A fit note is a medical document issued by a GP that states whether an employee is fit or unfit for work, and — if they are fit for work — what adjustments might be needed to enable them to return. The fit note replaced the old sick note in the UK on 6 April 2010, shifting the emphasis from simply confirming absence to advising on what an employee can do rather than just what they cannot. The system is governed by Statutory Sick Pay (SSP) rules and administered through the Department for Work and Pensions (DWP) (GOV.UK, Fit Notes).
Fit notes matter because they sit at the centre of the employee-employer relationship during sickness absence. They determine whether SSP is payable, guide workplace adjustments, and — when used well — help employees return to work faster by identifying suitable modifications.
Key Takeaways
- A fit note is issued by a GP after the first seven days of sickness absence; for seven days or fewer, employees self-certify.
- Fit notes advise whether an employee is “not fit for work” or “may be fit for work” with specified adjustments.
- Employers are not legally required to follow a GP’s recommendations, but doing so is best practice and reduces absence duration.
- Fit notes are free to obtain through the NHS; they are also available through private GPs.
- Employers cannot request a fit note before the seven-day self-certification period has elapsed.
What Is a Fit Note?
A fit note is a medical statement from a doctor that tells an employer about the impact of an employee’s health condition on their ability to work. It replaced the old sick note (formally a “statement of fitness for work”) in 2010 following a government consultation that found the old system focused too narrowly on absence and not enough on supporting a return to work.
Under the current system, a GP has two main options when issuing a fit note:
- Not fit for work — The employee should not work at all during the period stated on the note. This is the most straightforward option and is used when an employee’s condition makes any work unsafe.
- May be fit for work — The employee can work, but only with specific adjustments. The GP will recommend modifications such as phased hours, reduced duties, ergonomic changes, or temporary role modifications.
Importantly, “may be fit for work” is advisory, not binding. The employer decides whether they can implement the recommended adjustments. If they cannot, the employee is treated as not fit for work for SSP purposes (GOV.UK, Fit Notes).
When Do Employees Need a Fit Note?
The rules are straightforward:
| Absence Duration | What Happens |
|---|---|
| 1-7 calendar days | Employee self-certifies using form SC2 (or equivalent). No fit note needed. |
| 8+ calendar days | Employee needs a fit note from a GP (or hospital doctor, registered nurse, pharmacist, physiotherapist, occupational therapist, or practitioner psychologist with NHS referral rights). |
| Hospital admission | Hospital doctor issues the fit note. |
| Ongoing/recurring conditions | GP can issue a fit note for future dates covering a planned absence. |
The self-certification period covers the first three working days as unpaid (waiting days) for SSP purposes, but you as an employer can choose to waive the waiting days in your company policy.
Self-Certification vs Fit Note
Understanding the distinction between self-certification and a fit note is essential for managing short-term absence effectively:
| Feature | Self-Certification | Fit Note |
|---|---|---|
| When issued | First 7 days of absence | Day 8 onwards |
| Issued by | Employee (form SC2) | GP or approved healthcare professional |
| Legal requirement | No statutory form, but employer can require | Yes, for SSP entitlement after 7 days |
| Cost to employee | Free | Free (NHS) or private GP fee |
| What it covers | Reason for absence, expected return date | Fitness status, adjustments, duration |
| SSP impact | Employee can self-certify for SSP purposes during days 1-7 | Required to continue SSP from day 8 |
Some employers choose to request a GP fit note even within the first seven days — they are entitled to do so, though most accept self-certification for short-term absences. A more generous approach, common among progressive employers, is to accept self-certification for the full seven-day period and only request a fit note if absence extends beyond that.
How the SC2 Self-Certification Form Works
The SC2 form is not a statutory requirement in the sense that there is no official government SC2 template that employees must use. However, the term “SC2” is widely understood in UK HR practice as the self-certification form employees complete when they are sick for seven days or fewer.
The form typically captures:
- Employee details — Name, job title, department.
- Dates of absence — First and last day of sickness.
- Reason for absence — A brief description (you are not required to disclose a specific diagnosis).
- Declaration — A statement confirming the information is accurate.
Employers are free to create their own self-certification form. Many organisations embed a self-certification option into their HR system or absence management platform. There is no legal obligation for the employee to provide a specific diagnosis — a general reference to illness or health reasons is sufficient.
If an employee is off sick for exactly seven calendar days, the self-certification period covers the entire absence. A fit note is only required if absence extends into day eight.
Employer Obligations for Fit Notes
When an employee provides a fit note, you as an employer have several obligations and best-practice recommendations:
Legal Obligations
- Pay SSP if applicable. If the employee has been off for eight or more days and meets SSP eligibility criteria (average earnings of at least £123 per week in 2025/26, employed in the UK), you must pay SSP from the first qualifying day.
- Keep records. Retain copies of fit notes and self-certification forms for at least three years for PAYE and SSP compliance.
- Do not discriminate. An employee’s health condition may constitute a disability under the Equality Act 2010. Refusing reasonable adjustments without justification could amount to discrimination.
Best Practice
- Engage with the GP’s recommendations. If the fit note says “may be fit for work” with adjustments, explore whether you can implement those adjustments. Research consistently shows that employees return to work faster when adjustments are made early.
- Use the fit note as a starting point for a return-to-work discussion. It provides a structured basis for conversations about modified duties, reduced hours, or workplace changes.
- Do not request a fit note before the self-certification period ends. Doing so undermines trust and adds unnecessary cost to the employee if they see a private GP.
Frequently Asked Questions
Can I get a fit note on the first day of illness?
A GP can issue a fit note at any point during your absence, but employers generally cannot require one for the first seven days. If you are seriously unwell from day one, a GP can issue a backdated fit note covering the entire period. Some employees prefer to obtain one early to avoid the need to return for a second appointment.
Does a fit note mean I have to stay off work?
No. A fit note with “may be fit for work” means you can potentially work with adjustments. The final decision rests with your employer — if they cannot accommodate the adjustments, you are treated as unfit for work. You also have the right to choose to remain off work if you feel unable to continue.
Can my employer challenge my fit note?
Your employer can request a fit note from their own occupational health service or refer you to an independent medical expert, but they cannot override your GP’s professional medical opinion. If there is a genuine dispute about your fitness for work, the employer should engage in an occupational health assessment.
How long does a fit note last?
A fit note can cover any period the GP considers appropriate. For short-term conditions, it typically covers the expected recovery period. For ongoing conditions, a GP can issue a fit note covering several weeks or months, or issue a series of notes with review dates. There is no maximum duration.
Is a fit note different from a medical report?
Yes. A fit note is a brief statement about your ability to work. A medical report is a more detailed document that may include diagnosis, treatment history, and prognosis. Employers can request a medical report (with your written consent) but cannot require one as a condition of employment or absence management outside of specific statutory contexts.
This article is general information, not legal advice. Consult a qualified employment lawyer for guidance on your specific jurisdiction and circumstances.
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