Fit Notes aka “Sick Lines”

Do I Need a Fit Note?

We are publishing this as we often find patients are misinformed by employers that they need a Fit Note (“sick line”), when in fact they don’t. We suggest that you read the formal NHS/Government guidance on this to check that your employer’s insistence on a Fit Note is reasonable:

When do I need a fit note? – NHS (

What Does the GP Need to Do?

We are publishing this to make it clear what we can/can’t, should/shouldn’t do when it comes to the issuing of Fit Notes. Unnecessary aggravation can be caused by queries arising relating to what are legal requirements, not GPs’ desire to be difficult. Here is the British Medical Association’s summary of the legalities of Fit Notes:

What you (GP) need to do

  • You do not need to issue a fit note for the first seven calendar days of a patient’s sickness absence. Patients can self-certify for this period.
  • If you assess that your patient’s health affects their fitness for work, you should give them a fit note indicating they are not fit for work OR may be fit for work.
  • GPs should note that they can back date a fit note; in certain situations, parts of the fit note may need to include dates which are earlier than the date of the statement.
  • If you are issuing a fit note based on an assessment conducted at an earlier date, you should enter the date of this earlier assessment in the date of assessment field.
  • If your patient’s condition has affected their function for some time without a previous fit note being issued, you must enter an estimated date that their function was affected from in the ‘this will be the case from’ field.


Information you should provide

  • Fit notes should record the advice given to the patient, along with other factual information including an accurate diagnosis, except on the occasions when a doctor feels that it could be prejudicial to their patient’s wellbeing if the true diagnosis were given.
  • The comments section on medical statements allows for additional comments about the disabling effects of the diagnosed condition, its treatment and prognosis.
  • Generally GPs should not speculate but should provide only factual information and should not certify something they are unable to verify.
  • GPs are reminded that they might be asked to provide further information in such circumstances. If you think that a patient would benefit from the help or advice of a disability employment adviser, say so in the remarks section.


How Do I Request a Fit Note?

If this is your first Fit Note for the current illness, you need to let us know what is happening, so we can assess the request. If something quite definitive has already happened e.g. death in the family, you had a heart attack, we might be able to just accept a request without speaking to you; we suggest using the form below to let us know the various details. Sometimes we may call you to clarify some details.

If you are looking to extend a Fit Note for the same condition e.g. you are ill for longer than anticipated, you can still use the form below, or by replying to the sick line text message if you received your fit note via text.

If you have been advised to be off work following a hospital visit, operation or admission your specialist team should issue a Fit Note. However, if you are unable to contact them or they are unwilling to provide you with one, please fill out the form below.