Fit note

Read the advice, not just the outcome

A fit note records one of two outcomes: the person is "not fit for work", or they "may be fit for work" if suitable support can be agreed. The second outcome is an invitation to discuss what is workable. It is not an instruction that the employer must accept every suggestion.

Doctors, registered nurses, occupational therapists, pharmacists and physiotherapists can issue fit notes. The GOV.UK fit note guidance explains how employers should use the advice. For an absence lasting more than seven calendar days, a fit note can also provide evidence for Statutory Sick Pay purposes.

Turn recommendations into a work conversation

Start with the person's actual job. A note may suggest altered hours, amended duties, workplace adaptations or a phased return. Ask which tasks are affected, what support may help and when the arrangement should be reviewed.

If a suitable change cannot be agreed, the employee does not need to obtain another note saying "not fit for work". Record what was considered and why the proposed arrangement was not workable. Occupational health may help where the advice needs to be connected more closely to the role.

Handle the note as health information

Keep a copy only for as long as there is a clear employment or record-keeping reason. Restrict access to people who need it for absence, support or payroll decisions. Managers usually need the functional advice and dates, not a wider medical history.

A fit note provides evidence and advice. It does not decide which workplace changes are reasonable or replace a conversation with the employee.