Time off for medical appointments: what employers should allow, pay and record

Start with the ordinary rule, then check for an exception

There is no general legal right to time off work for an ordinary medical, dental or hospital appointment. Acas says employees should check their contract and relevant workplace policies. Many employers allow reasonable time where an appointment cannot be rearranged, but the time may be unpaid. An employer can choose a more generous arrangement, including paid time, flexible hours or making up the time by agreement.

That ordinary rule is only the starting point. Paid time off for antenatal care has specific statutory rules. Disability-related appointments can engage the Equality Act duty to make reasonable adjustments. If the person is too unwell to work, the absence may be sickness rather than appointment leave. An employer-arranged occupational health assessment should also follow the organisation's stated process. Managers should classify the request before applying a pay or attendance code.

A policy should say who approves the request, how much notice is expected, whether time is paid, which alternatives can be agreed and where the decision is recorded. It should also warn managers to refer pregnancy, disability or recurring-treatment cases to HR rather than applying the ordinary rule without thought.

Acas: time off for medical appointments ↗ · Related guide: antenatal appointments at work →

Decide what time is actually needed

Ask for the appointment time and the expected period away from work, including necessary travel. Do not assume every appointment can be booked outside working hours; NHS and specialist clinics often offer limited choice. Equally, a request for a full day does not have to be accepted without discussion where the appointment and travel need much less time.

Consider practical options: a later start, earlier finish, extended break, shift swap, temporary home working or agreed unpaid time. For a North East employee travelling from a manufacturing site to a specialist clinic in Newcastle, Durham or Middlesbrough, reasonable travel may be a material part of the request. Record the arrangement clearly so payroll, the manager and the employee use the same hours and pay treatment.

Consistency matters, but consistency does not mean identical outcomes. Appointment availability, travel, operational cover and the employee's circumstances may differ. Use the same decision factors, explain departures from the normal policy and avoid making assumptions about whether an appointment is important based on how serious the condition sounds to a manager.

Disability can change the legal position

The Equality Act 2010 requires employers to make reasonable adjustments where a disabled worker would otherwise be placed at a substantial disadvantage. Acas gives paid time off for medical appointments and treatment as an example of an absence adjustment. EHRC guidance also gives the example of allowing time during working hours for rehabilitation, assessment or treatment.

This does not create a blanket entitlement to unlimited paid appointments. The employer should discuss the individual's disadvantage, the likely frequency and duration, the effectiveness of the proposed adjustment and the impact on the organisation. A short trial with a review date can be useful where the pattern is uncertain. Record what has been agreed, who will review it and what should happen if treatment changes.

Consider the attendance system as well as the immediate time off. It may be reasonable to record disability-related appointment time separately, adjust trigger points or exclude agreed disability leave from a routine warning. A rigid policy that allows ordinary appointments but penalises recurring disability treatment can create a discrimination risk even if the same wording is applied to everybody.

Acas: reasonable adjustments ↗ · EHRC: examples of workplace adjustments ↗ · Related guide: occupational health referrals →

Keep evidence requests proportionate and private

There is no general legal requirement for an employee to provide proof of an ordinary medical appointment. Acas says voluntary proof, such as a hospital letter or appointment text, can help the parties agree the time needed. A policy may ask for reasonable confirmation, but the request should be proportionate and should not become a demand for a diagnosis, test result or full clinical letter.

Appointment information can reveal health data. The ICO says employers must be clear about why they need workers' health information and should only collect what is necessary. Limit access to people who need it for the decision, payroll or workplace support. Do not leave appointment letters in a shared manager folder or repeat clinical details in rota notes.

If medical advice is genuinely needed to decide fitness, adjustments or a return-to-work plan, use a proper occupational health or doctor's-report process with the worker's knowledge and permission. That is different from asking for simple appointment confirmation.

ICO: workers' health information ↗ · Related guide: employee record retention →

Separate appointments, sickness and treatment recovery

Attendance at an appointment is not automatically sickness absence. If the employee is fit to work before and after it, use the agreed appointment code. If they are unwell or recovering from a medically required operation, the usual sickness-absence and sick-pay rules may apply. Acas distinguishes medically required operations from purely elective or cosmetic procedures, while recognising that surgery described as elective can still be medically advised.

Do not require a fit note merely because an appointment took place. For sickness lasting seven calendar days or less, an employee can normally self-certify; fit-note rules apply to sickness absence, not every medical visit. Keep the categories separate so attendance data is accurate and managers do not trigger an absence process on the wrong basis.

For an occupational health appointment arranged by the employer, state in policy whether attendance is paid and how travel is handled. Acas recommends making the pay position clear and warns that withholding pay could disadvantage a disabled worker. A manager should not commission a health assessment and then treat attendance as unauthorised time away.

Acas: occupational health assessments ↗ · Related guide: fit notes for employers →

Medical-appointment decision checklist

Legal requirements and official guidance were checked on 27 October 2026. A short, well-written policy will not decide every case, but it gives managers a reliable route from request to recorded decision and makes exceptions easier to identify before a routine appointment becomes a dispute.

• Check the contract, medical-appointments policy and any established enhanced practice.
• Identify whether the request is ordinary, antenatal, disability-related, occupational health or sickness absence.
• Ask for the appointment time, expected absence and necessary travel—not unnecessary clinical detail.
• Consider workable alternatives without insisting an NHS or specialist appointment is moved.
• Agree whether time is paid, unpaid, made up or taken flexibly before it happens.
• Consider reasonable adjustments for disability-related treatment and attendance triggers.
• Keep proof requests proportionate and store any health information securely.
• Record the decision, reason, hours and review date so payroll and attendance records agree.
• Apply the same decision factors consistently and escalate unusual cases to HR.