The Fit Note

Last updated Wednesday 6th July 2022

The programme supports the changes to regulations which specify who can issue a fit note and how it must be done. These changes took effect on 1 July and enable nurses, physiotherapists, occupational therapists and pharmacists, in addition to doctors, to certify and issue a fit note.

This training sits alongside two other key resources

  • Fit note: Getting the most out of the fit note. Guidance For healthcare professionals – which covers the practical task of undertaking a health and work conversation and completing the fit note form
  • Fit note: Who can issue fit notes. Guidance for healthcare professionals and their employers – which provides clarity for healthcare professionals, their employers and regulators as to which professionals can include this task within their scope of practice

Fit note – GOV.UK (

Why is the fit note important?

Good work is good for an individual’s mental and physical health and wellbeing; evidence is clear that patients benefit from being in some kind of regular work. This improves mental and physical health and can aid recovery. Health care professionals (HCPs) are well placed to maximise the use of the fit note to support employers to return or remain in work.

The training aims to:

  1. Help HCPS develop the confidence and skills to have an effective work and health conversation and to be able to understand and communicate (where appropriate) the importance of work as a clinical outcome.
  2. Enable HCPs in using their professional judgement to assess the impact of a health condition on an individual’s fitness for work.
  3. Support HCPs in negotiating and developing an agreed plan with the patient about their health and work, including advice about self-management and workplace modifications (where appropriate).
  4. Enable HCPs to complete the technical steps required in the process of completing a fit note and understand options for next steps after a fit note has been certified. For example, signposting.

Before you begin this training, it is recommended that you complete the Work and Health training which will give you a general introduction to this area Work and Health – elearning for healthcare (

There are 4 sessions in the fit note programme:

  • An enabling approach which explains the aims and importance of the fit note
  • Key legislation and guidance to help understand the context and dispel any myths
  • Making recommendations using case studies and examples of completed fit notes
  • Application of the fit note which brings together the knowledge gained to apply to case studies and the final assessment of your knowledge.

The learning takes a case study approach in exploring the common scenarios that present in GP surgeries and how the fit note can be used most effectively. The case studies are not real cases, but are illustrative examples of potential scenarios.

To complete the programme, you are required to do each session in order, before completing the final assessment.

This training course along with the supporting guidance will provide healthcare professionals with the knowledge and understanding of how to complete an effective fit note and who is best placed to do so.