Important Changes to the Fit Note

 From 1 July 2022, the law on fit notes was updated.  Fit notes can now be issued by nurses, occupational therapists, pharmacists, and physiotherapists in addition to doctors (so long as they are discussing your fitness to work with you).  The changes are made with the purpose to reduce the pressure on doctors (particularly GP’s) and make the process more flexible and efficient. In addition to this, it will enable patients to see the most relevant healthcare professional.  The individual signing off the fit note should still be treating the employee under NHS services.

This does not mean that an employee can ‘pop’ to a chemist and get signed off.  The fit notes can only be issued in a general practice or hospital setting and the medical professional must still assess whether the patient is fit to work.  They cannot be issued on request or over the counter.

Healthcare professionals still cannot issue fit notes during the first 7 calendar days of sickness absence (employees are still to self-certify for this time).  If, in accordance with your own sickness policy, you require medical evidence for those first seven days of absence, it is your own responsibility to arrange and pay for this as an organisation.

As advised by the Government, the basics on dealing with fit notes are as follows:

  1. Check whether your employee’s healthcare professional has assessed that they are not fit for work or may be fit for work.
  2. Check how long your employee’s fit note applies for, and whether they are expected to be fit for work when their fit note expires.
  3. If your employee may be fit for work, discuss their fit note with them and see if you can agree any changes to help them come back to work while it lasts.
  4. If your employee is not fit for work, or if they may be fit for work but you can’t agree any changes, use the fit note as evidence for your sick pay procedures.
  5. Consider taking a copy of the fit note for your records (your employee should keep the original).

Together with the changes on who can issue fit notes, came the removal of the requirement for fit notes to be signed in ink. There will be a transitional period during which both the 2017 and 2022 versions of the fit note will be legally valid which relevant IT systems are updated and stocks of paper fit notes in hospitals are replaced.

Guidance issued by the DWP

 Also on 1 July 2022, the DWP issued guidance on “getting the most out of the fit note” –

Getting the most out of the fit note: guidance for healthcare professionals – GOV.UK (  The guidance covers the changes set out above but also looks at factors factors that should be considered when assessing an individual’s fitness for work.  There is assistance on how the free text section should be completed and the importance of providing employers with practical advice. The guidance for employers (link word to Fit note: guidance for employers and line managers – GOV.UK ( and employees (link word to Fit note: guidance for patients and employees – GOV.UK ( has also been updated.

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