How to get a sick note in the UK

Do I need a sick note at all?

For the first 7 calendar days of illness (including weekends), you don't need a doctor's note. You "self-certify": tell your employer you're unwell and, if they ask, fill in their self-certification form. Employers can't require a doctor's note for statutory sick pay during those 7 days.

From the 8th day of illness, your employer can ask for medical evidence. Some employers also ask for evidence sooner under their own company sick pay policies - that's a matter of their policy rather than the law, and it's the most common reason people need a private certificate quickly.

Sick note, fit note, doctor's note - what's the difference?

They mostly mean the same thing. The official NHS document is the "fit note" (a Statement of Fitness for Work), which says whether you are not fit for work, or fit with adjustments. "Sick note" and "doctor's note" are everyday names for it.

A private medical certificate does the same job: a doctor confirms they assessed you, your condition, and the dates affected. It's signed by the doctor with their GMC number, and most employers, universities, and insurers accept it.

Route 1: a free fit note from the NHS

If your illness has lasted more than 7 days, your GP practice can issue a fit note free of charge - since 2022, nurses, pharmacists, occupational therapists, and physiotherapists involved in your care can sign them too. If you've been treated in hospital, the hospital can issue one covering your stay.

The catch is timing: routine GP appointments can take one to two weeks in much of the UK. If your employer wants evidence now, or your university deadline is this week, the free route is often too slow. NHS fit notes are the right choice when time isn't critical - and your GP can backdate one, which private online services generally can't.

Route 2: a private sick note online, usually same day

Online services like Velo Health connect you to a GMC registered UK doctor without an appointment. At Velo Health you describe your symptoms in a short questionnaire, verify your identity with photo ID, and then message the doctor directly on the website - no phone or video call. If the doctor is satisfied a certificate is appropriate, a signed PDF is emailed to you; Priority requests are completed within 24 hours or your money back.

Two honest limits. First, the doctor decides: if your condition needs an in-person examination, they will decline and you get an automatic full refund. Second, certificates start from the day of your consultation and cover up to two weeks - if you need evidence about an illness from last month, your own GP practice holds your record and is the right route.

How much does a sick note cost?

An NHS fit note is free once you're past day 7. Private certificates in the UK typically cost £20 to £40. Velo Health charges £25 (Standard, within 3 business days) or £35 (Priority, within 24 hours), always with a full automatic refund if the doctor can't issue your certificate. Even NHS practices commonly charge £20 to £50 for private letters - things like university evidence or insurance letters - because those fall outside NHS work.

Will my employer or university accept an online sick note?

In almost all cases, yes. What they're checking is that a real, registered doctor assessed you - which is why every Velo Health certificate shows the doctor's name and GMC number (verifiable on the public GMC register) plus a unique reference number your employer or university can ask us to confirm. Acceptance is ultimately at the organisation's discretion, so if you have a specific policy to satisfy - a university extenuating circumstances panel, say - check its wording first.

Medical evidence for university extenuating circumstances

Universities ask for medical evidence for extenuating (or mitigating) circumstances applications, missed exams, and coursework deadline extensions - and NHS GPs often treat these letters as private work, with a fee and a wait. Most UK universities accept a certificate signed by a GMC registered doctor: it confirms the doctor assessed you, the condition you reported, and the dates affected, and carries a unique reference the university can ask us to verify. Check your university's own policy wording first, and remember certificates start from the day of your consultation - for evidence about an earlier period, your GP practice holds your record.

More detail, including what the certificate says and how fast you can get one: medical evidence for university.

Medical evidence for holiday cancellation and insurance claims

Travel companies and insurers usually want medical evidence before they refund a cancelled holiday or pay a claim. A signed certificate from a GMC registered doctor covers most policies - it states the condition and dates and can be verified by reference. A few insurers additionally want records from your own GP practice, so check the policy wording before you buy anything. The same applies to gyms, events, and other bookings that ask for proof of illness.

More detail on what claims teams accept: medical evidence for cancellations and insurance claims.

When you should see a doctor in person instead

An online certificate service is for short-term, self-limiting illness - colds, flu, stomach bugs, migraines, back pain, stress. If your symptoms are severe or getting rapidly worse - such as chest pain, difficulty breathing, or thoughts of harming yourself - call 999 or go to A&E now, or call NHS 111 for urgent advice. For long-term or complex conditions, your own GP, who holds your full record, is the right person to assess you and can issue fit notes covering longer periods.