By PaySlipCheck Editorial
· Reviewed by PaySlipCheck Editorial Standards Team
· 14 June 2026
· 5 min read
The 'Fit Note' (formal name: Statement of Fitness for Work) replaced the old 'Sick Note' in 2010. It's issued by a GP, nurse, occupational therapist, pharmacist, or physiotherapist. It can say you're 'not fit for work' or 'may be fit for work' with certain adjustments. Since July 2022 the eligible issuer list was expanded. This guide covers when needed, who can issue, and how employers should respond.
Verified against 2 official sources · Last reviewed 14 June 2026
Day 8 onwards: fit note required for continued SSP / OSP
Who can issue (since July 2022)
GP (registered)
Hospital doctor
Registered nurse
Occupational therapist
Pharmacist
Physiotherapist
Expanded 2022 to relieve GP appointment pressure.
Options on the fit note
Option 1 — Not fit for work
- Standard for typical sickness
- Employee should not work
Option 2 — May be fit for work with adjustments
- Details recommended adjustments (phased return, altered duties, workplace changes)
- Employee + employer can discuss
- If employer agrees: return to work with adjustments
- If employer disagrees: treat as 'not fit for work'
Phased return
Common adjustments:
- Reduced hours (build up over 2-4 weeks)
- Altered duties (avoid heavy lifting, screen time, etc.)
- Working from home
- Delayed shift start
Duration
Fit notes typically:
- 1-2 weeks initially
- Up to 3 months maximum per note
If ongoing, request renewal from health professional.
Employer duties
Accept fit note
Discuss any 'may be fit' adjustments
Reasonable adjustments if disability under Equality Act 2010
Cannot dismiss for taking sickness leave unfairly
What if you disagree with the fit note?
Employee: request second opinion
Employer: cannot override; may request Occupational Health referral for independent view
In short
Fit note from day 8 of sickness. Now issued by GP, nurse, OT, pharmacist, physio. 'May be fit' enables phased return.
Frequently asked questions
Do I need a fit note for days 1-7 of sickness?
No — self-certification is sufficient. Fit note required from day 8 of continuous sickness.
Can any GP issue a fit note?
Any GP, hospital doctor, registered nurse, occupational therapist, pharmacist, or physiotherapist since July 2022.
What does 'may be fit for work' mean?
You could return with specific adjustments (phased hours, altered duties, workplace changes). Discuss with employer.
Can my employer reject my fit note?
Cannot reject a 'not fit for work' note. Can decline the adjustments in a 'may be fit' — then treated as 'not fit for work'.
How long does a fit note last?
Typically 1-2 weeks initially, up to 3 months maximum per note. Renew via health professional if needed.
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Last reviewed: 14 June 2026.
Next review due 14 December 2026.
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