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Doctor’s notes and letters

Doctor’s notes and letters are available through our service. Our GMC-registered clinicians can provide fit notes, referrals to specialists for treatment and fit for travel letters.

1. 10-minute online video consultation

2. Several doctor’s notes and letters available

3. Authorised medical evidence from registered clinicians

If you would like to discuss a doctor’s note or letter with one of our GMC-registered clinicians, you can book a face-to-face appointment using our online video consultation service. Our doctors are available between 9.30am-4.30pm, Monday to Friday. 

Doctor’s notes and letters
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When would I need a doctor’s letter?

You may require a doctor’s letter for one of a number of reasons: you may have been off work sick for more than 7 days, or you may need to provide evidence of a health condition, or fitness to fly.

You may need to provide proof of your fitness to enter a sporting event, or evidence of a health condition so that suitable adjustments can be made for you in the workplace, for example. It may be the case that you need to be referred to a specialist for treatment by a doctor.

In these circumstances, doctor’s notes provide essential proof of your fitness or health for your employer, the airline company you are flying with (if required) and any other organisations that request them. Airlines reserve the right to refuse you entry on to flights without a fit for travel letter, for instance, and organisers of sporting events reserve these rights too.

What does a doctor’s note include?

Your doctor will confirm when they assessed you and what your health circumstances are. They will specify what your fitness is in light of their assessment and declare the status of your health.

What does a fit note include?

If your doctor is providing a fit note specifically for your employer, they will declare whether you are not fit to work or whether you may be fit to work, taking into account that you may benefit from a phased return to work, altered hours, amended duties or from certain adjustments being made to your workplace.

What does a Fit to Fly letter include?

If your clinician is issuing a Fit to Fly letter, they will typically state that you should check with your airline if any other checks need to be performed before you travel, and they may refer to any other measures that can be conducted at airports, including temperature checks.

They will usually refer to requirements for entry to a particular country, and in light of the emergence of COVID-19, the importance of following government guidelines to prevent any further spread of the infection. 

What does a referral to a specialist for treatment include?

In the case of referral letters to specialists for treatment, your doctor will refer to your medical history, to give the specialist vital background information, and any details that the specialist should be particularly mindful of.

When doctors correspond with other doctors about your care, they should provide you with a copy of any letters or emails which are exchanged. If you do not receive a copy, you can request one.

In addition to referrals to specialists, your clinician can assist you with identifying stop smoking services, weight loss services, or other self-management sessions that help you to prevent or manage a condition. 

Page last reviewed:  19/10/2020
Types of doctor's letters

Fit notes

If you are off work for more than 7 days, your employer will usually request to see a fit note. Your doctor or your hospital doctor (if you are receiving treatment in hospital) can provide one.

Your clinician will assess your condition, and if they determine that your health impacts on your fitness to work, they can issue a fit note advising that you are either ‘not fit to work’ or that you ‘may be fit for work taking into account the following advice’.
Your doctor will opt for ‘may be fit for work’ if they feel that you are capable of doing some work, even if it’s not work that you would typically do, with the support of your employer.

You should discuss this advice with your employer to establish if you can return to work.

In terms of the specific advice from your doctor, they may suggest implementations such as:

  • returning to work gradually, for instance, by starting part-time
  • working different hours for a period of time
  • carrying out different duties or tasks
  • getting other support to do your job. For example, avoiding any heavy lifting if you’re experiencing back pain

If your employer cannot facilitate these changes, the fit note is treated as though it stated ‘unfit to work’.

Please note that if you are off work due to COVID-19, you should not ask your GP for a fit note. You can instead request an isolation note to send to your employer as evidence that you need to remain at home.

Your GP surgery can advise you as to whether you need to make an appointment to see a doctor about a fit note or arrange a phone consultation.

You can also book a consultation about a fit note with one of our registered clinicians via our online video service.

Referral to a specialist for treatment

If your doctor decides that it’s clinically necessary, they can refer you to a specialist for treatment.

Should you wish to be referred to a specialist in a specific field (for example, a surgeon or a gynaecologist), you should discuss this with the GP you are registered with. This is due to all of your medical records being held by that practice.

Your GP also usually has the best understanding of your medical history and treatments that you’ve taken, and will decide whether to refer you to a specialist on this basis.

If you ask your GP to refer you to a specialist, they are likely to recommend that you try various tests or explore treatment options first, to see if your condition improves. Usually, you can’t refer yourself to a specialist via the NHS. The only exceptions to this are access to sexual health clinics and A&E treatment.

To see a specialist, you will require a referral letter from your GP. Your GP will provide the specialist with any crucial information about your medical background, such as your patient history, and any details that the specialist should be particularly aware of.

In the event that you would like to see a private specialist, you should still request a referral letter from your GP.

Fit for travel letters

Airline companies may request to see authorisation of your fitness to fly from a doctor (or alternatively a midwife, if you are over 28 weeks pregnant) before you travel. If you have a medical condition that is stable, you won’t usually be asked to provide evidence of medical clearance, but an airline may ask to see a Fit to Fly letter in the following circumstances:

  • You’ve been in hospital recently
  • You’re recuperating having had an operation
  • You’re over 28 weeks pregnant
  • You’re travelling for medical reasons (to get treatment)
  • You have a heart condition
  • You have angina
  • You have experienced a heart attack
  • You have had heart failure
  • You have a pacemaker
  • You have undergone heart surgery
  • You have high blood pressure
  • You have asthma
  • You have a broken bone
  • You have diabetes
  • You have a disability

The above list is not exhaustive. If you have a medical condition or are uncertain as to whether you need a Fit to Fly letter, you should make an appointment to discuss this with a registered doctor in the first instance.

A clinician can make an assessment of your fitness to fly, and they will take any of the above factors into consideration. If a doctor determines that you are fit to travel, they will issue a confirmation letter, which is stamped and signed and ready for you to show to airline staff at the airport, should they request to see it.

Guidance on fit to travel letters may vary from one airline to the next, so you should check with the company you are looking to fly with in advance of your journey.

It’s also important to ensure that you have medical clearance for the exact time and date of your flight. If your Fit to Fly letter is dated earlier than this, there’s a strong likelihood that it will no longer be suitable for your upcoming flight.

If you have a recurring or chronic medical condition, it’s advised that you request a fit for travel letter from your doctor where applicable every time you fly. 

Page last reviewed:  19/10/2020
Questions and Answers

Is there a charge for doctor’s letters?

There isn’t a charge from an NHS doctor for issuing a fit note if you are off sick from work for longer than 7 days.

For sickness of 7 days or fewer, your GP practice can charge you to issue a private medical certificate.

An example of this is where an employer asks for medical evidence from employees who take time off sick repeatedly, even if on each occasion they are off sick for 7 days or less. A fit note cannot be issued on this basis, and a doctor may charge you for a private certificate.

There is no charge for a referral to a specialist from an NHS doctor if they are referring you to a specialist on the NHS, but if you want to see a private specialist and pay for your treatment privately, there may be a charge from your GP for the referral.

There may be a charge from your GP for a fit for travel letter.

If you are using a private health service, it’s likely that there will be a charge for fit notes, referrals to specialists for treatment and for Fit to Fly letters.

Do I still need to take out health or travel insurance if I have a fit for travel letter?

Yes. A Fit to Fly letter is not a substitute for health or travel insurance. A fit for travel letter only serves as verification from your doctor that you are medically fit to fly. It does not provide you with any financial cover. You should ensure that you are suitably insured before you travel.

Do I need to see a doctor in person to get a doctor’s note?

No, not necessarily. It may depend on a number of factors: why you are off work sick, whether a GP needs to assess you face-to-face and if you have been in hospital.

In the first instance, you should get in touch with your GP practice. They can inform you if you should make an appointment to see a doctor or if a phone consultation is feasible.

A GP can provide you with a doctor’s letter on the day of your assessment or at any point afterwards.

If you have been in hospital, a hospital doctor can issue you with a fit note, as well as a certificate to confirm that you have been an inpatient.

Some online pharmacies also provide video consultations with registered doctors.

If I have already seen another healthcare professional, will a clinician refer to this in the doctor’s letter?

If you have seen a nurse, physiotherapist or occupational therapist, for example, a doctor can use the reports that they have written as a basis for your doctor’s note. A clinician may refer to a letter from the hospital that you were admitted to, or notes from a previous consultation with a GP at the same practice.

Where can I get a doctor’s note online?

You can speak to a GMC-registered doctor about a doctor’s letter using our online video consultation service. Our clinicians are available for 10-minute face-to-face appointments between 9.30am-4.30pm, Monday to Friday.

Page last reviewed:  19/10/2020

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