You only need a doctor’s note for sick leave in the UK if you have been off for more than 7 days in a row, including weekends and non-working days. For anything shorter you self-certify. And it no longer has to come from a doctor: since 2022, five categories of healthcare professional can legally issue one.
The document itself has not been called a sick note in official use for years. It is a fit note — formally a Statement of Fitness for Work — and the rename reflects a real change in what it does. A fit note can say you are not fit for work, or that you may be fit for work with support, and the second option is used far less than it should be.
Key Takeaways
- 7 days or fewer: no note needed. You self-certify. GOV.UK confirms employees “do not need to give their employer a fit note or other proof of sickness”.
- More than 7 days in a row: a fit note is required, counting calendar days including weekends.
- Fit notes can be issued by a GP or hospital doctor, registered nurse, occupational therapist, pharmacist or physiotherapist — not doctors only.
- Your employer cannot withhold Statutory Sick Pay because a fit note arrived late.
When Do You Actually Need a Doctor’s Note?
The trigger is 7 consecutive days, and the counting method catches people out. You count calendar days, not working days, and the count includes the days you would not have worked anyway.
Work through three cases for someone on a Monday-to-Friday week.
| Absence | Calendar days | Fit note needed? |
|---|---|---|
| Monday to Friday, back the next Monday | 5 | No — self-certify |
| Monday to the following Monday | 8 | Yes |
| Thursday to the following Friday | 9 | Yes |
The middle row is the one people get wrong. Five working days off plus the weekend plus one more Monday is eight calendar days, so a fit note is required even though only six working days were missed.
Note the direction of the rule too: it is a maximum your employer can require, not a minimum they must. An employer cannot lawfully demand a fit note on day two, and asking a GP for one would not get you very far in any case.
Who Can Issue a Fit Note in 2026?
This changed in July 2022 and a great many absence policies have never been updated. GOV.UK lists the healthcare professionals who can issue a fit note as:
- GP or hospital doctor
- Registered nurse
- Occupational therapist
- Pharmacist
- Physiotherapist
The professional must be involved in your care, and they assess your fitness for work based on that involvement. In practice this means a physiotherapist treating a back injury can issue the note without you booking a separate GP appointment — which is the whole point of the change.
Fit notes have also been digital since 2022. They no longer require a wet-ink signature and can be issued and sent electronically. If your absence policy still says “original signed sick note must be posted to HR”, it is describing a document that no longer exists in that form.
What Is Self-Certification?
Self-certification is you telling your employer, in your own words, that you were unwell and unfit for work. It covers absences of 7 days or fewer and requires no medical involvement at all.
Employers commonly use a short form — the old SC2 shape — asking for the dates, the general nature of the illness, and a signature on return. Some employers ask for it during a return-to-work conversation instead. Either is fine. What an employer cannot do is refuse to accept self-certification and insist on medical evidence for a short absence.
Two things worth knowing:
- Self-certification is a statement you are responsible for. Falsifying it is a conduct matter and, where sick pay is involved, potentially a dishonesty one.
- Self-certified absence still counts in your absence record, your absence rate, and any trigger system your employer runs.
What Does “May Be Fit for Work” Mean?
Every fit note offers the issuer two options: not fit for work, or may be fit for work taking account of the following advice. The second is the underused one.
Where “may be fit for work” is ticked, the professional can suggest a phased return, altered hours, amended duties, or workplace adaptations. That advice is not binding on either side. If the employer cannot accommodate it, the note is treated as though it said “not fit for work” and the absence continues on the normal basis.
For employers, this is the most valuable field on the form and the one most often skimmed past. A note suggesting three weeks of reduced hours is an invitation to get someone back sooner, and — where the underlying condition might be a disability — engaging with that suggestion is also part of demonstrating you considered reasonable adjustments. Our guide to long-term sick leave and dismissal in the UK explains why that record matters later.
Does a Late Fit Note Affect Your Sick Pay?
No. GOV.UK states plainly that an employer “cannot withhold SSP if the employee is late sending you a fit note”. Evidence rules and notification rules are separate, and only late notification of the sickness can affect SSP.
To be precise about which rule does what:
| Notifying you are sick | Providing a fit note | |
|---|---|---|
| Deadline | Employer’s own limit, or 7 days if none set | After 7 consecutive days of absence |
| Can SSP be withheld for lateness? | Yes, for the late days, absent a good reason | No |
| Governed by | SSP (General) Regulations 1982, reg 7 | Employer’s evidence policy |
Statutory Sick Pay itself is £123.25 a week for the 2026/27 tax year, or 80% of average weekly earnings if lower, payable for up to 28 weeks (GOV.UK). Our UK Statutory Sick Pay guide covers eligibility in full, and sick leave notice rules covers the reporting side.
What This Means for You
Employees: do not book a GP appointment for a three-day absence — you do not need one and you will not get a note. If you are heading past a week, ask whoever is actually treating you, whether that is a physiotherapist, a pharmacist or a nurse. And send the note when you have it; the delay will not cost you SSP, but it will slow down any return-to-work planning.
Employers: check your absence policy against three things — that it says 7 calendar days and not 7 working days, that it names all five professional categories rather than just doctors, and that it accepts digital notes. Those three edits fix the overwhelming majority of out-of-date UK sickness policies.
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This article is general information, not legal advice. Statutory entitlements described are correct as at July 2026; check GOV.UK or take advice for your specific circumstances.