The number of people taking sick leave from work has potentially started to decrease after more than doubling over the past ten years. The issuance of “fit notes” authorizing sick leave surged from approximately 5.2 million in 2015/16 to over 11 million in 2025, primarily driven by prolonged illnesses and mental health concerns. Recent analysis of the 2025 data indicates a slight increase in sick notes where doctors have indicated that the patient may be fit for work with certain adjustments to their responsibilities.
According to NHS England data, a total of 11.17 million sick notes were issued in 2025, with 93% (10.37 million) classified as “not fit for work” and around 8% (almost a million) deemed “may be fit for work,” suggesting a phased return to work with modified hours and duties. The trend of increasing “not fit for work” notes seems to be reversing, as the total number slightly decreased from 10.44 million in 2024.
Health Secretary Wes Streeting criticized the existing fit note system, advocating for a new approach to help individuals either remain employed or return to work. Pilot programs in 15 regions have been initiated to connect individuals receiving fit notes with support services offering work and health guidance.
Fit notes serve to certify an individual’s illness, providing a valid reason for absence from work and eligibility for sick pay. Recent data from the last quarter of 2025 revealed a decrease in the number of fit notes issued compared to the previous year. The North East region had the highest rate of fit note issuances per 100,000 registered patients, while London had the lowest.
Consultancy firm Broadstone’s analysis of the 2025 data shows that the number of people being signed off work remains notably high, with the majority of fit notes issued to women. Mental and behavioral disorders accounted for the most common reason for sick leave, followed by musculoskeletal conditions. A significant portion of sick notes did not specify a diagnosis.
Jamie Burdess, a principal consultant at Broadstone, expressed concerns about the high number of individuals being deemed unfit for work and questioned the effectiveness of the sick note system. He emphasized the need for the system to support individuals in staying employed or returning to work, rather than facilitating a complete exit from the workforce.