The Complete Guide to UK Sick Notes: Everything You Need to Know in 2025

It's Monday morning. You've been battling flu all weekend, there's no way you can work, and your employer is asking for a sick note. But your GP surgery says the next available appointment is in two weeks. Sound familiar? Welcome to the confusing world of UK sick notes—where the rules aren't always clear, the terminology keeps changing, and getting that piece of paper can feel harder than recovering from your illness.

Here's everything you need to know about sick notes (now called fit notes) in 2025, including the rules, your rights, and the quickest ways to get one when you need it.

First Things First: The 7-Day Rule

Let's clear up the biggest confusion right away. If you're off work sick for 7 days or less, your employer should not ask for medical evidence that you've been ill. This is the law, not a guideline.

The Magic Number: 7 Calendar Days

• Includes weekends and bank holidays

• Counted consecutively from your first day off

• Self-certification is your legal right

• No GP note required or allowed

Example: If you're ill from Monday to the following Monday, that's 8 days—you need a fit note. But Monday to Sunday? That's 7 days—self-certification only.

Sick Note vs Fit Note: What's the Difference?

In 2010, "sick notes" officially became "fit notes" (Statement of Fitness for Work). The change wasn't just semantic—it reflected a shift from simply signing people off to actively supporting their return to work.

What a Fit Note Can Say:

1. "Not fit for work" - You need time off to recover

2. "May be fit for work" - You could work with adjustments

The "may be fit" option revolutionised workplace health by suggesting accommodations like:

• Phased return (gradually increasing hours)

• Altered hours (avoiding rush hour, working from home)

• Amended duties (lighter work, no heavy lifting)

• Workplace adaptations (ergonomic equipment, regular breaks)

Who Can Issue Fit Notes? (It's Not Just GPs!)

Here's something many don't know: nurses, occupational therapists, pharmacists, and physiotherapists, in addition to doctors, can certify fit notes. This expansion means:

• Physiotherapist treating your back? They can issue a fit note

• Hospital nurse managing your care? They can sign you off

• Pharmacist managing your condition? In some cases, yes

• Online GP via video consultation? Absolutely

This change has made getting fit notes significantly easier—if you know your options.

The Step-by-Step Guide to Getting a Fit Note

Scenario 1: You Need Your First Fit Note (8+ Days Off)

Option A: NHS GP Surgery

1. Call on day 7 of illness to book appointment

2. Explain you need a fit note for work

3. May be offered phone/video consultation

4. Receive fit note digitally or collect from surgery

5. Cost: Free

Option B: Online GP Service

1. Book video consultation via WhatsApp

2. Explain symptoms and work situation

3. GP assesses and issues fit note

4. Receive digitally same day

5. Cost: £120 (includes consultation and fit note)

Option C: Hospital/Walk-in Centre

1. If already being treated, ask for fit note

2. Hospital doctors can issue on discharge

3. Walk-in centres for urgent cases only

4. Cost: Free but long waits

Scenario 2: You Need an Extension

Been off 2 weeks and still unwell? You don't always need another appointment:

• Many GPs can extend based on phone consultation

• Online GPs offer quick extension appointments

• Request before current note expires

• Explain why you're still unable to work

Scenario 3: Emergency Fit Note Needs

"My employer demands a note for 3 days off"

• Politely remind them of the 7-day rule

• They should still be paid the amount of sick pay they're entitled to without a note

• If they insist, they must pay for private certification

"I'm too ill to get to the surgery"

• Request phone/video consultation

• Use online GP services

• Ask about home visits (rare but possible)

• Family members can sometimes collect on your behalf

Digital Revolution: Getting Fit Notes Online

The pandemic accelerated digital healthcare, and fit notes followed suit. A new version of the fit note was introduced to replace the signature in ink with the name and profession of the issuer, which means that you can receive your fit note through digital channels.

Benefits of Digital Fit Notes:

• No lost paperwork

• Instant delivery to employer

• Easy to request extensions

• Environmentally friendly

• Legally valid everywhere

How Online GP Fit Notes Work:

1. Book consultation (usually same day)

2. Video assessment with UK GP (£120)

3. Discuss symptoms and work impact

4. Receive fit note via email/WhatsApp

5. Forward directly to employer

For simpler cases, a 15-20 minute phone consultation (£60) may be sufficient.

Common Misconceptions Debunked

Myth: "I need to be completely better before returning to work" Reality: You should go back to work as soon as you feel able to. Talk to your employer if you feel well enough to return to work before the end date on your fit note. You don't need GP permission to return early.

Myth: "Private GP sick notes aren't valid" Reality: Any registered healthcare professional can issue valid fit notes. However, some employers prefer NHS notes—check your company policy.

Myth: "I must see a GP in person for a fit note" Reality: Phone and video consultations are perfectly acceptable for fit note assessments, especially for conditions not requiring physical examination.

Myth: "Fit notes cost money" Reality: There is never a charge from a healthcare professional for providing a fit note if you're off sick from work for more than 7 days via the NHS. Private services charge for the consultation, not the note itself.

Your Rights and Employer Obligations

Your Rights:

• Self-certify for 7 days or less

• Free fit notes from NHS after 7 days

• Return to work early without GP clearance

• Confidentiality about your condition

• Reasonable adjustments if recommended

Employer Obligations:

• Cannot demand notes for 7 days or less

• Must pay for any requested early certification

• Should discuss recommended adjustments

• Cannot withhold sick pay for late fit notes

• Must treat "may be fit" as "not fit" if adjustments impossible

Red Flags from Employers:

• Demanding notes for short absences

• Refusing to accept digital fit notes

• Pressuring early return against medical advice

• Threatening disciplinary action for legitimate illness

• Demanding specific medical details

Special Circumstances

Mental Health Fit Notes

Mental health is a completely valid reason for fit notes. GPs understand that depression, anxiety, and stress can be just as debilitating as physical illness. Be honest about your symptoms—mental health fit notes are common and nothing to be ashamed of.

Pregnancy-Related Illness

Pregnancy-related sickness is treated differently from regular illness for sick pay purposes. Always specify if your illness is pregnancy-related, as this protects your maternity rights.

Long-Term Conditions

If you have a chronic condition causing repeated absences:

• Discuss a long-term management plan with your GP

• Consider occupational health referrals

• Know your rights under disability discrimination laws

• Keep detailed records of absences and symptoms

Hospital Admissions

If admitted to hospital:

• Ask for a fit note before discharge

• Hospital notes cover your entire stay

• Outpatient appointments don't usually provide fit notes

• A&E can issue short-term notes if necessary

The Cost of Delayed Fit Notes

For Employees:

• Lost sick pay (SSP is £109.40 per week)

• Disciplinary issues with employer

• Stress of juggling illness and admin

• Potential job security concerns

For Employers:

• Uncertainty about return dates

• Difficulty planning cover

• Potential tribunal claims

• Damaged employee relations

The Solution: Quick, accessible fit note services benefit everyone. That's why online GP services have become increasingly popular—turning a stressful multi-day process into a 30-minute solution.

Practical Tips for Smooth Sick Leave

Before You're Ill:

• Know your employer's sickness policy

• Save your GP surgery's phone number

• Understand your sick pay entitlement

• Keep Online GP contact details handy

When Illness Strikes:

• Notify employer immediately (follow their process)

• Keep notes of symptoms and dates

• Don't wait until day 8 to seek help

• Be honest about recovery time needed

During Recovery:

• Keep employer updated on progress

• Request fit note extensions early

• Discuss phased return if appropriate

• Document everything

Returning to Work:

• Communicate with your manager

• Implement any recommended adjustments

• Monitor your health closely

• Seek support if struggling

Why Online GPs Excel at Fit Notes

The traditional system wasn't designed for the modern workplace. Online GPs offer:

Speed

• Same-day appointments

• No phone queues at 8am

• Fit notes issued immediately

• Available evenings and weekends

Convenience

• Consultation from your sickbed

• No travel when unwell

• Digital delivery to employer

• Easy extension requests

Understanding

• Experienced in workplace health

• Familiar with employer requirements

• Pragmatic about return-to-work planning

• Mental health aware

The Bottom Line

Getting a fit note shouldn't add stress to being unwell. Understanding the rules—especially the 7-day self-certification right—empowers you to manage sick leave confidently. Whether through your NHS GP or an online service, the key is acting promptly when you need medical certification.

Remember: fit notes exist to protect both employees and employers by providing medical evidence and supporting appropriate returns to work. They're not bureaucratic obstacles but tools for managing health in the workplace.

Don't let fit note stress delay your recovery. Focus on getting better, and use the services available to handle the paperwork efficiently.

Need a fit note quickly? The Online GP provides same-day video consultations and instant fit note issuing. No waiting rooms, no phone queues—just professional medical assessment when you need it. WhatsApp +44 7399323620 to book your consultation and get your fit note today.