Fees General practitioner

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Guidance on issuing fit notes

Doctors providing primary medical services under the National Health Services Acts are required, under the Social Security Acts, to issue free of charge a fit note (Statement of Fitness for Work, Form Med 3, or Med 3), to patients for whom they provide clinical care.

The Department for Work and Pensions (DWP) issues guidance about fit notes. GPs should be familiar with this.

Fit note guidance for GPs

Read the Fit for Work guidance 


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 whether your patient is 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.

  • Fit notes should indicate clearly the information required. 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 to substantiate certification in such circumstances. In cases where you consider that a patient would benefit from the help or advice of a Disability Employment Adviser (DEA) this opinion should also be included in the remarks section.