Sick leave in the UK: when you need a fit note and what 'may be fit for work' means

You fall ill, and the questions start: do you need a note, from which day, who issues it, and what happens if it says "may be fit for work". Here is how sick leave works in the UK.

Do you need a note from day one?

No. For an absence of 7 days or less no fit note is needed. The employee self-certifies. The employer may ask you to confirm the absence on your return, usually by an agreed method such as a form or an email.

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When does a note become compulsory?

When you have been off for more than 7 days in a row. And every consecutive day counts, including weekends and bank holidays, not just working days. This trips people up: they count shifts and leave it too late to see someone.

Who can issue a fit note?

Not only a GP. A fit note can be issued by a GP, a hospital doctor, a registered nurse, an occupational therapist, a pharmacist or a physiotherapist, after assessing your fitness for work. That widens the list of people you might reach sooner than your own surgery.

What does "may be fit for work" mean?

A note says either "not fit for work" or "may be fit for work". The second does not mean you must simply turn up as normal. It means the employer should discuss adjustments with you: different hours, different tasks, a different workload.

And crucially: without agreement, the employee should be treated as not fit for work. A failure to agree is not read against you.

Can anything replace a fit note?

With the employer's agreement, an Allied Health Professional Health and Work Report can be used instead. That is an option by agreement, not an automatic substitute.

Who keeps the original?

You do. The employer may take and keep a copy, but the original stays with the employee. Worth knowing in advance if someone asks you to hand it in to HR.

What if you fall ill during annual leave?

Leave can be switched to sick leave. Those days are then paid as Statutory Sick Pay and count towards holiday pay. The exceptions are employees who do not qualify for SSP, and those receiving occupational sick pay instead.

How much is paid while off sick?

The statutory minimum is Statutory Sick Pay, up to £123.25 a week. The employer pays it, for up to 28 weeks. Less than the statutory amount cannot be paid.

More can be: an employer may run its own sick pay scheme, and the terms will be in the employment contract. So the first document to open at the start of a long absence is that contract — the gap between the statutory minimum and a company scheme is often several times over. Agricultural workers have separate sick pay rules.

In short

Up to 7 days, self-certify. More than 7 consecutive days, counting weekends, you need a fit note. More professions than you think can issue one. "May be fit for work" starts a conversation about adjustments rather than obliging you to return. The original stays with you.

Checked against GOV.UK on 27 October 2026.