit) but also improve the quality of information on the incidence and prevalence of occupational disease as a whole.5

We thank all the medical and nursing advisers in the Health and Safety Executive who helped conduct the telephone interviews.


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