GP practices in England issued 2,972,596 fit notes in January–March 2026. Of these, 40.9% covered five weeks or longer. This page brings together the latest GP fit note figures and the 2026 reform proposals, keeping notes, episodes and people distinct.
The statistical source is NHS England’s Fit Notes Issued by GP Practices series. It covers electronically recorded GP practice activity in England, rather than every fit note issued throughout the UK. DWP publications provide the reform context; their consultation responses are not a representative survey of all employers or patients.
Key facts and figures
- 2,972,596 fit notes were issued by GP practices in England in January–March 2026, down 0.1% year on year.
- 40.9% of those notes covered five weeks or longer — 1,215,820 notes.
- More than 9 in 10 fit notes were described as “not fit for work” in DWP’s May 2026 reform announcement.
- 1,172,977 fit note episodes were recorded in January–March 2026; episodes are not a count of unique people.
- About 11 million fit notes a year were cited by DWP in May 2026; this is a count of notes, not people.
- 59% of employer respondents to DWP’s 2024 call for evidence rated the process ineffective; findings were published in 2026.
- 3,172 vs 1,911 fit notes per 100,000 registered patients — North West and London respectively, January–March 2026.
- £3 million backs the first-year WorkWell fit note reform pilots across 4 sites (DWP, 2026).
Checked on 15 October 2026. The latest available NHS England release covers January–March 2026. The next quarterly release is scheduled for 22 October 2026, after this review date.
How many fit notes are issued in the UK each year?
GP practices in England issued 2,972,596 fit notes in January–March 2026, according to the March 2026 NHS England release. This was 1,576 fewer notes than in the same quarter a year earlier, a decrease of 0.1%. The denominator is notes issued, not workers or sickness-absence days.
There were 1,172,977 fit note episodes in the quarter, 30,212 fewer than a year earlier (2.5%). An episode can contain several notes, and an individual can have more than one episode. Neither measure identifies the number of unique people signed off work.
DWP’s May 2026 reform announcement referred to about 11 million fit notes being issued annually. That broad annual figure should not be converted into a daily count of people: repeated notes for the same illness and person are part of the system.
What percentage of fit notes say “not fit for work”?
DWP’s May 2026 announcement said more than nine in ten fit notes stated “not fit for work”. The alternative “may be fit for work” option can support a discussion about a phased return, altered hours, amended duties or workplace adaptations. Advice must be considered in the context of the person’s health and the work available.
Diagnosis completeness in the statistical dataset is a separate issue from what is written on an individual patient’s fit note. Missing coded diagnoses in the data must not be described as proof that the issued certificate contained no diagnosis. The current quarterly headline figures are most useful for volumes, duration and regional rates.
A fit note can inform a discussion about support and adjustments, but does not replace that conversation or a workplace risk assessment. Employers should consider the advice, the person’s circumstances and any applicable reasonable-adjustment duties, seeking occupational-health advice where appropriate.
How long can a fit note last, and how many run for 5 weeks or more?
In January–March 2026, 1,215,820 fit notes covered five weeks or longer: 40.9% of all notes. In the same quarter a year earlier, the equivalent figures were 1,190,260 and 40.0%. This duration band describes the certificate period, not a measured outcome such as permanent departure from work.
During the first six months of a health condition, a fit note can cover a maximum of three months at a time. After that, it can cover a longer period where clinically appropriate. Doctors, nurses, occupational therapists, pharmacists and physiotherapists can certify fit notes within the relevant rules and their competence.
The table compares the latest quarter with the same quarter a year earlier, using the latest published figures.
| Measure | January–March 2026 | January–March 2025 |
|---|---|---|
| Fit notes issued | 2,972,596 | 2,974,172 |
| Change in notes, latest versus prior year | −1,576 (−0.1%) | Comparison period |
| Fit note episodes | 1,172,977 | 1,203,189 |
| Notes for five weeks or longer | 1,215,820 | 1,190,260 |
| Share covering five weeks or longer | 40.9% | 40.0% |
How has fit note volume changed over time?
Long-run fit note counts require particular care. The inclusion of TPP system data in 2019 substantially expanded the practices covered. A comparison between early totals and recent totals therefore cannot be presented as a like-for-like doubling in illness or certification.
Within a consistent period, note counts can still change because of certification duration, repeated notes, recording and population changes. The statistical series alone cannot establish why an individual is absent, whether a condition was caused by work, or whether a note was improperly issued.
Which regions issue the most fit notes?
In January–March 2026 the North West had the highest reported regional rate, at 3,172 notes per 100,000 registered patients, while London had the lowest at 1,911. These rates adjust for the number of registered patients but are not age-standardised measures of workplace sickness or employee absence.
Regional figures describe GP practice activity among registered patients. Employers should use their own appropriately collected absence information to understand their workforce, rather than treating a regional patient-based rate as a prediction for a particular workplace.
Is the fit note system being reformed in 2026?
In May 2026 DWP announced £3 million for the first year of fit note pilots at four WorkWell sites in England. The pilots were intended to cover up to 100,000 appointments within a wider WorkWell programme intended to support up to 250,000 people. These are announced programme capacities, not completed outcomes.
DWP published its call-for-evidence results in May 2026, based on responses submitted from April to July 2024. Among respondents, 29% of primary-care clinicians and 61% of secondary-care clinicians agreed issuing fit notes was a good use of GP time. Some 59% of employer respondents rated the process ineffective, while 82% of patient, carer and current or former user respondents rated it effective. These self-selected responses should not be generalised to every employer or patient.
The consultation results and announced pilot scale answer different questions, as the table makes clear.
| Reform measure | Figure | Source / period |
|---|---|---|
| Primary-care clinician respondents: good use of GP time | 29% | 2024 call for evidence; published May 2026 |
| Secondary-care clinician respondents: good use of GP time | 61% | 2024 call for evidence; published May 2026 |
| Employer respondents: process ineffective | 59% | 2024 call for evidence; published May 2026 |
| Patient/carer/user respondents: process effective | 82% | 2024 call for evidence; published May 2026 |
| WorkWell pilot funding (year one) | £3m across 4 sites | DWP, May 2026 |
| Appointments covered by pilots | Up to 100,000 | DWP, May 2026 |
| Wider WorkWell programme intended reach | Up to 250,000 people | Announced programme capacity, May 2026 |
For sickness lasting seven days or less, employees normally self-certify; medical evidence can be required for longer absences. Fit note reform announcements do not remove existing duties to manage workplace risks or make reasonable adjustments where the Equality Act applies.
What does this mean for employers and absence management?
Read the fit note alongside a supportive conversation about the individual’s work and health. Agree feasible adjustments, keep relevant records securely and review arrangements. A statistical dataset’s missing diagnosis code does not establish that a particular certificate lacks useful clinical advice.
Where work may cause or worsen ill health, assess the relevant hazards and act on the findings. A fit note is not a substitute for preventing harm, but nor does receipt of one prove that the employer caused the condition or could have prevented every absence.
Frequently asked questions
How many fit notes are issued in the UK each year?
DWP referred to about 11 million fit notes annually in May 2026. The latest quarterly NHS England series records 2,972,596 GP practice fit notes in January–March 2026. That series covers England, and counts notes rather than unique people.
What percentage of fit notes say “not fit for work”?
DWP’s May 2026 reform announcement described more than nine in ten fit notes as “not fit for work”. A “may be fit for work” note can instead advise adjustments such as altered duties, amended hours or a phased return.
How long can a fit note last, and how many run for 5 weeks or more?
During the first six months of a condition, a fit note can cover no more than three months at a time; longer periods can be certified afterwards where clinically appropriate. In January–March 2026, 1,215,820 notes, or 40.9%, covered five weeks or longer.
Is the fit note system being reformed or scrapped in 2026?
DWP announced reform pilots in May 2026, with £3 million for year one at four WorkWell sites and up to 100,000 appointments. Those are announced capacities, not evidence that all fit notes have been replaced or that the pilots have already delivered those volumes.
Do fit note statistics cover the whole UK?
No. This NHS England series covers electronically recorded fit notes from GP practices in England. It is not a complete count of all fit notes issued across the UK or in other settings, and it does not identify unique people.
Related guides
- Work-Related Stress Statistics UK: HSE Facts & Data
- Risk Assessment Statistics UK: Compliance Facts & Data
- HSE Enforcement Statistics UK: Fines, Prosecutions & Notices
- How to carry out a stress risk assessment
- What is a risk assessment? A guide to UK workplace law
Sources & references
- NHS England — Fit Notes Issued by GP Practices, March 2026
- DWP — fit note reform announcement, May 2026
- DWP — results of the 2024 fit note call for evidence, published May 2026
- GOV.UK — fit note guidance for employers and line managers
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Mark writes about workplace health & safety, risk assessment and accredited online training for Risk Assessment Training, part of Online CPD Academy.