A fit note lands in a manager's inbox marked ‘may be fit for work’. That is not an instruction to put the employee straight back on normal duties, and it is not a reason to leave them absent until the note ends. The note gives medical advice about how a health condition affects fitness for work in general. The employer still needs a sensible conversation about the actual role, practical changes, health and safety, pay and review dates. Used properly, the note starts a plan; it does not replace one.
Know when a fit note is—and is not—required
For the first seven calendar days of sickness, an employee does not need a fit note or other clinical proof. They can self-certify in the way agreed with the employer. Count non-working days, weekends and bank holidays within the continuous period. A fit note is normally required only when sickness lasts for more than seven days in a row.
Managers should therefore avoid demanding a GP letter on day three simply because an internal form has not been completed. Apply the organisation's notification and self-certification process consistently, then ask for appropriate medical evidence when the absence passes the seven-day point. This keeps the evidence request proportionate and avoids sending employees back to healthcare services unnecessarily.
GOV.UK: taking sick leave and self-certification ↗ · Related guide: holiday entitlement during sickness absence →
Check the document before deciding what happens next
A valid fit note may be issued by a doctor, registered nurse, occupational therapist, pharmacist or physiotherapist who is suitably trained and involved in the person's care. It can be handwritten, printed or sent digitally. Check that it identifies the issuer by name or signature, states their profession and practice address, covers the relevant dates and says either ‘not fit for work’ or ‘may be fit for work’. The employee should retain the original; the employer can keep a secure copy.
Read the functional advice, not just the diagnosis. The useful question is what the employee may be able to do safely and reliably. The note may indicate a phased return, altered hours, amended duties or workplace adaptations, and the comments box may explain the effects of the condition. A fit note does not design the final arrangement for a particular job. The manager and employee do that together, using their knowledge of the role and workplace.
‘May be fit’ means discuss a workable plan
Start with the employee's current capabilities and the essential parts of the job. Could shorter days, different start times, home working, temporary removal of a task, different equipment, additional supervision or a phased increase in duties make work feasible? In a North East engineering firm that might mean removing driving or manual handling temporarily; in a professional office it might mean fewer client calls and more breaks. Do not promise an arrangement before checking operational and safety implications.
Agree the change, its start date, expected duration, pay position, contact person and review point in writing. Temporary adjustments should be specific enough for the employee and their supervisor to understand. If the suggested change cannot reasonably be provided, the same ‘may be fit’ note can be treated as evidence that the employee is not fit for work. The employee does not need to return to the healthcare professional for a replacement note merely to change the wording.
The fit-note discussion and the Equality Act duty are connected but not identical. A fit note does not decide whether somebody is disabled. Where the employee may meet the legal definition, the employer must consider reasonable adjustments and should not dismiss an option simply because it is inconvenient. Record what was explored, what was agreed and why an option was or was not workable.
Acas: reasonable adjustments ↗ · Acas: phased returns to work ↗
Handle expiry and an early return without inventing another certificate
There is no ‘fit for work’ certificate. If an employee is fit to return when the note expires, they normally return without a separate sign-off. If they remain unwell, they should obtain further medical advice and, where appropriate, another fit note. Build a short return-to-work meeting into the process so the manager can confirm current capability, any agreed changes and the next review date.
An employee can also return before the fit note expires without first going back to the healthcare professional. That does not mean the employer should ignore the note. Discuss what has changed, take account of its advice, complete any relevant safety procedures and consider whether a risk assessment is needed. This matters particularly where the role involves driving, machinery, lone work, medication effects, physical handling or responsibility for other people's safety.
Give managers a clear fit-note process.
HR + SAFETY can help North East SMEs assess ‘may be fit’ advice, document practical adjustments and handle difficult sickness-absence decisions consistently.
Discuss fit-note supportUse occupational health when the workplace question is unclear
A fit note can be enough for a straightforward short-term change. Occupational health becomes useful when restrictions are unclear, absence is repeated or prolonged, work may be contributing to the condition, the role carries material safety consequences, or managers need advice about sustainable adjustments. A focused referral should explain the job demands and ask practical questions about function, likely duration, adjustments and review—not ask occupational health to decide an employment outcome.
Obtain the employee's informed consent and share only what is necessary. The report should support the employer's decision-making; it does not replace consultation with the employee. Where medical evidence and the employee's account differ, pause, clarify and avoid jumping from uncertainty to capability action.
Related guide: occupational-health referrals for employers →
Fit-note checklist for managers
Legal requirements and official guidance were checked on 8 October 2026. Keep the document and the manager's working plan separate in purpose: the fit note supplies medical evidence and advice; the employer's record should show the workplace discussion, decision, reasons and review. Store health information securely, limit access and retain it only for a justified period.
- Use self-certification for sickness of seven calendar days or less.
- Check the dates, fit-for-work outcome and issuer details on the note.
- Focus on functional effects and the actual demands of the role.
- Discuss phased hours, duties, location, equipment and support where relevant.
- If ‘may be fit’ changes are not workable, treat the note as ‘not fit’ evidence.
- Consider the separate duty to make reasonable adjustments for disability.
- Confirm agreed changes, pay, ownership and review dates in writing.
- Assess safety risks before an early or adjusted return where the work warrants it.
- Seek occupational-health advice when the workplace questions remain unclear.
- Keep fit notes and health information confidential with genuine need-to-know access.
Treat a fit note as the start of a structured workplace decision. Check the evidence, discuss function rather than assumptions, agree and review practical changes, address any safety or disability issues, and record why the resulting plan is reasonable.
This guide provides general information for UK employers. It is not legal advice and should not replace advice based on the facts of a specific matter.