Private Fit Note in London 2026. When You Do Not Need One, What Makes It Valid and How to Get One the Same Day

Reviewed by the medical team at The Wellness. Last updated 1 September 2026.

Ask whether you need a fit note today or email team@thewellnesslondon.com or call 020 3951 3429.

When you do not need a fit note

For the first 7 calendar days of sickness, including weekends and days you would not have worked, you self-certify. Your employer can ask you to complete their own form or the SC2 form, and that is all the law allows them to ask. Statutory Sick Pay starts from the fourth qualifying day and does not depend on a note in that first week. An employer who insists on a fit note for a 3-day absence is asking for something no doctor should issue and no policy can require.

You also do not need a fit note to return to work. The rule that a doctor had to sign you back in ended in 2010 when the fit note replaced the sick note, and an employer who asks for a return-to-work certificate is asking for a document that no longer exists. Where you are well enough to return with changes, the fit note itself carries a may be fit for work box with adjustments the doctor recommends, and that is the document to use.

What makes a fit note valid

A fit note is the Statement of Fitness for Work, form Med 3, and since 2022 it can be issued digitally and does not need a wet signature. It is valid when it is issued by a registered doctor, nurse, pharmacist, physiotherapist or occupational therapist after an assessment, states whether you are not fit for work or may be fit with adjustments, gives the condition or a description of it, covers a stated period, and carries the professional's name and registration. Nothing in the law requires it to come from your NHS GP.

The assessment can be by video or telephone as well as in person, and the Department for Work and Pensions guidance says so explicitly, which is why a same-day video consultation is the right route for most people. What the assessment cannot be is absent. A fit note from a form filled in at midnight with no professional having spoken to you is not a fit note, and the General Medical Council's guidance on certificates says a doctor must only sign what they have taken reasonable steps to verify.

Send us your dates to check appointment availability or email team@thewellnesslondon.com.

Can a fit note be backdated

Partly, and honestly. A doctor can issue a fit note covering a period before the consultation where the clinical picture supports it, and the DWP guidance allows this, because people are often too unwell to be seen on day 8. What the doctor records is what you reported for that period and their opinion on whether it is consistent with what they find, and the note states the date of the assessment. What a doctor cannot do is write that they observed you on a day they did not see you, and a clinic that offers to do so is offering something a tribunal will take apart.

The same applies to duration. A first fit note in the first 6 months of a condition can cover up to 3 months, and after 6 months it can be open-ended, but a doctor issues the period the assessment supports and reviews it, rather than the period requested. A 4-week note for a 2-week condition helps nobody, and an employer reading it knows that.

What the fit note should say for mental health

Mental health is the commonest reason for a fit note in England, and it is also where the wording matters most. The condition can be described as stress at work, low mood or anxiety without a formal diagnosis where none has been made, and the may be fit for work section can recommend a phased return, altered hours, amended duties or workplace adaptations, which is often more useful to you than a longer absence. A doctor who takes 30 minutes over that section is writing a document that changes your return, not only your absence.

The consultation is also a consultation. A fit note for anxiety or low mood is issued after a PHQ-9 and GAD-7 have been scored, the risk questions have been asked, and the options have been discussed, including free self-referral to NHS Talking Therapies and where it applies a psychiatrist. If the same-day appointment finds something that needs more than a note, that is said, and the plan follows. A page about fit notes that does not say this is selling paper.

What does a private fit note cost in London

At the top of the market, 12-month programmes with a retained doctor run to £49,995 and comprehensive health programmes exceed £32,000, where a fit note is written by the doctor who already holds your record. Harley Street GP consultations run £250 to £350 before any certificate, and an occupational health assessment arranged by an employer costs £300 to £600 per report.

Beneath that sits a tier defined by its conditions rather than its price, online form services with no consultation, no assessment and no professional who will answer when your employer or a tribunal asks who signed it. At The Wellness, fit notes depend on clinical assessment. Confirm consultation and document fees, inclusions and timing before booking. All figures are from prices.

• Principal Programme: enquire for the current fee, coverage and inclusions

• Continuous Care Programme: enquire for the current fee, coverage and inclusions

• Executive Health Programme: enquire for the current fee, assessment and inclusions

• Psychiatrist consultation, separate from the GP: enquire for the current fee

• Home visits £450. Hotel visits £495 daytime. Enquire for office visits

• Extended 45-minute consultation: enquire for the current fee

• In-person consultation: enquire for the current fee

• Same-day video consultation, 30 minutes, from £150

• Fit note or medical certificate following assessment: enquire for the current fee

Why The Wellness is the best private fit note service in London

Every note follows a consultation with a doctor, and that is countable. Appointment availability is confirmed before booking. A note is issued only when clinically appropriate; any fee and delivery timing are confirmed before booking. The assessment is recorded and any note states the assessment date, period covered and doctor’s GMC number. That is why our notes are accepted by HR departments and have held up when questioned, and why nobody here is asked to fill in a form and wait for a PDF.

The consultation assesses your symptoms and what support may help. Depending on the findings, the doctor may discuss treatment, workplace adjustments or mental health support. A fit note is issued only when clinically appropriate; the assessment determines its wording and period covered. Confirm any fee and document delivery timing before booking.

We also say what a note cannot do. It cannot state something the doctor did not find, it cannot cover a period the assessment does not support, and it cannot certify a person the doctor has not assessed. Places on the 12-month programmes are limited by the number of people one doctor can hold properly, so they begin with an allocation call.

Book a consultation to assess whether a fit note is appropriate; confirm any fee and delivery timing before booking or call 020 3951 3429.

Related reading

This page is one spoke of the Private GP in London hub. Students who need evidence for a university rather than an employer are covered in Extenuating Circumstances Letter in London, passengers who need a certificate for an airline in Fit to Fly Letter in London, and the assessment behind a mental health fit note in Private Mental Health Assessment in London.

Frequently asked questions

Do I need a fit note for the first week off sick

No. For the first 7 calendar days you self-certify, your employer can ask only for their own form or the SC2, and Statutory Sick Pay does not depend on a note in that week. A fit note is needed from day 8. At The Wellness a same-day video consultation from £150 is booked for day 8 onwards, and a note for the first week is refused because the law does not require it.

Is a private fit note valid

Yes. Validity comes from the registered professional who assessed you, not from the NHS, and the Department for Work and Pensions confirms fit notes can follow a video or telephone assessment. A note from an online form with no consultation is the one an employer can question. At The Wellness every note follows a consultation from £150 and carries the doctor's GMC number.

How much does a private fit note cost in London

A Harley Street GP consultation costs £250 to £350 before any certificate, and an occupational health report arranged by an employer £300 to £600. At The Wellness, video consultations are from £150. Enquire for in-person consultation and fit note fees, and confirm document timing before booking.

Can a fit note be backdated

A doctor can issue a note covering a period before the consultation where the clinical picture supports it, recording what you reported and their opinion on consistency, with the assessment date stated. A doctor cannot state they observed you on a day they did not see you. At The Wellness that is explained before the consultation from £150 is booked.

Can I get a fit note for stress or anxiety

Yes. Mental health is the commonest reason for a fit note in England, and the note can describe stress at work, low mood or anxiety and recommend a phased return or adjustments. The consultation includes PHQ-9 and GAD-7 scoring, risk questions and the NHS Talking Therapies route. At The Wellness it is from £150 by video, with psychiatrist fees confirmed before booking where needed.

Do I need a doctor's note to return to work

No. The requirement ended in 2010 when the fit note replaced the sick note, and no return-to-work certificate exists. Where you can return with changes, the may be fit for work section of the fit note recommends adjustments. At The Wellness that section is completed in the consultation from £150 when it helps you.

The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Imaging is arranged at specialist centres and reported by consultant radiologists, and blood analysis is performed by accredited laboratories. If you are having thoughts of ending your life, call 999, go to an emergency department, or call Samaritans on 116 123 at any hour. This article is general information and not a substitute for medical advice about your own health.

Send us your question about fit notes or email team@thewellnesslondon.com or call 020 3951 3429.