Fit notes in the UK: sick notes and self-certifying for 7 days

In short

• A fit note is the UK sick note, officially the Statement of Fitness for Work (Med 3 form). You must give one to your employer if you have been ill for more than 7 days in a row and have taken sick leave. The 7 days include non-working days, such as weekends and bank holidays (as of November 2026, GOV.UK).
• Self-certifying for 7 days: if you are off for 7 days or less, you do not need to give a fit note or other proof from a healthcare professional. When you return, your employer can ask you to confirm you were off sick (self-certification) (GOV.UK).
• Who can issue a fit note: a GP or hospital doctor, a registered nurse, an occupational therapist, a pharmacist or a physiotherapist. They must first assess your fitness for work.
• Cost: a fit note is free if you have been ill for more than 7 days when you ask for one.
• What the form says: “not fit for work” means you are not fit for work of any kind. “May be fit for work” is meant to help you and your employer discuss changes that would support you staying in work or returning (GOV.UK).

What a fit note is and what it is for

A fit note is the common name for the Statement of Fitness for Work, or Med 3 form, introduced in 2010 (as of November 2026, GOV.UK). It gives you and your employer advice about the impact of your health condition on your fitness for work. It can also enable you to access health-related benefits or serve as evidence of eligibility for Statutory Sick Pay (SSP).

The DWP guidance for patients and employers that we use is marked “correct as of August 2023”. “November 2026” here is the date we checked it.

Rules from the guidance:

• You only get a fit note if your health affects your fitness for work. You cannot be given a fit note stating that you are “fit for work”, and a person who is fit for work does not need one.
• A healthcare professional cannot give you one for non-medical problems, such as problems at home or trouble at work.
• The fit note belongs to you. Your employer can take a copy for their records.
• It can be handwritten or computer-generated, and printed or shared digitally. It must include the issuer’s name and profession and the address of the medical practice.
• A fit note without the issuer’s name or signature is not valid: your employer or the DWP can reject it and ask you to get a new one.

When you do not need a fit note: 7 days and form SC2

If you are off for 7 days or less, you do not need to give your employer a fit note or other proof of sickness from a healthcare professional (as of November 2026, GOV.UK). When you return, your employer can ask you to confirm you were off sick: this is called self-certification. You might need to fill in a form or send details of your sick leave by email.

If you are off for more than 7 days in a row (including non-working days), you must give your employer a fit note, printed or digital (GOV.UK). You must usually tell your employer you cannot work before the deadline they set (or within 7 days if they have not set one).

Form SC2. If your employer needs something in writing, you can use form SC2. It can be used to self-certify a sick absence or alongside a fit note (GOV.UK). You fill it in online and you cannot save your progress. The form asks for:

1. your National Insurance number,
2. your phone number,
3. details of your sickness, including the dates you were sick,
4. the date of your last working day before your sickness began,
5. your clock or payroll number.

Give the completed form to your employer and keep a copy for yourself.

Who can issue a fit note and how to get one

A fit note can be issued by (as of November 2026, GOV.UK):

1. a GP or hospital doctor,
2. a registered nurse,
3. an occupational therapist,
4. a pharmacist,
5. a physiotherapist.

How to get one: contact the healthcare professional treating you. Before issuing a fit note, they must assess your fitness for work, by face-to-face appointment, video call, telephone consultation or by considering a written report by another healthcare professional (GOV.UK).

What the form says

The healthcare professional decides on one of three assessments: “fit for work”, “may be fit for work” or “not fit for work”. They think about your fitness for work in general rather than just for your current job (as of November 2026, GOV.UK).

If your employer cannot offer the support advised, the fit note is also treated as though it says “not fit for work” (NHS).

With “may be fit for work”, the healthcare professional can tick options on the form:

• 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, such as no heavy lifting,
• workplace adaptations, such as working from home.

These options are not binding on you, and you can discuss other options. In the first six months of your health condition, a fit note can only be issued for a maximum of three months at a time, and a review date can be set.

Access to Work is a discretionary grant that can provide practical and financial support to people with a disability or health condition to help them stay in, or return to, work. We cover sick leave, SSP and Access to Work in the context of mental health in our guide to mental health in the UK.

Fit notes and money: SSP, Universal Credit and ESA

SSP. A fit note can serve as evidence when claiming SSP. We explain the rules in our guide to employee rights in the UK.

Universal Credit. You must get a fit note if your health condition or disability affects your capability to work for longer than 7 days (as of November 2026, GOV.UK). If you are moving from ESA, you might not need one. While you are waiting for the decision about your Work Capability Assessment, you must continue to get fit notes. If your fit note expires during that time and your health still affects your capability to work, get a new one; without it, you may be expected to work or look for work.

ESA. To apply, you need a fit note if you have not been able to work for more than 7 days in a row because of a disability or health condition. You may also need to send fit notes regularly (GOV.UK).

If you are not eligible for SSP or it has ended, you may be able to apply for Universal Credit or ESA; form SSP1 can support your application (GOV.UK). For disability benefits, see our guide to PIP.

Will fit notes change?

The government is considering changes to the fit note system (as of November 2026, GOV.UK). Sir Charlie Mayfield’s Keep Britain Working Review, published in November 2025, found that the fit note “is not working as intended”, with the process often acting as a barrier rather than a bridge between employees and employers. According to the report, the call for evidence and the review’s recommendations are helping the government consider how to improve the system. The sources we checked do not give any specific changes or dates.

Scotland, Wales and Northern Ireland

Until July 2022 only doctors could issue fit notes. From 1 July 2022 nurses, occupational therapists, pharmacists and physiotherapists can too. In England, Scotland and Wales the change covers all registered professionals on this list and doctors “at point of registration” (as of November 2026, GOV.UK). According to this guidance, Northern Ireland is laying its own legislation, which will mirror this change. The guidance does not say what the position is now.

Frequently asked questions

Do I need a fit note if I am ill for 3 days?

No. If you are off for 7 days or less, you can confirm the sickness yourself (as of November 2026, GOV.UK). If your employer wants something in writing, you can use form SC2.

Can a pharmacist issue a fit note, and can I get one at a pharmacy?

Community pharmacists do not have access to the Med3 form, and fit notes are not part of the NHS services that community pharmacies provide (as of November 2026, GOV.UK). Pharmacists in multidisciplinary teams within general practices or hospitals who can assess fitness for work do have access to Med3. Fit notes are issued by, among others, pharmacists at GP surgeries, hospitals and clinics (NHS).

How much does a fit note cost?

It is free if you have been ill for more than 7 days when you ask for one (as of November 2026, GOV.UK). If you have been ill for 7 days or less, the healthcare professional might charge a fee. If your employer asks for evidence for the first 7 days, they should pay that fee (NHS). The guidance does not give the amount of such a fee.

Can I go back to work before my fit note ends?

Yes, this may be before your fit note expires, as long as you go back when you feel able to and with your employer’s agreement (as of November 2026, GOV.UK). You do not need to go back to your healthcare professional, even if they indicated that they need to assess you again.

Can my employer reject a fit note or ask for more evidence?

An employee cannot be required to provide further medical evidence beyond a fit note (GOV.UK, as of November 2026). However, your employer can reject a fit note that does not include the issuer’s name or signature. If your employer does not pay you SSP, you can raise a dispute with HMRC or seek help from a trade union or Acas (GOV.UK).

Where to get help

• The healthcare professional treating you: this is who you ask for a fit note. We explain how GPs and 111 work in our guide to the NHS in practice.
• NHS: the page Getting a fit note.
• GOV.UK: Taking sick leave and Statutory Sick Pay.
• Complaints about a fit note: raise them with the organisation providing or commissioning the service; it will have its own complaints arrangements (as of November 2026, GOV.UK).
• Jobcentre or work coach: if you receive a health-related benefit, you can speak to them about possible work opportunities.