Sick note rules in the UK: the complete 2026 guide
The rules around sick notes in the UK are not complicated, but they are scattered – a bit in employment law, a bit in NHS guidance, a bit in whatever your employer’s absence policy says. And several of them changed in April 2026.
This is all of it in one place: who needs a note and when, who can issue one, how long it can cover, what it can and cannot be backdated to, what you get paid, and what your employer is actually allowed to require.
The rules around sick notes in the UK are not complicated, but they are scattered – a bit in employment law, a bit in NHS guidance, a bit in whatever your employer’s absence policy says. And several of them changed in April 2026.
This is all of it in one place: who needs a note and when, who can issue one, how long it can cover, what it can and cannot be backdated to, what you get paid, and what your employer is actually allowed to require.
The rules at a glance
| Point in the absence | What the rules say |
|---|---|
| Day 1 | Tell your employer as soon as you reasonably can. Statutory Sick Pay starts from today. |
| Days 1 to 7 | You self-certify. Calendar days, including weekends and bank holidays. Your employer cannot require a doctor’s note. |
| Day 8 onwards | Your employer can require a fit note from an eligible healthcare professional. |
| Within 7 days | You must have notified your employer, or within any shorter deadline their policy sets, to protect your sick pay. |
| First 6 months of a condition | A single fit note can normally cover up to 3 months at a time. |
| After 6 months | A single fit note can cover a longer period where clinically appropriate. |
| After about 4 weeks | Usually treated as long-term sickness. Occupational health and review meetings become likely. |
| 28 weeks | Maximum period Statutory Sick Pay is payable for one period of sickness. |
What changed in April 2026
The Employment Rights Act 2025 made three significant changes to sick pay, all of which took effect on 6 April 2026. A lot of guidance online still describes the old system.
| Rule | Before April 2026 | Now |
|---|---|---|
| When sick pay starts | Day 4 – the first three days were unpaid “waiting days” | Day 1 of sickness |
| Minimum earnings | You had to earn at least the Lower Earnings Limit to qualify | No earnings threshold – all employees qualify |
| The rate | A flat weekly rate only | The lower of £123.25 a week or 80% of average weekly earnings |
The 7-day self-certification rule, the fit note rules and the 28-week limit were not changed.
Days 1 to 7: self-certification
For the first week of any sickness absence you certify yourself. There is no doctor involved, no appointment, and no charge.
Three details people get wrong:
- They are calendar days, not working days. Weekends and bank holidays count towards the seven. An absence starting Thursday is self-certified to the following Wednesday.
- Your employer cannot insist on a doctor’s note during that week. They can require you to complete their own form or confirm the details in writing, but not to see a GP.
- There is no official form. HMRC’s SC2 was withdrawn. Any written statement with your name, the dates and a brief reason is valid.
Our free self-certification letter generator produces a completed letter in about a minute, and there is a blank SC2-style form to download if you prefer to fill one in by hand.
Day 8 onwards: fit notes
From the eighth day, your employer can require a fit note – formally a Statement of Fitness for Work, and still called a sick note by almost everyone.
The note states that a healthcare professional has assessed you, gives a reason, and says either that you are not fit for work, or that you may be fit for work taking account of certain advice. That second option is where the doctor can suggest a phased return, altered hours, amended duties or workplace adaptations.
“May be fit for work” is advice, not an instruction. If your employer cannot accommodate the suggestions, the note is treated as though it said not fit for work.
Who can issue a fit note?
Since July 2022, fit notes are not restricted to doctors. They can be issued by:
- Doctors
- Registered nurses
- Occupational therapists
- Pharmacists
- Physiotherapists
Fit notes also no longer require a handwritten signature, which is why a digital note sent by email is perfectly valid. A note issued after a video consultation is as valid as one issued face to face, provided a genuine assessment took place.
That last point is the one worth being careful about. Some online services issue certificates from a questionnaire alone with no clinician involved, and employers are increasingly sceptical of them. What makes a note valid is the assessment behind it.
How long a fit note can cover
| Stage of the condition | Maximum a single note can cover |
|---|---|
| First 6 months | Up to 3 months at a time |
| After 6 months | A longer period, where clinically appropriate |
Within those limits the length is a clinical judgement. A first note for a short-term illness is commonly one or two weeks.
Notes can be extended as many times as necessary – there is no limit on how long you can be signed off. Arrange the next one before the current one expires, because a gap in certification is a gap in your evidence and can hold up sick pay.
Backdating: what is and is not possible
A fit note can be backdated where it is clinically appropriate, but not indefinitely and not on request.
The principle is that a doctor certifies a period they have assessed. They can date a note from an earlier assessment, or from a date they can reasonably judge you were unfit based on what you tell them – but they cannot certify weeks they know nothing about. In practice most clinicians will backdate by a few days rather than weeks.
If an absence has already passed and you have no note for it, that is a conversation with your employer rather than a document problem. The first 7 days are covered by self-certification retrospectively in any case, so a short absence rarely needs one.
Sick pay rules
| Rule | Detail |
|---|---|
| When it starts | Day 1 of sickness |
| Weekly rate | The lower of £123.25 or 80% of average weekly earnings |
| Who qualifies | Employees, including part-time, agency and zero-hours. No minimum earnings. |
| Which days are paid | Your qualifying days – the days you would normally have worked |
| Maximum | 28 weeks per period of sickness |
| Linked absences | Absences 8 weeks apart or less count towards the same 28 weeks |
| Notification deadline | Your employer’s deadline, or 7 days at the latest |
| When it ends | Your employer issues form SSP1 so you can claim ESA or Universal Credit |
| Tax | Paid through payroll and taxed like normal wages |
| Self-employed | Not covered – there is no employer to pay it |
Many employers pay more than the statutory minimum under their own scheme. Check your contract. Work out what you will be paid.
What your employer can and cannot require
| Can your employer… | Answer |
|---|---|
| Require a doctor’s note during the first 7 days | No |
| Require a fit note from day 8 | Yes |
| Require you to complete their own absence form | Yes |
| Require you to follow their notification procedure | Yes |
| Ask for a general reason for your absence | Yes |
| Demand a diagnosis or your medical records | No |
| Contact your GP without your consent | No |
| Contact you while you are signed off | Yes, if reasonable |
| Require you to work while signed off | No |
| Hold a return to work discussion | Yes |
| Refuse to pay SSP because you self-certified | No |
| Count pregnancy-related absence towards triggers | No |
| Dismiss you for a single sickness absence | No |
NHS and private fit notes
An NHS GP must issue a fit note free of charge when you have been off more than 7 days. For notes covering the first 7 days, or notes for other purposes, a practice may charge – that is a private service and is not covered by the NHS contract.
Private fit notes from a GMC-registered doctor are valid medical evidence for an employer in the same way. The one difference worth knowing: a private certificate is not an NHS Med3 form, and some benefit claims specifically require the Med3 issued by an NHS GP. If your note is for a benefits application rather than your employer, check which is needed.
Repeat and linked absences
Each new period of sickness gets its own 7 days of self-certification, and there is no annual cap on self-certifying.
For sick pay, absences 8 weeks apart or less are linked and count towards the same 28-week maximum. Separately, many employers score attendance patterns using the Bradford Factor, which weights frequent short absences far more heavily than one long one – you can work out a Bradford Factor score and see what it means.
Returning to work
Nothing in the rules requires you to be fully recovered before returning. A fit note marked “may be fit for work” with altered hours or amended duties is the normal mechanism for a gradual return, and most employers will complete a return to work form on your first day back.
Build a phased return plan if you are coming back after a longer absence, and download a free return to work form if your employer does not have one.
Free tools for each stage
- Self-certification letter generator – for days 1 to 7
- Sick pay calculator – what you will actually be paid
- How to call in sick – what to say, with text and email examples
- Return to work form – free template to download
- Phased return planner – build a week-by-week plan
- Bradford Factor calculator – absence scoring explained
If you need a fit note and cannot get a GP appointment in time, Health Works issues them the same day after a short video consultation with a GMC-registered doctor. Get a fit note online.
Frequently asked questions
How many days can you be off sick without a sick note?
Seven calendar days, including weekends and bank holidays. You self-certify for those days and your employer cannot require a doctor’s note. From day 8 they can.
Can my employer ask for a sick note after 3 days?
No. They can ask you to complete their own self-certification form or confirm the details in writing, but they cannot require a doctor’s note until day 8.
Who can issue a fit note in the UK?
Doctors, nurses, occupational therapists, pharmacists and physiotherapists. Fit notes no longer need a handwritten signature, so a digital note is valid.
How long can a sick note last?
In the first six months of a condition a single note can normally cover up to three months. After six months it can cover longer where clinically appropriate. There is no limit on how many times a note can be extended.
Can a sick note be backdated?
Where clinically appropriate, yes, but not indefinitely. A doctor certifies a period they have assessed, so in practice backdating is usually limited to a few days rather than weeks.
Do you get paid from the first day off sick?
Yes. Since 6 April 2026, Statutory Sick Pay is paid from day one. The three unpaid waiting days were abolished, and the minimum earnings threshold was removed.
Is a private sick note valid?
Yes, for an employer. A fit note from a GMC-registered doctor is valid medical evidence whether the consultation was NHS or private, in person or by video. Some benefit claims specifically require an NHS-issued Med3.
Does my sick note have to say what is wrong with me?
It must give a reason and cannot be blank, but only in general terms. You are not required to discuss symptoms, treatment or personal details with your employer beyond what the note says.
What happens after 28 weeks of sick pay?
Statutory Sick Pay stops and your employer issues form SSP1, which you use to claim Employment and Support Allowance or Universal Credit. Your employment continues unless it is formally ended.
Can I be sacked for taking sick leave?
Not for a single absence. Capability dismissal after long-term absence is possible, but the employer must follow a fair process, obtain medical evidence and consider reasonable adjustments.
Last reviewed August 2026 by Dr Eoghan Mac Sweeney, GMC 4776354.
