Issuing fit notes

Guidance for GP practices on issuing fit notes to patients to declare they are not fit to work. Find out what to do and what considerations to make.

Location: UK
Audience: GPs Practice managers
Updated: Monday 7 September 2020
GP practice article illustration

Doctors are required, under the Social Security Acts, to give fit notes to their patients for free.

The Department for Work and Pensions has guidance on fit notes. GPs should be familiar with this.


What you 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.