Comparison · Employment · 2026
Fit Note vs Occupational Health Referral UK 2026
A GP fit note documents whether you are fit for work and usually triggers Statutory Sick Pay. An occupational health referral, arranged by the employer, digs deeper into work-specific adjustments and return-to-work planning. Here is how they differ for 2026.
TL;DR - 30-Second Summary
- - Fit note: from your GP after 7 days off sick; evidences SSP eligibility (£123.25/week for 2026/27)
- - OH referral: arranged by the employer for work-specific advice and adjustments
- - They work together — a fit note covers the sickness period; OH plans the return
Frequently Asked Questions
What is a fit note?
A fit note (formally a Statement of Fitness for Work) is issued by a GP or other authorised healthcare professional after 7 consecutive days of sickness absence, stating whether an employee is "not fit for work" or "may be fit for work" with suggested adjustments. Employees can self-certify the first 7 days without a fit note.
What is an occupational health referral?
An occupational health (OH) referral is arranged by the employer, usually for longer or recurring absences, to get an independent clinical assessment of how a health condition affects someone's ability to work and what reasonable adjustments or support might help a return to work.
Who arranges each one?
A fit note comes from the employee's own GP or hospital doctor as part of routine care; an occupational health referral is initiated and typically paid for by the employer, using either an in-house OH team or an external provider.
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Does either affect Statutory Sick Pay?
A fit note (or self-certification for the first 7 days) is usually what triggers and evidences eligibility for Statutory Sick Pay of £123.25/week for 2026/27. An occupational health referral does not itself pay SSP but can influence decisions about return-to-work adjustments, phased returns, or ultimately capability procedures.
Can my employer insist on an occupational health referral?
Yes, provided this is set out in the contract or a reasonable management instruction — most employers can require a referral for extended sickness absence, though attending is generally advisable rather than strictly compulsory in every case, and refusal without good reason can be a factor in a fair capability or disciplinary process.
How do the two work together?
They are complementary, not alternatives: a fit note documents fitness for work over the sickness period, while an OH referral provides deeper, work-specific medical opinion (often including recommended adjustments under the Equality Act 2010) to help both employee and employer plan a sustainable return.
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Disclaimer: This is educational information, not legal or medical advice. Sickness absence and occupational health processes vary by employer — see gov.uk/statutory-sick-pay and your employer's absence policy for specifics.
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