GP Guidance

Fit notes were introduced in April 2010, replace the Med3 form or ‘sick note’, to allow GPs to give more information to patients about the functional effects of their health conditions.

Fit notes can only be completed by doctors and, when issued, must be provided free of charge.

The dates are inclusive, so a fit note dated from 24 May to 3 June will no longer apply from 4 June onwards.

Is a fit note needed?

GPs do not need to issue a fit note for the first seven calendar days of sickness absence. Patients self certify for this period.

If a patient or employer requests certificates for periods of less than seven days, the GP is entitled to charge a fee

Medical assessment

Assessments can be conducted face to face, by telephone or issued after considering a written report from another doctor or healthcare professional (such as hospital discharge summary).

How long do fit notes last?

In the first six months of a patient’s condition, a fit note can cover a maximum of three months.

If a condition has lasted longer than six months, a fit note can be for any clinically appropriate period up to ‘an indefinite period’.

Can I issue a fit note with a future start date?

No. The date of statement must always be the date that you issue the fit note.

Can I back-date a fit note?

Yes - in certain situations, parts of the fit note may need to include dates, which are earlier than the date of the statement.

Fit for work is NOT job-specific

The assessment whether the patient is fit for work is not intended to be job-specific.

The guidance asks GPs to consider whether a patient could do work of some kind before advising they are not fit for work.

Of note, a person can return to work at any point that he or she feels able to, even if this is before the expiry date of a fit note.

Referral to Fit for Work AND/OR occupational health assessment

If sick leave is for four weeks or more, you can refer them to Fit for Work which will carry out an occupational health assessment and provide them with a Return to Work plan.

A fit note may be required to cover the first two weeks of sickness absence from when a referral is made to a Fit for Work assessment.

Once a Return to Work Plan has been issued, this can be used in place of a fit note.