What is a Fit Note?

A fit note is an official statement from a registered healthcare professional saying whether an employee is:

Not fit for work
May be fit for work with some adjustments

It replaced the old ‘sick note’ back in 2010. Same idea, just with a new name and a bit more flexibility. The idea is to support employees back into work if they’re able to do so, with the right tweaks in place.

It’s important to note that a fit note can only be issued if a healthcare professional believes that a person's ability to work is affected. If an individual is deemed fit for work, they won't receive a fit note.

When do employees need to provide a fit note?

Employees only need to give you a fit note after they’ve been off for 7 calendar days in a row. That includes weekends and bank holidays.

For anything less than 7 days, they can self-certify. That means they just tell you they were sick with no doctor’s note needed. You can ask them to fill out a self-certification form if you want something in writing, but you can’t demand a fit note for shorter absences.

It’s important to note that if there is a delay in getting the fit note from your employee, they should inform you why there is a delay and when you are expected to receive it.

Who can issue a fit note?

It used to be just GPs, but the rules have widened. These days, fit notes can be issued by:

Doctors
Nurses
Occupational therapists
Pharmacists
Physiotherapists

By law, in order to issue a fit note a healthcare professional must conduct an assessment, which can be done in person, via video call, over the phone, or by reviewing a written report from another professional.

Digital vs Printed fit notes

Done are the days when you always got a paper slip with a doctor’s scrawl on it. These days, fit notes can be issued digitally or on paper and both are equally valid.

Digital fit notes

Healthcare professional can now send fit notes electronically via secure NHS systems. Your employee can then forward it to you by email, download it from a portal or even screenshot it for you.

Printed fit notes

Still common, especially for face-to-face appointments. These can be physically handed to you, scanned or photographed then sent over.

What matters is that the note includes the required information:
The issuers name, professions and address of the medical practice
Statement of the employee’s fitness to work
Signature from the healthcare professional
The date the advice applies and for how long it’s valid

It’s important to note that your responsibilities as an employer don’t change whether the note is emails or printed. Both formats carry the same weight legally.

What should you do when you get a fit note?

You should read the note properly and carefully consider any fit note recommendations. The note will either say, “Not fit for work”, in which case it’s business as usual. Your employees stays off, and you manage their absence.

Or “May be fit for work if...”, followed by some recommendations like:

Reduced hours
Working from home
Avoiding heavy lifting

If you can make the suggested changes, implementing those recommendation might enable your employee to get back to work sooner. If you can’t reasonably accommodate them If you can’t reasonably accommodate them, the note defaults to “not fit for work” and your employee stays off sick.

However, if the recommendation are reasonable adjustments for a sickness or disability under the Equality Act 2010, you need to take extra care. Because if you don’t make the reasonable adjustments, and an employee is disadvantaged as a result, you could face a disability discrimination claim.

If you need more information you can ask for a report from your employees’ doctor, but you must (and we mean must) ask your employees permission before doing this.

How to check a fit note is genuine

Believe it or not, but you can receive fake sick notes for work. While most employees are honest, occasionally something might not sit right. Especially as modern technology like AI can make some pretty accurate replications.

If you’re unsure whether a fit note is the real deal, here’s what to look for:

That the healthcare professional’s name matches the signature (handwritten or digital)
It clearly states the role of the healthcare professional with address of the medical practice
The statement: “Not fit for work” or “May be fit for work” is stated
Unique serial number or valid QR code or barcode for digital notes

If you’re still in doubt, some red flags you can look for are:

Blurry scans or handwritten notes that don’t follow the usual format
Suspicious dates or overlapping absences
A note that claims to be from a healthcare professional but doesn’t include a surgery name

It’s good business practice to respect your employees when they hand you a note. Don’t automatically assume it must be fake.

Accusing someone of faking a sick note is serious business. Always approach the situation with caution. If you’ve got concerns, seek advice from an HR employment law expert before taking any action.

Employment law and fit notes

Knowing your legal duties when it comes to sick leave and fit note rules, is serious business. Mishandling any step can land you in hot water.

Here’s what the law says you must do:

You have a duty of care

Under the Health and Safety at Work Act 1974, you’re legally responsible for protecting your employee’s health, safety and wellbeing. So, if a fit note suggests adjustments, ignoring them could be seen as a failure of that duty.

Discrimination laws apply

If the illness of condition counts as a disability under the Equality Act 2010, you have a legal obligation to make reasonable adjustments. Dismissing someone or treating them unfairly because of a disability, is a fast-track ticket to an employment tribunal.

Unfair dismissal

While you can dismiss an employee fairly due to repeated and frequent sickness. You can’t just dismiss someone for simply being off sick. Especially if they’ve followed the correct process and provided fit notes. So, you need to tread carefully and ensure that you’ve followed a fair process. This includes medical evidence, meetings, and proper documentation.

This becomes particularly tricky when it involves Long-term sickness. Jumping the gun can be classed as unfair dismissal.

Frequently asked questions about fit notes

Can you challenge a fit note?

Short answer: Not really. You can’t just ignore a fit note because you don’t like what it says. But if you’re unsure, or if something doesn’t add up, you can request further medical information from your employee. However, you can’t force them to provide more than what's already on the fit note.

Does the fit note affect sick pay?

To be entitled to SSP your employee must provide proof after 7 days in the form of a fit note. However, if the employee has been off for less than 7 days, they still qualify for SSP if they’ve been off for at least 4 days in a row (including non-working days) and meet the other eligibility criteria.

You can also have your own company sick pay scheme, but whatever you do, make sure it’s clearly set out in your employee handbook or contract.

How should you store fit note?

Treat them as confidential medical records. Keep them somewhere secure and only share with people who need to know. Usually, HR or a manager directly involved in managing the absence.

Can an employee return to work before the fit note runs out?

If your employee wants to return to work before their fit note expires, they can. However, you should make sure they’re well enough to do so. Which can be done by talking with them to make sure they’re not putting their health at risk by returning early.

Get the business support you need to manage fit notes and sick leave

Fit notes aren’t just paperwork, they’re a tool to help your team recover and return to work safely. Knowing the rules helps you stay compliant and support your staff. But if, keeping on top of fit notes, absence records, and return to work meetings is taking up more time than you’d like, help is at hand.

Need expert guidance? Get clear, confidential advice, day or night, from BrightAdvice, our 24/7 employment law advice line. Whether you’ve got questions about fit notes, SSP, or long-term sick leave, our experts have your back.

Want to make absence tracking effortless? Our absence management software helps you, log, track, and manage sickness in a few clicks. No spreadsheets, no stress.

Because when it comes to your business, it pays to have expert advice and smart tools on your side.