Fit note advice for employers can help businesses respond correctly when an employee provides medical evidence about their ability to work.
A fit note may state that the employee is not fit for work. Alternatively, it may suggest that they could work if the employer provides suitable support or temporary changes.
Employers should consider the information carefully, discuss it with the employee and avoid treating every recommendation as either compulsory or irrelevant.
What is a fit note?
A fit note is an official statement from a registered healthcare professional about how an employee’s health affects their fitness for work.
Doctors, nurses, occupational therapists, pharmacists and physiotherapists can issue fit notes where this falls within their professional role.
An employee normally self-certifies sickness for the first seven calendar days. If the absence lasts longer, the employer can usually ask for a fit note.
The seven-day period includes weekends and non-working days. Therefore, a part-time employee may need a fit note even if they were not scheduled to work on every day of the absence.
Fit note advice for employers after seven days
The employee should provide the fit note on the seventh day of absence or as soon as reasonably possible afterwards.
Employers should allow some flexibility where the employee has difficulty obtaining an appointment. However, they can ask when the employee expects to provide the document.
A fit note should normally show:
- the employee’s name;
- the date of the medical assessment;
- whether they are not fit or may be fit for work;
- the period covered by the note;
- any relevant recommendations; and
- the issuer’s name and professional role.
The employee retains the original fit note. The employer can keep a copy for its records.
Our employee statement of sickness page explains the rules that apply during the initial self-certification period.
When a fit note says “not fit for work”
A “not fit for work” statement means the healthcare professional believes the employee should not work during the specified period.
The employer should record the absence, apply the relevant sick pay arrangements and maintain reasonable contact with the employee.
However, the employee can return before the fit note expires if they feel well enough. They do not normally need another medical statement confirming that they are fit.
Before allowing an early return, the employer should discuss whether the employee can work safely. It may also need to consider medical advice, workplace risks and temporary support.
The employer should not pressure the employee to return before they feel ready. Doing so could worsen the condition and create health and safety or discrimination risks.
Fit note advice for employers when an employee may be fit
A fit note may state that the employee “may be fit for work” if the employer can provide appropriate support.
The healthcare professional may recommend:
- a phased return to work;
- altered hours;
- amended duties;
- changes to the employee’s workstation;
- home or hybrid working; or
- avoiding particular physical activities.
The employer should discuss these suggestions with the employee and consider whether they are workable.
The recommendations are generally advisory rather than automatic instructions. However, an employer may have a legal duty to implement them where they amount to reasonable adjustments for a disabled employee.
If the employer cannot provide the recommended support, the employee is treated as not fit for work for the period covered. They do not normally need a replacement fit note.
Discussing medical recommendations with the employee
The employer should arrange a private discussion rather than making assumptions from the brief wording on the fit note.
Useful questions may include whether the employee feels able to return, which duties present difficulties and how long temporary support may be needed.
The manager should focus on the practical effect of the condition rather than asking for unnecessary medical details.
If the recommendations are unclear, the employer can ask the employee for further information. With the employee’s consent, it may also seek advice from occupational health or request a medical report.
Our employee sickness management page explains how medical evidence should fit within the wider absence process.
Fit notes and reasonable adjustments
A fit note may alert the employer to a condition that could meet the definition of disability under the Equality Act 2010.
The employer should then consider whether workplace arrangements place the employee at a substantial disadvantage and whether reasonable adjustments could reduce it.
Possible adjustments could include modified duties, different working hours, specialist equipment or changes to absence-management procedures.
Employers should not reject a recommendation solely because it creates some inconvenience. They should consider its likely effectiveness, cost, duration and effect on the organisation.
If a particular proposal is not reasonable, the employer should discuss other options and record why it reached that decision.
Pay during a supported return
The employer and employee should agree how pay will operate if the employee returns on reduced hours or amended duties.
The employee should normally receive their contractual rate for the hours they work. Pay for the remaining hours may depend on the contract, company sick pay scheme, Statutory Sick Pay rules or another temporary agreement.
Employers should confirm the arrangement in writing before the return begins. This can prevent later disagreement about wages and sick pay.
When further medical evidence is needed
A fit note may provide enough evidence for a straightforward absence. However, it may not answer every question in a long-term or complex case.
The employer may need further evidence where:
- the likely return date remains unclear;
- the employee has repeated absences;
- the condition may amount to a disability;
- the role involves significant safety risks;
- recommendations are unclear or outdated; or
- the employer is considering capability action.
The employer should obtain the employee’s consent before requesting a medical or occupational health report.
Where absence becomes prolonged, our long-term sickness employment rights page explains the steps employers should take before considering dismissal.
Common fit note mistakes
Employers often create problems by demanding a fit note during the first seven days, ignoring “may be fit” recommendations or insisting that an employee obtains a second note before returning early.
Other mistakes include sharing medical information too widely, failing to discuss adjustments and treating the fit note as conclusive evidence that dismissal is justified.
A fit note supports workplace decision-making. It does not replace consultation, reasonable adjustment duties or a fair capability procedure.
Further fit note advice for employers
Fit note advice for employers should help managers understand the employee’s current ability to work and identify practical support.
Employers Law helps businesses interpret medical evidence, manage sickness absence and make fair decisions about return arrangements, adjustments and capability.