How to Get a Fit to Work Certificate & Medical Declaration in the UK (Step-by-Step Guide)

Whether you’re starting a new job or returning to work after an illness, you might be asked for a Fit to Work Certificate or a Medical Declaration. These documents confirm that you’re medically capable of performing your job safely and effectively. In the UK, they’re especially important in safety-critical sectors like construction, transportation, and healthcare.

This comprehensive guide walks you through everything you need to know—from how to get one, where to go, who pays for it, and what happens if you're deemed not fit for work.

What Is a Fit to Work Certificate?

Definition and Purpose

A Fit to Work Certificate—sometimes called a Fitness for Work Certificate—is an official medical document issued by a qualified healthcare provider. It confirms that you are either:

• Fit to carry out your job duties,

• Fit with certain adjustments, or

• Not currently fit for work.

When It Is Required

Employers may request it:

• Before hiring, especially in physically demanding roles

• After extended sick leave

• When returning from mental health leave

• After an injury, especially one that might impact job performance

Understanding the Medical Declaration

What Is Included in the Declaration

A Medical Declaration is a formal written statement signed by a healthcare professional. It typically includes:

• Medical history relevant to the job

• Physical and mental fitness evaluation

• Any recommended work restrictions

Who Is Authorised to Issue It

• General Practitioners (GPs)

• Occupational Health Physicians

• Specialist Nurses (in workplace settings)

Who Needs a Fit to Work Certificate in the UK?

Safety-Critical Roles

Employees working in the following must often be declared fit:

• Construction workers

• Train drivers

• Bus and lorry drivers (under DVLA regulations)

• Scaffolders and crane operators

Sectors That Commonly Require Certification

• Healthcare – Nurses and surgeons need to be physically and mentally fit.

• Transport and logistics – Driving jobs demand excellent vision, reflexes, and alertness.

• Manual labour and trades – Lifting and handling work needs clearance.

Step-by-Step Process to Get a Fit to Work Certificate

1. Booking an Appointment

You can do this by:

• Contacting your GP

• Speaking to your employer’s occupational health team

• Booking through a private clinic or provider like Bupa, Medigold, or Health Assured

2. Attending a Medical Assessment

You’ll undergo a health screening tailored to your job type. Expect to answer detailed health and lifestyle questions.

3. Receiving Your Certificate

If you are deemed fit, you’ll receive your certificate the same day or within a few working days.

Where to Get a Fit to Work Medical in the UK

Through NHS Occupational Health Services

Free but typically reserved for NHS employees or referred patients.

Private Occupational Health Providers

• More flexible scheduling

• Faster turnaround

• Often used by construction firms and driving schools

Employer-Arranged Services

Many large employers partner with providers to offer on-site assessments or reimburse your appointment costs.

What Happens During the Medical Assessment?

Health History Questions

Topics may include:

• Medications

• Chronic conditions

• Hospital stays or surgeries

• Mental health history

Physical Exam and Job-Specific Testing

Depending on your job:

• Vision tests

• Hearing exams

• Mobility and flexibility checks

• Lung and cardiovascular function

How Long Does It Take to Get the Certificate?

Average Processing Time

• GPs and NHS: 3–5 working days

• Private providers: Same day or next-day service

Fast-Track Options for Urgent Employment

Many private clinics offer express services for a fee, with same-day certificates.

Cost of Fit to Work Certificates in the UK

NHS vs Private Options

• NHS: Often free, but access is limited.

• Private: Prices range from £50 to £250 depending on complexity.

Who Pays – Employer or Employee?

• Most employers pay, especially when it's a job requirement.

• Self-employed individuals or contractors may need to cover the cost.

Validity and Renewal of Fit to Work Certificates

How Long Certificates Last

• Typically valid for 6 to 12 months

• Shorter in cases of chronic illness or progressive conditions

When to Renew or Reapply

• After a new illness or injury

• If changing roles or tasks

• Upon expiry of current certificate

What If You Are Found Not Fit to Work?

Partial Fitness and Workplace Adjustments

You may still be allowed to work if:

• Duties are modified

• Work hours are adjusted

• Equipment or aids are provided

Appeal and Reassessment Process

You can:

• Request a second opinion

• Submit additional medical evidence

• Undergo a reassessment in a few weeks or after treatment

Legal Requirements & Employee Rights

Data Privacy and Consent

• Your employer can only receive the fitness outcome, not your full medical history.

• Written consent is required for full report sharing.

Equality Act Protections

Employers must not discriminate based on disability. They are legally required to make reasonable adjustments under the Equality Act 2010.

Common Mistakes to Avoid When Applying

1. Incomplete Documentation

Bring ID, NHS number, and any relevant medical history.

2. Missing Medical History

Be honest and thorough when disclosing conditions, even minor ones.

3. Delaying Assessments

Late submission can delay job offers or return-to-work plans.

Tips for Preparing for Your Assessment

What to Bring

• Photo ID (passport or driver’s licence)

• GP letters or hospital discharge summaries

• Current medication list

Questions to Expect

• “Do you have any conditions affecting your mobility or concentration?”

• “Are you taking medications that might affect your reflexes or alertness?”

Being Honest About Limitations

Concealing problems can lead to future accidents or disciplinary action. Transparency helps you get support.

Fit Notes vs Fit to Work Certificates

Key Differences

Fit Note	Fit to Work Certificate
Issued by GP	Issued by occupational health
Short-term focus	Focuses on overall job fitness
Common after sick leave	Often pre-employment or post-injury

When Each Is Used

• Fit Notes: For short-term illness (used for sick pay)

• Fit to Work Certificate: Used to clear a person for return to or start of work

FAQs on Fit to Work Certification in the UK

1. Is a Fit to Work Certificate the same as a GP Sick Note?

No. A sick note confirms inability to work. A Fit to Work Certificate confirms ability.

2. Can I work without a Fit to Work Certificate?

In high-risk jobs, you legally cannot begin work without one.

3. What if I disagree with the result?

You can seek a second opinion or appeal through occupational health channels.

4. Can I get a certificate from my GP?

Sometimes, but occupational health providers are preferred for job-specific assessments.

5. Will the employer know my medical history?

No. They only receive a fitness outcome, not detailed records.

6. Is mental health considered in the evaluation?

Yes. Stress, anxiety, and other conditions are assessed as part of overall fitness.

Conclusion: Ensuring Workplace Safety Through Medical Fitness

Obtaining a Fit to Work Certificate and Medical Declaration in the UK is a crucial step in ensuring that both employees and employers are protected. These assessments promote safety, productivity, and legal compliance in the workplace.

Whether you're starting a new job or returning from leave, take the process seriously. Book your appointment, prepare your documentation, and be honest during your assessment—because your health and safety at work matter.