The first seven days
For an absence of seven calendar days or fewer, you do not need anything from a clinician. You self-certify.
- The seven days are calendar days, counting weekends, bank holidays and days you were not scheduled to work.
- Tell your employer according to their absence policy, usually on the first day.
- Complete their self-certification form, or form SC2 if they do not have one.
- A fit note is only required from day 8.
An employer cannot demand a fit note in the first week
They can require self-certification, and they can ask about your absence — but they cannot require a fit note for the first seven days. A GP practice may charge for a private certificate covering that period, because it is outside NHS services. If your employer insists, it is reasonable to ask them to cover the fee.
What a fit note actually is
The official name is a Statement of Fitness for Work. It replaced the old sick note in 2010 precisely because the old one only had one setting. A fit note has two.
| Assessment | Meaning | What happens next |
|---|---|---|
| Not fit for work | You should not be working at present. | You stay off for the period stated. A new note is needed if the absence continues beyond it. |
| May be fit for work | You could work with support. | The clinician suggests a phased return, altered hours, amended duties or workplace adaptations. You discuss it with your employer. |
"May be fit" is not a demand that you return
If your employer cannot provide the suggested adjustments, the note is treated as "not fit for work" for the period stated. You do not need to go back to the clinician for a replacement note.
A fit note can be issued for a period in the past and, at the clinician's discretion, forward. It does not have to be issued face to face, and it does not have to be signed in wet ink — digital fit notes are valid.
Who can issue one
This changed in July 2022 and remains the least-known part of the system. Fit notes are no longer doctors-only.
| Professional | Typical route |
|---|---|
| Doctor (GP or hospital) | Your GP practice, or the hospital team treating you. |
| Registered nurse | Practice nurse, specialist nurse or hospital nursing team. |
| Pharmacist | Community or practice pharmacist involved in your care. |
| Occupational therapist | Where an OT is already involved in your treatment. |
| Physiotherapist | Common for musculoskeletal absence — the physio treating you can certify. |
Ask the clinician already treating you
If you are under a physiotherapist for a back injury or a specialist nurse for a long-term condition, they can often issue the note there and then. That avoids a separate GP request entirely — and they know your case better.
Getting one online
A fit note does not require an in-person appointment. Most practices now handle requests remotely where the reason for absence is already documented.
| Route | Cost | Notes |
|---|---|---|
| GP practice online form or app | Free | Usually the fastest NHS route. Look for "admin request" or "fit note" on the practice site. |
| GP telephone or reception request | Free | Reception can often process it without an appointment. |
| Hospital or clinic team treating you | Free | Any eligible clinician involved in your care can certify. |
| Private online doctor service | Fee applies | Legally valid. Useful when you cannot get a timely NHS appointment. |
When you request one, say clearly: the first date of absence, the reason, and how long you expect to be off. A vague request generates a phone call and a delay.
Beware "guaranteed" sick note sellers
A valid fit note requires an actual clinical assessment by a registered professional. Any service promising a note without one is selling a document your employer can challenge, and using it can be treated as a disciplinary matter. Legitimate private services assess you first and may decline.
Sick pay and your rights
The certificate and the pay are two separate systems, and the timings do not line up.
| Day of absence | Certification | Pay |
|---|---|---|
| Days 1–3 | Self-certification | Waiting days — no SSP unless your employer offers contractual sick pay |
| Day 4 onwards | Self-certification until day 7 | SSP begins, if you meet the earnings threshold |
| Day 8 onwards | Fit note required | SSP continues for up to 28 weeks |
| After 28 weeks | Fit note still required | SSP ends — Employment and Support Allowance may apply |
- SSP is paid by your employer, not the state, and requires earnings at or above the lower earnings limit.
- Contractual sick pay in your contract may be more generous and may start from day one.
- Sickness absence still accrues annual leave, and leave can usually be carried over if you were too unwell to take it.
- If your condition meets the definition of a disability, your employer has a duty to make reasonable adjustments.
What employers can and cannot ask
| They can | They cannot |
|---|---|
| Ask you to follow a reasonable absence-reporting procedure | Require a fit note for the first 7 days as an NHS entitlement |
| Ask for self-certification | Demand your diagnosis or clinical details |
| Ask for a fit note from day 8 | Contact your GP for information without your consent |
| Refer you to occupational health, with your agreement | Ignore adjustments suggested on a "may be fit" note without discussing them |
| Hold a return-to-work discussion | Treat protected disability-related absence as ordinary misconduct |
Keep your own copy
Fit notes are frequently needed again later — for an insurance claim, a benefit application, or a dispute about absence. Photograph or scan each one before you hand it over, and keep it with your own health records rather than relying on your employer's file.
If you are also dealing with the Irish system, the equivalent process is set out in our guide to sick certs in Ireland, where the rules and the Illness Benefit timeline differ significantly.
Common questions
How many days can you be off sick without a sick note in the UK?
Seven calendar days, including weekends and non-working days. For absences of 7 days or fewer you self-certify to your employer. A fit note is only required from the eighth day of absence onwards.
Can I get a sick note online in the UK?
Yes in most cases. Many NHS GP practices accept fit note requests through their website, app or telephone without a face-to-face appointment. Private online doctor services can also issue fit notes, usually for a fee, and these are legally valid.
Who can issue a fit note?
Since July 2022, fit notes can be legally certified by doctors, registered nurses, pharmacists, occupational therapists and physiotherapists. Before that only doctors could issue them.
Is a sick note the same as a fit note?
Yes. The official name is a Statement of Fitness for Work, introduced in 2010 and commonly called a fit note. "Sick note" is the older, informal term for the same document.
Do GPs charge for a fit note?
An NHS fit note for an absence of more than 7 days is free. A practice may charge for a private certificate covering the first 7 days, or for other private letters, because those fall outside NHS services.
What does "may be fit for work" mean on a fit note?
It means the clinician thinks you could work with support. The note may suggest a phased return, altered hours, amended duties or workplace adaptations. If your employer cannot provide those, the note is treated as "not fit for work" and no new note is needed.
How much is Statutory Sick Pay and when does it start?
SSP is paid by your employer from the fourth qualifying day of sickness for up to 28 weeks, provided you earn at least the lower earnings limit. Many employers offer contractual sick pay that is more generous — check your contract.
Where these figures come from
Charges and thresholds change. We check these figures regularly, but always confirm the current rate with the official source before you rely on it. This page explains entitlements, costs and process — it is not medical advice.
Day 8 and no GP appointment
Certification is the easy part; getting seen is not. ViscaCare members get online Doctor access from day one across Ireland, the UK and Europe, with prescriptions where clinically appropriate.
Related guides
Register with a GP
What a practice can and cannot ask for, and what to do if you are refused.
Read moreSick certs in Ireland
What a cert costs, and how Illness Benefit and employer certification work.
Read moreNHS prescription charges
The £9.90 charge, exemptions, and whether a prepayment certificate saves you money.
Read moreGP visit card
Free GP visits on higher income limits than a medical card.
Read more