First 7 days vs after 7 days
The first 7 calendar days — self-certify
If you're off sick for 7 days or fewer, you do not need a fit note or any proof from a healthcare professional. You self-certify by completing:
- your employer's own self-certification form, or
- form SC2 (the standard self-certification form) if your employer doesn't have one.
More than 7 days — you need a fit note
You only need a fit note if you've been ill for more than 7 days in a row. That 7-day count includes non-working days — so weekends and bank holidays count too.
Quick rule
7 days or fewer = self-certify (no fit note). More than 7 days in a row = get a fit note. The clock counts every calendar day, not just the days you'd have worked.
Who can issue one + how to get it
A fit note is the statement of fitness for work (the form is "Med 3"). Since July 2022, as well as doctors (GPs), it can be issued by:
- registered nurses
- pharmacists
- physiotherapists
- occupational therapists
It can be issued after an assessment in person, by phone or by video — so you don't always need a face-to-face appointment. You usually request one through your GP practice.
Digital fit notes
Since 2022, a fit note no longer needs a hand-written (wet ink) signature. It's authorised digitally and simply shows the name and profession of the healthcare professional who issued it, so it can reach you through digital channels where the practice's IT supports it.
You can ask for a fit note covering a past period if it's clinically appropriate — the dates the healthcare professional puts on it can cover an earlier period where they judge it right. The NHS fit note is always free; you don't have to pay for a private "sick note".
"Not fit for work" vs "may be fit for work"
A fit note will say one of two things:
- "Not fit for work" — the healthcare professional advises you should not work for the stated period.
- "May be fit for work" — you could work if your employer can support some changes.
If it says "may be fit for work", you and your employer should discuss changes that might help you return, for example:
- a phased return (building hours back up)
- amended duties (different tasks)
- altered hours
- workplace adaptations
It's advice, not an order
"May be fit for work" is the healthcare professional's advice — your employer doesn't have to agree to it. If the suggested changes aren't possible, the fit note is treated as "not fit for work" and you stay off for the period it covers. You don't need to go back for a new note just to confirm that.
What it means for your pay
The pay link
A fit note doesn't pay you — it supports the things that do. For shorter absences it backs up your Statutory Sick Pay; for longer-term illness it supports a benefit claim.
You can often claim ESA and Universal Credit together. A free benefits check will show what fits your situation if illness affects your income.
Do this now
Do this now — free
- Off 7 days or fewer? Self-certify on your employer's form or form SC2 — no fit note needed.
- Going to be off more than 7 days? Contact your GP practice and request a fit note (often by phone or video).
- Give the fit note to your employer and discuss any "may be fit" changes that could help you return.
You can't be sacked just for being off sick
Being dismissed because you're unwell may be unfair dismissal, and dismissal connected to a disability may be discrimination. If you're worried, talk to ACAS or Citizens Advice before agreeing to anything — see
your rights at work. For urgent health concerns, call NHS 111.
Free UK support
- GOV.UK — Taking sick leave — self-certification, the 7-day rule + fit notes.
- NHS — Getting a fit note — who can issue one + how to request it.
- ACAS — 0300 123 1100. Free advice on sick leave, fit notes and work rights.
- NHS 111 — for urgent (non-emergency) health concerns.
- Citizens Advice — 0800 144 8848. Free help + a benefits check if you're off long term.