We, the undersigned, call upon the Department for Work and Pensions (DWP) and NHS policymakers to urgently expand the scope of healthcare professionals authorised to issue MED 3 fit notes to include HCPC-registered paramedics working in primary care settings.

Paramedics are now highly skilled, autonomous clinicians working at advanced and consultant levels across general practice and urgent care. These professionals routinely assess, diagnose, treat, and manage undifferentiated patients independently—providing care equivalent to other non-medical prescribers already permitted to issue fit notes (such as nurses, physiotherapists, and pharmacists).

Advanced paramedics currently:

-Prescribe medication,
-Manage patients with complex, chronic, and palliative care needs,
-Lead end-of-life care discussions, sign Do Not Attempt Resuscitation (DNAR) orders and diagnose and manage death.

However, they are still not permitted to certify a fit note (MED 3) for a patient—a restriction that is outdated, impractical, and impacts both patient experience and service efficiency.

This policy:

Undermines the role and capability of advanced paramedics,
Causes unnecessary delays and duplication in patient care,
And places avoidable strain on GPs who must co-sign notes for patients already managed by a paramedic.
We respectfully urge the DWP to modernise the legislation and include HCPC-registered paramedics in the list of professionals legally allowed to issue MED 3 fit notes—ensuring consistency in care, recognition of current clinical roles, and better use of NHS workforce skills.