Fit notes – “Med3” medical certificates (previously known as sick notes)

There is an excellent explanation of the regulations regarding time off work due to ill-health on the government website, where you can also download a self-certificate if you have been off for seven days or less.

Doctors are not permitted to issue a backdated note which pre-dates your first assessment for the condition. For example, if you suffer from a flu-like illness and miss two weeks of work, but only make contact with us at the end of that period for the purpose of obtaining a note, the practice cannot issue a backdated note to cover that second week of absence. The assessment can be done by telephone, so if you have been unwell and absent from work for a week (covered by your self-certificate) but do not need to see a doctor, then please ring and ask for a telephone consultation. If the doctor agrees that you are unfit to work, a certificate can be issued.

If you are under review by a hospital specialist for the condition which means you are unable to work, it is the specialist who is obliged to provide your certificate. Sometimes they, or their colleagues, will tell you that the GP will do it, but it is their responsibility as they are the ones with detailed knowledge of your condition and are best placed to provide the detail on the certificate. You must ask them for a certificate whilst you are in clinic with them. Similarly if you have had surgery and have been told that you must remain off work for a period of time afterwards, you should be provided with a certificate by your surgeon or a member of their team to cover that period of time before you are discharged. You must ask them for it before you leave the hospital, often they will not offer one without being asked.

Requests for fit notes are not medically urgent, and will not be processed as such, given the current pressures facing general practice. Please allow 48 hours for a request to be processed. Please remember that in many circumstances when the certificate is for an ongoing condition, the certificate can be backdated to provide continuity from previous note.

You do not need a “Return to work” note, even if you plan to return before the originally stated end-date on the certificate.

If your employer requests a doctor’s certificate for periods less than seven days, or a return to work note, these are not covered by the regulations and are deemed to be a private letter and as such will incur a fee.

Supporting letters for Personal Independence Payment (PIP) applications

The Department of Work and Pensions (DWP) staff and Citizens’ Advice Bureau staff sometimes suggest that individuals submitting applications for PIP ask for a “supporting letter” from their GP. Often, due to the health conditions which make someone eligible to apply for PIP, these can be long and complicated reports which would take up a lot of the doctor’s time. They are not covered under the terms of the NHS GP Contract, which means that there is no time or funding provided for the time needed to do these. We are aware that charging the usual professional fees may be unaffordable for some of those applying for these benefits, and therefore in the interests of fairness it is practice policy not to provide supporting letters. However, the practice will gladly supply a print-out of medical diagnoses and medications which can be submitted, and of course under the data protection regulations all patients can request a copy of their entire medical record. If the DWP requires additional medical information they will ask for it, and they have specific forms for the GPs to complete for this purpose – these do fall under the NHS GP Contract and will always be completed.

Notes for school or university absence through illness

As with employers, if your university requests that you provide a letter from your doctor following absence through illness, then the university must request this in writing., accompanied by a signed and dated consent from the patient for the sharing of their medical information. The university will be invoiced for a medical report at the appropriate rate.

The doctors will not provide a note for school absence. This is explained below in an excerpt from the BMA statement on the matter:

GPs do not provide sick notes for schoolchildren. When children are absent from school owing to illness, schools may request a letter from a parent or guardian, and this is no different during an exam period. However, children who have missed exams due to illness are frequently told by schools that a note from a doctor is required; but this cannot be provided by a GP. Parents/guardians are responsible for excusing their children from school. Aside from the fact that parents/guardians are responsible for excusing their children from school, GPs cannot provide retrospective sickness certification. When a child suffers from a long-term condition, any certification will be provided by the responsible specialist.

The GP Committee has sought and received confirmation from the Office of the Qualifications and Examinations Regulator that Awarding Organisations make no requirement for pupils to obtain a medical certificate in support of their application for special consideration. Students are asked for information in support of their application, but this may take the form of a statement by the school. The Joint Council for Qualifications has confirmed that as far as they are concerned, if a student was absent from an examination as a result of illness and has the support of the school or centre to be absent, special consideration will be granted on that basis. Awarding organisations do not insist that medical proof is provided.

Lasting Power of Attorney and Court of Protection “Deputy” applications

LPAs do not require completion by a doctor (or solicitor for that matter). The Donor must have capacity in order to apply, and friends can act as witnesses. If you are applying to the Office of the Public Guardian to become a Deputy for your relative who you believe has already lost capacity, and wish to ask one of our doctors to complete the COP3 form, this will incur a fee. If the doctor is unable to complete the form without a face to face assessment and examination, the fee will be higher.

Description of medical certificates GPs are obliged to provide under their NHS Contract

• To support a claim or to obtain payment either personally or by proxy; to prove inability to work or incapacity for self-support for the purposes of an award by the Secretary of State; or to enable proxy to draw pensions etc. (more commonly known as a Fit Note, medical certificate, Med3 and previously a “sick note”)
• To establish pregnancy for the purpose of obtaining welfare foods
• To secure registration of still-birth
• To enable payment to be made to an institution or other person in case of mental disorder of persons entitled to payment from public funds
• To establish unfitness for jury service
• To support late application for reinstatement in civil employment or notification of non-availability to take up employment owing to sickness
• To enable a person to be registered as an absent voter on grounds of physical incapacity
• To support applications for certificates conferring exemption from charges in respect of drugs, medicines and appliances
• To support a claim by or on behalf of a severely mentally impaired person for exemption from liability to pay the Council Tax or eligibility for a discount in respect of the amount of Council Tax payable