The Office for National Statistics has reported the highest rate of sickness absence in over a decade. Employers can therefore expect to receive more fit notes from employees. There have been some important changes to streamline the process for issuing and certifying fit notes which employers should be aware of.

What is a fit note, and what can it be used for?

A 'fit note' provides evidence to an employer of an employee's absence due to sickness. For statutory sick pay purposes, employees have to provide evidence of their incapacity after seven consecutive days' absence.

Following a health assessment, a fit note may specify either that:

  • the employee is 'not fit for work', meaning they may not work for the stated period of time; or
  • the employee 'may be fit for work', which means that the employee’s condition does not necessarily stop them from returning to work. In this case the healthcare professional has the option of suggesting amendments which would assist a return to work such as a phased return, amended duties, altered hours or workplace adaptions. It is good practice for employers to discuss any comments in a fit note with employees, particularly any suggestions made regarding changes to the role. If an employer is unable to accommodate suggested changes, the fit note is treated as if it says 'not fit for work' – a new fit note is not required.

If an individual is ‘fit for work’ they will not be issued with a fit note.

A fit note is classed as advice and is not legally binding on employers, although there should always be a good reason for not complying with one. If the employee is disabled, an obligation to make 'reasonable adjustments' may arise, failure of which may entitle the employee to bring a discrimination claim.

1 July 2022: more healthcare professionals can issue fit notes

Previously, only GPs or hospital doctors could provide fit notes. However, since 1 July 2022, the following healthcare professionals have also been able to issue and certify fit notes:

  • Nurses
  • Occupational therapists
  • Pharmacists
  • Physiotherapists

This change comes in light of significant pressure on GPs as they tackle appointment backlogs caused by the Covid-19 pandemic. It is expected to free up millions of appointments for those needing access to GP services, allowing people to get the right support.

6 April 2022: digital fit notes

A fit note no longer needs to be 'signed in ink' by the person issuing it.

Since 6 April 2022, a fit note can be issued and received digitally, with the name of the issuer stated within the fit note.  While digital fit notes are being rolled out, 'signed in ink' fit notes remain valid.

New guidance for healthcare professionals

The Department for Work and Pensions (DWP) has published: 'Getting the most out of the fit note: guidance for healthcare professionals' which, amongst other points:

  • restates that assessments should be focussed on whether an individual is fit for work generally, rather than being job-specific, listing key factors to consider;
  • provides information on how to discuss an individual's beliefs about their health and work if they are reluctant to return to work, listing helpful approaches to consider;
  • acknowledges the difficulties that incomplete fit notes cause employers when determining what support is required, highlighting the importance of giving practical advice to employers. 

The DWP has also issued non-statutory guidance on who can issue fit notes, following the recent changes.

What do these changes mean for employers?

Employers should review and update their sickness absence reporting procedures and ensure that staff are aware of their obligations when taking time off work due to sickness.

To discuss anything covered in this blog, please get in touch with a member of the Brodies Employment and Immigration team

Workbox by Brodies

Workbox by Brodies, our award-winning HR and employment law site, has detailed guidance on fit notes and managing sickness absence. Subscribers can access this here. If you would like to find out more about Workbox, please get in touch for a free online demo. 


Julie Keir

Practice Development Lawyer

Miguel Chui

Summer Placement Student