Fit notes can be issued by more healthcare professionals

From 1 July 2022, fit notes supporting a claim for New Style Employment and Support Allowance (ESA) can be issued by a registered nurse, occupational therapist, pharmacist or physiotherapist, as well as by a GP or hospital doctor¹. The change is recorded in the Department for Work and Pensions guidance for New Style ESA, which states:

A fit note, also called a sick note or a statement of fitness for work, is one of the items needed to apply for New Style ESA online where the claimant has not been able to work for more than 7 days in a row because of a disability or health condition¹. Claimants must also send fit notes regularly to keep getting New Style ESA, and report any change in their circumstances¹.

New Style ESA is a fortnightly payment that can be claimed on its own or at the same time as Universal Credit¹. It is a contributory benefit, normally available to people who have paid or been credited with enough National Insurance contributions in the 2 full tax years before the year of the claim¹. Claimants must have been an employee or self-employed and paid, or been credited with, National Insurance contributions, usually in the last 2 to 3 years¹. No New Style ESA is payable to someone receiving Statutory Sick Pay from an employer, but an application can be made up to 3 months before that pay ends¹. Where both New Style ESA and Universal Credit are awarded, the New Style ESA paid reduces the Universal Credit payment by the same amount¹.

Rates shown in the guidance are the figures for the year 2025 to 2026, updated on 7 April 2025¹. In the assessment phase, the first 13 weeks of a claim, the basic allowance is up to £75.65 a week for those aged 18 to 24 and up to £95.55 a week for those aged 25 and over¹. In the main phase, the basic allowance is up to £95.55 a week, plus a support component of £50.35 a week for those placed in the support group¹. The page was most recently updated on 6 April 2026 to update figures with 2026/27 values as part of uprating, but the new amounts are not set out in the text available¹.

Occupational or personal pension income above £85 a week reduces the New Style ESA payment by half of the amount over that limit¹.

Why it matters for households

People claiming New Style ESA, or applying for it, have a wider set of health professionals who can complete the fit note their claim depends on. That matters where access to a GP appointment is the practical obstacle to getting the note, since a nurse, occupational therapist, pharmacist or physiotherapist can now provide it. The change applies to fit notes used to support a New Style ESA claim from 1 July 2022¹. Fit notes remain a continuing requirement: claimants must send them regularly to keep receiving the payment, and must report changes in circumstances, including changes to their health condition or disability, going into hospital or a care home, starting or stopping work, education, training or an apprenticeship, moving house, changing their name, changes to their pension, changing their doctor, or going abroad for any length of time¹. A claim can be stopped or reduced if a change is not reported straight away¹. Claimants receiving both New Style ESA and Universal Credit must report changes to both services¹.

What happens next

The Department for Work and Pensions will contact a claimant within 10 working days of applying¹. Form WCA50, the capability for work questionnaire, is usually sent within 4 weeks of the first payment and must be returned within 28 days of the date it is received¹. Claimants who receive an ESA50 form can still complete and return it and do not need to fill in a WCA50¹. Further information on benefits is available.