ACAS Guidance on Fit Notes

ACAS has updated advice on fit notes following a change in the law this month. The law now allows health care professionals other than doctors to issue fit notes.

A fit note is an official written statement from a registered healthcare professional giving their medical opinion on a person’s fitness for work. Fit notes used to be called sick notes.

Healthcare professionals who can provide fit notes are:

  • doctors
  • nurses
  • occupational therapists
  • pharmacists
  • physiotherapists

The fit note might include recommendations for how the employer could support the employee. Whether you need a fit note depends on the length of sickness absence.
A fit note can be provided in writing or electronically.

Off sick for 7 days or less

If someone is absent due to sickness for 7 calendar days or less (including weekends), they do not need a fit note. This means they tell their employer they’re not well enough to work and do not need to provide any further medical evidence. This is called ‘self-certifying’ their sick leave. They should still be paid the amount of sick pay that’s in their contract.

Off sick for more than 7 days

If someone has a period of sickness absence for longer than 7 calendar days (no matter how many days they work each week), then they should get a fit note from a registered healthcare professional.

Getting a fit note

If the employee knows they’re likely to be off sick for longer than 7 days, they should try and get the fit note to their employer on the 7th day of sickness absence. A fit note cannot be provided before the 7th day of absence. If there’s a delay getting a fit note, for example difficulty booking a doctor’s appointment, the employee should contact their employer and explain. For full guidance go to

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