How do I get a fit note?

Since July 2022, nurses, occupational therapists, pharmacists and physiotherapists have been able to legally certify and issue a statement of fitness for work, informally known as a ‘fit note’. Previously only GPs or hospital doctors could issue fit notes. Find out what a fit note is, when you might need one and how to go about getting one.
Doctor issuing a note

The Statement of Fitness for Work, commonly known as the ‘fit note’ or Med 3 form was introduced in 2010. It is the medical statement used to give advice to patients about the impact of their health condition on fitness for work and is intended to support people to stay or return back to work.

Fit note changes

From 1 July 2022, registered nurses, occupational therapists, pharmacists, and physiotherapists, alongside doctors can certify and issue fit notes. This means you can receive a fit note from the healthcare professional treating you, for instance a physiotherapist, if it’s within their scope of practice.

A new version of the fit note was introduced in April 2022. The requirement for the healthcare professional to sign the form in ink has been removed and replaced by the issuer’s name and profession. This allows healthcare professionals to certify fit notes digitally, which means that you can receive your fit note through digital channels (where IT system support this). For more information on this, please visit government guidance.

When do I need a fit note?

If you are unable to work due to sickness for seven days or less, you are not required to provide your employer with medical evidence that you have been ill. Instead, you should self-certify sickness for this period. From the eighth day, if you are still ill then you may need to submit medical evidence in the form of a fit note to your employer.

To work out how many days you have been off sick, you need to count all the days in a row that you’ve been sick, including non-working days such as weekends and bank holidays. This is the same if you are claiming Universal Credit.

Tired woman with Long Covid

How do I get a fit note?

You can request a fit note from the healthcare professional who is treating you. This could be at during a consultation at your GP practice or a hospital. They will assess whether your health condition impacts on your ability to work and whether a fit note is required. Your healthcare professional may choose the “may be fit for work” option if they feel that you are able to do work, even if it is not your usual workload or job, with support from your employer.

How your fitness for work will be assessed

Your healthcare professional will assess your fitness for work by considering how your health condition affects what you can do at work. They will decide whether you are fit for work, ‘may be fit for work’ or are ‘not fit for work’.

Your healthcare professional will give you advice on the fit note about how your health affects what you can do at work. Make sure you discuss this with them and understand their advice, particularly as they will not automatically assess that you are not fit for work. They will consider your fitness for work in general instead of just thinking about your current job.

If they assess that you ‘may be fit for work’, they will provide advice on any workplace adjustments that would help you stay in or return to work. The fit note form may be updated during the assessment with the options below;

  • a phased return to work: a gradual increase in work duties or hours
  • altered hours: changes to the times or duration of work
  • amended duties: changing duties to take account of a condition
  • workplace adaptations: changing aspects of the workplace, such as working from home

This gives you and your employer the maximum flexibility to think about ways to help you stay or return to work, which might include moving you to a different job or location for a while, changing your duties, working from home (if appropriate) or offering a phased return to work.

You should discuss your fit note with your employer to see if they can help you stay or return to work and come to an agreement on what may be appropriate for you. We know that most employers want to help their employees succeed in work and can often make changes to the workplace or job duties. If your employer is unable to make or accommodate these changes, then your employer will need to arrange sick pay. Your healthcare professional might advise that you cannot do any kind of work. If this is the case, then show the fit note to your employer to arrange your sick pay.

They can take a copy, but you should keep the original. It’s usually a good idea to keep in touch with your employer while you are unable to work, so that you are ready when it’s time to go back. You can get advice about sick pay from your trade union or see information about sick pay.

What financial support am I entitled to if I’m sick and unable to work?

If you are classed as an employee and have average earnings of at least £123 per week, you may be eligible to receive Statutory Sick Pay which is paid at £109.40 a week for up to 28 weeks, starting from the fourth day you’re off sick.

Statutory Sick Pay is paid by your employer in the same way as your normal wages, for example weekly or monthly. You’ll be paid for all the days you’re off sick that you normally would have worked except for the first 3 days. You can check if you’re eligible for Statutory Sick Pay on the Government website.

If you’re self-employed you can apply for Universal Credit. How much you can get will depend on what stage your application is at, as well as things like your age and whether you’re able to get back to work at some point.