When employees go off sick – Fit notes

If your employee is sick for longer than seven calendar days, you should receive a fit note from them.

Last Modified: 3 October 2022



When employees go off sick – Fit notes

  • If an employee is sick and cannot work, they should notify their employer as soon as they can.
  • You should have agreed a process with employees for doing this – for example, who to call, text or email.
  • Disabled employees must be able to use a method of contact that they can use easily – for example, a deaf employee might not be able to telephone in sick so should be allowed to text or send a WhatsApp message.

When will you get a fit note?

If your employee is sick for longer than seven calendar days, you should receive a fit note from them.

Healthcare professionals cannot issue fit notes during the first seven calendar days of sickness absence. Employees can self-certify for this time, visit Employee’s statement of sickness to claim Statutory Sick Pay for a template form. If your organisation requires medical evidence for the first seven days of sickness absence, it is your responsibility to arrange and pay for this.

Who can issue a fit note?

From July 2022, fit notes can be certified and issued by nurses, occupational therapists, pharmacists and physiotherapists in addition to doctors. They must, however, be an eligible healthcare professional.

When will a healthcare professional issue a fit note?

People can only be given a fit note if their healthcare professional considers their fitness for work is impaired. If someone is fit for work, they will not be given a fit note.

What do fit notes look like?

Fit notes can be handwritten, computer-generated and printed out or computer-generated and sent digitally to your employee. It must include the issuer’s name and profession and the address of the medical practice.

If they are sent digitally or printed from a GP’s system, it will contain a bar code. You can scan the barcode using a QR code scanner so that you can add it to your sickness records.

If a healthcare professional has issued the fit note following hospital treatment, you may also receive a yellow Med 10 form stating the time your employee has spent as a hospital inpatient.

Five things to do if you are given a fit note

  1. Check what the fit note says carefully. It might say that the employee is not fit to do any work at all, or it might say that they are fit for some work. In the latter case, you need to talk to the employee about what they can do.
  2. If the fit note says the employee isn’t fit for any work, check how long your employee’s fit note applies for, and whether they are expected to be fit for work when their fit note expires.
  3. If your employee may be fit for work, discuss their fit note with them and see if you can agree any changes to help them come back to work while it lasts.
  4. If your employee is not fit for work, or if they may be fit for work but you can’t agree any changes, use the fit note as evidence for your sick pay procedures.
  5. Consider taking a copy of the fit note for your records (your employee should keep the original).

What does a fit note mean?

The advice in the fit note is about your employee’s fitness for work in general, and not specifically about their current job. This gives you the flexibility to discuss possible changes to help them return to work (which may include changing their duties for a while, or permanently).

Changes you could make if the fit note says the employee might be fit for some work could include:

  • Working fewer hours than normal – for example, shorter days or weeks until they are well enough to return to their usual hours
  • Working from home for all or some of their hours
  • If the person’s normal job cannot be done from home, doing some other work which they could do from home
  • Undertaking any online training – for example, health and safety – that could be done from home
  • Taking more rest breaks or being seated while performing tasks
  • Undertaking different or reduced duties – for example, working in a back office rather than dealing with members of the public, or not lifting or walking long distances
  • Work using equipment or technology such as a screen reader that reads out text on a screen.

If an employee has a disability or is off sick because of their condition has deteriorated, changes to duties or hours might have to become permanent. Employers must make reasonable adjustments for disabled employees under the Equality Act 2010.

Is a fit note binding?

No. Even if the fit note says that someone is fit for some work, they might not be able to work in your organisation until they have fully recovered. This decision should only be made after talking to the employee.

Alternatively, an employee might say that they are fit to undertake some work with adjustments, even if the fit note says they are not. In this case you can let the employee return to work, but you might want to undertake a risk assessment first.

Does the employee need to signed fit for work?

No, people do not need to certified fit to return to work. Employees should return to work once their fit note expires or they need to be issued with a further fit note by their healthcare professional. Note, however, that it can be difficult for people to get an appointment with a healthcare professional and so there might be a delay in receiving another fit note.


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