• Nurses, occupational therapists, pharmacists, and physiotherapists to certify and issue fit notes – reducing pressure on doctors, particularly GPs
  • Update will enable patients to see the most relevant healthcare professional and have better conversations about work and health
  • Changes follow the introduction of digital certifying of fit notes in April, simplifying the process of issuing and receiving fit notes

From 1 July 2022 nurses, occupational therapists, pharmacists, and physiotherapists will all be able to legally certify fit notes – something that at present only doctors can do. If you’ve been off work with illness for more than seven days, a fit note provides evidence to your employer about your absence and any relevant advice on how to support you to remain in or return to work.

The change, the most significant since the fit note’s inception in 2010, will support and empower better conversations about work and health between employers and staff by making it easier to get this advice certified by the most relevant healthcare professional. This change will be delivered in general practice and hospital settings.

It will also help reduce pressure on doctors, particularly GPs, while simplifying the process of issuing and receiving a fit note – cutting bureaucracy for employers and the National Health Service.

Minister for Disabled People, Health and Work Chloe Smith MP said:

The extension of fit note certification is fantastic news for patients, making it easier for them to get the support and advice they need from the right place, ensuring where possible that they are able to remain in work.

These latest fit note changes recognise the valuable role other professions play in helping manage people’s health, and I hope this will also help reduce unnecessary bureaucracy for doctors and general practice more widely.

Minister for Patient Safety and Primary Care Maria Caulfield MP said:

Improving access to GP services and reducing unnecessary bureaucracy is vitally important as we tackle the Covid backlog. Extending powers to provide fit notes to other healthcare professions will relieve further pressures on GPs, and is another step towards helping to deliver an extra 50 million appointments in general practice a year by 2024.

This is just another way in which we’re supporting GPs in primary care, and we remain on track to deliver 26,000 more primary care staff by 2024 to help improve patient access to appointments.

BMA England GP committee deputy chair, Dr Kieran Sharrock said:

This announcement is a positive step and we hope that it will go some way to both improving the process for people who need confirmation that they are too unwell to work, and free-up GPs time to care for patients who need their expertise.

The BMA has been clear for many years that it may not always be necessary or appropriate for a GP to issue a fit note, especially when a patient has seen a different member of the practice team for their condition, such as a nurse or physiotherapist.

At a time when the entire NHS is under pressure, reducing unnecessary administration and bureaucracy, while taking a more flexible and pragmatic approach to patient services is absolutely vital.

Chief Executive of The Chartered Society of Physiotherapy, Karen Middleton said:

We welcome this change in legislation as physiotherapists are ideally placed to have conversations about health and work with patients.

The longer someone is off work the less likely they are to return, so physiotherapy expertise at the start of an absence can be crucial for ensuring their rehabilitation is effective and they can get back in a timely manner.

So this announcement is good news for patients, with the added benefit being that they don’t need to make a separate appointment to get signed off by a GP.

Director of Practice and Innovation, at The Royal College of Occupational Therapists, Karin Orman, said:

By joining forces with DWP and being bold and progressive, we are happy to have helped opened this new opportunity for Occupational Therapists.

Workers and employers are crying out for more help to support people with health problems to stay in work where they are able to do so. These new changes mean Occupational Therapists are directly able to provide that advice.

The extension of fit note certification follows changes made in April 2022 that allow for fit notes to be certified and issued digitally making the process more efficient for employees, their employers and GPs.

They also deliver on commitments to reduce ill health related jobs loss made in the government’s Health is Everyone’s Business consultation response.

Additional information

  • Regulations were laid on 10 June 2022 to allow more healthcare professionals to certify fit notes. These professions are nurses, occupational therapists, pharmacists, and physiotherapists. The changes will come into effect on 1 July 2022.
  • Fit notes can only be issued following an assessment of a person’s fitness for work, so cannot be issued on request or via over-the-counter services.
  • This change follows legislation changes in April 2022, which removed the need for fit notes to be signed in ink. This change makes it possible for eligible healthcare professionals to certify fit notes digitally, and also for patients to receive their fit note via digital channels (where GP IT systems support this).

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    More healthcare professionals given powers to certify fit notes

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