Mastering Fit Notes: An Essential Guide for HR Professionals

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This guide is intended to provide an in-depth understanding of fit notes, their significance, and how HR professionals can effectively manage them.

What is a fit note?

A fit note, commonly known as a 'sick note,' is an official document issued by healthcare professionals such as general practice doctors, hospital doctors, nurses, occupational therapists, pharmacists, or community pharmacists. 

This note provides medical evidence about an employee's fitness for work, informing their employer about their health condition and their capability (or lack thereof) of performing their usual job or different duties. 

These notes are crucial in claiming employee benefits and statutory sick pay during health-related absences that extend for more than seven days, excluding weekends and bank holidays.

The role of fit notes in the workplace

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Fit notes serve as a bridge between the medical world and the workplace, helping manage how health affects the employee's performance and the broader work environment.

1. Validate employee absence: 

Fit notes offer medical evidence to support an employee's need for time off, helping to count sick days accurately. They legitimize the health condition leading to work absence, be it due to illness, injury, or a medical procedure.

2. Guide reasonable adjustments: 

These notes often guide potential workplace adjustments to accommodate an employee's health condition, ensuring they can return to work without jeopardizing their health.

3. Provide clear communication: 

Fit notes serve as a clear communication channel between healthcare professionals and employers, informing them of an employee's fitness for work or need for modified duties.

4. Help in risk management: 

By understanding an employee's health status and potential limitations, fit notes allow organizations to manage risks and ensure workplace safety.

5. Support in claiming benefits: 

Fit notes are crucial in processing claims for statutory sick pay and other health-related benefits, protecting employees' rights during health-related absences.

The mechanics of fit notes

What are the rules for fit notes?

A fit note is needed if an employee is off work sick for more than seven days. The seven days include days you don't normally work, known as 'non-working days,' such as weekends and bank holidays. 

For sickness leave of seven days or less, the employee can self-certify their absence without needing a fit note from a healthcare professional.

How are fit notes issued?

Healthcare professionals issue fit notes, including doctors, nurses, occupational therapists, and pharmacists.

They do this after assessing an individual and concluding that their health condition affects their ability to perform their job. 

It's important to remember that a hospital doctor can provide a fit note, but the duty often falls to the general practice doctor.

Common terminologies used in fit notes

When it comes to fit notes, understanding the lingo is key. Here are some common terms:

  • Fit for work: indicates that the healthcare professional has deemed the employee capable of performing their usual job.

  • Unfit for work: This is used when the healthcare professional determines that the employee should refrain from work due to their health condition.

  • May be fit for work: This suggests that the employee may be able to work, given certain adjustments or modifications in their work.

  • Isolation note: This term gained prominence during the COVID-19 pandemic and is used when an employee is advised to self-isolate due to potential exposure to the virus.

Time frames and durations associated with fit notes

Fit notes can be issued for a specified period (up to a maximum of three months for the first note) or marked as 'ongoing.' 

It's also important to note that if an employee is unfit for work for more than seven days, they may need to provide a private medical certificate if their healthcare professional does not issue fit notes.

Acting on fit notes

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Understanding a fit note is only half the battle; the next half involves acting on the information it provides. HR's role is crucial in this regard, translating the medical evidence into actionable steps that ensure the employee's well-being and the organization's smooth functioning.

How should HR respond to a fit note?

HR should respond promptly and proactively to a fit note. The first step involves reviewing the note, paying attention to key details like the duration of leave, any recommendations made by the healthcare professional, and whether the employee is unfit for their usual job or can perform different duties. 

Communication is essential here; HR should contact the employee, acknowledge receipt of the fit note, and discuss the next steps. At the same time, HR should consider how this absence affects team dynamics and workload and, if necessary, arrange for interim support.

Possible adjustments and accommodations for employees

Based on the guidance provided in the fit note, HR may need to adjust the employee's working conditions. This could include: 

  • Providing specialized equipment

  • Altering working hours

  • Modifying their role

  • Offering the option to work from home

The key is to have an open dialogue with the employee about what they feel would help them return to work safely and comfortably. It's important to remember that these adjustments are often temporary and should be reviewed regularly.

Navigating complex situations related to fit notes

Fit notes can sometimes present complex situations that need careful handling. Here are three examples:

1. Long-term sickness: 

An employee might be signed off for an extended period due to a serious health condition. In such cases, HR needs to maintain regular, sensitive communication with the employee, ensuring they don't feel isolated. 

Related: Understanding Long-Term Sick Pay: Your Rights and Benefits

Additionally, HR should liaise with line managers to manage workloads and consider getting an occupational therapist involved to assess the workplace and suggest necessary adjustments for the employee's return.

2. Disagreements about fitness to work: 

There may be instances where an employee disagrees with the fit note's content, or an employer has concerns about an employee's fitness for work despite a fit note stating otherwise. In such cases, seeking a second opinion from another healthcare professional or requesting medical evidence is advisable.

3. Unclear or vague fit note: 

Sometimes, a fit note might contain vague or unclear information, making it difficult for HR to understand the exact nature of the employee's health condition or recommended adjustments. HR should contact the healthcare professional (with the employee's consent) for clarification. Any actions taken must align with the employee's health needs and are in line with fit-note guidance.

Taking action on fit notes requires careful thought, clear communication, and a nuanced understanding of an employee's health conditions. By doing so, HR can ensure employees' well-being while minimizing workplace disruption.

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Legal obligations of employers and HR professionals regarding fit notes

Employers and HR professionals in the UK have several legal obligations regarding fit notes. These obligations are designed to protect the rights of both employers and employees.

1. Request a fit note:

Employers are required to request a fit note from an employee after they have been off work sick for more than 7 days. This is because a fit note can provide information about the employee's fitness for work, which can help employers to make decisions about their employment.

2. Consider the fit note

Employers must consider the fit note when deciding about an employee's employment. This includes decisions about whether to continue to pay the employee Statutory Sick Pay, make any changes to the employee's job, or take disciplinary action against the employee.

3. Keep fit notes confidential

Fit notes are confidential documents. Employers and HR professionals are required to keep fit notes confidential and to only share them with people who need to see them.

4. Provide reasonable adjustments

If a fit note says that an employee "may be fit for work with adjustments", employers are required to consider providing reasonable adjustments to help the employee return to work. Reasonable adjustments can include changing the employee's hours, providing them with a different workstation, or providing additional training.

Failure to comply with the legal obligations

Employers and HR professionals who fail to comply with the legal obligations regarding fit notes could be liable to legal action. This could include claims for unfair dismissal, discrimination, or breach of contract.

Employers and HR professionals need to know their legal obligations regarding fit notes. By understanding these obligations, employers and HR professionals can help to protect the rights of both employers and employees.

The role of fit notes in building a healthy workplace culture

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A healthy workplace culture prioritizes its employees' physical and mental well-being while fostering a positive and productive work environment. Fit notes play a crucial role in creating such a culture. Here's how:

  • Promote transparency: Fit notes encourage an open dialogue about health and well-being between employees, healthcare professionals, and employers. This transparency is key in fostering trust and understanding, essential elements of a healthy workplace culture.

  • Support accommodations: Fit notes often recommend adjustments or accommodations for employees. When employers act on these recommendations, they value their employees and are committed to supporting them. This not only aids the individual employees but also promotes an inclusive and supportive culture.

  • Encourage empathy: Fit notes can serve as a reminder that employees, like anyone else, can face health challenges. By understanding and responding to these situations, employers foster a culture of empathy and compassion.

  • Mitigate burnout: By ensuring employees take the necessary time off to recover from illness or medical conditions, fit notes help to prevent burnout, reduce stress levels, and promote overall well-being. This is crucial for creating a culture where health is prioritized.

    Useful Read: Stress Leave from work: Implications and Best Practices

  • Foster resilience: When employers act effectively on fit notes, it can help foster team resilience. Seeing that health issues are managed effectively can give employees confidence that they will be supported if they face similar challenges.

  • Build trust: Timely and effective handling of fit notes can significantly enhance employees' trust in their organization, knowing their health and well-being are taken seriously. Trust is a cornerstone of a strong and healthy workplace culture.

In essence, fit notes are not just administrative or legal necessities; they are tools that can be used to build and maintain a healthy workplace culture.


Understanding and effectively managing fit notes is crucial in creating a healthy, supportive, and productive workplace.

As HR professionals, our role in translating these medical notes into actionable steps is key to building employee trust and resilience. 

Let's prioritize employee health and well-being, as they form the backbone of every successful organization.

Frequently Asked Questions

  • Yes, an employee can return to work before the expiry date on their fit note if they're feeling well enough to do so. It's a common misconception that employees must stay off work until the fit note ends. 

  • Fit or sick notes can be issued for physical and mental health conditions. Any health issue that impacts an employee's ability to perform their work, whether physical or mental, can be a valid reason for a fit note. 

  • No, they don't need to. Employees can self-certify their absence for the first seven days of sickness absence without a fit note. This allows time for an employee to seek medical attention and receive a fit note if necessary. The fit note is generally required for sickness absences that last more than seven days. 

Rinaily Bonifacio

Written by:

Rinaily Bonifacio

Rinaily is a renowned expert in the field of human resources with years of industry experience. With a passion for writing high-quality HR content, Rinaily brings a unique perspective to the challenges and opportunities of the modern workplace. As an experienced HR professional and content writer, She has contributed to leading publications in the field of HR.


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