What is a fit note?
Fit notes are also called: MED3 (or MED 3), sick note, Statement of fitness for work.
Fit notes for illness absences for more than 7 days are free of charge.
How fit note requests are received
There are a few ways that patients might request a fit note:
🌐 By emailing or using the online form → in which case the Reception Lead will deal with these requests
☎️ By calling Reception → in which case you should check that the patient has internet access, then ask them to fill in the fit note request form online or email. If they cannot use the internet → take details of their request over the phone to pass to the Reception Lead.
(Please check that we have up-to-date contact details for the patient while they are on the phone.)
📆 During an appointment with a GP or AHP → in which case they will issue the fit note immediately during the appointment (see Issuing Fit Notes)
How to handle fit note requests
Patient requests a fit note over the phone
If a patient calls Reception to request a fit note, first check how long they've been sick:
- 7 days or less → we can't issue a fit note unless they've been ill for more than 7 days. You can send them a link to the self-certification of sickness form here via Accrux
- More than 7 days → we may be able to issue a fit note. This is done by Reception Leads, but the patient may require an appointment for assessment, which receptionists can organise.
1️⃣ First time fit note
Clear documentation of illness/injury is required for a fit note. This should be in the patient's notes, but it may have come from a hospital (e.g. x-ray results for broken bone) or some other external service (e.g. mental health report from private therapist).
When you get a request for a fit note → check the patient's notes to see if there is any documentation of their complaint.
✅ If the patient has been assessed for their complaint recently (either by one of our clinicians or by an external service) → book onto Reception leads’ book on EMIS.
❌ If patient has not been assessed → follow POST instructions for booking patient with the appropriate clinician.
♾️ Fit note extension
The usual maximum sick note time is 3 months (exceptions can occur in a cancer diagnosis). Therefore, if a patient requires an extension to their fit note, they may need to be re-assessed by a clinician. Follow the same procedure as listed above for "First time fit note".
Triaging fit note requests
Reception Leads are expected to triage all fit note requests on the day of receipt (within 24 hours) and allocate them fairly to AHPs working on site. If there is no AHP available → escalate to GPs. The leads should also keep the patient ‘in the loop’ and notify them if there are any delays.
All emails or forms from patients will go to ‘Sick notes’ in generic folder — check every morning and add patients to Reception leads’ book on EMIS.
If we are able to issue a fit note, check whether it falls within scope of AHP or GP.
- If AHP can issue, task to ‘Fit notes team’
- If there are no relevant AHPs on site today or tomorrow, task to GP → should be evenly distributed between GPs working that day
All tasks should be sent out in the format:
At the end of the day, check that all fit notes sent to AHPs and GPs that day have been completed.
Who can issue a fit note?
Fit notes are issued via EMIS on a pre-defined template by GPs and AHPs.
AHPs should be the first choice to issue a fit note if:
- they are within their scope of work (including LTCs)
- they relate to an accident / emergency / post-surgical case
- we have clear documentation of the condition already triaged / assessed by another clinician in the team / hub / secondary care (within the past few weeks)
- they are an extension to an existing fit note
NB. Tasks sent out after 1pm may not be processed on the same day - check whether they have been processed on the following day.