A sick note (also known as a ‘Fit Note’ or a ‘Statement of Fitness for Work’) is a certificate issued by a doctor. It is used to notify an employer, teacher or person in charge that an absence was due to health problems. Sick notes can say ‘fit for some work’ or ‘not fit for work’.
Sick notes are discretionary. A doctor can refuse to give you a sick note if they feel you are fit to work. It helps to document when your symptoms started, what symptoms you have had, and how severe they have been to give the doctor a clear and accurate picture of your health condition.
At times, it can feel like you have to jump through hoops to get a sick note. This is often made worse when you are feeling unwell. Our definitive guide makes it easy to get a sick note from a GP.
Sick notes are issued by doctors; from NHS GPs and hospital doctors to private doctors and online doctors. There are different costs, processes and timelines associated with each option. We can help with:
Where to get a sick note? And what is the best option for you?
You can get a sick note from:
a private doctor
Your employer can also ask for a self certified sick note when you return to work after being absent. Learn more about self sick notes.
Getting a sick note:
A written report from another healthcare professional can support your case to get a sick note. Examples include a hospital discharge summary or notes from a consultation with another GP.
NHS sick notes are free if you have been off sick from work for more than 7 days. Your NHS GP may charge you for a private medical certificate if you have been off sick for 7 days or less. Most private doctors charge additional fees to issue sick notes.
Sick notes from private doctors can cost £45 to £60 depending on the provider.
You may consider a private sick note if you have been off work for less than 7 days or need a sick note at short notice. Many online doctor services offer same day private sick notes. In many cases, you do not need to see a doctor in person to get a sick note.
Medicspot doctors can speak with you today and email you a sick note at no additional cost. Learn how Medicspot can help you.
Doctors can legally backdate sick notes. However, some doctors prefer to only issue sick notes providing they can assess your current illness. Some providers like Bupa do not provide sick notes for a retrospective illness. Medicspot doctors can provide backdated sick notes if there is sufficient evidence to support the retrospective condition.
You may have heard of the 7 day rule for sick notes: if you have been sick for 7 days or less, you may have to pay your NHS GP surgery for a sick note; if you have been sick for more than 7 days then you are eligible for a free sick note. You can complete a self certificate form for the first 7 days, however some employers and Universities require a doctor’s note.
Your employer or academic institution may require a sick note by a certain date. If this is the case, you may want to explore getting a sick note from a private GP. We can help with:
When do you need a sick note for work? And how do you calculate the number of days you have been off sick?
Sick notes are generally used to show your employer that you are unwell and need time off work. They can also be used to advise your employer that you need a change in your work hours or duties. Other organisations such as colleges and Universities may also ask for a sick note, particularly if you perform poorly or miss an exam due to being unwell.
Fit notes are designed to prevent people from taking time off work or school when they are not actually sick.
Do not attempt to get a sick note from a doctor if you are not actually sick. Lying about being sick may have severe consequences including disciplinary action.
Employers will usually ask for a sick note if you have been sick for more than 7 days in a row (including non-working days). You can get a sick note from your local GP or hospital doctor. NHS sick notes are free if provided after 7 days of consecutive sick days.
Employers do not usually ask for a medical sick note if you have been sick for 7 days or less. Some employers may require you to complete a self certification sick note to confirm that you have been ill. You can complete a self certified sick note yourself.
The number of days sick you can have off sick before you need a doctor's note is usually dependent on your employer’s absence policy. You may also find relevant details in your employment contract. As a rule of thumb, employers normally ask for a sick note after you have been ill for more than 7 days.
NHS sick notes are free if you have been sick for more than 7 days. During your appointment, the doctor will ask how many days you have been sick. When counting the number of days you have been sick, make sure to include weekends and bank holidays.
More than 500,000 people are off sick from work every 28 months for anxiety and stress-related conditions. Sick notes are not restricted to physical conditions like a bad back. They also encompass mental health issues that prevent you from being fit for work.
You may require time off work for emergency situations. There are many scenarios that are not health related but still require a leave of absence. We can help with:
What conditions can you get a sick note for? And what is compassionate leave?
You cannot get a sick note for bereavement. However, depending on your employer’s policy, you may be entitled to take compassionate leave. The UK government says “as an employee you are allowed time off to deal with an emergency involving a dependent.” A dependent is someone who depends on you for care. This includes your:
This leave does not apply if you knew about the situation beforehand (i.e. a pre-planned medical appointment). In some cases, you may be eligible for unpaid parental leave instead.
You can get a leave of absence from work for a death in the family if it involves a dependent. There is no limit on the amount of time you can take off as long as it is considered ‘reasonable’. If you need to take compassionate leave, make sure to:
Paid leave is at the discretion of your company.
You can get a sick note for short term health conditions like migraines or the flu. However, you are usually not required to get a sick note from a doctor if you are sick for 7 days or less. Migraines usually last between 4 to 72 hours and the flu is at its most contagious during the first 5 days of the infection.
You can get a sick note for mental health issues like depression, work related stress, and anxiety. The NHS introduced the Five Year Forward View for Mental Health in 2016 to reduce the long term impact for people experiencing mental health problems. There are resources available to support people with mental health and reintegration in the workplace.
Sick notes can be used for shorter term illness or injury to long term health conditions. You may feel better and fit for work earlier than the date stated on your sick note. If this is the case, you can usually return to work earlier than the given date on your fit note, provided your employer is in agreement with this.
It can be difficult understanding the difference between ‘fit for work’ and ‘fit for some work’. This guide will explain what this means for you. We can help with:
How to find out when your sick note runs out? And when can you return to work?
Box 2 shows when your sick note runs out. This is the period of time that your sick note is applicable for. Your sick note is no longer valid on any date after the end date. The start date, Box 3, is often the same as Box 1, the date of assessment, but can also be before the assessment date if the doctor has written a backdated sick note.
Your doctor will say on your sick note a date for you to go back to work. Sometimes, your GP may recommend that they need to see you again before you go back to work. If your condition is not serious, you may discuss with your employer about returning to work before your sick note end date.
In many cases, you are able to return to work before your sick note ends. You do not need to be fully fit to return to work. With your employer’s consent, you can go back to work before your sick note ends.
This may happen if you have recovered from injury or illness faster than anticipated or if your employer makes adjustments to support your early return to work.
Sometimes, you cannot return to work early because:
You do not need to be signed ‘fit’ by your doctor to return to work. However, in some cases you may not be able to return to work until:
This is common if you drive a large goods vehicle (like a lorry) or a passenger carrying vehicle (like a bus). The Driver and Vehicle Licensing Agency (DVLA) has rules about driving with a health condition or disability.
The doctor may think you are fit for work if certain criteria are met. They may suggest changes to your routine so you can still perform some elements of your job. Discuss these changes with your employer to see if you can return to work. If your employer cannot accommodate these changes, your sick note is considered to say unfit for work.
Possible changes may include:
Sick note rules can vary based on the absence policy of your employer or academic institution. It is a common misconception that employees are entitled to full sick pay when they are not fit for work due to illness or injury.
Occupational Sick Pay is a discretionary benefit provided by employers. Government programs like Statutory Sick Pay and Agricultural Sick Pay are mandatory for employers if you are eligible. We can help with:
What is Occupational Sick Pay? Will you receive Statutory Sick Pay?
Occupational Sick Pay (OSP) is up to the discretion of your employer. You can find out whether or not you will receive full sick pay in the terms of your contract. If your employer does provide OSP, they may require you to give them a sick note if you have been sick for more than 7 days in a row (including non-working days).
Statutory Sick Pay (SSP) is a UK program that provides financial support if you are not fit for work due to illness or injury. SSP applies if you have been sick for at least 4 consecutive days (including non-working days) and lasts for a maximum of 28 weeks.
The level of Statutory Sick Pay (SSP) for 2018/19 is £92.05 per week (rising to £94.25 on 6 April 2019), equivalent to £18.41 per working day. SSP will be paid the same way that you normally receive pay (like weekly or monthly). Tax and National Insurance will be deducted from your SSP. If you have multiple jobs you can get SSP from each employer.
Statutory Sick Pay (SSP) requirements:
You will not qualify for SSP if:
Each ‘linked’ period of sickness must be 4 days or longer and 8 weeks or less apart from one another.
To claim Statutory Sick Pay (SSP) you need to tell your employer before their deadline. If they do not have a deadline, you need to tell them within 7 days of being sick.
You should talk with your employer if you think they wrongly rejected your SSP claim or if you are not receiving the correct amount of SSP. You can also contact the HM Revenue and Customs (HMRC) statutory payment dispute team:
Telephone: 03000 560 630
If you are not entitled to Statutory Sick Pay (SSP) or if your SSP ends, you may be eligible for Universal Credit or Employment and Support Allowance (ESA).
If self-employed or unemployed, sick notes can be used to support benefit claims. You may qualify for ESA if you cannot work because of illness or disability. We can help with:
What is ESA? And how to apply for ESA?
ESA is a UK welfare payment made to people who have difficulty finding work due to illness or disability. ESA also provides personalised help so that you can work if you want to. ESA is available to people who are employed, self-employed or unemployed.
You can claim ESA if illness or disability affects your ability to work and you are:
You are entitled to ESA when employed if you:
You will usually receive the assessment rate for the first 13 weeks following your claim:
If you are then entitled to ESA, how much you get will depend on your circumstances (like income) and your type of ESA. ESA will be paid directly into your bank, building society or credit union account.
The fastest way to apply for ESA:
*To claim ESA, you will need your:
Jobseeker’s Allowance (JSA) is a UK welfare payment made to unemployed people who are actively looking for work. If you are sick for a short period of time because of illness or injury, you can still claim JSA if you have either:
An Extended Period of Sickness requires medical evidence (like a fit note) if you have been sick for longer than 2 weeks.
A self certification form is used to show to your employer the reason why you were off work sick. It provides evidence to support claims for Occupational Sick Pay or Statutory Sick Pay.
Self certification is only required by some employers when you have been absent from work for 7 days or less. We can help with:
What is self certification? And how do you self certify?
Some employers may ask for a self certification form to prove that absence from work was due to illness or injury. This can be asked if you have been off sick from work for up to 7 days. If you have been sick for more than 7 days then your employer may ask for medical evidence (like a sick note).
You can self certify yourself sick off work for 7 days or less. Self certification is not required by all employers. Check your company’s absence policy to see whether self certification is applicable for you. If you are unsure what to do, you can call the Fit for Work advice line for free on 0800 032 6235.
Getting full pay for time off sick is up to the discretion of your employer. Your contract or company policy will detail whether or not you will receive paid sick leave. If you are not entitled to Occupational Sick Pay, you should still receive Statutory Sick Pay if you are eligible.
When you complete a self certification form, make sure to provide as much detail as possible about:
Fit notes can be difficult to navigate for both employees and employers. They are designed to support people who are off work sick for more than 7 days so they can receive Occupational Sick Pay (if applicable) or Statutory Sick Pay.
However, almost half of the UK workforce has feigned sickness to take time off work. This may cause an element of mistrust that can cause disputes and affect pay outcomes.
For employees: a return to work plan reduces any feelings of isolation and uncertainty. Fit for Work explains what to include in your plan to help with reintegration in the workplace.
For employers: The Health and Safety Executive (HSE), the regulatory body for workplace health and safety, has a guide on managing sickness absence and helping people get back to work.
Mental health support services in the UK:
We’re on a mission to make healthcare more accessible and convenient. We have over 100 private doctor clinics across the UK - simply find your nearest one and see a GP today.
Our private doctors can help diagnose your condition, provide expert treatment and write sick notes and referral letters as needed. We can help with:
Where is your nearest clinic? And how can Medicspot help?
The Medicspot Clinical Station allows doctors to conduct a remote clinical examination to provide a safe, accurate diagnosis. Our doctors can then write sick notes and referral letters as needed.
Find your local clinic.