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Fit notes when off sick

1 . Getting a fit note or self-certifying

Employees might need a fit note when they're off sick. A fit note is an official statement from a registered healthcare professional giving their medical opinion on a person's fitness for work. Fit notes used to be called sick notes.

Healthcare professionals who can provide fit notes are:

  • doctors
  • nurses
  • occupational therapists
  • pharmacists
  • physiotherapists

Whether an employee needs a fit note depends on how long they're off sick.

Self-certification when off sick for 7 days or less

If someone is off sick for 7 calendar days or less (including weekends), they do not need a fit note.

They can tell their employer they're not well enough to work. They do not need to provide medical evidence.

This is called 'self-certifying' their sick leave. They should still be paid the amount of sick pay they're entitled to.

Getting a fit note when off sick for more than 7 days

If an employee is off sick for more than 7 calendar days, they should get a fit note from a registered healthcare professional.

This is the case even if the employee was not supposed to be at work for some of the 7 calendar days. For example if:

  • they work part time
  • some of the 7 calendar days were a weekend, when they do not work

The healthcare professional can provide the fit note by email or as a printed copy.

The employee should give the fit note to their employer on the 7th day of their absence, or as soon as possible after this.

If there's a delay getting a fit note

If there's a delay getting a fit note, the employee should contact their employer to explain:

  • why there's a delay – for example, difficulty booking a doctor's appointment
  • when their employer will get the fit note

An employer should only ask their employee for a fit note from the 7th day of absence. A healthcare professional might refuse to provide a fit note before the 7th day.

What a fit note says

The healthcare professional has to tick whether the employee:

Contact the Acas helpline

If you have any questions about fit notes or self-certification, you can contact the Acas helpline.

2. Not fit for work

A healthcare professional might say someone is not fit for work. They should say how long the fit note lasts.

When the fit note runs out, the employee will either:

  • return to work, if they are well enough
  • get another fit note, if they need more time off

While the employee is off, their employer should:

Returning to work before the fit note runs out

An employee can return to work before their fit note has run out, if they want to.

However, they should make sure they're well enough. They could talk with their doctor about this.

The employer should talk with the employee to make sure they're not putting their health at risk by returning early.

Contact the Acas helpline

If you have any questions about what to do with a fit note, you can contact the Acas helpline.

3. Might be fit for work

A healthcare professional could say someone might be fit for work. They should explain in the fit note what they think the employee is able to do.

They might say the employee is fit for work in general, but not for a specific task.

For example, a factory employee with a back injury might be able to do light tasks, but not heavy lifting.

The fit note might also say how the employer can help their employee get back to work. For example:

  • a phased return to work where they might come back for a limited number of hours or days a week to start with
  • flexible working
  • giving them different duties
  • making changes to their workstation or working pattern

What to do with fit note recommendations

The employer should carefully consider any fit note recommendations. Putting those recommendations in place could help the person return to work quicker.

If it's not possible for the employer to do anything that's recommended, the employee will become not fit for work. They do not need to get another fit note to show this.

The employer can ask for a report from the employee's doctor to help them:

  • assess if the employee is fit to carry out their work
  • support their employee to return to work

The employer must have the employee's permission to do this.

The employer must put recommendations in place if they are reasonable adjustments for a disabled employee.

Find out more about:

If an employee is unhappy with how their fit note has been handled

If an employee is unhappy with how their fit note has been handled, they should raise it with their employer.

Contact the Acas helpline

If you have any questions about fit note recommendations, you can contact the Acas helpline.

Support for employers

Employers and managers can get government guidance on supporting employees' health and disabilities.

Find support with employee health and disability on GOV.UK

4. Who to give a fit note to

In most cases employees should give fit notes to their manager or supervisor.

This is so the manager can:

  • understand the reason for being off sick
  • get an idea of how much time off the employee might need
  • support the employee when they're ready to return to work

To check who to give a fit note to, an employee should:

  • look at any relevant policy their employer has, for example an absence policy
  • check if the staff handbook covers this

They could also talk to:

  • someone they work with, for example a manager they trust
  • a trade union representative, if they're a member
  • HR, if their organisation has an HR department

If an employee wants to give their fit note to someone else

Sometimes, an employee might not feel comfortable giving their fit note to their manager. For example, if the fit note gives details of a sensitive operation they've had.

In this situation, the employee should:

  • give their fit note to a suitable alternative person, for example a senior manager or HR
  • explain why they're giving the fit note to them
  • make it clear if they want it to be kept confidential from their manager

The employee's manager might ask for a copy of a fit note. If the employee does not want to share it with them, they should explain who they've given the fit note to and why.

If their manager still asks for the fit note, the employee should ask them to discuss it with the person they gave the fit note to.

Keeping fit notes confidential

In most cases, an employee's fit note must be kept confidential. Information about an employee's health must be managed in line with UK GDPR.

If an employee asks for their fit note to be kept confidential from their manager, the person they've given it to must respect this.

There might be circumstances where information on the fit note needs to be shared with the employee's manager. For example, to protect the employee's health and safety.

The person with the fit note should discuss this openly and honestly with the employee and:

  • explain what information they need to share and why
  • agree what details from the fit note they can and cannot share