Sick and fit notes (Med3) are essential tools in general practice for certifying a patient’s fitness for work. This guide outlines the key responsibilities of GPs, the process for issuing notes, and common queries related to their use.
A Med3 certificate is only required if a patient has been absent from work for more than 7 calendar days (including weekends and bank holidays).
For absences of 7 days or less, patients should self-certify using form SC2, available from their employer or the government website.
A fit note should include:
The date of assessment (this can be the date of consultation or a past date based on the patient’s condition).
The condition that is affecting the patient’s ability to work.
Whether the patient is not fit for work or may be fit for work with adjustments.
The expected duration of the condition.
If a GP believes the patient could return to work with modifications, the fit note should include advice on:
Phased return to work
Altered hours
Amended duties
Workplace adaptations
It is not the GP’s role to enforce these adjustments; the employer is responsible for deciding if they can accommodate the suggested changes.
Fit notes can be backdated if necessary to reflect the start of an illness.
Fit notes should not be post-dated, as they are based on clinical assessment at the time of issue.
If a patient is under hospital care, the hospital team should issue the fit note, not the GP.
Discharge summaries should include appropriate certification where required.
GPs can issue private sick notes for patients who require documentation for statutory sick pay claims but are not obligated to do so.
Employers cannot insist on a Med3 for absences of 7 days or less.
A follow-up appointment may be necessary to review a patient’s condition before extending a fit note.
GPs should avoid issuing long-term fit notes without periodic reassessment.
Fit notes should be based on medical need; GPs should not issue them for non-medical reasons, such as workplace disputes.
Requests for retrospective fit notes should be based on medical records and clinical judgment.
Employers must not request a fit note for short-term absences.
Patients are responsible for informing their employer of their illness and following workplace sickness policies.
1. Can a GP refuse to issue a fit note?
Yes, if there is no medical justification. GPs are not obliged to issue fit notes upon request.
2. Can a fit note be used as evidence for benefits claims?
Yes, fit notes can support benefits claims, but the decision is made by the relevant agency, not the GP.
3. Can an employer override a fit note?
Employers can make their own decisions about workplace attendance but should consider medical advice given in the fit note.
4. Can a fit note be issued after a telephone or video consultation?
Yes, if the GP has sufficient clinical evidence to support their decision.
Fit notes are an important part of managing work-related illness but should be issued appropriately and in line with guidance. Employers and patients must understand their responsibilities, and GPs should ensure they only provide fit notes where there is a clear medical justification.