Fit Note Process 2026/27: When You Need One and What It Means for Pay

What Is a Fit Note?

A fit note, formally the Statement of Fitness for Work, is issued by a doctor or, since 2022, a wider range of healthcare professionals including nurses, occupational therapists, pharmacists and physiotherapists. It records whether someone is not fit for work, or may be fit for work with some form of support, and is the main piece of medical evidence an employer relies on for absences longer than a week.

Self-Certification for the First 7 Days

For the first 7 calendar days of sickness absence, including weekends and non-working days, no medical evidence is needed at all. The employee simply tells their employer they are unwell, usually through a short self-certification form or online system, and this is sufficient to support any contractual sick pay or the initial period of an absence that may later become eligible for Statutory Sick Pay.

Only once an absence continues into an 8th day does a fit note typically become necessary to keep being paid, though individual employer policies can be more generous than this minimum.

The Two Fit Note Outcomes

• Not fit for work: the person is assessed as unable to work at all for the period covered
• May be fit for work: the person could return with some form of support, such as a phased return, amended duties, altered hours, or workplace adaptations, which the employer is expected to discuss and consider seriously

Where "may be fit for work" is selected but the employer and employee cannot agree suitable adjustments within a reasonable time, the fit note is treated as if it said "not fit for work" for that period.

How It Connects to Statutory Sick Pay

Our full Statutory Sick Pay guide covers the eligibility rules in detail, but in short: SSP is paid from the fourth qualifying day of absence at £123.25 a week for 2026/27, for up to 28 weeks, provided average weekly earnings are at least £129 (the Lower Earnings Limit). A fit note is the standard piece of evidence an employer will ask for to keep paying SSP once self-certification for the first 7 days has run out.

Worked Example

Ahmed is off sick with a back injury. For the first week, he self-certifies by phone and text to his manager, with no fit note required. On day 8, still unwell, he sees a physiotherapist who issues a fit note stating "may be fit for work" with a recommendation of reduced hours and no heavy lifting for two weeks.

His employer agrees a phased return: three shortened days a week for the first fortnight, gradually increasing. Because he is working reduced hours rather than being fully absent, he is paid his normal (pro-rated) salary rather than Statutory Sick Pay for the days he does work, with SSP topping up any days he remains fully absent, subject to his employer's specific policy.

Common Pitfalls

• Assuming a GP appointment is always needed. Fit notes can be issued by a range of healthcare professionals and often after a phone or video consultation, not only an in-person GP visit.
• Ignoring "may be fit for work" advice. Employers who dismiss this advice without good reason risk both losing a return-to-work opportunity and creating employment law risk if a disability is involved.
• Not self-certifying properly for short absences. Skipping the self-certification process, even informally, can create disputes later about whether an absence was properly reported.
• Letting a fit note lapse without renewal. If an absence continues beyond the dates covered by a fit note, a new one is usually needed to keep sick pay flowing without a gap.
• Not requesting an occupational health referral. For longer or repeated absences, failing to involve occupational health can delay a safe and sustainable return to work.