The 7-day self-certification rule
For sickness absences of 7 calendar days or fewer (including weekends and bank holidays), employees can self-certify. They tell you they’re unwell, fill in a self-certification form when they’re back, and that’s enough. No GP appointment, no fit note.
From the 8th calendar day onwards, you can require a fit note from a registered healthcare professional. Day 1 is the first day the employee was unwell, even if it was a weekend. So if someone calls in sick on a Friday, day 8 is the following Friday.
You cannot ask for a fit note for short absences. You can require a self-certification form. Most employers ask for self-certs on return.
Who can sign a fit note in 2026
Until July 2022 only doctors could issue fit notes. Since the 2022 change, fit notes can also be signed by:
- Registered nurses
- Occupational therapists
- Pharmacists
- Physiotherapists
All fit notes (whether on paper or sent digitally) carry the same weight regardless of which profession signed them. The healthcare professional must record their profession on the form, and an employer cannot reject a valid fit note on the basis of who signed it.
“Not fit for work” vs “may be fit for work”
Every fit note has two boxes the healthcare professional ticks:
Not fit for work
Straightforward. The employee should not be at work for the period stated on the note. Pay SSP or company sick pay according to your policy.
May be fit for work
The healthcare professional thinks the employee could return with adjustments. The note will suggest a phased return, amended hours, altered duties, or workplace adaptations. As employer you must consider whether the suggested adjustments are reasonable and feasible — and have a conversation with the employee about it.
If you can’t accommodate the adjustments, the fit note functions as a “not fit for work” note for the duration.
How to record fit notes properly
Fit notes are health records. Mishandling them creates a GDPR liability and damages employee trust. The standard requirements:
Restricted access
Only HR and the relevant manager should be able to see fit note contents. Not the whole team.
Linked to absence record
Each fit note should link to the specific absence period it covers, not float on its own.
6-year retention
Keep for 6 years after the end of employment, then delete. Diary the deletion.
Audit trail
Log who viewed each fit note and when. Subject access requests need this.
Leavely handles all four of these by default — fit notes upload against the employee record, only the employee + their manager + admin can view, retention is configurable, and access is logged in the audit trail.
Frequently asked questions
When can an employer ask for a fit note in the UK?
For absences of 7 calendar days or fewer (including weekends), employees can self-certify — no fit note needed. From the 8th calendar day onwards, employers can require a fit note from a registered healthcare professional. The 7-day rule includes the day the employee first became unwell.
Who can issue a fit note in 2026?
Since July 2022, fit notes can be issued by GPs, registered nurses, occupational therapists, pharmacists and physiotherapists. Before that change only doctors could sign one. The healthcare professional must record their profession on the form.
What does "may be fit for work" mean on a fit note?
It means the healthcare professional thinks the employee could return to work with adjustments. The fit note will suggest options like a phased return, altered hours, amended duties or workplace adaptations. Employers should consider whether the suggested adjustments are reasonable and feasible.
Can employers reject a fit note?
No. A fit note is a medical opinion and must be accepted at face value. If an employer believes the absence is not genuine they have other routes — Occupational Health referral, capability proceedings — but they cannot simply refuse to accept a fit note from a registered healthcare professional.
How long should employers keep fit notes?
Six years after the end of employment. Fit notes are health records and fall under data protection law — store them securely, restrict access, and delete after the retention period. Leavely stores fit notes against the employee record with role-based access by default.
Can an employee return to work before their fit note expires?
Yes. The fit note states the period the healthcare professional believes the employee will be unfit to work, but the employee can return earlier if they feel better. A new fit note is not required to come back, only to extend the period off.
Do you need a fit note for COVID absences in 2026?
COVID is now treated like any other illness. The standard 7-day self-certification rule applies, and a fit note is required from day 8 onwards if the employee is still unable to work. There are no special COVID-specific rules in 2026.