Rise in GP match notes may imply ‘sick note Britain’ tradition is beginning to change
Uptick in GPs signing back-to-work fit notes suggests Health Secretary Wes Streeting’s demand to ‘stop writing people off’ might be having an impact
GPs may be more likely to sign you back to work(Image: Getty Images)
People signed off work sick may have finally started to fall after more than doubling in the past decade.
“Fit notes” signing people off work had soared from around 5.2 million in 2015/16 to over 11 million in 2025 driven by long term sickness and mental health issues.
However new analysis of the 2025 data suggests a small uptick in sick notes where GPs have authorised that the patient “may be fit for work” with adjustments to their role. It comes after Health Secretary Wes Streeting labelled the fit note system broken, arguing that it was too often writing people off.
READ MORE: Labour fight to keep NHS founder’s home town out of ‘devil incarnate’ Nigel Farage’s clutchesREAD MORE: MV Hondius hantavirus outbreak live: Human transmission fears as three dead
NHS England data shows 11.17 sick notes were issued in 2025 and of these, 93% or 10.37 million were classed as “not fit for work”. Almost a million, or 8% of those issued, were “may be fit for work” fit notes which advised a phased return to work, altered hours and amended duties.
The data suggests a decade-long trend may finally be turning as the total number of “not fit for work” notes fell slightly from 10.44 million in 2024.
It comes after Mr Streeting called for a new approach towards helping people stay in, or return to work, and launched pilots where GPs refer patients to work coaches or fitness specialists.
Last year Mr Streeting said: “It’s about fundamentally changing the conversation from, ‘You can’t’ to, ‘How can we help you?’. When someone walks into their doctor’s surgery worried about their job, they should walk out with a plan, not just a piece of paper that closes doors. We can’t afford to keep writing people off.”
Doctors appear to have started heeding this call while pilot schemes in 15 areas of the country have started connecting anyone in receipt of a fit note with support services which provide work and health advice.
A fit note certifies a patient is ill, confirming a valid reason for staying off work and eligibility for sick pay. Employees require one after the first week off sick, during which they can self-certify.
More recent data for the final three months of 2025 showed 2,853,624 fit notes were issued in the October to December period. This is down 14,935 on the same quarter the previous year. The region issuing the highest rate of fit notes per 100,000 registered patients was the North East, while the lowest was London.
The new 2025 analysis, by consultancy firm Broadstone, shows people being signed off work remains historically high. Of the total 11,17 fit notes, some 59% were issued to women and 41% to men.
Mental and behavioural disorders were the main stated reason at 36% followed by musculoskeletal conditions at 18%. The majority, or 8.28 million of sick notes issued, did not state any diagnosis.
Jamie Burdess, principal consultant at Broadstone, said time will tell whether the data has flatlined at a near record-high or whether the country is seeing the start of a reversal in workplace sickness. He said: “When more than 10 million people are being signed off as unfit for work, it raises questions about whether the sick note system is working as intended.
“In too many cases, it appears to be supporting a complete exit from the workforce, rather than enabling people to stay in or return to work. While workplace sickness absence has improved slightly from post-pandemic highs, it remains concerningly high.”
