A fit note, which is also officially known as a Statement of Fitness for Work or a Med 3 form, was introduced in 2010 to replace the traditional sick note. It’s a medical certificate provided by healthcare professionals that outlines how a health condition impacts an individual’s ability to perform their work duties. If a worker is off sick for more than seven consecutive days, including weekends and bank holidays, then an employer will usually need a fit note for them to qualify for Statutory Sick Pay (SSP). Employees who are off for less than seven days may not need a fit note. Instead, they can self-certify their illness by notifying their employer or by completing a self-certification form (SC2). A fit note consists of two options including ‘not fit for work’ and ‘may be fit for work’. Fit notes can be issued by a range of healthcare professionals, such as doctors, nurses, occupational therapists, pharmacists and physiotherapists.
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What is a fit note?
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When an employee is off work sick for a certain time, they may be required to provide a fit note.
This medical certificate helps employers understand what their condition is, when they're likely to recover, and what other support they may be entitled to.
When it comes to fit notes, employers must comply with the legal rules they come with. If you neglect them, you could make their condition worse, face tribunal claims, and cause business disruption.
In this guide, we'll look at what a fit note is, when they're needed, and how to support employees who are off work sick.
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A fit note is a certificate that provides medical evidence for a person's health condition. They're also referred to as a Statement of Fitness for Work, Med3 form, or sick note.
Only a healthcare professional can issue a fit note. They outline what their medical condition is, and whether their health affects their fitness to work.
When an employee is on sick leave for more than seven days, they can request a fit note free of charge. If they're sick for less than seven days, a general practice may only be able to provide a private medical certificate (which is chargeable).
When is a fit note required?
Fit notes are only required after an employee has been off sick after a certain period of time. For example:
Less than seven days
If an employee is off sick for seven days or less, they count as short-term absences. They don't need sick notes or a private certificate to prove their condition. Instead, they'll only need to provide something called self-certification (SC).
This is when they're able to self-certify their health condition and explain what was wrong with them. They will need to account for all the days they were off sick. (This includes non-working days, like weekends and bank holidays).
Employees only need to provide self-certification verbally or in writing (as a letter or an email). You can ask them to complete the HMRC's SC2 form, but this isn't a legal requirement.
More than seven days
If the employee is off sick for more than seven days, they count as . (Again, you need to count sick days that fall on non-working days, like weekends and bank holidays).
Here, sick employees need a fit note that's been issued by a healthcare professional. For example, from GPs or occupational therapists. It's not enough to self-certify or write a sick note themselves.
The fit note will state whether the employee is well enough to work; or whether they need more time to recover. Fit notes may also provide medical evidence that can help ease their return to work, like being referred to an occupational health (OH) professional.
Which healthcare professionals are allowed to provide fit notes?
Only certain healthcare professionals are allowed to provide a fit note. These include the following:
GP.
Hospital doctor.
Registered nurse.
Occupational therapist.
Pharmacist (who works in a hospital or general practice).
Physiotherapist.
Healthcare professionals who can issue fit notes will vary depending on where employees live. For example, community pharmacists are not allowed to issue a fit note.
Since July 2022, a new version of the fit note has been introduced. An eligible healthcare professional only needs to authorise an employee's fit note - they don't need to physically sign them. Whilst this legislative change is still being implemented, the previous Statement of Fitness for Work still stands as legally valid.
Are fit notes law-binding?
Fit notes aren't considered as law-binding under UK legislation. Following advice within a fit note is generally for the sick employee - not the employer. It's up to you whether to implement their medical advice or explore other options.
However, if an employee's fit note states they're fit enough to work - but you cannot implement the following advice - they should be treated as unfit to work. Here, the employee doesn't need a fit note in addition to their original one.
If an employee's fit note relates to a disability (either physical or mental), you may be legally obliged to provide reasonable adjustments. This is to ensure the employee isn't disadvantaged at work in comparison to their non-disabled colleagues.
Can an employer override a fit note?
Yes, an employer can override a fit note. This often happens when an employer doesn't have the means to act on the medical advice given in the note.
You might suspect an employee of ‘malingering’ (pretending to be sick to escape work). Before taking any action, you must have credible evidence to prove they're fit enough to work.
Employers may request medical evidence from an independent healthcare professional. You can only request medical evidence with the employee's permission. If you're proven right, you may follow through with appropriate
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Employers should always accept medical advice found in a Statement of Fitness for Work at face value. Remember, they're often issued because an employee is generally suffering from poor health or an ongoing illness.
When presented with a fit note, there are five steps every employer needs to consider:
Check the medical evidence from the healthcare professional.
Deal with employees fit enough to work.
Deal with employees unfit to work.
Make a copy of the fit note.
Ease the employee’s return to work.
Let's look at ways to manage fit notes from your employees:
Check the medical evidence from the healthcare professional
The first step every employer should take is check the medical evidence given by the healthcare professional.
They'll perform a full assessment on the sick employee in question. After this, they’ll reach a diagnosis and decide whether the employee's health affects their fitness to work.
Remember, an employer can only accept a fit note from a certain healthcare professional or GP practice. For example, a hospital doctor, nurse, occupational therapist, pharmacist, or physiotherapist.
Deal with employees fit enough to work
After the assessments are done, the healthcare professional will outline one of two results: fit enough to work or unfit for work.
If an employee is fit enough for work, it means they're able to perform part of their usual job. The fit note form will include four possible changes to consider:
Returning to work gradually: This is a plan to ease an employee back into their usual job role. For example, returning to work gradually by being given easier tasks during work hours.
Performing different duties: This is when an employee is given amended duties for a temporary period. For example, not being allowed to do heavy lifting after a set number of hours.
Working different hours: This allows an employee to change the number of work hours or amend their rotas. For example, starting and ending at different hours to avoid busy commute periods.
Providing reasonable adjustments: This involves changing an employee's working conditions or environment to make their job easier. For example, being assigned a mentor or work buddy that will provide additional help during work.
Deal with employees unfit for work
A healthcare professional may decide that an employee isn't ready to return to work. If that's the case, they'll issue a fit note that mentioned they're unfit for work.
They may recommend that the employee takes further sick leave, to rest or recover. After this period, the employee may need another assessment to decide whether they're fit enough to work again.
Sometimes, an employee may be fit enough to work, but they still require reasonable adjustments. If an employee is unable to make these workplace changes, the fit note will class the employee as unfit for work. But this will depend on individual circumstances.
Make a copy of the fit note form
The next step involves making a copy of the fit note form. It's important to remember that a fit note is legally owned by the employee.
As an employer, you can ask for the original certificate to make a copy. But you must return it to them as soon as possible.
Sometimes, fit notes aren't provided as a paper copy. For example, a GP practice may issue fit notes as a digital document. Whether you're sent a fit note form as a text message or on a mobile app, remember that these still count as viable alternatives.
Ease the employee’s return to work
Every employer should do their best to help employees return to work after being on sick leave. This is not only a legal duty, but also a moral one.
Make sure you count all the days that they were off sick. If they return to work before seven days, you can ask for self-certification or even a private certificate (if necessary). Try to be empathetic and ease them back into their regular work duties.
If they're returning after seven days, create a phased return to work plan for them. This may include possible changes; like changing work hours, performing different duties, or initiating a phased return.
Do you need a fit note to claim sick pay?
If an employee is off work sick (for either short or long-term absences), they may be able to claim sick pay. This will depend on what their legal rights are, as well as how long their sickness absence is.
They could receive statutory sick pay (SSP) which is £99.35 per week; and is paid up to 28 weeks (as of 2023). Employees are only eligible for statutory sick pay if they:
Have four or more sick days in a row (you must count sick days that fall on non-working days, like weekends and bank holidays).
Have provided notice and medical evidence proving their illness.
Earnt at least £123 per week (as normal pay).
Some employees may receive contractual sick pay; this must be higher than statutory sick pay. This is usually outlined within their employment contract, company handbook, or .
Employees can also take unpaid sick leave; this happens when they run out of sick days or don't qualify for sick pay (i.e., if they were self-employed). Here, they may seek other support, like Employment and Support Allowance (ESA) or Universal Credit (UC).
What is the end date of a fit note form?
The end date of a fit note form is set out by the healthcare professional who issued it. Depending on their assessment, they will decide how long an employee is fit or unfit for work.
The healthcare professional will also specify whether the employee needs to be assessed again after the end date period. If they believe the employee is still unfit, they may issue another Statement of Fitness for Work.
What if an employee doesn't return after sick leave?
Employees will take sick leave for all kinds of reasons. They may be off work sick for a long time - making it hard for them to come back. They might lack the confidence to return, or their health condition could have taken a turn for the worse.
If a sick employee doesn't want to return to work, you should respect their wishes. You may need to conduct a medical capability dismissal - which must be actioned in a fair and proper way. If not, you could end up causing an .
Can employees be given a fit note for mental health issues?
Yes, employees can be given a fit note for issues relating to mental health.
It's often assumed that mental health issues are less important compared to physical ones. But it’s not true. Some of the most common conditions include anxiety, stress, and depression - all of which can cause functional effects on a person's daily life.
Every employer must treat mental health issues with the same seriousness as physical ones. This includes ensuring the employee receives the same rights, like sick pay and leave entitlements.
FAQs: What is a fit note?
Do employers have to follow the recommendations on a fit note?
If an employer cannot make the recommended adjustments, then the employee should be considered as not fit for work, meaning they will continue to receive SSP. Also, under the Equality Act 2010, employers have a legal duty to make reasonable adjustments for employees with a disability.
Can employers challenge a fit note if they believe an employee is fit to work?
A fit note is a medical opinion and therefore doesn’t carry legal weight. However, this doesn’t mean employers can ignore them. With the employee’s consent, employers can request further information by contacting their GP. Employers may also request an occupational health assessment.
Can employers reject a fit note?
Employers that believe the fit note to be invalid may reject it. Valid fit notes must have the issuer’s name and profession, the medical practice’s address, and a signature or name of the healthcare professional.
What about employees who want to return to work before the note expires?
Provided they feel able to do so, employees can return to work whenever they please—it’s not necessary for this to be authorised by a healthcare professional. However, it’s recommended employers conduct a risk assessment to ensure it’s safe for them to do so.
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It's normal for an employer to deal with sick staff from time to time. Whilst they're off work sick, you still have a legal responsibility to request a Statement of Fitness for Work.
Make sure they know all about fit notes, whether they need to provide them, and how to return to work in a healthy manner. If you neglect this, you could end up making their condition worse, face tribunal claims, and cause further business disruption.
Peninsula offers expert fit note guidance. Our HR team offers 24/7 HR employment advice which is available 365 days a year.
Want to find out more? Contact us on 0800 158 2313 and book a free consultation with an HR consultant today.
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