Nurses, occupational therapists, pharmacists and physiotherapists can now certify and issue fit notes

  • The change is set to support patients getting advice and fit notes from their healthcare professional – without having to separately see a doctor
  • The reform follows fit notes going fully digital as they no longer need to be signed in ink.

From Friday 1st July 2022: nurses, occupational therapists, pharmacists and physiotherapists can all legally certify fit notes, reducing the pressure on NHS doctors, particularly GPs and scrapping unnecessary bureaucracy.

Updated guidance to health care professionals and their employers on these changes is also being published today, setting out how to support people to remain in work while managing a health condition.

This has been worked up and agreed with health professionals and DHSC to ensure these changes deliver benefits for both patients and clinicians. The existing guidance for employers and patients has also been updated.

This change recognises the importance of supporting people to remain in work, while managing a health condition by providing advice to an employer about how to support someone. By leveraging the expertise of a wider range of healthcare professionals, the change also streamlines the process.

The change, which applies across England, Scotland and Wales and is being mirrored in Northern Ireland, will support and empower better conversations about work and health between employers and staff by making it easier to get advice certified by the most relevant healthcare professional.

It will also improve a patient’s experience and reduce pressure on doctors, as people will no longer have to be sent to a doctor to have the fit note signed when seeing and receiving treatment from an alternative professional for their health condition.

The change is being delivered in GP surgeries, hospital and other NHS settings where healthcare professionals delivering NHS services will have access to the new fit note form.

Fit notes provide evidence to employers about a person’s absence and any relevant advice on how to support their employees to remain in or return to work. They also provide evidence for claims to benefits for those who are out of work.

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

Having a health condition doesn’t have to take you out of a job. This change will make it easier for people and employers to get the advice they need so people can stay in work, whilst also reducing bureaucracy and freeing up doctors’ time.

Too often we see people being faced with unnecessary challenges to get a fit note. More professionals being able to offer this vital service will speed up the process and support people to return to or remain in work.

Slashing unnecessary bureaucracy is key to ensuring more patients can see their GP quickly and get the care they need as we bust the Covid backlogs.

That’s why we have introduced these powers to ensure certifying fit notes can be carried out by other healthcare professionals – helping to relieve pressures on GPs so they can focus on patients and deliver an extra 50 million appointments a year by 2024.

Director of Practice and Development at Chartered Society of Physiotherapy Ashley James:

Physiotherapists are already at the forefront of patient care but these new powers to certify fit notes will ensure a more efficient process to support patients’ return to work.

Physiotherapist expertise is often key in having health and work conversations and providing effective rehabilitation throughout the return to work journey. Getting treatment and support right can help patients remain in work and manage conditions effectively or return to work in a timely manner.

These new measures remove the need for a separate appointment with a GP. This can only be good news for patients as well as help to take some pressure off primary care services.

Chair of the Royal College of Occupational Therapists Specialist Section for Work Dr Jain Holmes:

This new opportunity will mean more people can get expert advice from occupational therapists. The profession is keen to show how we identify work and health needs and then provide tailored advice for the people we see.

As Chair of the Royal College of Occupational Therapists Specialist Section for Work, we will be providing support to help the transition to this change which will benefit people’s everyday working lives.

The changes to the fit note deliver on commitments made last year to reduce ill health related job loss in the government’s Health is Everyone’s Business consultation response.


  • Regulations were laid on 10th June 2022 to allow more healthcare professionals to certify fit notes in addition to doctors. These professions are nurses, occupational therapists, pharmacists, and physiotherapists. The changes came into effect on 1st July 2022.
  • Updated guidance for healthcare professionals, employers and patients will be published on 1st July 2022 on
  • Fit notes can only be issued following an assessment of a person’s fitness for work.
  • This follows legislation changes in April 2022 which removed the need for fit notes to be signed in ink. This change made 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).
  • Fit notes provide evidence of an absence of more than 7 days.

PAYadvice.UK 1/7/2022

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