Fit Notes

All About Fit Notes

The Fit Note replaced the ‘doctor’s medical certificate’ back in 2010. Even though Fit Notes have been around for all this time, we are often asked about them and what is expected from an employer when a doctor issues their employee with a fit note that makes recommendations.


Unlike the old ‘doctor’s note’, the Fit Note allows doctors to comment on possible adjustments or changes to the employee’s job/work that may allow them to continue working or return to work sooner. This recognises that employees do not necessarily need to be 100% fit to be able to do some work, indeed it is recognised that work can sometimes aid recovery from health problems.

The Fit Note will confirm if someone is not fit for work of any kind or may be fit for work, taking account of advice. The doctor may then advise something like a phased return (reduced hours or changed hours) or changes to the job role or other changes/recommendations.

Interesting Points About Fit Notes

There are some interesting points to be aware of when it comes to Fit Notes:

If you do make any adjustment, it is good practice and strongly recommended that you confirm any adjustments in writing and agree a review period.  This provides clarity and can prevent misunderstandings down the road.

Additional Points / Questions

What about when someone suddenly wants to return to work after an extended period of absence, but you are sceptical about their fitness – perhaps it coincides with the end of their SSP? Or if you do not think someone is fit to return.

 In these situations, it would be advisable to ask for further medical advice, possibly from an Occupational Health Adviser, in order to assess the individual’s fitness to return to work. Ideally, your contracts of employment should contain the clause to enable the employer to do so (although employees still need to give consent).

If an employee says they are fit to return to work, but you don’t think they are, can you just refuse to allow them to return?

If you refuse to let someone return to work when they say they are fit (and there is no current Fit Note covering the period of absence), then you can only do this if you suspend them on medical grounds. In this case, you must pay the employee their full pay. If you decide to just not to pay them, then this will be an illegal deduction, and they could make a claim for money not paid. This is why it is much better to get an opinion from an Occupational Health Adviser in such circumstances.

Actions / Final Comments

You should take a copy of an employee’s fit note for your records (the original belongs to the employee).

Always consider any recommendations made by a GP and if you cannot accommodate them, communicate the reason why to the employee.

Check your contract for a clause to request a medical report (e.g., from Occupational Health or the employee’s own GP – but please note employees must still give consent).

Angela Dansey

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