Quick answer: what medical evidence do UK universities accept?
UK universities generally accept a dated, signed letter or certificate from a registered doctor or other qualified health professional. It must state your condition or the nature of the illness, the dates it affected you, and its likely impact on your studies. Retrospective notes, self-reports and evidence that is not independent are often rejected.
Key takeaways
This guide compares 17 published UK university policies and guidance pages, and explains how to get evidence that will be accepted.
Mitigating circumstances (also called extenuating or exceptional circumstances) are serious, unforeseen events outside your control that affect your ability to study, submit work or sit an exam. Illness, hospitalisation, bereavement and a flare-up of a long-term condition are common examples.
If a university accepts your claim, the usual outcomes are:
The name and rules differ between universities. Always follow your own university’s current policy, which is the final authority on what it will accept.
The common thread is evidence. Policies repeatedly treat missing or unsuitable evidence as grounds to refuse a claim, which is why the next sections focus on what each university says it wants.
Acceptable medical evidence is a document from a qualified, independent health professional that confirms you were unwell and when. Across the policies reviewed, strong evidence has five features:
Other documents that several universities accept include hospital admission or discharge letters, appointment letters for specialist care, and, for mental health claims, letters from counsellors (Liverpool, Dundee, Manchester).
A doctor’s letter is not always needed for very short illnesses. See the self-certification section below.
The table summarises 17 published university policies and guidance pages, read on 30 October 2026. Two rows are department-level or older versions (Warwick Classics, Manchester BMH 2022/23), so treat it as a guide and check your own university’s current policy.
| University | Accepted medical evidence | Timing / retrospective | Self-certification | Online doctor notes |
|---|---|---|---|---|
| Nottingham | Letter from an independent qualified professional, on headed paper, signed and dated; NHS app printouts | Retrospective reporting not acceptable; evidence must confirm circumstances were witnessed on the date | Generally not accepted (limited exam exception) | Accepted if UK-based and CQC-regulated |
| Coventry | Medical certificate or doctor’s note from an independent third party | Late applications and retrospective evidence not accepted; apply before the deadline or exam | Not mentioned | Online-only notes (e.g. Push Doctor) not accepted |
| Liverpool (Code of Practice, Appendix M) | Independent evidence from a GMC-recognised practitioner; GP or consultant letter; hospital discharge notice | Evidence not in existence at the time not accepted, with limited exceptions; normally claim within 5 working days | Not mentioned | Not mentioned; no face-to-face consultation for a condition lasting more than a few days can lead to rejection |
| Roehampton (June 2026) | Note from a suitably qualified practitioner who has seen the student during the period | Late evidence only if the delay was unavoidable | Up to 3 a year, each up to 5 working days | Not mentioned |
| Surrey (2026/27) | Signed, dated letter from a GP or clinical specialist giving the dates and how your work or attendance was affected | Request before the deadline or event; apply within 5 working days after an affected event; late requests must explain the delay | One self-certified claim per semester plus one in the late summer period, up to 5 working days each | Not mentioned; check with administration |
| UCL (Students’ Union guide, 2025/26) | Specific letter or certificate from a qualified doctor or registered practitioner, produced within the last 3 months and covering the full period | Within one week (5 working days) of the first affected assessment; compelling reason needed for delay; decision normally within 10 working days | Not part of the main route; a separate Delayed Assessment Scheme gives a short extension without evidence, up to 3 times a year | Not mentioned |
| Sussex | Robust, dated evidence that corresponds with the assessment date, from someone who can independently verify | Submit as close to the deadline as possible; fixed term deadlines (for example 26 January 2026 for autumn undergraduates); late claims cannot be approved | Self-certification form allowed but “limited”, when evidence is difficult to provide | Not mentioned |
| Leeds (2023 guidance) | Letter or certificate signed by a qualified practitioner, with dates and expected effect | Late applications not considered retrospectively; evidence within 14 days of applying | Up to 7 calendar days for coursework extensions | Not mentioned |
| London Met (2025/26) | GP or consultant letter or fit note, with a diagnosis and the period affected | Claim within 2 weeks of the deadline; post-dated medical evidence not accepted | Not mentioned | Not mentioned; contact the mitigation team |
| Exeter | Letter from a doctor or other medical professional with the dates affected | Late means within 3 weeks of the deadline; retrospective needs independent evidence | Fallback for illness of 7 days or fewer when no third-party evidence exists | Not mentioned |
| Westminster | Medical certificate or doctor’s letter with dates and a medical opinion | Fixed deadlines, e.g. 15 January 2027 for Semester 1 | Cannot be used as medical evidence | Not mentioned |
| Manchester (BMH handbook, 2022/23) | Letter from a doctor, other health professional or counsellor | Evidence within 2 weeks of the form; short extensions at least 5 days before the deadline | BMH: GP-signed form, 7 days or under. Central procedure: up to 7 calendar days of absence from teaching, not assessments | Not mentioned |
| Solent | Statement from a medical practitioner (template provided) | Apply as soon as possible; too late after results are released | Not acceptable | Not mentioned; ask the Student Hub |
| Leeds Beckett | Doctor’s note with the relevant dates; medical appointment letter | Panel rejects late claims | Up to 5 working days for an extension | Not mentioned |
| Dundee | Doctor’s note for the period; counsellor note | Report as soon as possible; faculty deadlines fall before the exam board | Not mentioned | Not mentioned |
| Heriot-Watt | Supporting evidence required for all applications; Wellbeing Services can confirm | Late only if you show you could not apply; 10 working days to add missing information | Form for illness of 7 days or fewer when no evidence is available | Not mentioned |
| Warwick (Classics) | Medical documentation or a professional letter | Requests after the deadline are not approved; a mitigating circumstances application is needed instead | Two extensions of 5 working days a year | Not mentioned |
The pattern is consistent: evidence must be independent, specific and tied to the dates of your assessment. Self-certification, timing and online-doctor rules differ widely, and most policies are silent on online doctors.
Universities most often reject evidence that is retrospective, self-reported, vague, altered or about a minor illness. The policies reviewed list these specific problems:
A letter written weeks after you were ill can only repeat what you reported. Because several universities want evidence that confirms the illness at the time, waiting until after your results or after a missed deadline can make a genuine claim fail. If you are ill during an assessment period, seek a consultation and evidence as soon as you can rather than later.
It depends on the university, and most policies do not say. Of the 17 reviewed, only two address online doctors directly, and they disagree. Nottingham accepts online doctor certificates “provided that they are UK based and CQC-regulated.” Coventry says online-only medical notes (for example from Push Doctor) “aren’t acceptable medical evidence.”
The others usually ask for a statement from a qualified or GMC-recognised practitioner and do not mention online services. Several stress that the practitioner should have seen you at the time. Roehampton asks for a note from a practitioner “who has seen the student during the period of the condition”, and Liverpool does not accept statements from practitioners approached only after the assessment, or where no face-to-face consultation took place for a condition lasting more than a few days.
Before you rely on any online or private doctor’s note, email your academic or student office and ask in writing. A simple message works: “Will you accept a medical letter from a UK-registered, GMC-registered doctor who consulted me by video on [date] as evidence for a mitigating circumstances claim?” Keep their reply with your claim.
If you decide a UK doctor consultation online is right for you, The GP Clinic offers a Student Mitigation Letter (£89). Only use it if your university accepts online or private doctor evidence.
Attending can count against you. Coventry says that if you submit work or attend an exam, “it means you’re declaring yourself fit to do so,” and later claims will not be accepted. UCL asks you to claim within one week if you were too unwell to take an exam. If you are too ill to sit it, get medical evidence on the same day.
Short extensions are often handled separately from full claims. Warwick (Classics) allows two self-certified extensions of 5 working days a year, Roehampton three, and Leeds up to 7 calendar days. Most require you to ask before the deadline. For anything longer, expect to provide a doctor’s letter.
Universities want independent evidence, not a self-description. Liverpool asks for written evidence on headed paper from a GP, psychiatric practitioner or counsellor, explaining how and why your studies were affected and the period involved. Dundee does not accept “exam nerves or self-diagnosed stress/anxiety”, and Nottingham says stress or anxiety before or during an assessment is not accepted unless a medical diagnosis has been made. Some universities allow late evidence where undisclosed difficulties made it hard to seek help (Liverpool; Roehampton’s confidential confirmation from support services).
A long-term condition with adjustments in place is often not accepted as a new circumstance. Sussex, Liverpool and Dundee say so, usually unless there is an unforeseeable flare-up. Warwick says that once Disability Services confirms your adjustments, you do not need to submit further evidence for extensions. If you have a long-term condition, register with disability support early.
Westminster, Nottingham, Leeds, Solent and UCL require translations of evidence not in English, and Nottingham says they are at the student’s cost. Liverpool accepts overseas practitioners only if they belong to a recognised professional body and are qualified to diagnose.
The safest approach is to act early, get independent evidence for the dates affected, and submit before your university’s deadline. Follow these steps:
Self-certification means declaring your illness yourself instead of providing a doctor’s letter. It is a limited option and varies a lot:
If you may need more than one claim in a year, or your illness lasts longer than a week, plan to get proper medical evidence.
The common rhythm across policies is: act at once, claim within days, and send evidence within weeks.
A good evidence letter is dated, signed and written by a qualified doctor who assessed you. The layout below shows the details policies ask for. Only a doctor can decide what goes in your letter, and you should never write or edit it yourself.
[Clinic or practice letterhead]
Date of letter: [date]
Re: [Student full name], date of birth [DOB]
I assessed [name] on [date] by [in person / video consultation].
Diagnosis or nature of illness: [diagnosis]
Period affected: from [date] to [date]
Impact: In my opinion this condition [affected / would have affected] the
student's ability to [study / sit the exam on date / submit work due on date].
Signed: [Doctor's name], [qualification], [GMC number]
[Contact details]Use this checklist before you submit:
Policies are specific about what a clinician’s letter needs. Drawing on the policies reviewed, a doctor writing a student evidence letter should:
Decisions are usually quick for extensions and slower for full claims. UCL normally decides within ten working days; London Met normally considers claims within four weeks; Warwick (Classics) responds to extension requests within three working days; Leeds Beckett answers extensions in two to three working days, with panels normally meeting monthly. Some universities do not confirm a claim until your evidence arrives, so keep your submission reference and watch for requests for more information.
Most universities allow an appeal, but the window is short and the grounds are narrow. Coventry allows 5 working days to appeal a rejected delayed submission and 7 working days for a rejected deferral, on grounds of significant new evidence not previously included or a problem with how the request was handled. Leeds requires appeals within 20 working days of the final publication of results. Heriot-Watt marks claims with insufficient evidence “Further Info Required” and gives 10 working days to add it.
If you are rejected, read the outcome letter for the stated reason and the appeal deadline, gather new independent evidence that answers that reason, and do not alter existing documents.
If you finish your university’s internal procedures and are still dissatisfied, you may be able to complain to the Office of the Independent Adjudicator for Higher Education (OIA), the independent complaints scheme that many universities subscribe to. Check that yours does. The OIA must receive your complaint form within 12 months of the date of your university’s Completion of Procedures letter. It cannot review academic judgments, teaching quality or admissions.
The GP Clinic offers two student documents, issued online by a UK doctor after a consultation:
These are most useful when you are ill during an assessment period, cannot easily see your own GP in time, and need dated medical evidence for your claim. Some universities do not accept online-only notes (Coventry says so explicitly) and most do not say, so confirm with your university in writing before you rely on one, and send the letter within its deadline.
A letter is evidence only. The decision on any extension, deferral or resit always rests with your university’s mitigating circumstances panel.
Related reading: Medical Letters vs. Medical Certificates, How to Get a Medical Letter from a Doctor Without Visiting a Clinic, Medical Doctor Notes in the UK and Sick Notes: Myths vs. Reality.
All pages listed were opened and read on 30 October 2026.
A dated, signed letter or certificate from a qualified, independent health professional stating the illness, the dates affected and its impact. Hospital letters and, in some cases, counsellor letters are also accepted.
It depends, and most do not say. Nottingham accepts online doctor certificates that are UK-based and CQC-regulated. Coventry says online-only notes (for example from Push Doctor) are not acceptable. Ask your university in writing before relying on one.
Sometimes. Surrey allows evidenced claims up to 5 working days after the assessment, and Exeter handles late applications within three weeks of a deadline. Others use fixed cut-offs, so check early.
Often not. Sussex and Nottingham reject notes that do not show the illness was confirmed at the time of the assessment.
Some universities allow it, with caps. Roehampton allows 3 a year and Surrey one per semester, while Westminster and Nottingham do not accept self-certification as medical evidence.
Usually not. Sussex and Exeter both exclude minor illness unlikely to disrupt your work.
Policies ask for a signed, dated letter from a qualified practitioner that gives the diagnosis or nature of the illness, the period affected and its impact on study. London Met says “a diagnosis is essential, as is a clear indication of the period affected”, and Westminster asks for a clear medical opinion.
Ask your academic or student office in writing before you pay for or submit evidence.
Yes, if a qualified professional confirms it. Liverpool asks for written evidence from a GP, psychiatric practitioner or counsellor. Dundee and Nottingham do not accept exam nerves or self-diagnosed stress or anxiety without a medical diagnosis.
Submit your claim on time and say that evidence is coming. Leeds gives 14 calendar days, London Met 2 weeks, and Surrey lets you submit a request before the evidence arrives. The claim is usually not confirmed until the evidence arrives.
Usually yes. Coventry allows 5 or 7 working days depending on the outcome, and Leeds allows 20 working days from the final publication of results. Appeals normally need significant new evidence or a problem with how your claim was handled.
Yes, get one on the same day if you can. Coventry says that attending an exam means declaring yourself fit, and UCL asks you to claim within one week of an exam you were too ill to take.
Sometimes. London Met lists a fit note from a GP or consultant as acceptable evidence, but rejects fit notes that do not cover the full assessment date. Many policies want a letter that also states the diagnosis, dates and impact, which a fit note may not show. Check your university’s wording.
