FIT Notes and Sick Notes Explained: A GP Guide to Work and Health
A FIT note, formally known as a Statement of Fitness for Work, is a medical document issued by a doctor that provides evidence about your ability to work when you are unwell.
It replaced the traditional “sick note” in the UK and is designed to help employees, employers and healthcare professionals manage illness in a way that supports both recovery and a safe return to work.
Most people do not need a FIT note during the first few days of illness. However, if health problems affect your ability to work for longer periods, a doctor may provide medical advice and documentation to support appropriate workplace adjustments or time off.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
What is a FIT note?
A FIT note is a medical certificate issued by a doctor that confirms whether a person is not fit for work or may be fit for work with adjustments.
It replaced the older “sick note” system to allow more flexibility in how people return to work following illness or injury.
Instead of simply confirming that someone cannot work, a FIT note may also include advice such as:
- A phased return to work
- Adjusted duties
- Reduced hours
- Workplace adaptations
This approach recognises that many people benefit from remaining connected to work while recovering, provided appropriate adjustments are in place.
When do you need a FIT note?
In the UK, most employees can self-certify illness for the first 7 calendar days of sickness absence. During this period, a formal medical certificate is usually not required.
A FIT note is typically needed if:
- Illness lasts longer than 7 days
- An employer requests medical evidence after extended absence
- Adjustments are required to safely return to work
- Ongoing health issues affect work capacity
Employers may have their own policies, but these generally follow the same framework.
Do private FIT notes count for Statutory Sick Pay (SSP)?
In the UK, Statutory Sick Pay (SSP) is usually supported by a FIT note issued through NHS services, often referred to as a MED3 certificate.
Private GPs can provide medical certificates following assessment, but these are not always accepted for SSP purposes, as employers may specifically require NHS-issued documentation.
If you require documentation for SSP, it is advisable to check your employer’s policy or speak to your NHS GP.
Private medical certificates are commonly used for:
- Employer records
- Occupational health discussions
- Insurance or administrative purposes
Can a private GP issue a FIT note?
Private doctors can provide medical certificates and clinical documentation following a consultation and appropriate assessment.
The format may differ slightly from the NHS-issued document, but the purpose is the same: to provide medical evidence regarding a person’s fitness for work.
Most employers accept medical documentation issued by registered doctors, whether provided through NHS services or private medical consultations.
What conditions commonly require a FIT note?
Many different health problems can affect someone’s ability to work temporarily. A doctor may consider issuing a FIT note following assessment for conditions such as:
- Acute infections or illness
- Recovery from injury or surgery
- Musculoskeletal pain
- Severe fatigue or viral illness
- Mental health conditions such as anxiety or stress
- Migraine or neurological symptoms
The key consideration is whether the condition significantly affects the ability to perform normal work duties.
Can a FIT note be backdated?
A FIT note can sometimes be backdated if a doctor is satisfied that you were unwell during the earlier period.
This is based on clinical judgement and available information, rather than automatic entitlement.
Backdating is more likely where:
- There is clear evidence of recent illness
- Symptoms have been ongoing
- There has been limited access to medical care
Doctors cannot issue backdated documentation without sufficient clinical basis.
What does “may be fit for work” mean?
A FIT note does not always mean complete absence from work.
The “may be fit for work” option allows doctors to recommend adjustments that could allow someone to continue working safely during recovery.
Examples include:
- Temporarily reduced hours
- Avoiding physically demanding tasks
- Flexible working arrangements
- Gradual return to normal duties
Employers can consider these recommendations and decide whether adjustments are practical in the workplace.
Can you get a FIT note for stress or mental health?
Yes. Mental health conditions are a common reason people require time away from work.
Conditions such as:
- Anxiety
- Burnout
- Depression
- Severe workplace stress
may significantly affect concentration, decision-making, sleep and overall wellbeing.
A GP assessment can help determine whether time away from work or workplace adjustments would support recovery.
How long can a GP sign someone off work?
The duration of a FIT note depends on the nature and severity of the illness.
Some notes may cover a short period of recovery, while others may recommend review after several weeks.
Longer periods of absence are typically reassessed periodically to ensure that recovery and return-to-work plans remain appropriate.
What if you are self-employed?
If you are self-employed, a FIT note is not usually required for statutory sick pay, but medical documentation may still be useful.
Some people request medical certificates for:
- Insurance claims
- Mortgage or financial protection policies
- Evidence of illness for administrative purposes
A GP can advise on appropriate documentation depending on your situation.
GP insight
In clinical practice, requests for FIT notes often reflect broader health concerns such as stress, burnout or unresolved physical illness.
A consultation provides an opportunity not only to discuss documentation, but also to review the underlying condition and consider appropriate treatment or investigations where necessary.
Supporting recovery and safe return to normal activities is usually the primary goal.
Frequently asked questions
Do you need a sick note for less than 7 days?
Most employees can self-certify illness for the first 7 calendar days without a FIT note.
Can a private GP issue a sick note?
Private GPs can provide medical certificates following assessment. Acceptance depends on employer requirements.
Can you get a FIT note for stress?
Yes. Mental health conditions such as stress, anxiety or burnout may affect fitness for work and can be assessed by a GP.
Can a FIT note recommend adjustments instead of time off?
Yes. A doctor may suggest adjustments such as reduced hours or modified duties.
When to speak to a GP
Consider booking a GP consultation if:
- Illness prevents you from working for more than a week
- Your health condition is worsening or not improving
- Mental health difficulties are affecting your ability to work
- You need guidance about returning to work safely
Medical advice can help clarify the situation and determine whether documentation or further investigation is appropriate.
Further Reading and Hub Links
Visit our Understanding Your Health hub or browse more health topics in the AccessGP Knowledge Base.
If you would like to discuss a health concern affecting you at work or need a fit note, book an appointment with one of our GPs.
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Last reviewed by Dr Zamiel Hussain, GMC registered GP
Updated: 16 March 2026