A doctor can give the employee advice to help them return to work with a fit note. This is because it's recognised that work can play an important part in helping people recover from illness or injury.
Fit note advice On the fit note, the doctor can select one of two options to advise that the employee is: ▼ Not fit for work The doctor selects this option if they believe the employee's health condition prevents them working. ▼ May be fit for work The doctor selects this option if they believe the employee can return to some form of work while they recover. On the form, the doctor can enter comments to help the employer understand how the employee's condition affects them. They can suggest one or more common ways to help the employee return to work, for example: - A phased return to work
- Altered hours
- Amended duties
- Workplace adaptations
You don't have to act on the doctor's advice, and the employee doesn't have to be fully fit to return to work.
How long is it valid for? The doctor can state a specified length of time, for example, one week, or until a specific date. They can also state whether or not they need to assess the employee's fitness for work at the end of this period. If the employee wants to return to work before the end date on their fit note, they must have your agreement. They don't need further documentation from their doctor. If their doctor advises they aren't fit for work, the employee shouldn't go back to work before the fit note end date.
What happens if the doctor selects 'May be fit for work'? If the doctor advises that the employee may be fit for work, agree with your employee: - How they'll return to work
- What support they'll receive
- How long the support will last
If the employee's on a phased return to work, does it affect statutory sick pay (SSP)? You can process SSP as normal when you need to pay it to an employee with a fit note. From 6 April 2026, waiting days no longer apply. This means that when you process one or more days of SSP, your software calculates the payment for your employee. To find out more about the SSP changes, visit the changes to Statutory Sick Pay from 6 April 2026 article.
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