A fit note is an official medical statement from a doctor that advises whether your health condition affects your ability to work. Used across the UK, it replaced the old “sick note” in 2010 and serves as the document your employer needs when you’ve been off work for more than seven consecutive days due to illness or injury. The name change reflected a shift in thinking: rather than simply declaring someone “sick,” the fit note focuses on what you can still do.
How a Fit Note Works
When you visit your GP or hospital doctor about a health condition that’s keeping you from work, they can issue a fit note with one of two possible outcomes. The first is “not fit for work,” which means your doctor believes your condition prevents you from doing any work at all for a set period. The second is “may be fit for work taking account of the following advice,” which means you could potentially return to work if your employer makes certain adjustments.
Those adjustments might include a phased return with shorter hours, amended duties that avoid tasks your condition makes difficult, workplace adaptations like a different chair or workstation, or altered hours to accommodate medical appointments or fatigue patterns. Your employer doesn’t have to accept these suggestions. If they can’t make the recommended changes, the fit note effectively functions the same as a “not fit for work” note, and you stay off on sick leave.
When You Need One
For the first seven days of illness, you can self-certify. This means you simply tell your employer you’re unwell without needing any medical documentation. Your employer may ask you to fill out a self-certification form (sometimes called an SC2 form) when you return, but no doctor’s involvement is required.
From day eight onward, you need a fit note. The seven-day count includes weekends and bank holidays, not just working days. So if you fall ill on a Monday and you’re still unwell the following Monday, you’ll need to see a doctor for a fit note to cover from that point forward. Some employers have their own policies that kick in earlier, but legally, seven days is the threshold.
Who Can Issue a Fit Note
GPs are the most common source, but they aren’t the only healthcare professionals who can issue fit notes. Hospital doctors can write one if you’re being treated as an inpatient or outpatient. Since July 2022, the list expanded to include nurses, occupational therapists, pharmacists, and physiotherapists, provided they are involved in your care. This change was designed to reduce the pressure on GP appointments, since fit note requests had become one of the most common reasons people booked to see their doctor.
Fit notes can now be issued digitally, and many GP practices send them electronically rather than printing paper copies. A digital fit note holds the same legal weight as a paper one. You can forward it to your employer by email or print it out yourself.
What It Covers and How Long It Lasts
A fit note can cover any length of time your doctor considers appropriate. For short-term conditions like a bad infection or a minor operation, it might cover one to two weeks. For longer-term conditions, a doctor can issue a fit note lasting several months. There’s no fixed maximum, though in practice most doctors will want to review your condition periodically rather than signing you off for extremely long stretches.
The note will state the date it was issued, the date range it covers, your diagnosis (described in general terms), and whether you’re not fit for work or may be fit with adjustments. Your doctor doesn’t need to have examined you on the day the fit note starts. They can backdate it if they’re confident about your condition, and they can also issue a note based on a phone or video consultation without seeing you in person.
If your fit note runs out and you’re still unwell, you need to get a new one. There’s no automatic renewal. Letting a fit note lapse without getting a replacement can affect your sick pay entitlement, so it’s worth booking a follow-up appointment before the current note expires.
Fit Notes and Sick Pay
Your fit note is the key document that triggers Statutory Sick Pay (SSP) from your employer. SSP is currently paid at a flat weekly rate for up to 28 weeks, and your employer is legally required to pay it as long as you meet the eligibility criteria and have a valid fit note covering the absence. Many employers offer contractual sick pay on top of SSP, and the specific terms vary by workplace, but the fit note is the underlying proof of incapacity either way.
If you’re claiming benefits like Universal Credit or Employment and Support Allowance, the fit note also serves as your medical evidence. The Department for Work and Pensions accepts fit notes as proof that your health limits your ability to work, at least in the initial stages of a claim before any further assessments.
What Your Employer Can and Cannot Do
Your employer is not obligated to follow the fit note’s recommendations, but they are obligated to take them seriously. If the note says you may be fit for work with adjusted duties and your employer can reasonably accommodate that, refusing to do so could create legal complications, particularly if your condition qualifies as a disability under the Equality Act 2010.
Your employer cannot demand to know your specific diagnosis. The fit note will include a description of your condition, but you’re under no obligation to share further medical details beyond what’s written on it. Some employers ask for additional information, and you can choose how much to disclose, but the fit note itself is the only document they can formally require.
Employers also cannot insist you return to work before your fit note expires, even if you look or feel better. Equally, a fit note doesn’t guarantee your job is protected indefinitely. After extended absences, employers can begin a process to discuss your return or, in some cases, consider whether the role can be held open. Those conversations have their own legal framework, but the fit note itself is simply the medical evidence of your condition.
Getting a Fit Note Without Seeing Your GP
If your condition is being managed by a hospital specialist, that specialist can issue a fit note directly, saving you from needing a separate GP appointment. Physiotherapists treating a musculoskeletal condition or occupational therapists managing a workplace-related health issue can also provide one. This is particularly useful if you’re already attending regular appointments with a non-GP clinician, since asking them to issue the note during an existing session avoids doubling up on healthcare visits.
For mental health conditions, which account for a significant proportion of fit note requests, your GP remains the most likely issuer. But if you’re under the care of a mental health team, a qualified nurse or psychiatrist within that team can provide the note instead.