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NHS Fit Notes report allows for regional comparisons to be made for the first time

Coverage in NHS Digital’s latest fit notes publication has increased to include data from 96% of GP practices.
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Coverage in NHS Digital’s latest fit notes2 publication has increased to include data from 96% of GP practices3.

Between April and December 2018, 6.9m fit notes were issued in England – with 3.9m issued to women (56.7%) and 3.0m issued to men (43.3%).

Of these, 93.1% were declared “not fit for work” and 6.9% were declared “maybe fit for work”.

In the latest month’s figures (December 2018), “mental health and behavioural disorders” accounted for 32.9% of fit notes with a known diagnosis4.

Diseases of “musculoskeletal system and connective tissue” was the second most common diagnosis, which accounted for 16.7% of fit notes with a known diagnosis in December 2018.

NHS Digital has been publishing Fit Notes Issued by GP Practices5 since August 2017, but this is the first time that the coverage has been high enough to allow regional comparisons to be made across CCGs.  

In December 2018, Knowsley CCG issued the highest number of fit notes (3,125 per 100,000 population) and Westminster CCG issued the lowest number of fit notes (688 per 100,000 population)6.

A fit note is issued after the first seven days of sickness absence, following a doctor’s assessment of the patient’s fitness for work.

The doctor can decide if the patient is 'unfit for work' or 'may be fit for work subject to the following advice...' with accompanying notes on suggested adjustments or adaptations to the job role or workplace.

Read the full report:

Fit Notes issued by GP Practices, England December 2018


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Notes to editors

  1. NHS Digital is the national information and technology provider for the health and care system.  Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals and citizens depend. During the 2017/18 financial year, NHS Digital published 275 statistical reports. Our vision is to harness the power of information and technology to make health and care better. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. We provide ‘Information and Technology for better health and care’. Find out more about our role and remit at
  2. The Statement of Fitness for Work (the Med3 form or 'fit note') was introduced in April 2010 across England, Wales and Scotland. Doctors issue fit notes to people to provide evidence of the advice they have given about their fitness for work. They record details of the functional effects of their patient's condition so the patient and their employer can consider ways to help them return to work.
  3. The previous publication (Fit Notes Issued by GP Practices, England September 2018) included data from 62% of GP practices.
  4. A total of 4,789,085 out of 6,931,192 fit notes analysed between April and December 2018 were not mapped to ICD-10 medical codes and therefore have no known diagnosis.
  5. The data is aggregated and fully anonymised. No patient-level information is extracted, nor can an individual patient be identified.
  6. This report uses the 18–65-year-old patient population as a proxy for working age in order to calculate the proportion of patients covered by this data, as a fit note is likely to be required for a person who is of working age.
  7. For media enquiries please contact or 0300 303 3888.

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Last edited: 9 May 2019 8:50 am