Medical letters and medical certificates are often confused, but they serve different purposes. Here's how to tell them apart and which one you actually need.
Medically reviewed by Dr Sulaiman Shah, GMC No. 7038832 — The GP Clinic, 124 City Road, London.
Last updated: September 14, 2026
Quick answer: In the UK, a legitimate doctor’s note (fit note) obtained online must come from a GMC-registered doctor or other authorised healthcare professional, working through a CQC-regulated online GP service. It carries exactly the same legal standing as an in-person note, provided it’s based on a genuine clinical assessment — not a form filled in with no consultation at all.
Getting medical documentation used to mean booking time off to sit in a waiting room. Today, most UK patients can get a doctor’s note online for work or travel — assessed properly from home, over video or phone.
This guide covers how the process actually works, what makes a note legitimate, and where people go wrong getting a doctor’s note.
A doctor’s note (in UK employment contexts, usually a fit note) is a formal statement from a healthcare professional confirming you were assessed and, in their clinical judgement, are unfit for work — or fit with adjustments — for a stated period. A properly issued note typically includes:
For the first 7 calendar days of any absence, UK employees don’t need a doctor’s note at all — self-certification covers that period. A note only becomes relevant from day 8 onwards, or where an organisation (an airline, for example) specifically requires medical clearance.
If you want the full breakdown of typical note lengths, see how long a sick note can last.
Note that a standard sick note and a fitness-to-fly letter aren’t always the same document — airlines often have their own specific form or requirements, so it’s worth checking with the airline directly before booking an appointment.
This is the step people skip, and it’s the one that matters most. In England, any service providing online GP consultations, remote assessment, or remote prescribing must be registered with the Care Quality Commission (CQC). Before booking, check that the service:
If a “clinic” doesn’t require any consultation at all before issuing a note, that’s a strong warning sign — not a shortcut.
Most reputable UK online GP services offer same-day or next-day appointments. You’ll typically:
During the consultation, the clinician will ask about your symptoms, how they’re affecting your ability to work or travel, and any relevant history. This is a genuine clinical assessment, not a formality — the clinician decides whether a note is clinically justified, exactly as they would in person.
If a note is appropriate, you’ll usually receive it as a secure digital document you can:
Get a sick note online in the UK walks through this process in more detail if you’re ready to book.
Both routes can issue a legitimate online note, but they suit different situations.
NHS online consultations (via your GP practice’s online system, or NHS 111 where appropriate) are free at the point of use, but appointment availability depends on your practice’s current capacity — same-day slots aren’t guaranteed, especially during busy periods.
Private online GP services typically offer faster, more predictable turnaround — often same-day — for a consultation fee. This is usually the better option when timing is critical: an urgent work deadline, a last-minute travel requirement, or when your NHS practice can’t offer an appointment quickly enough.
Neither route is inherently “more legitimate” than the other — a fit note from an NHS GP and one from a CQC-regulated private online GP carry identical legal weight, provided both involved a genuine clinical assessment.
Yes — a note issued by a GMC-registered doctor (or another authorised professional, such as a registered nurse, pharmacist, occupational therapist, or physiotherapist) through a properly regulated online consultation carries the same legal standing as one issued face-to-face. UK employment law doesn’t distinguish between “online” and “in-person” fit notes; what matters is that a genuine assessment took place and the clinician is appropriately registered.
That said, two practical checks are worth doing:
For more on where you stand legally if a note is questioned, see the legal implications of GP sick notes.
Any service that issues a note without any genuine assessment isn’t operating legitimately in the UK, regardless of how professional the website looks. This isn’t a grey area — a fit note is meant to reflect real clinical judgement.
While legally valid, some organisations set their own internal documentation standards. If you’re getting a note for a specific, high-stakes purpose (an airline, an insurance claim), it’s worth confirming acceptance criteria in advance rather than after the fact.
Not every online service offers genuinely same-day turnaround. If timing matters, check the guaranteed response time before booking rather than assuming.
Yes, legally. As long as it’s issued by a GMC-registered doctor or authorised clinician through a properly regulated service following a genuine assessment, an online note carries identical legal standing to one from a face-to-face appointment.
It depends on the provider and your situation. Many UK online GP services offer video, phone, or secure messaging consultations — but the clinician will choose (or require) the format that lets them properly assess your condition, which sometimes means video is needed rather than messaging alone.
Sometimes, but check first. Airlines often have their own specific requirements for fitness-to-fly documentation, separate from a standard sick note, so it’s worth confirming exactly what the airline needs before booking your consultation.
Search for the provider on the CQC’s public register to confirm it’s registered for online primary care, and check that the doctors are listed on the GMC register. A legitimate service will make this information easy to find, not hidden.
Because online and in-person fit notes carry the same legal weight, an employer can’t dismiss one purely for being issued remotely. If a note is disputed, employers can seek their own occupational health opinion, but that’s a separate process — it doesn’t cancel your existing note.
That can happen, and it’s a normal part of a genuine assessment — not every consultation results in a note. If the clinician judges you’re fit for work or that your symptoms don’t warrant time off, they’ll explain why, and most services won’t charge a full fee purely for issuing paperwork you don’t clinically need.
No — a fit note is issued to the person the clinician has actually assessed. A parent or carer can usually be present during a child’s consultation, but the note itself is based on a direct assessment of the patient, not a secondhand description.
No. Private online GP services are independent of your NHS registration, so you can use one regardless of which practice you’re registered with, or even if you’re not currently registered anywhere.
Yes, though self-employed people don’t need one to claim SSP, since SSP doesn’t apply to the self-employed. A note can still be useful for other purposes — client contracts, insurance claims, or simply as documented evidence of illness.
Most UK online GP services set their own minimum age, commonly around 16 or 18 for independent bookings, with younger patients typically needing a parent or guardian to arrange and be present for the consultation. Check the specific provider’s policy, as this varies.
