Sick Notes, Fit Notes and Medical Letters: What UK Patients Need to Know

A recent news story from Germany has put sick notes back in the headlines, after reports of changes to when workers may need medical proof for sickness absence.

But if you live or work in the UK, the important thing to know is this: German sick leave rules are not UK sick leave rules.

In the UK, most people do not need a fit note from a GP for the first few days of illness. There are clear rules around when a fit note is usually needed, what it can say, and when a GP or other healthcare professional can provide medical evidence.

If you are unwell, stressed, recovering from an injury, returning to work after illness, or being asked by an employer for medical proof, it can be confusing to know what you actually need.

Here is a practical guide to sick notes, fit notes and medical letters in the UK.

People often say “sick note”, “doctor’s note” or “medical certificate”, but the official UK term is usually “fit note”.

A fit note is a medical statement about how your health affects your ability to work. It can say that you are “not fit for work”, or that you “may be fit for work” with support from your employer.

That support might include things like:

• reduced hours
• amended duties
• avoiding heavy lifting
• working from home
• a phased return
• changes to your workstation or working pattern

The point of a fit note is not just to prove that you have been unwell. It can also help you and your employer discuss what support may help you recover or return to work safely.

In the UK, you usually do not need a fit note if you are off sick for 7 days or less. This includes non-working days, weekends and bank holidays.

For this first 7-day period, you can usually self-certify. That means your employer may ask you to confirm that you were off sick, but you do not normally need medical evidence from a GP or other healthcare professional.

If you are off sick for more than 7 calendar days, you may need a fit note.

This is where people often get caught out. The 7 days are calendar days, not working days. So if you become unwell before a weekend, those weekend days still count.

Sometimes an employer may ask for medical evidence even when someone has been off sick for 7 days or less.

In that situation, you may still be able to ask for a private medical letter or certificate, but this is different from the usual fit note process.

A GP will still need to assess you and decide whether a letter is clinically appropriate. Medical letters are not automatic, and they should reflect what the doctor can reasonably confirm based on your symptoms, history, examination where needed, and any supporting information.

In some cases, yes.

A fit note or medical letter does not always require a physical examination. Some requests may be suitable for an online or video GP appointment, especially where the doctor can make an appropriate assessment based on your symptoms, history and supporting information.

However, some situations are better suited to an in-clinic appointment. If the GP needs to examine you in person, check an injury, assess mobility, review physical symptoms or carry out tests, they may recommend a clinic visit.

At DocTap, sick notes and medical letters can be considered after an online or in-clinic GP assessment. In-clinic appointments are often best where a physical examination may be needed.

The important point is not whether the appointment is online or in person. The important point is whether the GP has enough clinical information to issue the note or letter safely and appropriately.

A fit note or medical letter is a clinical document. It is not just an admin form.

Before issuing one, a GP needs to understand:

• what symptoms or condition you have
• when the problem started
• how it affects your ability to work or study
• what kind of work you do
• whether you need time off, adjustments or further assessment
• whether there are any red-flag symptoms
• whether treatment, tests or follow-up are needed

This matters because two people with the same condition may be affected very differently.

For example, a back injury may affect a warehouse worker very differently from someone who works at a desk. Anxiety, depression or stress may affect concentration, sleep, decision-making or social interaction in different ways depending on the person and their role.

A useful fit note should reflect the individual, not just the diagnosis.

Problems with mental health are one of the common reasons people may need time off work or adjustments.

Stress, anxiety, depression, burnout, grief, panic symptoms and sleep problems can all affect someone’s ability to work. Sometimes time away from work is appropriate. Sometimes a phased return, reduced hours, remote working or changes to workload may be more helpful.

A GP appointment can help assess what is going on, whether physical health checks may be needed, whether medication or talking therapy should be considered, and whether a fit note or medical letter is appropriate.

The important point is that a fit note should sit within a wider plan. It should not be the only support someone receives.

A fit note is usually about fitness for work after illness.

A medical letter is broader. It may be used to confirm specific medical facts or provide supporting evidence for work, university, travel, insurance or another organisation.

Examples of medical letters may include:

• employer letters
• proof of medical condition letters
• medication confirmation letters
• fit to fly letters
• university or school absence letters
• private referral letters
• fit to work certificates

A GP can only write what they can clinically support. For example, they may be able to confirm that you attended an appointment, that you reported certain symptoms, that you have a documented condition, or that a particular adjustment may be medically reasonable.

They cannot simply write whatever an employer, university, airline or insurer asks for if it is not supported by the medical assessment.

Employers, universities, insurers and other organisations may need to check that a sick note or medical letter is genuine.

This is especially important because medical documents are often used as formal evidence for absence, workplace adjustments, travel, study, insurance or other administrative decisions.

DocTap sick notes include a unique verification code, allowing employers, universities and insurers to verify a sick note online.

Organisations can also verify a medical letter online using the DocTap verification page.

This helps make the process simpler for everyone. The patient receives a document issued after clinical assessment, and the organisation can confirm that the document is genuine without needing to request extra information unnecessarily.

Verification confirms that the document is authentic. It does not remove the need for a proper GP assessment before the document is issued.

If you need a sick note, fit note or medical letter quickly, a private GP appointment may be an option.

This can be helpful if:

• you have been unwell for more than 7 days
• your employer has asked for medical evidence
• you need a letter for work, university or travel
• you need advice about whether you are fit to return
• you are dealing with stress, anxiety or burnout at work
• you need documentation after an injury or illness
• you want to discuss possible workplace adjustments

It can be useful to book a GP appointment quickly, but the same rule applies: the doctor needs to assess you first. A fit note or medical letter can only be issued where clinically appropriate.

A fit note can say that you are “not fit for work” or that you “may be fit for work” with advice.

If it says you may be fit for work, it can include recommendations to help you return safely.

This might be useful if you are recovering but not yet ready to return to your normal duties.

For example, your GP may advise that you could return with shorter hours, lighter duties, home working, regular breaks or a temporary change in workload.

Your employer does not have to accept every recommendation, but fit note advice can help start a practical conversation about what is safe and realistic.

If you need a fit note or medical letter, it helps to bring as much relevant information as possible.

This may include:

• your job role and main duties
• how long you have been unwell
• any medication you are taking
• hospital letters or discharge summaries
• previous fit notes
• test results
• employer forms or wording requirements
• university or travel documentation
• details of any adjustments already discussed

The more context the GP has, the easier it is to write something accurate and useful.

A fit note can be useful, but it is not always the whole answer.

If you are repeatedly needing time off, struggling with your mental health, dealing with long-term symptoms, or finding that work is making your health worse, it may be worth having a fuller GP review.

Depending on your situation, a GP may suggest:

• treatment or medication
• blood tests
• counselling or talking therapy
• referral to a specialist
• occupational health input
• workplace adjustments
• follow-up appointments
• further investigation if symptoms are not settling

The aim should not just be to get a note. It should be to understand what is going on and what support you need next.

DocTap offers private GP appointments online and at London clinics.

If clinically appropriate after assessment, a DocTap GP can provide sick notes, fit notes and medical letters as part of your appointment. This may include employer letters, university or school letters, proof of medical condition letters, medication confirmation letters, fit to fly letters and other GP-issued certificates.

Some requests may be suitable for an online or video appointment. Others may need an in-clinic appointment if the GP needs to examine you in person.

DocTap sick notes and medical letters are issued by GMC-registered doctors and can be verified online by employers, universities, insurers and other organisations.

That verification step is useful because it allows the organisation receiving the document to check that it is genuine, while keeping the process straightforward for the patient.

A fit note or medical letter is never just a piece of paper. It should reflect your health, your circumstances and what is clinically appropriate.

If you are unsure what type of note you need, start with a GP appointment. The doctor can assess your situation and advise what documentation, treatment or next steps may be appropriate.

Book a private GP appointment with DocTap.