How much does a sick note cost in the UK?
Getting a sick note — officially a fit note since 2010 — is free through the NHS. But it costs the taxpayer an estimated £49 per GP consultation (PSSRU Unit Costs 2024), and NHS waiting times can stretch to several weeks. This page covers every route, what each genuinely costs, your legal rights, and when a private certificate makes more practical sense. You can get a sick note online from £47 with a GMC-registered UK doctor.
Do you actually need a sick note?
Many people obtain a GP certificate that is not legally required. UK law draws a clear line at 7 calendar days.
For absences of 7 calendar days or fewer, your employer cannot require a GP fit note as a condition of Statutory Sick Pay. You have the legal right to self-certify. The 7 days includes weekends and bank holidays — not just working days.
From day 8 onwards, your employer can request a fit note from any GMC-registered doctor — including online services. It does not need to be your NHS GP.
When you do NOT need a certificate
- Absence of 7 calendar days or fewer
- Short illness where employer accepts self-cert (SC2 or company form)
- Company sick pay policy more flexible than SSP minimum
When you DO need a fit note
- Absence of 8 or more calendar days in a row
- Claiming Statutory Sick Pay beyond day 7
- Company sick pay policy requires one
- Insurance, benefits, or DWP claims
SSP change from April 2026: Under the Employment Rights Act 2025, Statutory Sick Pay is now payable from day one of illness — the three-day waiting period has been removed. Self-certification rules are unchanged: no fit note is required for the first 7 days.
Sick note cost breakdown — every route
All ways to obtain a fit note in the UK, including patient cost, real cost to the NHS, typical wait time, and whether backdating is available.
| Route | Patient Cost | Actual Cost | Typical Wait | Backdated? | Notes |
|---|---|---|---|---|---|
| NHS GP — in-person | Free | ~£49 (taxpayer) | 1–3 weeks | Yes, up to 28 days | Free for absences 8+ days. Standard NHS appointment. |
| NHS GP — phone / online | Free | ~£49 (taxpayer) | 3–10 days | Yes, up to 28 days | Online booking mandatory across all practices from Oct 2025. |
| NHS GP — under 7 days (employer request) | £25–£40 | Private fee | Days–1 week | Limited | Outside the NHS fit note system. GP may decline or charge. |
| Walk-in / Urgent Care | Free | NHS-funded | 2–6 hrs same day | Limited | Not designed for sick note issuance. Staff may decline. |
| Private GP — in-person | £70–£200 | Same | Same day–48 hrs | Yes | London prices at higher end. Consultation + note usually bundled. |
| Online private — MedicalCert | From £47 | Same | Same day | Yes, up to 28 days | GMC-registered UK doctor. Certificate emailed same day. |
| Employer cert (under 7 days) | £25–£50 | Same | Varies | Depends | Some employers reimburse where they require early documentation. |
* ~£49 taxpayer cost per 10-minute GP surgery consultation — PSSRU Unit Costs of Health and Social Care 2024 (University of Kent / University of York). Source: pssru.ac.uk. Patient-facing NHS appointments are free at the point of use.
Key insight: The zero-cost perception of NHS sick notes masks a real public cost of £49 per consultation — and a wait that can run to weeks. For short-term illness where the clinical picture is clear, an online consultation is faster, draws on the same GMC-registered doctor standard, and eliminates the indirect costs of waiting.
The hidden costs of getting an NHS sick note
The patient-facing NHS cost is zero — but several indirect costs affect the real-world decision.
| Hidden Cost | Who Bears It | Impact |
|---|---|---|
| GP appointment capacity | NHS / taxpayer | ~£49 per consultation (PSSRU 2024) |
| Waiting time (1–3 weeks) | Patient | Delays employer documentation; may affect company sick pay eligibility |
| Lost income while waiting | Patient | Without a fit note, some employers withhold company sick pay above SSP. For higher earners the gap far exceeds £47. |
| Travel to surgery when unwell | Patient | Transport cost and effort for a non-clinical administrative task |
| GP time spent on admin | NHS / GP workforce | Fit note issuance for straightforward illness consumes clinical appointment capacity |
The zero next to 'patient cost' is the most misleading figure in this comparison. NHS sick notes are not free — they consume £49 of public capacity per consultation, plus the patient's waiting time and any income lost during the gap.
When does a fit note require a GP appointment?
Dr Maria Knobel, Medical Director — MedicalCert.co.uk (GMC 7495073)
NHS GP appointments are free to patients, but they are not cost-free — each consultation draws on limited public healthcare capacity. With general practice under sustained demand pressure, it is worth asking whether every sick note genuinely requires a face-to-face appointment.
From a clinical standpoint, most fit notes for short-term illness — typically 3 to 14 days of a common condition such as a respiratory infection, migraine, or musculoskeletal strain — do not require a physical examination to certify safely. A structured online consultation covering symptom history, duration, severity, and impact on work capacity meets the same clinical standard, provided it is conducted by a GMC-registered doctor who takes full clinical responsibility for the assessment.
Patients should also be aware of their rights: employers cannot legally require a fit note for absences of seven days or fewer under SSP rules. For absences of eight days or more, a fit note from any GMC-registered doctor — including doctors working in online services — is legally valid. The doctor does not need to be your NHS GP.
Can my NHS GP charge for a sick note?
This is one of the most frequently misunderstood areas of sick note rules.
For absences over 7 days
NHS GPs are required to issue fit notes free of charge when a patient has been off work for more than seven days. You should not be billed — this is part of your NHS entitlement.
For absences of 7 days or fewer
If your employer requests a sick note for an absence under 7 days — even though they are not legally entitled to require one — your NHS GP may decline or charge a private fee (typically £25–£40). This falls outside the NHS fit note system. In this situation a private online service is usually faster and cheaper.
Some employers include a requirement for early medical evidence in their company sick pay policies. This is legal, but the employer should make clear whether they will reimburse the cost. If they require documentation for an absence under 7 days but will not reimburse it, you can reasonably challenge this given the SSP self-certification rules.
NHS or private — which makes sense for you?
There is no universal answer. It depends on urgency, complexity, and your employer's sick pay policy.
| Situation | NHS GP | Private online (MedicalCert) |
|---|---|---|
| Employer needs documentation urgently | Not suitable — 1–3 week wait | Same day |
| Short-term, clear illness (3–14 days) | Possible but slow | Suitable — structured online consult |
| Complex or ongoing condition needing clinical review | More appropriate | Assess case by case |
| Certificate backdated up to 28 days | Available | Available |
| Absence under 7 days, employer requesting note | GP may decline or charge | Available from £47 | Three surgical changes, nothing else touched. Sorry for the back and forth. Sonnet 4.6Claude is AI and can make mistakes. Please double-check responses.Sick note cost final · HTMLCopyFailed to load file content
| Illness requires treatment or referral | Use NHS | Can refer back to NHS |
Frequently asked questions
Sources: PSSRU Unit Costs of Health and Social Care 2024, University of Kent / University of York (pssru.ac.uk). GOV.UK: Getting a fit note. GOV.UK: Statutory Sick Pay. Employment Rights Act 2025.
Reviewed by Dr Maria Knobel, Medical Director, MedicalCert.co.uk (GMC 7495073). Last reviewed: March 2026.