Phased Return to Work Letter - Do I Need a Sick Note?
If you're returning to work after illness, injury or surgery, your employer may ask for a phased return to work letter from your doctor confirming the recommended adjustments to your duties, hours or working environment.
A phased return to work doesn't always require a new sick note — but it does usually require a formal letter from a GMC-registered GP setting out what adjustments are needed and for how long. Get yours online today, same day, direct to your inbox. Apply online anytime, no appointment needed.
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Complete a short online questionnaire
No appointment required. Complete a short medical questionnaire and upload any supporting evidence.
Doctor reviews your evidence
A GMC-registered doctor reviews your submission individually. No automated approvals.
✔ Full refund if the GP cannot issue.
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Most certificates arrive same day or by 9AM next morning, delivered via email a signed PDF. All consultations subject to clinical assessment. Issued only where clinically appropriate.
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Phased Return to Work Sick Note, Return to Work Certificate & Light Duties Letter
Returning to work after sick leave often requires medical documentation, whether you are coming back gradually on reduced hours, resuming duties with specific adjustments, or your employer needs written confirmation that you are fit to return. Every certificate is reviewed individually by a GMC-registered UK doctor and delivered as a signed PDF with a verifiable GMC registration number.
Phased Return to Work Sick Note
A phased return to work sick note is issued under the "may be fit for work" assessment on a fit note. It certifies that you are not yet ready for full duties but can return in a limited capacity, for example three days per week initially, building to five over four weeks. This is different from a standard sick note (which certifies full incapacity) and from a return-to-work clearance letter (which certifies full recovery).
Not fit for work
Standard sick leave. Full incapacity. You cannot work at all and your employer should not pressure you to return. Used during active illness or recovery.
May be fit for work ← phased return
You can return in a limited capacity if the employer can accommodate specific arrangements. The doctor specifies reduced days, hours, duties, or other conditions. If the employer cannot accommodate them, the note is treated as "not fit for work."
ACAS guidance on fit notes and proof of sickness confirms that fit note recommendations are advisory. Employers must consider them but are not legally obliged to implement them. If your condition qualifies as a disability under section 6 of the Equality Act 2010, your employer has a legal duty under section 20 of the Act to consider the phased return recommendation as a reasonable adjustment. GOV.UK fit note guidance for employers also encourages accommodating "may be fit for work" recommendations wherever practicable.
Sick pay during a phased return: April 2026 changes
From 6 April 2026, the Employment Rights Act 2025 significantly improves sick pay during phased returns. SSP is now assessed day by day rather than requiring four consecutive sick days. This means an employee returning on three days per week receives SSP for the two days per week they are not yet able to attend, something that was rarely possible under the old rules.
Previous rules: SSP required four consecutive absent days. Phased return working patterns typically broke this run, meaning most employees on phased returns received no sick pay for absent days.
New rules: SSP payable from day one of absence, assessed per qualifying day. Rate: £123.25 per week or 80% of average weekly earnings, whichever is lower. The lower earnings limit has been removed, so all employees qualify regardless of income. Full details are published in the MedicalCert Statutory Sick Pay guide and on GOV.UK.
Employer Obligations: Managing a Phased Return
ACAS guidance recommends that employers treat a phased return as a structured, documented process rather than an informal arrangement. The following obligations apply whether the recommendation comes from a GP fit note, an occupational health report, or the employee's own request.
- Consider the recommendation genuinely. When a fit note says "may be fit for work" with a phased return, the employer must assess whether the arrangement can be accommodated. A blanket refusal without consideration is not defensible if later challenged.
- Discuss the arrangement with the employee. ACAS recommends a return-to-work meeting to agree hours, duties, duration, and review points. The employee can bring a union representative or colleague. The employer cannot unilaterally impose a phased return arrangement the employee has not agreed to.
- Put the agreement in writing. Document the phased return plan, including start date, working pattern, duties, duration, pay arrangements, and review dates. Both sides should have a copy. This protects both the employer and the employee if the arrangement is challenged later.
- Review regularly. Check in with the employee at agreed intervals to assess progress. If the employee is not building back as planned, discuss options: extending the phased period, adjusting the plan, seeking updated medical advice, or in some cases reverting to full sick leave.
- Consider Equality Act duties. If the condition meets the disability threshold (a substantial and long-term adverse effect on day-to-day activities), the employer has a duty to make reasonable adjustments under section 20 of the Equality Act 2010. A phased return recommended by a healthcare professional is likely to be considered a reasonable adjustment in most circumstances.
- Do not dismiss prematurely. Dismissing an employee during or shortly after a phased return, without having followed a fair process including obtaining medical evidence and exploring alternatives, carries significant unfair dismissal risk. The MedicalCert guide to fit note employer rights covers this in detail.
GP and Occupational Health Roles in a Phased Return
A phased return can be recommended by a GP through a fit note, by an occupational health professional through a workplace assessment, or requested by the employee or employer directly. In practice, the GP and occupational health serve different functions.
| Role | GP (via fit note) | Occupational Health |
|---|---|---|
| How they recommend a phased return | Ticks "may be fit for work" on the fit note and notes reduced hours, days, or duties in the comments | Writes a report recommending a phased return with workplace-specific detail on tasks, hours, and restrictions |
| Who requests it | The employee, from their own GP or healthcare provider | The employer, with the employee's consent |
| Focus | General fitness based on the clinical condition | Fitness for the employee's specific role, tasks, and workplace environment |
| Level of detail | Typically brief: "reduced hours" or "phased return over 4 weeks" | Can be highly specific: start at 3 hours/day for week 1, increase to 5 hours in week 2, avoid specific tasks until week 4 |
| Cost | Free via NHS after 7 days' sickness. If employer requests evidence in the first 7 days, the employer should cover the cost | Paid by the employer |
| When to use | Standard absences where the employee's GP has a clear picture of their condition and recovery | Complex or prolonged absences, safety-critical roles, where the employer needs workplace-specific guidance, or where the GP recommendation lacks sufficient detail |
If a GP fit note and an occupational health report conflict on the phased return recommendation, the employer should discuss the differences with the employee and document their reasoning. Neither opinion automatically overrides the other. Employers who choose to follow one over the other should be able to justify that decision if it is later challenged at an employment tribunal.
Pay During a Phased Return
| Pay approach | How it works | Who uses it |
|---|---|---|
| Full salary throughout | Employer pays the employee's full salary for the entire phased return period, regardless of hours worked. The most supportive approach and most likely to encourage a successful return. | Common in public sector, large employers, and organisations with generous contractual sick pay schemes |
| Normal pay for hours worked + SSP for absent days | Employee receives their normal hourly rate for the hours they attend. For each qualifying day they are absent, SSP is paid at £123.25/week or 80% of AWE (whichever is lower), assessed per day. This is the statutory minimum from April 2026. | The default position for employers without a contractual sick pay scheme that covers phased returns |
| Normal pay for hours worked + annual leave for absent days | Employee uses accrued annual leave to cover absent days, maintaining full pay. Statutory holiday entitlement continues to accrue during sick leave, so this leave may already be available. Employer and employee must agree this arrangement. | Used where SSP would cause financial hardship, or where the employee has significant accrued leave from the sick leave period |
| Normal pay for hours worked + unpaid for absent days | Employee receives pay only for hours attended. Absent days are unpaid. This should only apply if SSP entitlement has been exhausted (28 weeks) and the employer does not offer contractual sick pay. | Rare. Only where SSP has been exhausted and no contractual sick pay applies |
ACAS recommends that the pay arrangement is agreed in writing before the phased return begins. If the employer offers a lighter workload rather than reduced hours, the rate of pay for those lighter duties is a matter for agreement between employer and employee. Check your employment contract or company sick pay policy for any specific provisions covering phased returns.
Return to Work Certificate: Fit to Return Letter from Doctor
A return to work certificate (also called a fit-to-return certificate, return to work letter from doctor, or medical clearance letter) is issued when you have recovered from illness and your employer requires written medical confirmation before reinstating you. It is the document that closes the sick leave episode.
Many employers request this for absences of four weeks or more, for safety-critical roles, or as a matter of occupational health policy. While employers cannot generally make return legally conditional on such a letter in standard employment situations, the request is common and legitimate, particularly for longer absences.
What a return to work certificate includes
- ✔ Your full name, date of birth, and contact details
- ✔ Confirmation you are medically fit to return to work
- ✔ The date from which you are cleared to return
- ✔ Whether you are fit for full duties or a structured return arrangement
- ✔ Any recommended adjustments or restrictions, where applicable
- ✔ GMC registration number of the signing doctor
- ✔ Unique QR code for employer verification
Light Duties Letter & Reasonable Adjustments Letter
A light duties letter, also called a reasonable adjustments letter, adjusted duties letter, or work adjustment certificate, documents specific ongoing modifications to your role. Unlike a phased return note (which is time-limited and covers the transition back) or a return-to-work certificate (which confirms full recovery), a reasonable adjustments letter addresses permanent or long-term modifications needed because of an ongoing condition, disability, or recovery period.
Common scenarios where a light duties or reasonable adjustments letter is needed:
Equality Act 2010: your employer's legal duty
Where your condition meets the Equality Act 2010 section 6 disability definition, a substantial and long-term adverse effect on normal day-to-day activities lasting 12 months or more, your employer has a legal duty under section 20 of the Act to consider reasonable adjustments. A medical letter documenting the adjustments recommended by a GMC-registered doctor provides the clinical basis for that duty to be acted on.
Employers cannot lawfully refuse to consider reasonable adjustments where the disability threshold is met. A light duties letter gives your employer documented clinical evidence of what adjustments are appropriate, which both supports your request and provides the employer with evidence of due process if the adjustment is challenged.
For detailed workplace modification documentation, a dedicated work adjustment certificate provides a more clinically detailed framework than a standard sick note or return certificate.
Which Certificate Do You Need?
The table below compares the three return-to-work documents side by side.
| Document | When it is issued | What it certifies | Typical duration | Sick pay position |
|---|---|---|---|---|
| Phased return sick note | While you are still partially unfit | "May be fit for work" with reduced hours, days or duties specified by the doctor | Usually 2 to 6 weeks, reviewed at milestones | Normal pay for hours worked. From 6 April 2026, SSP payable for each qualifying absent day |
| Return to work certificate | Once you have fully recovered | Fitness to resume duties from a stated date, fully or on a structured plan | One-off clearance, closes the sick leave episode | Normal pay resumes from the cleared return date |
| Light duties / adjustments letter | During or after return, for an ongoing condition or disability | Specific role modifications recommended on clinical grounds | Long-term or permanent, not time-limited | Normal pay for hours worked under the adjusted arrangement |
Common scenarios and which document applies
Returning from 6 weeks off with back pain, employer wants confirmation before you resume: Return to work certificate. Confirms fitness to resume and can note any physical restrictions.
Returning from depression but not yet ready for full hours: Phased return sick note. "May be fit for work" with reduced hours documented. SSP applies to non-working days from April 2026.
Back at work but an ongoing condition means you cannot lift heavy loads permanently: Light duties / reasonable adjustments letter. Documents the ongoing restriction for employer records and Equality Act purposes.
Returning from surgery but want a structured 3-month build-back: Phased return sick note for the first few weeks, then a return to work certificate once fully reinstated.
Employer wants documentation before you return and you are fully recovered: Return to work certificate. Straightforward medical clearance with a confirmed return date.
How to Get Your Certificate: Same Day
Complete the online consultation
Describe your condition, how long you were off, your current capacity, and what arrangement you are proposing, whether that is reduced days, light duties, or specific adjustments. The more specific you are, the more useful the certificate will be to your employer.
GMC-registered doctor reviews your case
One of our GPs reviews the same day and issues the appropriate certificate, whether phased return, return-to-work clearance, or a light duties/adjustments letter, based on your clinical picture. If a certificate cannot be supported, you receive a full refund.
Certificate delivered to your inbox
Most certificates approved same day or by 9AM next morning. Forward directly to your employer or HR. The QR code allows instant credential verification. ACAS recommends putting any agreed return arrangement in writing, and the certificate gives both sides the clinical documentation to support that agreement.
Phased Return to Work FAQs
Sources & References
The guidance on this page is based on the following official sources. Clinically reviewed by Dr Maria Knobel, Medical Director (GMC 7495073).
- •ACAS: Phased return to work
- •ACAS: Fit notes and proof of sickness
- •ACAS: If a fit note says might be fit for work
- •ACAS: Statutory sick pay (SSP)
- •GOV.UK: Taking sick leave
- •GOV.UK: Fit note guidance for employers
- •GOV.UK: Statutory Sick Pay
- •Equality Act 2010: section 6 (definition of disability) and section 20 (duty to make adjustments)
- •NHS: Getting a fit note
