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:
"Not fit for work" - You need time off to recover
"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
Call on day 7 of illness to book appointment
Explain you need a fit note for work
May be offered phone/video consultation
Receive fit note digitally or collect from surgery
Cost: Free
Option B: Online GP Service
Book video consultation via WhatsApp
Explain symptoms and work situation
GP assesses and issues fit note
Receive digitally same day
Cost: £120 (includes consultation and fit note)
Option C: Hospital/Walk-in Centre
If already being treated, ask for fit note
Hospital doctors can issue on discharge
Walk-in centres for urgent cases only
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:
Book consultation (usually same day)
Video assessment with UK GP (£120)
Discuss symptoms and work impact
Receive fit note via email/WhatsApp
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.