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 £45 per GP consultation (PSSRU Unit Costs of Health and Social Care 2024 Manual, 2023/2024 figures), 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 for work 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, the GOV.UK employer guide states that an employer can only ask for a fit note if the employee is off work for more than 7 days in a row. You self-certify for that first period. 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 payable from day one of a qualifying absence, the waiting days having been abolished on 6 April 2026. From that date SSP is £123.25 a week, or 80% of average weekly earnings if that is lower, for up to 28 weeks. 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 | ~£45 (taxpayer) | 1–3 weeks | Yes, where an earlier assessment supports it | Free for absences 8+ days. Standard NHS appointment. |
| NHS GP, phone / online | Free | ~£45 (taxpayer) | 3–10 days | Yes, where an earlier assessment supports it | Since 1 October 2025, GP practices in England must keep an online consultation tool open through core hours, 8am to 6:30pm, for non-urgent requests. |
| NHS GP, under 7 days (employer request) | Fee set by the practice, commonly £25 to £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 | Fee set by the provider, commonly £70 to £200 | Same | Same day–48 hrs | Yes | Each practice sets its own fee. London prices sit at the higher end. Consultation and note usually bundled. |
| Work Sick Note, MedicalCert | From £47 | Same | Same day | Yes, where an earlier assessment supports it | GMC-registered UK doctor. Certificate normally emailed the same day. |
| Employer cert (under 7 days) | Fee set by the practice, commonly £25 to £50 | Same | Varies | Depends | Some employers reimburse where they require early documentation. |
* ~£45 taxpayer cost per 10-minute GP surgery consultation, Table 9.4.2, unit cost 2023/2024, including direct care staff and qualification costs. PSSRU Unit Costs of Health and Social Care 2024 Manual (University of Kent / University of York). Source: pssru.ac.uk. Patient-facing NHS appointments are free at the point of use.
MedicalCert does not issue NHS fit notes. A Med3 statement of fitness for work is an NHS document, issued free by an authorised NHS healthcare professional once you have been ill for more than 7 calendar days. MedicalCert issues private medical certificates. These are commonly used for employer sick pay policies, but they are not a substitute for a Med3 where a benefit claim or a formal NHS process requires one.
Key insight: The zero-cost perception of NHS sick notes masks a real public cost of about £45 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 | ~£45 per consultation (PSSRU 2024 Manual) |
| 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 roughly £45 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: under GOV.UK guidance an employer can only ask for a fit note once someone has been off for more than seven days in a row. Beyond that point, medical evidence from a GMC-registered doctor working in an online service can serve the same purpose, and the doctor does not need to be your NHS GP. What an employer will accept is still the employer's decision, so it is worth checking your own sick pay policy.
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
GOV.UK's fit note guidance for patients and employees states that you will not have to pay for a fit note if you have been ill for more than 7 calendar days, including weekends and bank holidays. You should not be billed for one.
For absences of 7 days or fewer
If your employer asks for a sick note for an absence under 7 days, even though the GOV.UK employer guide says they can only ask for a fit note after more than 7 days in a row, your NHS GP may decline, or charge a private fee. Practices set these fees themselves and they are commonly in the £25 to £40 range. 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. GOV.UK's guidance for patients and employees says that where an employer requires medical evidence for the first 7 days of sickness absence, the healthcare professional may charge a fee and this cost should be covered by the employer. 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 dated to cover an earlier period | Available | Available |
| Absence under 7 days, employer requesting note | GP may decline or charge | Work sick note from £47 |
| 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.
