Hero illustration about sick notes: desk with laptop, calendar, plant, mug, phone, and a person signing a tablet, for an article titled 'What Happens When Your Sick Note Runs Out?'

What Happens When Your Sick Note Runs Out?

When a sick note expires, you have three options: return to work if you have recovered, request a new sick note if you are still unwell, or discuss a phased return with your employer if you are partially recovered. Your employer cannot force you back before you are medically fit, and a sick note running out does not automatically end your employment or your right to Statutory Sick Pay.

A sick note (formally called a fit note or statement of fitness for work) covers a specific period set by the issuing healthcare professional. The "until date" printed on the certificate marks the last day your sick leave is certified. It does not mean you must return to work the next day regardless of how you feel.

What happens next depends entirely on whether your condition has improved. Many people assume a fit note expiring means they must go back to work immediately, but UK employment law protects employees who remain genuinely unwell. The critical step is to arrange a new assessment before the current certificate expires, so there is no gap in your medical evidence.


Three Scenarios When a Sick Note Expires

When the date on your fit note passes, one of three things should happen. Each has a different process and different implications for your pay and employment rights.

✅ You Have Recovered

Return to work on the first working day after the "until date" on your sick note. You do not need a separate certificate confirming you are fit. The expiry of the fit note itself signals the end of certified sick leave. Notify your employer of your return date and discuss any support you may need in your first week back.

⚠️ You Are Still Unwell

Request a new sick note before the current one expires to avoid a gap in your medical evidence. Contact your GP, hospital doctor, another authorised healthcare professional, or a private online service one to two days before the expiry date. A new assessment is required because the clinician needs to evaluate your current condition. Your employer should not contact you demanding a return if you have a valid, continuous certificate.

🔄 You Are Partially Recovered

Discuss a phased return, amended duties, or adjusted hours with your employer. An authorised healthcare professional can issue a fit note stating you "may be fit for work" with specific recommendations. If your employer cannot accommodate the recommended changes, you continue to be treated as not fit for work. DWP fit note guidance for employers confirms that in that situation the same certificate still counts as evidence for sick pay purposes.


How to Get a New Sick Note Before Your Current One Expires

There is no automatic renewal for sick notes. Each new certificate requires a fresh medical assessment because your doctor needs to evaluate whether your condition has changed, improved, or worsened since the previous review.

1

Check the expiry date on your current certificate

The "until date" is the last day your current sick note covers. Plan to arrange a new assessment one to two days before this date so there is no uncovered gap between certificates.

2

Request a new assessment

Contact your GP surgery for a telephone or face-to-face appointment, ask your hospital consultant if your condition is being managed by a specialist, or use a private online medical certificate service for a same-day assessment. You do not always need to see the same doctor who issued the original certificate.

3

Submit the new certificate to your employer

Forward the new sick note to your employer or HR department as soon as you receive it. Most employers accept digital certificates sent by email or uploaded to an HR portal. Keep the original for your own records.

Can a sick note be backdated?

Yes. DWP fit note guidance for healthcare professionals confirms that a fit note can include dates earlier than the date it is written. If your condition has been affecting your ability to work before the assessment date, the doctor can include an estimated start date reflecting when the illness began affecting you. This means a short gap between certificates does not necessarily leave you without cover, though it is always better to avoid the gap in the first place.


How Long Can a Sick Note Last?

The duration of a fit note depends on how long you have been unwell and the clinical judgement of the issuing healthcare professional. Department for Work and Pensions (DWP) guidance sets maximum periods they should follow.

Stage of illness Maximum fit note duration Notes
First 6 months of condition Up to 3 months per certificate Shorter periods are common for acute conditions expected to improve
After 6 months Any clinically appropriate period, including indefinite Doctors may issue longer certificates for chronic or progressive conditions
Self-certification (no sick note needed) Up to 7 consecutive days Employee tells employer they are ill. No medical evidence required.

These are maximums, not targets. A doctor may issue a shorter certificate if they expect you to improve sooner, or recommend a review date to reassess your fitness for work. If your condition is genuinely long-term, asking your GP for a longer certificate reduces the number of renewals you need and avoids repeated assessment appointments.


What Happens to Your Pay When a Sick Note Runs Out

Your pay during sickness absence depends on your employment contract and how long you have been off. The statutory minimum is Statutory Sick Pay (SSP), but many employers offer contractual sick pay above this level.

Statutory Sick Pay (SSP) timeline

Day 1 onwards
SSP is payable from your first qualifying day of sickness. As of April 2026, the previous three waiting days have been abolished. The current rate is £123.25 per week, or 80% of average weekly earnings, whichever is lower.
Weeks 1 to 28
Your employer pays SSP for up to 28 weeks. It can ask for medical evidence once you have been off for more than seven days in a row, and it decides what evidence it accepts. It cannot withhold SSP because your evidence arrived late. Contractual sick pay, if offered, runs alongside or instead of SSP depending on your contract terms.
After 28 weeks
SSP ends. If it is clear your SSP will end before your sickness does, your employer must give you form SSP1 on or before the beginning of the 23rd week of your absence. If SSP ends unexpectedly while you are still sick, they must give it to you within seven days. The form supports a claim for Universal Credit or Employment and Support Allowance (ESA). Your employment does not end when SSP stops.

⚠ Important: SSP ending does not mean your job ends

The end of Statutory Sick Pay does not change your employment status. You remain employed, continue to accrue holiday entitlement, and retain all statutory employment rights under the Employment Rights Act 1996 until your employment is lawfully terminated through a fair process. Your employer cannot simply stop paying you and assume you have resigned.


Can Your Employer Dismiss You While You Are on a Sick Note?

Having a valid sick note does not make you immune from dismissal, but it does mean your employer must follow strict legal procedures before ending your employment. A sick note is medical evidence of your condition. Dismissing you without following a fair process could amount to unfair dismissal under the Employment Rights Act 1996.

What your employer must do before considering dismissal

✅ Obtain up-to-date medical evidence

Your employer should request a medical report or occupational health assessment before making any decision about your continued employment. They cannot rely solely on the length of your absence.

✅ Explore reasonable adjustments

Under the Equality Act 2010, employers must consider whether changes to your role, hours, or workplace could enable you to return. This applies particularly where your condition meets the legal definition of a disability.

✅ Follow a fair capability process

ACAS guidance says dismissal for long-term sickness should be a last resort. Your employer should support your return first, consider reasonable adjustments, explore all other options, and hold meetings where you can put your case before any decision is made. A dismissal reached without that process is open to challenge as unfair.

✅ Consider alternative roles

If you cannot return to your original role, your employer should explore whether any other suitable position is available within the organisation before moving to dismiss.

Employees currently need two or more years of continuous service to challenge ordinary unfair dismissal at an employment tribunal. From 1 January 2027 that qualifying period falls to six months, under section 25 of the Employment Rights Act 2025, for dismissals where the employment ends on or after that date. If your condition qualifies as a disability under the Equality Act 2010, additional protections apply regardless of length of service.


Equality Act 2010 Protections for Long-Term Illness

If your illness has lasted, or is expected to last, 12 months or more and has a substantial impact on your ability to carry out normal day-to-day activities, it may qualify as a disability under the Equality Act 2010. This applies even if your symptoms fluctuate or are managed with medication.

Conditions commonly recognised as disabilities include depression, anxiety, back injuries, cancer, multiple sclerosis, and many chronic conditions. The protection means your employer has a legal duty to make reasonable adjustments to help you stay in work or return to work, and cannot treat you less favourably because of absence caused by the disability.

Section 15 of the Equality Act specifically prohibits discrimination arising from disability. If your employer dismisses you because of sickness absence that is caused by a disability, this could be unlawful unless they can demonstrate the dismissal was a proportionate means of achieving a legitimate aim. Section 15(2) also gives your employer a defence if it did not know, and could not reasonably have been expected to know, that you were disabled.


How to Avoid a Gap Between Sick Notes

A gap between sick notes can create problems with your SSP payments, your employer's absence records, and your overall employment protection. The simplest way to avoid it is to arrange your next assessment before the current certificate expires.

Option Typical turnaround Best for
NHS GP appointment 1 to 3 weeks (varies by surgery) Ongoing conditions where your GP already holds your medical history
NHS telephone or video review Same week in many surgeries Renewals where a face-to-face assessment is not needed
Private online medical certificate Same day or next morning Urgent renewals where a GP appointment is not available in time
Hospital consultant At your next scheduled appointment Specialist conditions managed by secondary care

If a gap does occur, tell your employer immediately. Explain that you remain unwell and that you are arranging a replacement certificate. A short gap in documentation does not automatically entitle your employer to treat your absence as unauthorised, provided you communicate clearly and obtain the replacement as soon as possible.


Need a New Sick Note Before Your Current One Expires?

If your sick note is about to run out and you are still unwell, MedicalCert can help you avoid a gap in your medical evidence. GMC-registered UK doctors review your online consultation and issue a signed medical certificate, typically the same day or by 9AM the next morning.

No GP appointment needed. No waiting room. Full refund if a certificate cannot be issued on clinical grounds.


Frequently Asked Questions

No. You should only return to work when you are medically fit to do so. If you are still unwell when your sick note expires, contact your doctor for a new assessment and a fresh certificate. Your employer should not require you to return while you remain certified unfit for work, though it can begin a capability process if your absence is long term. Returning before you have recovered risks worsening your condition.

Yes. Private online services like MedicalCert allow you to complete a medical consultation form online. A GMC-registered UK doctor reviews your case and, if clinically appropriate, issues a signed medical certificate the same day or by the next morning. This is particularly useful when a GP appointment is not available before your current sick note expires.

A gap between sick notes can delay your SSP payments and may lead your employer to record the uncovered days as unauthorised absence. However, GOV.UK guidance confirms that employers should not withhold SSP solely because medical evidence arrived late. Notify your employer immediately, confirm you are still unwell, and arrange a replacement certificate as quickly as possible. A backdated sick note can cover the gap where clinically justified.

There is no legal limit on the number of consecutive sick notes you can receive. Each certificate requires a fresh medical assessment, and as long as your doctor is satisfied that you remain unfit for work, they can issue another certificate. SSP is payable for up to 28 weeks of continuous absence. After that, you may be eligible for Universal Credit or Employment and Support Allowance.

Yes. ACAS guidance encourages employers to maintain reasonable contact with employees on sick leave. This is a welfare check, not pressure to return. The contact should be supportive rather than intrusive, and your employer should agree the frequency and method of communication with you. You are not obliged to discuss the details of your medical condition beyond what is on your sick note.

After 28 weeks, your employer is no longer required to pay SSP. If it is clear your SSP will end before your sickness does, your employer must give you form SSP1 on or before the beginning of the 23rd week of your absence. If SSP ends unexpectedly while you are still sick, they must give it to you within seven days. The form supports a claim for Universal Credit or Employment and Support Allowance (ESA) from the Department for Work and Pensions. Your employment does not end when SSP expires. You remain employed and continue to accrue statutory holiday entitlement until your contract is lawfully terminated.

Yes. ACAS confirms that you can return to work before a fit note has expired if you feel well enough. You do not need a separate certificate clearing you to return. Let your employer know in advance so they can prepare for your return. Your employer may want to carry out a brief risk assessment to confirm you are ready.

DWP guidance for employers confirms that a private medical certificate can be accepted as medical evidence in the same way as a fit note, subject to your employer's agreement. Most UK employers accept them for absence records and Statutory Sick Pay purposes, but your employer decides what evidence it accepts. The certificate does not need to be an NHS Med3 fit note for employer use. However, if you need to claim government benefits such as Employment and Support Allowance, you will need an NHS Med3 fit note issued by an authorised healthcare professional: a doctor, nurse, occupational therapist, pharmacist independent prescriber or physiotherapist.

An employer can potentially dismiss you for long-term sickness, but only after following a fair capability procedure. This includes obtaining medical evidence, exploring reasonable adjustments, considering alternative roles, and giving you the opportunity to respond. If your illness qualifies as a disability under the Equality Act 2010, dismissing you without properly considering adjustments could amount to disability discrimination. Employees currently need two or more years of continuous service to challenge ordinary unfair dismissal at an employment tribunal, and from 1 January 2027 that qualifying period falls to six months.

Yes. Statutory holiday entitlement continues to accrue during sickness absence, however long you are off. If you work irregular hours or part of the year, that accrual is 12.07% of your average weekly hours. If you fall ill during annual leave, you can request to take those days as sick leave instead. Your employer cannot force you to use holiday entitlement to cover sickness absence.

Sources and further reading

GOV.UK, Taking sick leave • GOV.UK, Statutory Sick Pay (SSP) • ACAS, Fit notes and proof of sickness • Equality Act 2010, Section 15 • Employment Rights Act 1996 • Department for Work and Pensions, Statement of Fitness for Work: a guide for general practitioners and other doctors

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Reviewed by Dr Maria Knobel

Medical Director, MedicalCert · GMC 7495073 · Last updated: 22 August 2026