Sick Note: Guide for Employers

If an employee is ill, they are by law permitted to take time off work to recover. Depending on the length of absence, they can either self-certify or they may have to get what used to be known as a sick note, now officially referred to as a ‘fit note’, from a qualifying medical professional. If a sick note is required, this should be referred to by the employer to support with the employee’s return to work.

Employers have to handle fit notes in accordance with UK employment law, particularly regarding Statutory Sick Pay (SSP) and employee rights. Failure to manage fit notes properly could lead to disputes or non-compliance with legal requirements.

The following guide for employers sets out the purpose of the sick note, including the rules on self-certifying and when a fit note is needed, as well as the requirements on employers to make changes to support employees with the return to work.

 

Section A: What is a Sick Note?

 

In UK employment law, there is no specific legal document called a ‘sick note’, but the term is commonly used to refer to what is officially known as a ‘fit note’. It is an official document or form from an issued by a qualified medical professional to certify whether an employee is either ‘not fit for work’ or ‘may be fit for work’. The sick note will also set out the nature of the condition for which the patient has been absent from work. Fit notes are generally required after an employee has been absent for more than seven consecutive calendar days, including weekends and non-working days. For shorter absences, employees can self-certify their sickness.

The fit note can provide two types of advice. The employee will either be determined to be ‘Not fit for work’, and too ill to work, or ‘May be fit for work’, which means the employee may be able to return to work with certain adjustments.

If someone is certified as ‘may be fit for work’, the medical practitioner completing the form may indicate what changes need to be made to help them return to work. The note will also specify the prognosis period of the illness, and whether or not a further assessment of fitness for work will need to be made at the end of this period.

Employers should consider the recommendations on the fit note to facilitate the employee’s return to work.

If the worker has a disability, under the Equality Act 2010 the employer is required to make reasonable adjustments to ensure they are not substantially disadvantaged when doing their job. Where it is not possible to implement or work to the recommendations, the fit note will change from ‘might be fit for work’ to ‘not fit for work’. The employee will not then be required to obtain a new fit note.

In some circumstances, the worker may be able to obtain a document akin to a sick note from a different professional, such as a physiotherapist or occupational therapist. This is known as an Allied Health Professionals (AHP) report. The employer, however, will need to agree to accept an AHP report by way of alternative to a sick note from the GP or hospital doctor.

Employees generally become entitled to Statutory Sick Pay if they have been off sick for at least four days in a row, including non-working days.

Employers are not allowed to withhold SSP if the employee is late in submitting their fit note.

 

Section B: When is a Sick Note Needed?

 

If someone is absent from work for seven or fewer consecutive days, including non-working days such as weekends and bank holidays, they are not required to give their employer a sick note. Instead, on their return to work, you can ask them to self-certify to confirm their absence due to illness.

The return to work process should be detailed in the organisation’s absence policy, specifying the information that will be required from the employee which will be added to their personnel file. This would usually include the dates of absence and reason for absence. To ensure consistency in the information gathered, employers should use a return to work form, the employee’s statement of sickness (SC2) form on GOV.UK. or as a minimum, ask that the employee submits the details of absence in writing, via email or letter.

There are some circumstances where the employee will not be able to self-certify and where they will need to provide official evidence that they are, or have been, poorly, and are now fit and able to return to work.

This means if they have been ill for more than seven consecutive days and have taken sick leave, they are under an obligation to provide you with a fit note.

 

Section C: Who Can Issue a Sick Note?

 

Since July 2022, sick notes (officially known as ‘fit notes’) can be issued by a broad range of healthcare professionals, such as GPs, hospital doctors, nurses, occupational therapists, pharmacists and physiotherapists. The employee should request the note from the healthcare professionals who is treating them for their illness or condition. The profession should determine the patient’s fitness to work after assessing their condition.

 

Section D: Returning to Work after Illness

 

The fit note does not cover a ‘fit for work’ option, as such the worker does not need a fit note to confirm they can return to work after illness.

However, workers should not return to work before the date on the fit note if the GP has advised them to remain off for the full period as noted on the fit note and the doctor has stated they want to see them again.

Employees do not need to be fully recovered to return to work and in many cases, employees can feel ready and able to return to work before the date on the fit note.

In such instances, the worker will first need to discuss with their employer if it is possible to return to work before the date on the fit note.

The employer may stipulate in its absence policy that professional medical advice is needed in writing to verify that they are fit and able to resume work. This would not be covered by a standard fit note, and instead, the worker may need a private medical certificate or the employer may require that they attend an occupational therapist for a professional opinion.

The employer would also be expected to carry out a risk assessment to determine if an early return could be accommodated as this may require changes to be made. For example, whether a phased return to work would be appropriate, varying working hours temporarily or giving support to do the job, such as avoiding heavy lifting.

In some circumstances, the employer may request a doctor’s report to find out more about the employee’s condition and health, for example, to assess whether the employee is fit to carry out their work, to prevent health and safety risks and prevent disability discrimination. The employer must have the employee’s consent for such a report. In agreeing to a medical report, the employee can ask their doctor not to give information they think could be damaging or is not relevant, ask to see the doctor’s report first and not agree to the doctor’s report being shared with their employer if they disagree with what it says.

If the employee does not wish the employer to see their medical information, the employer must base their decision on the information they have.

If the employer does not agree to an early return, perhaps due to the risk assessment or issues with any adjustments that may need to be made, the worker would need to stay off until the date on the fit note.

 

Section E: Supporting the Return to Work

 

The premise of the fit note is that employees may not need to be at 100% health to return to work, and that resuming duties may in some circumstances support recovery.

Where a sick note indicates that an employee ‘may be fit for work’, the employer should explore any changes that may need to be made to support the return to work.

Where a GP or doctor has certified that the worker may be able to return to work, as previously indicated, the sick note will often indicate what type of changes may need to be made, such as:

 

a. A phased return to work, for example, part-time to full-time

 

b. Altered hours, for example, fewer hours or flexible working hours

 

c. Amended duties, for example, nothing involving physical activity

 

d. Workplace adaptations, for example, the provision of specialised equipment, such as an ergonomically designed chair where you have been off sick with back problems

 

The sick note can also include detailed comments on the functional effects of their condition and how any suggested changes will help. However, in the event that no agreement can be reached between the employer and the worker as to any suitable changes, they should continue to be treated as unfit for work.

 

Section F: Disabilities & Reasonable Adjustments

 

Where there is a delay in returning to work is related to a disability, by law the employer is required to make reasonable adjustments in the workplace to ensure that the worker is not substantially disadvantaged when carrying out their job.

Workers will be treated as having a disability under the Equality Act 2010 where they have a physical or mental impairment, and that impairment has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. The impairment is long-term if it has lasted for at least 12 months, or is likely to last for at least 12 months, or is recurring.

Where they have a disability, any failure by their employer to make reasonable adjustments to support the return to work could amount to disability discrimination for which they can make a claim to an employment tribunal.

What constitutes reasonable adjustments will depend on a number of factors, including the nature of the work, the type of workplace environment and the size of the organisation and the resources it has available to make the reasonable adjustments. Examples of reasonable adjustments could include installing a disability ramp for wheelchair users, providing specialised equipment, discounting disability-related absence or modifying performance targets, for example, due to disability-related fatigue.

The employer is not, however, required to change the basic nature of the worker’s job.

Employees should not be asked to pay for the adjustments to be made. Government grants may be available to help cover the costs of practical support in the workplace under the Access to Work scheme. A grant through this scheme can be used to fund special equipment, adaptations or support worker services to help you return to work.

 

Section G: Sick Notes & Sick Pay

 

Statutory sick pay (SSP) may be payable if a worker is too ill to work and they have been off work for four or more consecutive days, including non-working days. SSP starts on the fourth day.

To qualify for SSP, the worker will need to be earning an average of least £123 per week and must also have notified their employer of their illness within any specified timeframe under the terms of their contract, or within seven days.

SSP is payable in line with the employee’s standard working pattern, known as ‘qualifying days’ and payable on the employee’s usual payday, and is subject to the usual deductions for tax and national insurance.

Employers may also offer contractual sick pay terms, the terms of which should be specified in the employment contract.

 

Section H: Sickness Absence & Holiday Entitlement

 

During a period of sickness absence, the worker will continue to accrue their statutory holiday entitlement, regardless of how long they are absent.

In circumstances where the worker falls ill just prior to or during any period of annual leave, they are entitled to take this as sick leave instead. The employer cannot force a worker to take annual leave if they are eligible for sick leave. However, they may be able to take paid holiday for any time that they are off work sick, for example, where you do not qualify for sick pay.

 

Section I: Summary

 

A sick note, also known as a fit note, is a document issued by a healthcare professional in the UK, confirming if an employee is fit or unfit for work due to illness or injury after a period of absence from work of more than seven consecutive days. The fit note provides details on the employee’s condition and may include recommendations for adjustments that could help them return to work sooner.

For employers, managing sick notes requires careful attention to legal obligations, such as ensuring compliance with Statutory Sick Pay (SSP) requirements and respecting employee rights. Mishandling fit notes can lead to disputes, potential claims of unfair treatment, or even legal challenges. Employers will also want to be vigilant to check the authenticity of fit notes to prevent fraudulent claims.

Sick notes, and sickness absence in general, should be handled with sensitivity and fairness to maintain a positive relationship with the employee while they are off work and to support the return to work. Employers should also be prepared to implement any necessary workplace adjustments recommended in the fit note to support the employee’s return.

 

Section J: Need Assistance?

 

DavidsonMorris are experienced employment law specialists offering guidance and support to employers on all aspects of workforce management, including managing absences due to ill-health and sickness.

We have particular expertise in advising on disability discrimination and reducing the risk of unfavourable treatment and discrimination at work relating to reasonable adjustments and supporting the return to work.

For expert advice on managing sickness absence or disability discrimination, contact us.

 

Section K: Sick Note FAQs

 

What is a fit note, and when is it required?

A fit note, commonly referred to as a sick note, is a document issued by a healthcare professional to confirm that an employee is unfit for work due to illness. It is generally required when an employee has been absent from work for more than seven consecutive calendar days, including weekends and non-working days.

 

Can an employee return to work before the fit note expires?

An employee can return to work before the fit note expires if they feel well enough to do so. They do not need to get a new fit note or seek permission from their doctor, but it’s advisable for them to discuss their return with their employer to ensure appropriate arrangements are in place.

 

What should an employer do if they suspect a fit note is not genuine?

If an employer has concerns about the authenticity of a fit note, they can contact the issuing healthcare professional for verification. It’s important to handle such situations sensitively and in accordance with legal guidelines to avoid potential disputes.

 

Are employees entitled to Statutory Sick Pay (SSP) with a fit note?

Employees may be entitled to Statutory Sick Pay (SSP) if they meet certain eligibility criteria, such as having been off work for at least four days in a row and earning above the Lower Earnings Limit. The fit note serves as evidence for their claim to SSP.

 

Can an employer challenge the advice given on a fit note?

Employers can seek clarification from the issuing healthcare professional if they have concerns about the advice given on a fit note. However, it is generally advisable to accept the medical advice provided unless there is strong evidence to suggest otherwise.

 

What adjustments might be recommended on a fit note?

A fit note may suggest adjustments such as altered working hours, modified duties, or workplace adaptations to help the employee return to work. Employers should consider these recommendations and discuss them with the employee to find a suitable arrangement.

 

How long should employers keep fit notes on file?

Employers are advised to keep fit notes on file for a reasonable period, typically as long as required for Statutory Sick Pay (SSP) records or other legal obligations, which can be up to three years. Keeping accurate records can help in managing absence and addressing any future disputes.

 

Can an employer contact someone off work sick?

While there are no specific rules on contacting employees off sick, employers should act reasonably, for example considering the length and reason of the absence.

 

What evidence should I ask from an employee returning from sick leave?

For the first 7 days of absence, the employer cannot ask for a fit or sick note. After this period, the employer can request a fit note to confirm the individual is able to return to work.

 

Section L: Glossary

 

 

Term	Definition
Fit Note	A document issued by a healthcare professional indicating whether an employee is fit for work.
Sick Note	Common term for a fit note; used to certify an employee’s inability to work due to illness.
Statutory Sick Pay (SSP)	The minimum amount employers must pay eligible employees when they are off work due to illness.
Self-Certification	The process by which an employee declares their sickness to their employer for absences up to seven days.
Healthcare Professional	A qualified individual, such as a GP, nurse, or physiotherapist, authorised to issue fit notes.
Long-Term Sickness	A prolonged period of illness, typically extending beyond four weeks, that may require special handling by employers.
Occupational Health	A field of healthcare focused on the physical and mental wellbeing of employees in the workplace.
Return to Work	The process and considerations involved when an employee resumes work after a period of sickness.
Adjustments	Modifications to work duties, hours, or conditions recommended to accommodate an employee’s health needs.
Lower Earnings Limit	The minimum amount an employee must earn to qualify for Statutory Sick Pay (SSP).

 

 

Section M: Additional Resources

 

UK Government – Fit Notes: Guidance for Employers and Employees
https://www.gov.uk/government/publications/fit-note-guidance-for-employers-and-line-managers
Comprehensive guidance on how to use fit notes in the workplace, including legal obligations and best practices.

 

NHS – Fit Notes (Sick Notes)
https://www.nhs.uk/conditions/fit-note/
Information from the NHS about fit notes, when they are needed, and how they are used to support employee health.

 

ACAS – Managing Absence: A Good Practice Guide
https://www.acas.org.uk/managing-absence
A guide from the Advisory, Conciliation and Arbitration Service (ACAS) offering practical advice on handling employee sickness and absence.

 

Health and Safety Executive (HSE) – Managing Sickness Absence
https://www.hse.gov.uk/sicknessabsence/index.htm
HSE guidance on managing sickness absence in the workplace, including legal duties and how to support employees.

 

Chartered Institute of Personnel and Development (CIPD) – Absence Management
https://www.cipd.co.uk/knowledge/fundamentals/relations/absence/factsheet
A resource for HR professionals, providing insights and strategies for effectively managing employee absence.