OBJECTIVE: To identify the challenges and key learning and development needs of First Contact Physiotherapists (FCPs) providing fitness for work and sickness absence certification from Occupational Health physiotherpists' viewpoints. DESIGN: An online modified version of the Nominal Group Technique. PARTICIPANTS: A convenience sample of 21 expert occupational health physiotherapists as participants whose substantive job role was within a public or private UK based occupational health provider. MAIN MEASURE: Consensus on each competency was defined a priori as an agreement of more than 60%. RESULTS: Nine items ultimately reached the required 60% threshold consensus level from the Occupational Health expert group for Question 1 on the challenges involved in providing fitness for work and sickness absence certification. Of these items, five reached full consensus
two of which ('Time' and 'Lack of knowledge') were deemed the most important items. For Question 2 on the learning and development needs, six items reached full consensus from the group (100% of participants that ranked an item) and two of these items ('Work conversations' and 'Training in Occupational Health topics') both reached full consensus from the group and were deemed the most important items. CONCLUSION: Most employees in the UK do not have access to Occupational Health services. Fit Notes can be an important vehicle to provide work-related, fitness for work and sickness absence advice to help prevent long-term sickness absence. This study provides insights into some barriers and educational development needs of FCPs in primary care, as judged by an expert Occupational Health physiotherapy group.