Completing a fit note

Category: Advice for GPs

If you think that your patient is able to undertake some form of work, the fit note is an opportunity to record your advice. Your assessment may indicate that your patient's fitness for work isn't affected by a health condition. In this case a fit note is not required.

The advantages of the fit note

The fit note plays an important role in aiding your patient's return to work by:

  • managing their expectations
  • encouraging them to discuss their situation with their employer
  • giving clear clinical advice to help them return to work safely.

It allows you to detail the various factors you have taken into account during your assessment including:

  • the functional limitations of your patient's health condition
  • the duration of their health condition and any possible fluctuations
  • interactions with any current clinical management
  • whether any form of work will exacerbate their health condition.

When to issue a fit note

You don't need to issue a fit note if:

  • your assessment indicates that your patient's health condition doesn't affect their fitness to work
  • your patient has been absent for 7 days or less — when returning to work they should complete a self certificate

The contents of the fit note

The fit note can indicate that your patient:

  • isn't fit for work
  • may be fit for work.

If you decide that your patient may be fit for work, you should tick this box and provide supporting advice around what adjustments might be necessary to support them. This could take the form of:

  • a phased return to work
  • altered hours
  • amended duties
  • workplace adaptations.

You should tick any of these boxes as applicable, providing personalised advice within the free text section.

When giving advice in this section, you should consider:

  • Are there things your patient can't do?
  • What types of activities should be avoided or altered
  • How long should these activites be avoided
  • Do they need further appointments during working hours?
  • How your patient's workplace might impact on their condition
  • Could they benefit from an occupational health assessment?

This advice will be used by your patient, and their employer, to discuss possible adaptations and changes to working conditions.

The fit note and your patient

If your patient is employed, they can use the fit note to claim sick pay. They should keep the original for their records.

The fit note can also be used:

  • as a means of initiating a work-focused conversation with their employer If your patient is employed and you advise that they may be fit for work
  • to claim health-related benefits if your patient is unemployed.

Returning to work

Your patient can return to work at any point they feel able to, even if this is before their fit note expires.

They do not need to get a new fit note, or come back to see you even if you have indicated that you need to assess them again.

Alternative formats

The fit note can be issued in both electronic and paper (handwritten) forms. Using a computer based fit note brings a number of advantages, including:

  • improved access for employers and patients
  • reduced need to recreate duplicates
  • automatic completion of parts of the form
  • integration with other clinical monitoring procedures
  • ease of access for internal audits and knowledge sharing.

Your practice's IT provider will be able to give you access to computer generated fit notes.

Visit GOV.UK for further information on the fit note for GPs and guidance on other health and work issues