Number of UK fit notes increases 11% to hit record high 10.4m

Number of UK fit notes increases 11% to hit record high 10.4m

22nd March 2023

The number of fit notes issued by NHS medical professionals hit a record high of 10.4m, increasing 11% in 2021/22, shows an analysis of data by GQ|Littler, the specialist employment law firm.

Fit notes are issued by medical professionals and offer medical opinion as to that person’s fitness for work. They are issued if a person is unable to work at all, or unable to fully perform their role, for health reasons. Fit notes also suggest accommodations employers could make, for example reducing working hours.

GQ|Littler says there are likely to be several factors behind the rise in fit notes issued, including (i) a return to employers seeking fit notes, which were sometimes difficult to obtain during the pandemic; (ii) the economic climate and repercussions of the pandemic leading to more mental health related absences; (iii) an increase in illnesses as restrictions eased and people mixed more again; and (iv) employers getting people back into the workplace once COVID restrictions ended.

Employees may self-certify their absence from the workplace for up to seven consecutive days of illness. For absences of more than seven days employers can request a fit note.

Sophie Vanhegan, Partner at GQ|Littler, says many companies were more relaxed about requiring fit notes for extended absences during the pandemic, when it was difficult to see a doctor. However, they are now becoming more rigorous about getting certification from medical professionals.

A change in legislation in July 2022, has enabled nurses, occupational therapists, pharmacists, and physiotherapists to certify fit notes, in addition to doctors. This was designed to alleviate pressure on GPs.

Sophie Vanhegan says: “Employers are now back to following their policies of requiring fit notes for longer periods of absence.”

“The cost-of-living crisis and challenging economic climate is also having an effect on the mental health of employees, which could lead to an even further rise in the number of fit notes issued for mental health related absences.”

“It’s essential that companies take a proactive approach to supporting employee health and mental wellbeing at work to try to minimise employee sickness absence. Offering workplace support and encouraging open dialogue about health issues can help to flag issues early on, before they develop into long-term absence issues.”

The number of fit notes issued by the NHS in England



*Year-end September 30


About GQ|Littler

GQ|Littler is a leading specialist employment law firm and the London office of  Littler, the largest global employment and labour law practice devoted exclusively to representing management. With more than 1,700 lawyers in 100 offices across 28 countries, Littler serves as the single source solution provider to the global employer community. 

Offering risk-based contentious and non-contentious advice, our legal expertise includes employment, immigration, data privacy and employee tax and incentives. Our client base spans a wide range of sectors including financial services, technology, healthcare, professional services and luxury goods, in the UK and internationally. 

GQ|Littler is recognised as a leader in its field by both Chambers & Partners and Legal 500. The firm is described in Legal 500 2023 as “undoubtedly the best boutique firm specialising in employment law for employers in London.” For expert insight into the pandemic’s impact on the future of the European workplace, including how employers are responding to a myriad of workplace issues and ever-changing regulations, see Littler’s European Employer Survey Report


This story was covered in HR News and People Management.