How Much Does a Sick Note Cost in the UK?

People usually search for the cost of a sick note when they are already stressed. They may be unwell, under pressure from work, and unsure whether they are expected to pay for medical evidence themselves. The answer is clearer once you separate three different situations: standard NHS fit notes after more than 7 days of sickness, employer requests for evidence during the first 7 days, and private medical certificates or letters.

In the UK, the price depends less on the words "sick note" and more on what document is actually needed, how long you have been off sick, and who is asking for it. A standard fit note after the first 7 days should usually be free. A request for medical evidence in the first 7 days may carry a fee, and official guidance says the employer should cover that cost. Private services are different again because they are private assessments rather than ordinary NHS fit note provision.

This guide sticks closely to what the official UK guidance says, then explains where private evidence sits without blurring the lines between the two.

Quick answer

If you have been ill for more than 7 calendar days and need a standard fit note, you should not normally have to pay for it. If your employer asks for medical evidence during the first 7 days of sickness absence, a healthcare professional may charge a fee, and the official guidance says the employer should cover that cost.

Private providers may charge for private medical certificates, letters, or assessments because those are private services rather than the routine NHS fit note route. There is no official national private tariff, so what matters most is understanding the difference between a free standard fit note and a paid private service.

When a sick note is free

For most employees, the key rule is simple. If you have been ill for more than 7 calendar days and need a fit note, it should usually be free. That is because a fit note becomes part of the ordinary sickness absence process once the self-certification window has ended.

The 7 day count is based on calendar days, not just the days you were scheduled to work. That means weekends and bank holidays still count. If you have been off from Monday and are still unwell into the following week, the normal system is that you move from self-certification to a fit note without having to pay for that routine evidence.

This is one of the biggest sources of confusion online. Many people assume anything involving a doctor or clinician must carry a charge. In reality, the standard UK fit note route is not supposed to work that way once the absence has gone beyond 7 days.

What happens in the first 7 days

The first 7 calendar days are handled differently. During that period you can usually self-certify rather than provide a fit note. That is why the first question is often not "how much does it cost?" but "do I need one at all?" In many ordinary short absences, the answer is no.

If an employer still asks for medical evidence in those first 7 days, the healthcare professional may charge a fee for providing it. The official patient and employer guidance both say that if the employer wants that early evidence, the employer should cover the cost.

That is an important practical protection. If someone is only a few days into an illness and their employer says they must bring a doctor’s note straight away, it does not automatically become the worker’s job to pay for a document the standard system would not normally require yet. If you need the background, our guide to self-certification for the first 7 days explains why the ordinary first-week rule matters so much.

NHS fit notes and private medical certificates are not the same thing

A lot of cost confusion happens because people use the phrase "sick note" to describe several different documents. A standard NHS fit note is the official evidence used in the normal sickness absence process after 7 days. It is issued by an eligible healthcare professional after assessing your fitness for work.

A private provider may instead offer a private medical certificate, a general medical letter, or another form of documentation. Those can be useful in some situations, but they are not automatically the same thing as an NHS Med3 fit note. Whether another form of private evidence is accepted can depend on the employer or organisation receiving it.

That difference is exactly why the cost picture changes. The rule that a standard fit note should usually be free after 7 days does not mean every private certificate must be free. Private services set their own fees because they involve private assessment and administration outside the usual NHS route.

Why private evidence may cost money

Private medical evidence usually reflects more than the document itself. A private service may involve clinical review, secure handling of health information, administrative processing, identity checks, and faster turnaround than someone can get through the ordinary route. Some providers also explain in advance what happens if the clinician decides the certificate should not be issued after review.

That does not make private evidence automatically better or more official. It just means the commercial structure is different. Some people choose a private route because they cannot get a timely GP appointment, because their employer accepts private documentation, or because they need a certificate or letter for an administrative purpose that sits outside the usual NHS fit note system.

The safest way to think about cost is this: the fee is for a private service, not for official status by itself. A paid certificate is not automatically more valid than a free fit note, and a free fit note is not automatically enough for every private administrative purpose.

Can a GP charge for a sick note?

A GP should not normally charge for a standard fit note once you have been ill for more than 7 calendar days and the note is part of the ordinary sickness process. That is the cleanest answer for the question most people mean when they ask about sick note cost.

A fee may arise if the request falls outside that route, especially if the employer is asking for medical evidence during the self-certification period or if what is really being requested is a private letter rather than a fit note. This is why it helps to ask exactly what document is needed before assuming the charge is right or wrong.

If you are not sure whether the document you need is a private medical certificate or an ordinary sickness note, our page on private medical certificates sets out where private documentation tends to fit.

Can an employer ask you to pay?

If the employer wants medical evidence in the first 7 days, the official guidance says the employer should cover that fee. That is the strongest current answer supported by UK guidance. After 7 days, the issue normally falls away because a standard fit note should usually be free anyway.

Disputes tend to arise when an employer asks for something more specific than the ordinary process requires. For example, they may want a letter worded in a particular way, extra details, or quicker evidence than the system usually expects. In those cases it is worth asking what they are requesting, why they want it, and whether they will cover any fee that arises because they are asking for something outside the ordinary route.

What to compare if you are looking at a private service

If you are considering a private provider, the most useful comparison is not a vague idea of the market average. It is what the service actually includes. A careful comparison usually looks at whether a real clinician reviews the case, what document can be issued, how quickly the outcome is delivered, whether pricing is clear before payment, and what happens if the clinician decides the certificate should not be issued.

That approach is more useful than chasing an unofficial average price because it keeps the decision tied to quality, suitability, and transparency. A lower fee is not automatically better if the document is not right for your purpose. A higher fee is not automatically justified if the provider is vague about what it can actually issue.

• what type of document the service may provide
• whether a real clinician reviews the case rather than the process being automatic
• how fast the review and delivery process is
• what refund or non-issue policy applies after clinical review
• whether the receiving employer or organisation is likely to accept that document

When private evidence may make sense

Private evidence can make sense when someone needs prompt documentation after clinical review, cannot easily access an NHS appointment, or needs private documentation for work, study, travel, insurance, or another administrative purpose. The point is not that private evidence replaces the standard route in every situation. It is that some people need something different from the ordinary free fit note process.

Where the issue is straightforward work absence after more than 7 days, the official route still matters most. Where the need is broader, such as a private certificate or letter, it makes sense to compare services and check acceptance in advance. If you want to see DoctorCert pricing without turning this guide into a sales page, you can check pricing and compare that with the type of certificate you actually need.

Questions worth asking before you pay for anything

Before paying for any medical evidence, it helps to slow the process down and ask a few basic questions. What document is actually being requested? Is it a standard fit note, a private medical certificate, or a more detailed letter? Who is asking for it, and for what purpose? A lot of unnecessary spending happens because someone pays for a private document when the standard free route would have covered the situation.

It is also worth asking whether the receiving employer, school, insurer, or other organisation has confirmed that it will accept the document you are buying. If not, the problem may not be the price at all. It may be that the wrong type of evidence is being requested or that the organisation has not explained its requirements clearly.

• ask whether a standard fit note would be enough
• ask whether the request falls inside or outside the first 7 days of sickness
• ask the employer whether they will cover a fee if they are insisting on early evidence
• ask any private provider exactly what document may be issued after clinical review

What not to assume

Do not assume a fee automatically means the document is more official. Cost and legal status are not the same thing. Do not assume every private certificate can replace an NHS fit note in every setting. Acceptance depends on what evidence is required. And do not assume the employee must always pay whenever an employer asks for a note. In the first 7 days, the official guidance points that cost back to the employer if they are the one demanding early evidence.

The most reliable question is not "what is the average price?" but "what document do I actually need, and who is asking for it?" Once you answer that, the cost picture becomes much clearer.

If you want to compare your options, start by checking pricing and reading more about private medical certificates.

Frequently Asked Questions

Are sick notes free from the NHS?

Yes. If you have been ill for more than 7 calendar days and need a standard fit note, it should usually be free.

Can my employer ask me to pay for a sick note?

If your employer requires medical evidence during the first 7 days of sickness absence, the official guidance says the employer should cover the cost.

Do you have to pay for a note under 7 days?

You usually do not need a fit note under 7 days because you can self-certify. If a clinician is asked to provide early medical evidence anyway, they may charge a fee.

Why do private sick notes cost money?

Private certificates are part of a paid private service rather than the standard NHS fit note route, so the provider sets its own pricing and terms.

Is a private medical certificate the same as an NHS fit note?

No. A private medical certificate is not automatically the same as an NHS Med3 fit note. Some employers or organisations may accept private evidence, but that depends on what they require.

Need a medical certificate?

If you need signed medical evidence for work, study, or administrative purposes, you can request a private medical certificate online from a GMC-registered doctor, usually issued within 2 hours during business hours. See the one-off pricing and how private medical certificates work before you start.