Fit Note Policy

Introduction

We understand that many patients expect their GP to provide a sick note (also known as a fit note) after any illness or hospital contact.  However, this is not always appropriate, and we would like to clarify the current guidance and our practice policy to help avoid any confusion or frustration. Kindly note that a sick note is a legal document, and it is issued by a healthcare professional based on clinical information and professional assessment. 

Who Should Issue Sick Notes?

Guidance has been developed by the government in consultation with the Local Medical Committee, the British Medical Association and patient representatives clarifying responsibility for issuance of Fit notes. Through this guidance, it has been ascertained that the responsibility for issuing fit notes lies with the treating or managing healthcare professional—the clinician who is actively overseeing your care.This is to ensure that the fit note is accurate and based on up-to-date medical knowledge of your condition.

Supporting Documents

For your reference, the following documents outline this guidance in more detail:

• Government policy on fit notes - The fit note: guidance for patients and employees
• Fit Note guidance for Healthcare professionals - Getting the most out of the fit note: guidance for healthcare professionals
• Referral to Specialist leaflet of the Local Medical Committee (LMC) what to expect
• What happens when you are referred by your GP to see a Specialist

GP practices are under significant pressure, and issuing fit notes adds to this burden. In many cases, we are not the best-placed clinicians to assess your condition if we have not been directly involved in your recent care.
Assessing your fitness to work without sufficient information can be both inaccurate and unsafe, and in some cases, it goes against national guidance.

Therefore, in keeping with the aforementioned guidance Penrhyn  Surgery will not issue sick notes for the following categories:

Categories of Inappropriate Sick Note Requests

1, The contractual responsibility lies with the treating heathcare professional

Please do not request a sick note from us following

1. Attendances at A&E
2. Inpatient hospital stays/ admission
3. In patient stays for procedures or surgical operations. 
4. Sick note extensions following expiration of a Fit note, originally issued in the hospital/community. 
5. Outpatient appointments (e.g., follow-ups with specialists)
6. Attendance at Community based services, such as:

• Diabetic clinics
• Physiotherapy/MSK services
• Dermatology services

7. Attendance at Mental health services (including inpatient and outpatient care)

In addition, we will not issue Fit notes for 
8. Fit note requests without any details
9. Non-medical reasons
10. Fit note requests, stretching beyond medical justification
11. Situations where a Fit note isn’t required
12. Requests when the patient has not been seen by any healthcare professional for the illness in question 
13. Requests for illnesses that have not been reviewed in a significant period of time
14. Illnesses within the first 7 days – these should be self-certified using the appropriate form for employers

Please note GPs do not issue documentation stating that you are Fit to return to work. 

If we consider your Fit Note request to be inappropriate, we may 

• Send you a refusal text/communication which outlines why we have refused the request and guidance on what to do next. This may include contacting the hospital, clinic, or specialist team that provided your care
• Redirect you to the appropriate support (HR policies, carers’ leave, bereavement support occupational health, citizens’ advice, etc.).

Examples of inappropriate sick note requests:

Non-medical reasons

• “I need time off because my partner is ill” (carer’s leave may apply- please discuss with your employer, but not a sick note).
• “I don’t like my job / I need a break from my boss.”
• “I want time off for a holiday/wedding/festival/football match.”
• “I need a sick note so I can cancel my gym membership/holiday / flight.”
• “My landlord wants a note saying I need quieter neighbours.”
• “The court is asking for a note saying I’m too stressed to pay fines.”

Situations where a note isn’t required

• “I’ve only been off for 2 days — but my employer insists on a doctor’s note.” (Fit notes are only legally required after 7 consecutive calendar days off work.)
• “My child is unwell, I need a note for my employer.” (Not appropriate — this is carer’s leave, not sickness absence.)

Stretching beyond medical justification

• “I’m tired of work — can you give me 2 months off?” without a health problem.
• Requesting back-dated fit notes for long periods with no prior consultation or evidence.
• Asking for notes for conditions that don’t impair fitness for work (e.g., a mild cold that doesn’t require absence).

Frequently Asked Questions

"Why can’t my GP just issue the sick note?"

• GPs are being asked to take on tasks that should be completed by the treating team, which creates a huge administrative burden and diverts our time away from providing direct clinical care to our patients. 
• Sometimes patients have been told by their specialist that they are fit for work, but they disagree. In these situations, your concerns should be taken back to the specialist—not to your GP.
• Unfortunately, in a small number of cases, patients are seeking fit notes inappropriately, and this undermines the system designed to support genuine need.

Other requests for time off work:

Occupational/Work-Related Conditions 

• This is separate issue and doesn’t always require a GP sick note. Occasionally we may issue a “a may be fit for work” certificate.
• For some workplace issues (especially ongoing or safety-related), you may require your employer to refer you to an Occupational Health (OH) advisor.

Bereavement leave (compassionate leave) 

We are sorry for your loss, however this an employment/HR matter, not a medical one. A fit note is only used if you’re unable to work due to a medical condition.  Most workplaces have policies granting paid or unpaid compassionate leave for the death of a close relative. We advise you to speak with your HR about compassionate leave policy.

Summary

Please ensure you direct your fit note request to the appropriate healthcare provider.

It is important to note that the issuance of a Fit note is an administrative and we may take up to 10 working days to review your request. 

Unfortunately, if your request is reviewed and deemed inappropriate and declined after 10 working days, this may lead to frustration. Therefore, please ensure your request is appropriate by reviewing this guidance closely and taking appropriate action as required.   

We appreciate your understanding and cooperation in helping us to deliver safe, effective care for all our patients.

Management Team
Penrhyn Surgery
September 2025