Sick leave in the UK: rules, pay and fit notes

Key takeaways

Topic	What to know	What to check next
Self-certification	For the first 7 calendar days, you usually self-certify rather than provide medical evidence.	Follow your employer’s reporting rule and keep a dated record.
Fit notes	A fit note is usually needed after more than 7 days off, including weekends and bank holidays.	Ask the clinician treating you and send the note as soon as you can.
SSP basics	Statutory Sick Pay can be paid from the first qualifying day if you meet the rules.	Check your payslip, PAYE status, and sickness dates.
Contractual sick pay	Some employers top up SSP or pay full salary for a period.	Read your contract, handbook, and HR portal.
If pay is refused	Your employer should explain why in writing and may need to give form SSP1.	Ask for the reason in writing and contact HMRC or Citizens Advice if needed.
Official help	Acas, GOV.UK, the NHS, Citizens Advice, and DWP are the main practical sources.	Use the right service for workplace, pay, proof, or benefits questions.

Summary points are based on the official GOV.UK, Acas, NHS, and Citizens Advice guidance listed in the sources below.

Sick leave, sick pay and your basic rights

In the UK, sick leave means time away from work because you are ill and not fit to do your job. That can include physical illness, injury, stress, anxiety, depression, or another mental health condition, not just something visible like flu or a broken bone.

A common question is whether being off sick means you will still get your full wages. It might not. Your pay depends on the legal minimum, your employment status, and whether your employer offers more in the contract or staff policy. For a wider overview of workplace protections, see Employment law and workers rights in the UK.

• You can be genuinely ill even if the condition is mental rather than physical.
• Sick leave can overlap with annual leave, but the employer and worker should agree in writing how that time is treated.
• You keep building up holiday while off sick.
• What you get in practice may differ if you are an employee, worker, agency worker, zero-hours worker, or self-employed.

Sick leave vs sick pay

Sick leave is the time you are allowed or accepted to be away from work because you are not well enough to do it. Sick pay is the money you may receive during that time.

That difference matters because you might be allowed to stay off work but still get only SSP, a reduced amount, or no pay from that employer. This is why your contract and payroll setup matter as much as the sickness rule itself.

Who can get paid and how much?

For many expats, the key question is simple: will I be paid if I am ill? Since 6 April 2026, eligible workers can receive Statutory Sick Pay from the first day of sickness absence, and the old lower earnings threshold has been removed. SSP is the lower of £123.25 a week or 80% of your average weekly earnings, and it can last for up to 28 weeks.

Some employers also offer contractual sick pay, sometimes called company or occupational sick pay. That might top up SSP or replace it for a period, but the detail sits in your contract or policy, not in the law alone. If you are unsure, start by checking your latest payslip, your written terms, and your payroll portal. For more on National Insurance and related support, see Social security in the UK: National Insurance entitlements.

Situation	Likely route	Common pitfall	Where to verify
Employee on PAYE	SSP, plus possible contractual sick pay	Assuming full pay is automatic	Contract, handbook, payroll
Agency worker on PAYE	SSP may apply	Looking only at agency wording, not tax status	Agency, payslip, PAYE record
Zero-hours worker on PAYE	SSP may apply for qualifying days	Thinking zero-hours means no rights at all	Employer, roster pattern, payroll
Self-employed	No SSP from a client	Assuming tax history creates SSP rights	DWP or benefits checker

Eligibility routes are summarized from GOV.UK, Acas, and Citizens Advice guidance and should be checked against each worker’s contract, payroll status, and sickness dates.

Check your status if you’re agency, part-time or zero-hours

If you work hospitality shifts, temp through an agency, or combine two part-time jobs, the detail can get messy quickly. One thing worth knowing is that SSP is tied closely to whether you are treated as employed for tax through PAYE, and whether there are qualifying days you would usually work.

If you have two employers, each one looks at your situation separately. So you might get SSP from one employer and not the other. If you are unsure, ask payroll or the agency how you are treated for tax, check your payslip, and use the GOV.UK employment status for tax checker before assuming you are excluded.

How to report sickness and get proof

The biggest early risk is not the illness itself, it is missing the reporting process. Many employers have a set call-in or reporting deadline, and if you miss it, pay can become harder to sort out later.

1. First: tell your employer as soon as possible, following their normal absence procedure. If they have no set rule, UK guidance still expects you to tell them within 7 days.
2. Next: for the first 7 calendar days off, you usually self-certify. A common mistake is thinking weekends do not count. They do.
3. Then: if you are off for more than 7 days, get a fit note and send it to the employer as soon as possible.
4. Last: if there is a delay getting proof, update your employer in writing, explain what is happening, and keep a record of messages and appointment attempts.

Another common mistake is waiting only for a GP. In the UK, the clinician treating you may be able to issue the note, and that can save days of delay. If you are new to British healthcare, it also helps to register with a GP early, before you need one. See Healthcare in the UK: understand how the NHS works and Guide to doctors and GPs in the UK.

Getting a fit note

A fit note is usually needed when you are off sick for more than 7 days, including weekends and bank holidays. It can say you are not fit for work or that you may be fit for work if your employer can make changes such as lighter duties, altered hours, or a phased return.

If your employer asks for proof earlier than day 8, a clinician may charge for it, and the employer should cover that cost. If appointments are delayed, tell your employer straight away, because they are expected to act reasonably where medical evidence takes time.

Long-term sickness, return to work and dismissal risk

If your absence lasts more than a few weeks, the practical picture changes. You may move from a simple reporting issue into a longer conversation about recovery, workload, reasonable adjustments, and how your role can be done safely. That is especially true after surgery, serious illness, or a period of stress or burnout.

Many expats worry that long sick leave means automatic dismissal. It does not. But long absence can become a capability issue, which means the employer may review whether you can do the role and what support is reasonable. The key question is whether they are handling that fairly and with evidence, not whether they can simply end things because you are unwell.

• Keep copies of fit notes, emails, meeting notes, and payslips.
• Ask for return-to-work plans, changes to duties, or phased return terms in writing.
• If a health condition could count as a disability, ask clearly about reasonable adjustments.
• If you feel pressured, singled out, or rushed back without support, speak to Acas or Citizens Advice early.
• If dismissal, discrimination, or grievance language appears, stop guessing and get advice before replying in detail.

One thing worth knowing is that a phased return does not have one standard format. It might mean fewer shifts, shorter days, home working where possible, or temporary lighter duties. What matters in practice is whether the plan matches your health and is recorded clearly.

What happens when SSP runs out?

SSP can only last for up to 28 weeks. If it is ending, your employer should give you form SSP1 on or before the beginning of week 23 if they know your sickness will last beyond SSP, or within 7 days if it ends unexpectedly while you are still off.

At that point, you may need to look at support such as Universal Credit or new style Employment and Support Allowance, depending on your situation. Do not assume you will qualify automatically. Use the official benefits checker or speak to Citizens Advice before making financial plans.

What expats should check in their contract, healthcare and finances

If you are new to the UK, the legal rule is only half the story. The real pressure often comes from practical gaps, such as not knowing where your sickness policy sits, not being registered with a GP, or not being sure how rent and bills will be covered if income drops.

This is different from systems where sick leave and salary continuation are handled in one obvious way. In the UK, you may be dealing with separate HR, payroll, NHS, and banking systems. A small admin problem can delay money or evidence even when you are genuinely ill. If you want a clearer picture of private cover options alongside the NHS, see Guide to getting health insurance in the UK in 2026.

• Check whether you are still in probation and whether the policy is different during that period.
• Read the sick pay clause, reporting route, and absence trigger points in your contract and handbook.
• Make sure your payslip shows who is paying you, especially if you work through PAYE.
• Register with a GP before you need a fit note or follow-up care.
• Plan how rent, utilities, and other direct debits will be covered if income falls for a month or more.

When private cover may help

The NHS is the main public route for treatment in the UK, but some expats choose private health insurance if they want faster access to consultations, specialist care, or extra peace of mind while juggling work and recovery.

That does not replace your workplace rights, but it can reduce delays around diagnosis or treatment. If you want to explore options, Cigna is one of the international providers often considered by expats looking for additional cover alongside the NHS.

Conclusion

If you are off sick in the UK, start with your employer’s reporting rules, then check whether you need self-certification or a fit note. Next, confirm whether you qualify for SSP or contractual sick pay, and keep an eye on your contract, payroll, and finances. For expats, the key is to stay organized and use official help early if something does not look right.

This guide is general information, not legal, medical, or financial advice. It explains what to report, what proof you may need, how SSP and contractual sick pay work, what to check in your contract, and where to get help if something goes wrong.

Sources

• GOV.UK: Official overview of Statutory Sick Pay, including the weekly rate and 28 week limit, checked on 25 June 2026.
• GOV.UK: Official eligibility rules for SSP, fit notes, and SSP1 timing, checked on 25 June 2026.
• Acas: Practical UK workplace guidance on SSP, PAYE status, qualifying days, and disputes, checked on 25 June 2026.
• Acas: Official guidance on how sickness and annual leave can overlap and when holiday can be carried over, checked on 25 June 2026.
• NHS: Official guidance on when a fit note is needed and which healthcare professionals can issue one, checked on 25 June 2026.
• Citizens Advice: Practical employee guidance on contractual sick pay, zero-hours work, multiple employers, and what to do if SSP is refused, checked on 25 June 2026.