Quick answer: If work-related stress is affecting your sleep, concentration, mood, physical health or ability to perform your job safely, tell the healthcare professional exactly what has been happening and how it affects your ability to work. You do not need to use a perfect phrase or prove that you are “burnt out”. A fit note is issued following a clinical assessment and may say that you are “not fit for work” or “may be fit for work” with suitable changes.
You have been staring at the same email for twenty minutes. It is not a complicated email, but you cannot decide how to answer it. Your shoulders are tense, you have slept badly for the third night in a row, and the thought of another meeting leaves you feeling close to tears.
Perhaps you work in an office where the workload has quietly expanded as colleagues have left. Perhaps you are an NHS employee finishing one difficult shift and already dreading the next. You might be a teacher carrying work home every evening, a carer who never fully switches off, or a manager who has spent months absorbing everybody else’s problems.
You know that something is wrong, but making a GP appointment brings another worry: What am I supposed to say?
Many people feel uncomfortable asking about a fit note for burnout or work-related stress. They worry that the GP will think they are exaggerating, that their employer will see them as unreliable, or that “burnout” is not a sufficiently medical reason to take time away from work.
This guide explains how UK fit notes work, how to prepare for an appointment and how to describe what you are experiencing without using a rehearsed diagnosis or demanding a particular outcome.
Can you get a fit note for burnout?
A healthcare professional may issue a fit note when your health is affecting your fitness for work. The decision is based on a clinical assessment of your health and functioning rather than on whether you use the word “burnout”.
The World Health Organization describes burnout as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed. It is not classified as a medical condition in its own right.
That does not mean the symptoms should be dismissed. Prolonged work-related stress can be associated with exhaustion, insomnia, anxiety, low mood, headaches, digestive symptoms, difficulty concentrating and a reduced ability to cope. A clinician may identify stress, anxiety, depression, insomnia or another health problem during the consultation.
The fit note records the healthcare professional’s assessment of how your health affects your ability to work. You do not have to arrive with your own diagnosis, and it is usually better not to build the appointment around persuading the clinician to write a particular label.
Instead, explain:
- what symptoms you are experiencing;
- when they began;
- whether they are getting worse;
- how work affects them;
- how they affect your ability to do your job; and
- what you are worried might happen if you continue as you are.
What is a fit note?
A fit note is formally known as a Statement of Fitness for Work. It replaced the older “sick note”, although many people still use that expression.
According to GOV.UK fit-note guidance, a healthcare professional can use it to indicate that you are:
- not fit for work; or
- may be fit for work, taking account of advice given on the note.
“May be fit for work” does not mean that you must immediately return to your normal duties. It means there may be changes that could allow you to remain at work or return safely.
Possible recommendations include:
- a phased return;
- altered working hours;
- amended duties;
- changes to the workplace;
- reduced workload or responsibilities;
- avoiding night shifts temporarily;
- working from home where practical;
- additional breaks; or
- support from occupational health.
The fit note is medical advice to help you and your employer discuss work. It does not force an employer to implement every suggestion in precisely the form written, although separate legal obligations concerning reasonable adjustments may apply where a health problem amounts to a disability.
Do you need a fit note during the first seven days?
Usually, no. Employees can generally self-certify for the first seven calendar days of sickness absence. Calendar days include weekends and days when you would not normally work.
For example, if you become unwell on a Monday and remain unwell through the following Sunday, that is seven calendar days. If the absence continues beyond that point, your employer can normally ask for a fit note.
GOV.UK guidance for employers states that an employer can ask for a fit note when an employee has been off work for more than seven days in a row.
You should still follow your employer’s sickness-reporting procedure from the beginning of the absence. This may involve telephoning a manager before a particular time, completing a self-certification form or recording the absence through an HR system.
Do not wait until the eighth day to seek medical help if you are struggling. The seven-day rule concerns evidence for work; it is not a recommendation to delay healthcare.
Who can issue a fit note?
A fit note is no longer something that can only be signed by a doctor. Eligible healthcare professionals include:
- doctors;
- registered nurses;
- occupational therapists;
- pharmacists; and
- physiotherapists.
The professional must be suitably trained and involved in assessing or managing your care. Not every nurse, pharmacist or physiotherapist will routinely issue fit notes in every setting.
Your GP practice may deal with a request through an online consultation, telephone appointment or face-to-face appointment. For an ongoing problem already documented in your records, the practice may have its own process for requesting a continuation note.
What should you say to a GP about burnout?
There is no password that unlocks a fit note. The most useful conversation is an honest account of what has changed and what you can no longer manage safely or reliably.
You could begin with:
For the past few weeks, I’ve been feeling increasingly exhausted and overwhelmed. I’m not sleeping properly, my concentration has become much worse, and I’m struggling to complete ordinary tasks at work. Work seems to be making the symptoms worse, and I don’t feel that I can continue as I am. I’d like help with what I’m experiencing and advice about whether time away from work or temporary adjustments would be appropriate.
This script works because it does four things:
- It gives a timeframe.
- It identifies specific symptoms.
- It explains the effect on work.
- It asks for clinical advice instead of demanding a certificate.
You can change the wording so that it sounds like you. You do not need to memorise it. Taking written notes into the consultation is perfectly reasonable, particularly if stress makes it difficult to organise your thoughts.
Describe function, not just feelings
Saying “I’m stressed” is a valid starting point, but the clinician will need to understand what that means in your life.
Compare these two descriptions:
Work has been stressful lately and I need some time off.
That statement does not explain the severity or functional effect of the problem.
I’m sleeping for only three or four hours most nights. At work, I’m reading the same information repeatedly without taking it in. I made two errors last week that I would not normally make, and yesterday I had to leave a meeting because I felt panicked and could not stop crying. I’m worried that continuing like this could lead to a more serious mistake.
The second account gives the clinician information they can assess. It is not dramatic language; it is a description of impaired functioning.
Symptoms worth mentioning honestly
Tell the healthcare professional about symptoms that are genuinely affecting you. These might include:
Changes in sleep
- difficulty falling asleep;
- waking repeatedly during the night;
- waking very early with thoughts about work;
- sleeping for much longer than usual; or
- feeling exhausted despite sleeping.
Changes in thinking
- difficulty concentrating;
- forgetting instructions or appointments;
- struggling to make routine decisions;
- repeatedly checking simple work;
- feeling mentally slowed down; or
- being unable to switch off from work.
Emotional symptoms
- feeling anxious before work;
- irritability or becoming angry more easily;
- crying unexpectedly;
- feeling numb or detached;
- losing interest in things you normally enjoy;
- feeling hopeless; or
- dreading contact from colleagues or managers.
Physical symptoms
- headaches;
- muscle tension;
- palpitations;
- nausea or digestive problems;
- changes in appetite;
- dizziness;
- persistent tiredness; or
- panic-like symptoms.
Effects on your work
- making mistakes;
- missing deadlines;
- being unable to prioritise tasks;
- struggling to communicate with customers, patients or colleagues;
- feeling unable to drive or operate equipment safely;
- being unable to manage conflict or emotionally demanding situations; or
- relying on alcohol, sedatives or other substances to cope.
Do not add symptoms because you think they will make the request sound more convincing. Equally, do not minimise important symptoms because you are embarrassed or worried about being judged.
Examples from different workplaces
An office worker
My workload has increased over the past three months. I’m logging back in most evenings and still falling behind. I wake at around 4 a.m. thinking about unfinished work. I’m forgetting meetings and making errors in documents. I no longer feel able to concentrate for a full working day.
An NHS or care worker
I’m exhausted before my shifts begin and I’m struggling to recover between them. My concentration is poor, and I’m worried about missing something important when caring for patients. I became tearful during my last shift and had to ask a colleague to take over. I don’t feel safe continuing without help.
A teacher
I’m working late most evenings and waking up anxious. I’m finding normal classroom noise overwhelming and becoming irritable in a way that is not like me. At home I have no energy for anything, and on Sunday evening I feel physically sick at the thought of Monday.
A shift worker
My sleep has broken down since the rota changed. I’m getting only a few hours between shifts and feel mentally foggy while working. I drive as part of my job and have noticed my reactions and attention getting worse. I’m concerned that I’m no longer working safely.
These are examples, not scripts to copy if they are not true for you. The most convincing explanation is the accurate one.
Should you ask directly for a fit note?
Yes, you can mention it directly. You do not need to wait for the healthcare professional to introduce the subject.
A reasonable way to ask is:
My employer has asked me to provide a fit note if I’m going to be absent for more than seven days. Could we discuss whether a fit note is appropriate and whether I should be completely off work or might manage with temporary adjustments?
This makes the practical reason for the request clear while leaving the clinical assessment open.
Avoid approaching the appointment as though the only acceptable outcome is a specific number of weeks away from work. The clinician may want to discuss treatment, safety, follow-up and whether changes at work could help.
“Not fit for work” or “may be fit for work”?
A person who is severely exhausted, unable to concentrate, experiencing significant anxiety or at risk of making dangerous errors may need a period away from work. In that situation, the fit note may state that they are not fit for work.
Another person may be able to continue with meaningful changes. For example:
- temporarily working shorter days;
- avoiding night shifts;
- reducing customer-facing or clinical duties;
- working from home for part of the week;
- having protected breaks;
- receiving clearer priorities from a manager;
- reducing travel; or
- returning gradually after a period of absence.
If the healthcare professional selects “may be fit for work” but the employer cannot accommodate the recommended changes, the employee is generally treated as not fit for work for the period covered. Discuss the situation with your employer and consult current guidance if there is uncertainty.
Acas guidance gives examples of mental-health adjustments and explains how employees and employers can discuss them.
How long can a fit note last?
There is no standard period for burnout or work-related stress. The length depends on the healthcare professional’s clinical judgement, the severity of the problem and the likely period of reduced fitness for work.
The official patient guidance states that during the first six months of a health condition, a fit note can generally be issued for a maximum of three months at a time. This is a maximum, not the usual length for every patient.
A clinician may issue a shorter note and arrange a review. The review provides an opportunity to assess:
- whether symptoms are improving;
- whether treatment or further support is needed;
- whether a return to work is realistic;
- which adjustments might help; and
- whether another fit note is clinically appropriate.
Can a fit note be backdated?
In certain circumstances, a fit note can cover an earlier period. Government guidance for healthcare professionals permits earlier dates where the person’s functioning was already affected before the fit note was issued.
Tell the clinician:
- when the symptoms began;
- the last day you worked;
- when you first became unable to work; and
- why you could not obtain an appointment sooner.
Backdating is a clinical decision. A fit note cannot simply be dated retrospectively for convenience without an appropriate assessment and supporting information.
What if the clinician does not issue a fit note?
A healthcare professional is not required to issue a fit note solely because one is requested. They may decide that:
- your health does not currently make you unfit for work;
- you could remain at work with suitable adjustments;
- more assessment is needed;
- the issue is primarily a workplace dispute rather than a health condition;
- you are still within the self-certification period; or
- another professional involved in your care is better placed to assess fitness for work.
Ask the clinician to explain their reasoning and what they recommend instead. You might discuss workplace adjustments, occupational health, counselling, NHS Talking Therapies, treatment for anxiety or depression, sleep support or a follow-up appointment.
If the consultation was extremely brief and you feel important symptoms were not understood, you can request another appointment. This does not guarantee a different decision, but it allows you to explain the situation more fully.
What should you tell your employer?
Follow the sickness-reporting procedure in your contract or staff handbook. You can usually keep the initial message straightforward:
I am currently unwell and not able to work. I have sought medical advice and will provide the required fit note. I will keep you updated in accordance with the sickness-absence policy.
You do not need to give your manager a detailed account of every symptom during the first telephone call. However, some information may be helpful if you want the employer to consider particular adjustments.
Keep a copy of the fit note before submitting it. If you have two jobs, government guidance says that one fit note can generally be shown to both employers, with each employer keeping a copy.
Can you return before the fit note expires?
Yes. Government guidance says that you can return to work before the end of a fit note if you feel able. You do not normally need to obtain another note declaring you “fit for work”.
That does not mean you should rush back because you feel guilty or because colleagues are busy. Speak to your employer about whether a return-to-work meeting, occupational-health assessment or phased return would be sensible.
A phased return might involve shorter days, fewer shifts or temporarily amended duties. The appropriate arrangement depends on your health and your job.
Burnout is not always caused by work alone
Work may be the final pressure rather than the only one. Caring responsibilities, bereavement, financial problems, relationship difficulties, chronic illness or poor sleep can reduce a person’s ability to cope with workplace demands.
A fit note can only be issued in relation to the patient’s own health. It cannot normally be issued simply because a relative needs care or because there is a difficult situation at home. However, if those pressures have resulted in a health problem that affects your fitness for work, the clinician can assess that health problem.
Tell the full story. The GP consultation is not an employment tribunal. Its purpose is to understand your health, assess risk and consider appropriate support.
Printable GP appointment preparation sheet
You can print this page or copy the section below into a document or note on your phone. Complete only the parts that apply to you. Use the checklist below to organise your thoughts before speaking to a healthcare professional. You can write your answers separately, copy the questions into your phone or take a screenshot for your appointment.
Fit Note Appointment Preparation Worksheet
When to seek urgent help
Burnout language can sometimes conceal a more serious mental health crisis. Seek urgent help if you:
- feel unable to keep yourself safe;
- are thinking about harming yourself or ending your life;
- feel unable to cope until a routine appointment;
- are experiencing severe panic, confusion or agitation; or
- believe your symptoms place you or somebody else in immediate danger.
If there is immediate danger, call 999 or attend A&E. If you need urgent mental health help but it is not an emergency, use NHS 111 online or call 111 and select the mental health option where available.
The NHS stress guidance also provides information about support, including NHS Talking Therapies. In England, many adults can refer themselves to NHS Talking Therapies without first speaking to a GP.
Frequently asked questions
Will a GP give me a fit note if I say I am burnt out?
Not automatically. The healthcare professional will assess your symptoms, health and ability to work. Explain the functional effects rather than relying only on the word “burnout”.
Can stress be written on a fit note?
A healthcare professional chooses the wording based on their assessment. They may use an appropriate description such as stress-related symptoms, anxiety, depression or another health problem. The wording is their clinical decision.
Can I request a fit note online?
Many GP practices accept fit-note requests through an online consultation system, particularly for an ongoing condition. The practice may still arrange a telephone or face-to-face assessment.
Do I need to pay for a fit note?
A standard NHS fit note required for sickness absence is normally provided without charge. Other private medical certificates requested for purposes outside the statutory fit-note system may attract a fee.
Can my employer contact my GP?
Your employer does not have an automatic right to your medical information. Access to a detailed medical report generally requires your knowledge and consent. An employer may check whether a fit note is genuine without receiving additional confidential medical details.
Can I be dismissed while off with stress?
Sickness absence does not provide absolute protection against dismissal, but employers must follow a fair process and consider relevant legal obligations. Long-term mental health conditions can sometimes meet the definition of disability under the Equality Act 2010. If you are concerned about your employment, obtain individual advice from Acas, a trade union or an employment adviser.
Can occupational health issue a fit note?
An eligible occupational therapist involved in your care may issue a fit note if appropriately trained and working within the relevant arrangements. An occupational-health report can also provide separate advice to you and your employer about adjustments and returning to work.
What if the problem is bullying or an unreasonable workload?
Tell the clinician how the situation is affecting your health. Separately, keep a factual record of workplace events and consider speaking to HR, a trade union, an employee-assistance programme or Acas. A fit note addresses fitness for work; it does not resolve the underlying employment dispute.
The most important thing to say
You do not need a medical vocabulary or a perfectly delivered speech. Start with what has changed.
Tell the clinician how you are sleeping, thinking and functioning. Explain what happens before, during and after work. Mention mistakes, safety concerns, panic, persistent low mood or reliance on alcohol or medication if these are part of the picture.
You can then ask calmly:
Based on what I’ve explained, do you think I am currently fit to work? Would a period away from work or temporary changes be appropriate, and could we discuss whether I need a fit note?
That is enough. The rest of the conversation can develop from there.
Sources and further information
- GOV.UK: Fit-note guidance for patients and employees
- GOV.UK: Notice and fit notes
- GOV.UK: Fit-note guidance collection
- GOV.UK: Who can issue fit notes
- NHS: Get help with stress
- NHS: Talking Therapies
- Acas: Time off with stress
- Acas: Mental-health adjustments
- World Health Organization: Burnout as an occupational phenomenon
Medical and employment disclaimer: This article provides general information and is not personal medical, legal or employment advice. A fit note can only be issued following an appropriate assessment by an eligible healthcare professional. Workplace rights and sick-pay arrangements depend on individual circumstances and current rules.
Corrections and updates
Fit-note and employment guidance can change. If you believe this article contains a material error, please email pryhelmuk@gmail.com. Verifiable corrections will be reviewed promptly.