How long can a doctor give a sick note for? UK rules
Who can sign you off work, for how long, what it costs, and which evidence counts for sick pay and benefits. Checked against GOV.UK and DWP guidance.
The short answer. In the first 6 months of a condition, a doctor or other eligible healthcare professional can sign you off for up to 3 months on one fit note. After you have been off on professional advice for 6 months, there is no fixed limit if it is clinically appropriate. For the first 7 calendar days you need no note at all: you self-certify.
When do I need a sick note for work?
Not for a short absence. If you are off for 7 days or fewer, you do not need to give your employer a fit note or other proof from a healthcare professional, and it cannot be made a condition of Statutory Sick Pay. You tell them you are ill, and when you come back they can ask you to confirm it in writing. That is self-certification, and the self-certification guide covers the forms and the counting in detail.
The point that catches people out is how the days are counted. It is 7 days in a row, including weekends, bank holidays and any day you would not normally work. If you are still off on day 8, you need a fit note or other evidence your employer accepts.
Two other deadlines sit alongside this. You should tell your employer you are sick by the deadline in their policy, or within 7 days if they have not set one. And if you are claiming Universal Credit or Employment and Support Allowance (ESA), the benefit rules ask for a fit note once your health has stopped you working for more than 7 days.
If your employer wants a note sooner
Some employers ask for medical evidence inside the first 7 days. They can ask, but DWP guidance says that if a healthcare professional charges for it, the employer should cover the cost. NHS staff may also decline to write a fit note for the first week, because self-certification already covers it. See when a GP can refuse a sick note.
Who can sign you off, and for how long
The four kinds of sickness evidence used in UK workplaces, side by side. Where the answer depends on your employer, the table says so.
| Evidence | Covers which days | Maximum length | Cost | Accepted as SSP evidence | Accepted for Universal Credit or ESA |
|---|---|---|---|---|---|
| Self-certification (your own statement) | The first 7 calendar days of an absence, weekends and bank holidays included | 7 days in a row | Nothing to pay: no healthcare professional is involved | Yes. For the first 7 days your own statement is the evidence | Not on its own once you have been unable to work for more than 7 days |
| NHS fit note from a GP or hospital doctor | Absences of more than 7 days in a row. It is not required for the first 7 | Up to 3 months per note in the first 6 months. After 6 months off on professional advice, no fixed limit if clinically appropriate | Free if you have been ill for more than 7 days when you ask. A fee may be charged for 7 days or less | Yes | Yes |
| Fit note from a registered nurse, occupational therapist, pharmacist or physiotherapist | The same as a doctor’s fit note, where that professional chooses to issue one | The same limits as any fit note | The same NHS rules apply in primary care. High-street pharmacists do not have access to the fit note form | Yes | Yes |
| Private doctor’s certificate | The days the doctor’s assessment supports, including the first 7 if your employer wants evidence | Set by the doctor on assessment | Set by the provider (£47 for ours) | Depends on your employer. If they accept it, no further fit note is needed | No. Benefit claims need an NHS fit note |
Evidence, not an order. A fit note is advice about your fitness for work. DWP describes it as an advisory document, and your employer decides whether to accept it. What an employer cannot do is insist on further medical evidence on top of a fit note.
How long does a sick note last?
Exactly as long as the clinician writes. There is no standard length for flu, a back injury or anxiety. The person assessing you decides how long you are likely to be unfit, within two legal limits:
- Early in a condition: during the first 6 months, one fit note can cover 3 months at most.
- Longer illnesses: the regulations lift that ceiling once you have stayed off work on professional advice for at least 6 months. DWP guidance says there is then no limit on duration, provided it is clinically appropriate, and the rules allow an indefinite period where you will not be fit for the foreseeable future.
The maximum is a ceiling, not a target. A clinician can choose a shorter period and assess you again when it ends, so a short note is not a sign that you are expected back quickly.
The dates themselves cause more questions than the length. Whether the last date is a day off or your first day back is covered in sick note dates explained. If you were already ill before you saw anyone, see whether a sick note can be backdated.
How long can you be signed off work?
For as long as you remain unfit and keep being assessed. No rule ends your entitlement to be signed off after a set number of notes. Each note follows its own assessment, and only one note is issued per assessment, so a long absence is usually a chain of notes rather than one.
What does run out are other things:
- Statutory Sick Pay is paid for up to 28 weeks. The statutory sick pay guide explains the rate and what happens at the end.
- Long-term sickness: GOV.UK says employees off for more than 4 weeks may be considered long-term sick.
- Your job: dismissal for long-term sickness is allowed as a last resort, but only after your employer has looked at whether you could return, for example on different hours or duties, and has consulted you.
- Benefits: on Universal Credit, if your capability for work is affected for longer than 28 days you may need a Work Capability Assessment.
How long can you be off sick from work without a note?
7 calendar days. After that, the question is not whether you are allowed to stay off but what evidence you give. Your employer cannot hold back Statutory Sick Pay just because a fit note reaches them late.
Sick note, fit note and private certificate: the words
“Sick note” is what most people say. The official NHS document is the fit note, also called a Med3, and it can say either that you are not fit for work or that you may be fit with some changes. A private medical certificate is a separate document written by a doctor outside the NHS. The fit note and sick note comparison sets out where each one works.
Going back before the dates run out
A note is not a ban on working. You can go back before the end date without seeing the clinician again, and nobody needs to sign you back to work. If you feel well enough sooner, talk to your employer: returning before your sick note ends covers what to agree first.
Where a private sick note fits
If you cannot get a GP appointment, or your employer wants a doctor’s note for a shorter absence, a private sick note is another route. A GMC-registered UK doctor reviews an online questionnaire, with no appointment, and decides whether a certificate is appropriate. DWP guidance says employers can accept a private certificate as medical evidence in the same way as a fit note, if they agree to. It cannot be used for Universal Credit or ESA. A doctor can refuse if a note is not clinically appropriate, and in that case you are refunded in full.
Common questions
How long can a doctor give a sick note for in the UK?
For a condition in its first 6 months, a single fit note can last no more than 3 months. Beyond that, once you have stayed off work on professional advice for at least 6 months, the clinician can set a longer period, and the regulations allow an indefinite one where you will not be fit for the foreseeable future.
When do I need a sick note for work?
Once you have been off sick for more than 7 days in a row. Your employer counts every calendar day, including days you would not have worked anyway. Before that point you confirm the absence yourself.
How long does a sick note last?
As long as the period written on it, which the clinician sets after assessing you. Two notes for the same illness can have quite different lengths, because each is based on how you are at the time.
How long can you be signed off work?
There is no overall cap on how long you can be signed off, as long as each new note follows a fresh assessment. The limits that bite are on sick pay and, in the end, on how long your employer can keep your job open.
Can a doctor give a sick note for mental health for as long as a physical illness?
Yes. The same length rules apply whatever the condition, and Acas says employers must treat mental and physical health as equally important.
Can a nurse or pharmacist sign me off work?
They can. Since 1 July 2022, registered nurses, occupational therapists, pharmacists and physiotherapists have been able to certify fit notes, but the law lets them decline. Pharmacists working in high-street pharmacies do not have access to the form.
Sources. The legal, pay and clinical facts on this page were checked against these primary sources on 27 October 2026. Rules and rates change, and your employer’s own policy may add to them, so check your contract or HR policy too.
Need a doctor to assess your absence?
Answer an online questionnaire and a GMC-registered UK doctor decides whether a private sick note is right for you. £47. Your employer decides whether to accept it.
Start your assessmentAssessed by a GMC-registered UK doctor. Full refund if a note cannot be issued on clinical grounds.