A statement about how a health condition affects a patient’s fitness for work after an appropriate assessment.
An eligible healthcare professional working within their competence and responsible for the episode of care.
Issue only after an appropriate assessment and in line with current fit-note guidance.
The note is normally given to the patient to share for its intended purpose.
Usually not chargeable
A fit note records how a health condition affects fitness for work. It is not an occupational-health report, a benefits decision or a judgement about an employment dispute.
Clarify whether this is for an employer, Statutory Sick Pay, Universal Credit, or a duplicate. These are not interchangeable requests.
Ask about essential tasks, hours, travel, physical and cognitive demands, safety-critical duties and adjustments already tried.
Establish what the patient can and cannot do on a typical day. Assess relevant clinical and safety risks in the usual way.
Consider modified duties, altered hours, a phased return or workplace adaptations before deciding that no work is currently possible.
Link the duration to expected recovery, treatment and a meaningful review point. Record the evidence and reasoning in the consultation.
Open the image for a larger view. This is the official DWP sample form; patient-facing and clinical-system versions may be presented differently.
The Primary Care IT walkthrough begins in consultation mode with Add fit note, followed by a new “not fit” or “may be fit” note, or a duplicate/reprint.
Its sending workflow is a third-party example and may not match your current local setup. Use your practice’s approved secure process.
View the illustrated EMIS walkthroughThis external example shows how the main fields appear when populated. Treat it as orientation only, not recommended wording or current national guidance.
Open the supplied Med3 exampleUse this when the patient could work if suitable changes are available. Add practical functional advice and select the relevant options:
If the employer cannot make the changes, the note is treated as “not fit”. The patient does not need a replacement note.
Use this when your assessment supports that the patient cannot do any form of work at present—not simply because they cannot perform every part of their usual role.
Document the functional rationale, expected course and follow-up plan.
Do not extend automatically. Reassess current function, progress, treatment, barriers and the return-to-work plan. Longer absence may be justified, but each note still needs a clinical rationale and an appropriate review point.
Avoid assuming either that work is always harmful or that it is always therapeutic. Consider symptoms, risk, job demands, support and the patient’s view. Some people benefit from modified work; others may be unable to do any work at that time.
A fit note can support a benefits claim, but it does not determine work capability. Clarify the exact request, keep the certificate clinically grounded and do not use it as a substitute for a Work Capability Assessment or bespoke report.
Normal investigations do not by themselves prove that a patient has no functional limitation. Reassess the clinical picture, function, red flags and wider barriers; make a plan and seek senior or specialist input where appropriate.
“My role is to advise how your health affects work. I cannot decide your employer’s policy, but I can describe the functional restrictions clearly.”
“The evidence today suggests that some work may be possible with changes. If your employer cannot make those changes, this note is treated as saying you are not fit for work.”
“Before extending the note, I need to review what has changed, what support has been tried and the plan for recovery or return.”
If you are logged in, “Save note” keeps this note privately in your GP Navigator account so that it is available on your other devices. Without an account, it stays only in this browser. Do not include patient-identifiable information.
Check your practice workflow for electronic issuing, duplicate handling and who is expected to complete any associated benefits or occupational-health paperwork. A fit note is not a substitute for a bespoke report or an occupational-health assessment.
Function: what can the patient manage? Restriction: what should they avoid? Time: how long is the advice likely to apply?