Private Sick Notes and Fit Notes UK 2026. What Employers Can Ask For, What They Cannot, and How to Get One Today
The rules are simpler than most people are told. For the first 7 calendar days of sickness absence you self-certify, and no employer is entitled to a doctor's note for that period, though many ask for one anyway.
From day 8 your employer can require a fit note, formally a Statement of Fitness for Work, and since July 2022 these can be issued by doctors, nurses, occupational therapists, pharmacists and physiotherapists, and since 2022 they no longer require a wet signature. NHS practices provide fit notes free from day 8. Anything else, a note covering the first week, a letter for an employer or university, evidence for an insurer or a return-to-work assessment, is a private service your practice can charge for or decline.
At The Wellness a GMC-registered doctor assesses you by video the same day from £150, in person from £220, or at home from £495, and issues the note or letter in the appointment. What we will not do is write a note without a consultation, because a document from a doctor who has not assessed you is worthless to an employer and a breach of GMC guidance besides. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Get a fit note today on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
Your rights, stated clearly
The first 7 calendar days are self-certified. You tell your employer you are unwell, complete their form or the SC2 if they ask for it, and that is the requirement. Weekends and bank holidays count toward the 7 days.
From day 8 an employer can ask for a fit note. The NHS issues these free of charge, and if you can get an appointment that is the cheapest route. Where your employer asks for a note during the first week, they can ask, but they are not entitled to one under statutory sick pay rules and they should expect to cover the cost of obtaining it. Many employers do exactly that, and we invoice the employer directly where that is the arrangement.
A fit note says one of 2 things. Not fit for work, or may be fit for work with adjustments, which is the option most people do not know exists. The second is often better for everyone, because it allows a phased return, altered hours, amended duties or a workplace adaptation instead of a blanket absence. Employers cannot compel you to accept adjustments, and if they cannot accommodate them the note is treated as not fit for work.
What a private note can and cannot do
It can cover the first 7 days where your employer wants documentation. It can be issued the same day, including evenings and weekends, when your practice cannot see you for a fortnight. It can be more detailed than a standard fit note where an employer, university or insurer has asked for specifics, and it can set out adjustments in a way that helps a return to work actually happen. It can be backdated in the sense that a doctor can record that you describe symptoms over a preceding period and give a clinical opinion on whether that account fits the condition found.
It cannot state as fact that a doctor observed you on a day they did not see you. No doctor can write that, and a note that does will not survive a competent HR department. It cannot be issued without an assessment, and any service offering one should be avoided for the same reason you would avoid a garage that signs an MOT without looking at the car.
And it does not change statutory sick pay entitlement. Since the Employment Rights Act 2025 removed the 3 waiting days, statutory sick pay is payable from day 1 of absence, which is worth knowing because a number of employers have not updated their policies.
Ask what note you need on WhatsApp or email team@thewellnesslondon.com.
The other letters people need
Employer letters explaining an absence, a phased return or a workplace adjustment, written to the specific question HR has asked rather than a generic note. University and school letters for missed work, extenuating circumstances or absence, written to the institution's own requirements.
Insurance and claim documentation, including travel insurance cancellation certificates, income protection forms and private medical insurance paperwork, all of which are refused when the dates and clinical detail are imprecise. Fitness to travel and fitness to work letters. Return-to-work assessments after illness, surgery or injury.
Occupational health style opinions on capability and adjustments, which sit between a fit note and a full occupational health report and are frequently what an employer actually wants when they ask for a note. And for anything requiring a formal medico-legal or capability report rather than a letter, the Medico-Legal Wing handles it separately.
What it costs
Membership and concierge practices in central London charge annual retainers running into thousands before any appointment, then £400 to £600 and above per visit. Harley Street consultations run £250 to £350 before any document is written, with letters charged on top. Below that sits a tier defined by its conditions rather than its price, questionnaire services issuing notes with no consultation, no examination and nothing behind them when an employer queries the document.
At The Wellness the consultation and the note are 1 fee. All figures are from prices.
Home, hotel or office visit, evenings and weekends, from £695, and daytime from £495.
Extended 45-minute consultation with a detailed report for complex absence or a capability question, from £395.
In-person consultation in Marylebone, 30 minutes with examination, with the note issued in the appointment, from £220.
Same-day video consultation with the fit note or letter issued in the appointment, from £150.
Amended or supplementary letter responding to employer, university or insurer queries, from £150.
Employer-funded appointments invoiced directly to the company on request.
Same-day appointments 7 days a week, in Arabic, French, Spanish and Dutch. Notes are issued by secure email in the appointment.
Why The Wellness is the best place to get a fit note
Because you get an actual consultation, which is the only thing that makes the document worth anything. A 30-minute appointment with a GMC-registered doctor produces a note that carries the doctor's name, GMC number and contact details, and an employer who checks it finds a real assessment behind it.
Because the note is written to what the reader needs. HR asking about adjustments gets adjustments. A university panel gets dates and functional impact. An insurer gets the clinical detail their form requires. Generic notes get queried, and a queried note costs you more time than the appointment did.
And because the appointment does more than produce paper. If you are unwell enough to need a note, you are unwell enough to be assessed, and bloods at an accredited laboratory, imaging at a specialist centre or a referral to a named consultant are all arranged from the same appointment. Most people come for the document and leave with a diagnosis, which is the right way round.
Book today on WhatsApp or call 020 3951 3429.
Frequently asked questions
How do I get a sick note or fit note quickly in the UK
For absence from day 8, your NHS practice issues fit notes free of charge. For the first 7 days, for same-day issue, or where you cannot get an appointment, a private consultation produces one immediately. At The Wellness a GMC-registered doctor sees you by video the same day from £150, in person from £220 or at home from £495, with the note issued in the appointment.
Do I need a sick note for the first week off work
No. The first 7 calendar days are self-certified, including weekends and bank holidays, and employers are not entitled to a fit note for that period under statutory sick pay rules. Employers can still ask, and where they do they should expect to cover the cost, which we invoice to the company where that is the arrangement.
Who can issue a fit note
Since July 2022, doctors, nurses, occupational therapists, pharmacists and physiotherapists can all issue fit notes, and a wet signature is no longer required. The note must follow an assessment by the person issuing it.
Can a fit note be backdated
A doctor can record that you describe symptoms over a preceding period and give a clinical opinion on whether that account is consistent with the condition found. No doctor can state as fact that they observed you on a day they did not see you, and a note claiming otherwise will not withstand scrutiny.
What does may be fit for work with adjustments mean
It is the option on every fit note that most people never use. It allows a phased return, altered hours, amended duties or a workplace adaptation instead of full absence. Your employer cannot force you to accept adjustments, and if they cannot accommodate them the note is treated as not fit for work.
Can you write a note without seeing me
No. A note from a doctor who has not assessed you is worthless to an employer and outside GMC guidance. The consultation is what makes the document mean something, and it is included in the fee rather than charged on top.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Notes and letters are issued only following a consultation and clinical assessment, and only where the findings support them. This article is general information and not legal, employment or medical advice about your own circumstances.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. GOV.UK guidance on taking sick leave and self-certification for the first 7 days. Department for Work and Pensions guidance on the Statement of Fitness for Work, including the July 2022 extension of issuing rights to nurses, occupational therapists, pharmacists and physiotherapists and the removal of the signature requirement. Employment Rights Act 2025, removal of statutory sick pay waiting days. General Medical Council, Good Medical Practice and guidance on writing reports and signing documents. Published 2026 London private GP market pricing.
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