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29 January 2020


SANC position statement on issuing of Sick Notes by Professional Nurse Practitioners



The South African Nursing Council (SANC) is mandated in terms of the Nursing Act, 2005 (Act No. 33 of 2005) to regulate the Nursing and Midwifery professions by establishing and maintaining nursing education, training as well as practice standards. The SANC advocates on behalf of the public in matters concerning nursing by monitoring compliance with Regulatory prescripts. The SANC is cognizant of the constant changing environment, legislation and relevant policies that affect and impact on the nursing profession. 
The SANC is currently inundated with enquiries regarding issuing of sick notes by nurses and midwives. 



This position statement aims to address inconsistent practices with the issuing of sick notes by registered nurse practitioners and provide standardization of practices in the provision of nursing services both in the public and in private practice. The position statement is informed by relevant policy provisions, consultation with relevant stakeholders and competencies for nurse specialists as well as benchmarking with best practice and will be subject to change in accordance with legislation applicable to nursing practice.

The SANC recognizes the provisions of section 23(2) of the Basic Conditions of Employment Act (Act 75 of 1997) in respect of the requirements for valid medical (sick) certificates, which must be issued and signed by a Medical Practitioner or any other person who is certified to diagnose and treat patients. In the context of the SANC such a person is a Professional Nurse who holds an additional qualification in Clinical Nursing Science, Health Assessment, Treatment and Care and is registered as such by SANC. This nurse is capable of providing direct patient care for all types of illnesses and ailments, offering the first level of nursing care that patients receive and is competent to independently render appropriate and skilled primary care service.



Professional Nurse Practitioners who possess an additional qualification in Clinical Nursing Science, Health Assessment, Treatment and Care are deemed competent to assess, diagnose, treat and issue sick notes to patients. 

The recommended period for Professional Nurse Practitioners to issue out a sick note is a maximum of two (2) days.

If the patient condition is not improved, the patient should be referred to a Medical Practitioner or to the next level of care for further management. 
Nurse Practitioners who fail to comply with the directive will be liable for acting beyond their scope of practice.

N.B Professional Nurses who do not possess the additional qualifications as stated above may only issue certificates of attendance.

To be valid, a sick note issued by the Nurse Practitioner must contain the following:

bulletThe name, address and qualification of the attending practitioner;
bulletThe name of the patient;
bulletThe date and time of the examination;
bulletWhether the certificate is being issued as a result of personal observations by the practitioner during an examination, or as the result of information received from the patient and which is based on acceptable medical grounds;
bulletThe exact period of recommended sick leave;
bulletThe date of issuing of the sick note; 
bulletIdentity of the practitioner who issued the certificate which shall be personally and originally signed by him or her next to his or her initials and surname in printed or block letters; and 


The Council approved the position statement in November 2019.


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