Fit Note

Fit Note

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Understanding Fit Notes

Regulatory Framework and Requirements

Relationship to Statutory Sick Pay (SSP)

Essential Processing Checklist

Implementing Effective Absence Management

What is a Fit Note?

What is a Fit Note?

Understanding Fit Notes

Fit notes (officially called a "Statement of Fitness for Work" and also known as sick notes) serve as the official documentation for employee illness and return-to-work readiness in the UK. Understanding the regulations surrounding these medical statements is essential for HR professionals managing absence processes and ensuring compliance with government requirements. This comprehensive guide covers everything HR teams need to know about fit notes, including documentation timelines, proper handling procedures, and integration with broader absence management systems.

A fit note is a medical document issued by a healthcare professional when an employee has been absent due to illness for seven or more consecutive days of sickness. Beyond simply documenting illness for accurate records, fit notes give valuable guidance about an employee's capacity to return to work and any potential adjustments that might help their return because of the functional effects of their medical condition.

Who Can Issue Fit Notes?

Fit notes can be provided by a range of healthcare professionals including:

  • General practitioners (GPs)

  • Hospital doctors

  • Occupational therapists

  • Nurses with appropriate specialist knowledge

  • Other allied health professionals with relevant expertise

This expanded range of fit note issuers helps improve access to medical evidence when employees need documentation for their absence.

Purpose and Function

Fit notes serve multiple important uses:

  • Documentation of legitimate illness for absence records

  • Medical assessment of an employee's health condition

  • Recommendations for workplace adjustments to facilitate recovery

  • Guidance on phased employee returns to work following extended sickness absence

Phased Return Recommendations

Fit notes often include suggestions for graduated returns to work, which might include:

  • Temporary modifications to working hours

  • Altered duties or responsibilities (such as avoiding heavy lifting)

  • Workplace adjustments or equipment adaptations

  • Other support measures to facilitate successful reintegration

It's important to note that while doctors provide recommendations in medical statements, employers are not legally obligated to implement these adjustments, they are not legal duties or legal obligations. However, accommodating reasonable adjustments typically benefits both the employee's recovery and the organization's long-term interests by facilitating earlier returns and preventing prolonged periods of absence.

Regulatory Framework and Requirements

Understanding when fit notes are required helps HR professionals maintain compliant absence policies:

The Seven-Day Rule

Employees only need to provide an official fit note when their sickness absence extends beyond seven consecutive days. For shorter absences, self-certification is sufficient.

This seven-day period includes:

  • All consecutive days of illness

  • Weekends and bank holidays

  • Non-working days

For example, if an employee falls ill on Saturday and remains unwell through the following Friday, they would need to obtain a fit note provided by a healthcare professional despite only missing five working days.

Medical Certification Limitations

Doctors cannot issue fit notes before the seventh day of health-related absences except in special circumstances. This sometimes creates a gap between when an employee reaches the seven-day period of sickness threshold and when they can secure a doctor's appointment. HR should be aware of these potential delays when processing documentation.

If an employee has been absent for seven days but their doctor determines they are fully fit to return, no fit note will be issued. In these cases, the period of sickness absence should still be documented according to company policy, but without the accompanying medical evidence.

Company-Specific Requirements

While the seven-day rule represents the statutory minimum, organizations can establish more stringent documentation requirements in their absence policies. If your company requires medical evidence for absences shorter than seven days, the organization must:

  • Clearly communicate these requirements in your sickness policy

  • Arrange for appropriate medical assessments

  • Cover any costs associated with obtaining medical statements

Understanding when fit notes are required helps HR professionals maintain compliant absence policies:

The Seven-Day Rule

Employees only need to provide an official fit note when their sickness absence extends beyond seven consecutive days. For shorter absences, self-certification is sufficient.

This seven-day period includes:

  • All consecutive days of illness

  • Weekends and bank holidays

  • Non-working days

For example, if an employee falls ill on Saturday and remains unwell through the following Friday, they would need to obtain a fit note provided by a healthcare professional despite only missing five working days.

Medical Certification Limitations

Doctors cannot issue fit notes before the seventh day of health-related absences except in special circumstances. This sometimes creates a gap between when an employee reaches the seven-day period of sickness threshold and when they can secure a doctor's appointment. HR should be aware of these potential delays when processing documentation.

If an employee has been absent for seven days but their doctor determines they are fully fit to return, no fit note will be issued. In these cases, the period of sickness absence should still be documented according to company policy, but without the accompanying medical evidence.

Company-Specific Requirements

While the seven-day rule represents the statutory minimum, organizations can establish more stringent documentation requirements in their absence policies. If your company requires medical evidence for absences shorter than seven days, the organization must:

  • Clearly communicate these requirements in your sickness policy

  • Arrange for appropriate medical assessments

  • Cover any costs associated with obtaining medical statements

Relationship to Statutory Sick Pay (SSP)

Understanding how fit notes interact with statutory sick pay obligations helps HR teams manage absence costs appropriately:

SSP Eligibility Timeline

Statutory Sick Pay becomes payable when an employee has been ill for at least four consecutive days (including non-working days). The first three days are considered "waiting days" during which employers can choose whether to provide company sick pay according to their policies.

When an absence extends to seven consecutive days, the fit note requirement aligns with ongoing SSP obligations, providing documentation for continued payment. Employees may need to provide their National Insurance number when claiming SSP.

Documentation for Performance Management

Fit notes serve as important records beyond immediate absence management. They give objective medical evidence that can be relevant during:

Proper storage and retrieval of these documents supports fair and consistent absence management practices and helps maintain accurate records.

Early Return Considerations

In most cases, employees can return to work before the end date specified on their fit note if they feel recovered and both they and their employer agree. However, exceptions apply when:

  • The healthcare professional has explicitly indicated the employee should not return for a period of time before the specified date

  • The doctor has requested a follow-up assessment before return

  • The nature of the medical condition requires specific return-to-work protocols

When considering early returns, employers should:

  • Discuss the situation with the employee

  • Consider conducting a workplace risk assessment based on medical statements

  • Document the decision-making process

  • Implement any necessary reasonable adjustments

Understanding how fit notes interact with statutory sick pay obligations helps HR teams manage absence costs appropriately:

SSP Eligibility Timeline

Statutory Sick Pay becomes payable when an employee has been ill for at least four consecutive days (including non-working days). The first three days are considered "waiting days" during which employers can choose whether to provide company sick pay according to their policies.

When an absence extends to seven consecutive days, the fit note requirement aligns with ongoing SSP obligations, providing documentation for continued payment. Employees may need to provide their National Insurance number when claiming SSP.

Documentation for Performance Management

Fit notes serve as important records beyond immediate absence management. They give objective medical evidence that can be relevant during:

Proper storage and retrieval of these documents supports fair and consistent absence management practices and helps maintain accurate records.

Early Return Considerations

In most cases, employees can return to work before the end date specified on their fit note if they feel recovered and both they and their employer agree. However, exceptions apply when:

  • The healthcare professional has explicitly indicated the employee should not return for a period of time before the specified date

  • The doctor has requested a follow-up assessment before return

  • The nature of the medical condition requires specific return-to-work protocols

When considering early returns, employers should:

  • Discuss the situation with the employee

  • Consider conducting a workplace risk assessment based on medical statements

  • Document the decision-making process

  • Implement any necessary reasonable adjustments

Essential Processing Checklist

When receiving a fit note or statement of fitness from an employee, HR professionals should follow these five key steps:

1. Verify Work Capacity Assessment

Check whether the healthcare professional has indicated:

  • "Not fit for work" - indicating the employee should remain absent for the specified period of illness

  • "May be fit for work" - suggesting possible workplace adjustments to facilitate return

The fit note form typically includes tick boxes for these assessments.

2. Review Timeframes

Carefully note:

  • The period covered by the fit note

  • Whether reassessment is required before return

  • Any recommendations regarding phased returns

  • The prognosis period provided by the healthcare professional

3. Conduct Return Discussion

Have a compassionate conversation with the employee to:

  • Understand their perspective on their recovery

  • Discuss any recommended reasonable adjustments

  • Plan appropriate employee return arrangements

  • Consider any guidance for patients provided by their healthcare professional

4. Process for Payroll Purposes

Ensure the fit note information is:

  • Recorded for sick pay calculations

  • Documented if adjustments cannot be implemented

  • Integrated with attendance records

  • Properly filed for evidence of incapacity

5. Maintain Proper Documentation

Always:

  • Make a copy of the medical certificate for company records

  • Return the original document to the employee

  • Store the copy securely in accordance with data protection requirements

  • Include any detailed comments or additional information provided

When receiving a fit note or statement of fitness from an employee, HR professionals should follow these five key steps:

1. Verify Work Capacity Assessment

Check whether the healthcare professional has indicated:

  • "Not fit for work" - indicating the employee should remain absent for the specified period of illness

  • "May be fit for work" - suggesting possible workplace adjustments to facilitate return

The fit note form typically includes tick boxes for these assessments.

2. Review Timeframes

Carefully note:

  • The period covered by the fit note

  • Whether reassessment is required before return

  • Any recommendations regarding phased returns

  • The prognosis period provided by the healthcare professional

3. Conduct Return Discussion

Have a compassionate conversation with the employee to:

  • Understand their perspective on their recovery

  • Discuss any recommended reasonable adjustments

  • Plan appropriate employee return arrangements

  • Consider any guidance for patients provided by their healthcare professional

4. Process for Payroll Purposes

Ensure the fit note information is:

  • Recorded for sick pay calculations

  • Documented if adjustments cannot be implemented

  • Integrated with attendance records

  • Properly filed for evidence of incapacity

5. Maintain Proper Documentation

Always:

  • Make a copy of the medical certificate for company records

  • Return the original document to the employee

  • Store the copy securely in accordance with data protection requirements

  • Include any detailed comments or additional information provided

Create a better place of work today

Create a better place of work today

Simplify your people workflows and bring value to everyone in the organisation. Try Humaans today.

Simplify your people workflows and bring value to everyone in the organisation. Try Humaans today.

Book a demo

Book a demo

Implementing Effective Absence Management

Managing fit notes is just one component of comprehensive absence management. Modern HR functions need efficient systems to track, document, and analyze absence patterns.

Digital Absence Management

Humaans provides integrated absence management capabilities that allow organizations to:

  • Track all types of employee absence from a single platform

  • Store relevant documentation securely

  • Generate absence reports for analysis

  • Manage return-to-work processes and any workplace adjustments

  • Ensure compliance with your absence policy

An effective management system reduces administrative burden while providing valuable insights into organizational health and potential intervention opportunities.

Policy Development Considerations

When developing or revising absence policies, think of:

  • Clear guidelines on documentation requirements for medical evidence

  • Processes for handling fit note recommendations

  • Protocols for phased returns to work

  • Procedures for addressing patterns of absence

  • Integration with health services and occupational health services

Policies should balance compassionate support for genuinely ill employees with appropriate measures to manage attendance effectively.

Disability Discrimination Considerations

It's important to note that some health conditions documented by fit notes may qualify as disabilities under equality legislation. In these cases, employers have additional legal obligations to make reasonable adjustments. Seeking expert advice when handling complex cases can help prevent disability discrimination claims.

Experience how Humaans can transform your absence management processes by booking a demo.

Our platform provides the tools you need to track absences, store documentation, and maintain accurate records, including fit notes, all from a single, intuitive easy-to-use software.

Managing fit notes is just one component of comprehensive absence management. Modern HR functions need efficient systems to track, document, and analyze absence patterns.

Digital Absence Management

Humaans provides integrated absence management capabilities that allow organizations to:

  • Track all types of employee absence from a single platform

  • Store relevant documentation securely

  • Generate absence reports for analysis

  • Manage return-to-work processes and any workplace adjustments

  • Ensure compliance with your absence policy

An effective management system reduces administrative burden while providing valuable insights into organizational health and potential intervention opportunities.

Policy Development Considerations

When developing or revising absence policies, think of:

  • Clear guidelines on documentation requirements for medical evidence

  • Processes for handling fit note recommendations

  • Protocols for phased returns to work

  • Procedures for addressing patterns of absence

  • Integration with health services and occupational health services

Policies should balance compassionate support for genuinely ill employees with appropriate measures to manage attendance effectively.

Disability Discrimination Considerations

It's important to note that some health conditions documented by fit notes may qualify as disabilities under equality legislation. In these cases, employers have additional legal obligations to make reasonable adjustments. Seeking expert advice when handling complex cases can help prevent disability discrimination claims.

Experience how Humaans can transform your absence management processes by booking a demo.

Our platform provides the tools you need to track absences, store documentation, and maintain accurate records, including fit notes, all from a single, intuitive easy-to-use software.

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Create a better place of work today

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Simplify your people workflows and bring value to everyone in the organisation. Experience Humaans today.

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