The Fit Note - elearning for healthcare
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This programme has been created in collaboration with

Royal College of Nursing

About The Fit Note programme

Welcome to this elearning programme about the fit note – the statement of fitness for work, sometimes referred to as the Med 3 form.

This programme has been developed in collaboration with The Royal College of Nursing, The Royal College of Occupational Therapy, The Chartered Society of Physiotherapy, The Royal Pharmaceutical Society and The Royal College of General Practitioners.

This programme applies to all relevant healthcare professionals in England, Scotland and Wales, and has been developed in collaboration with The Royal College of Nursing, The Royal College of Occupational Therapy, The Chartered Society of Physiotherapy, The Royal Pharmaceutical Society and The Royal College of General Practitioners.

This training sits alongside two other key resources

  • Fit note: Getting the most out of the fit note. Guidance For healthcare professionals – which covers the practical task of undertaking a health and work conversation and completing the fit note form
  • Fit note: Who can issue fit notes. Guidance for healthcare professionals and their employers – which provides clarity for healthcare professionals, their employers and regulators as to which professionals can include this task within their scope of practice

Fit note – GOV.UK (

Why is the fit note important?

Good work is good for an individual’s mental and physical health and wellbeing; evidence is clear that patients benefit from being in some kind of regular work. This improves mental and physical health and can aid recovery. Health care professionals (HCPs) are well placed to maximise the use of the fit note to support employers to return or remain in work.

The training aims to:

  1. Help HCPS develop the confidence and skills to have an effective work and health conversation and to be able to understand and communicate (where appropriate) the importance of work as a clinical outcome.
  2. Enable HCPs in using their professional judgement to assess the impact of a health condition on an individual’s fitness for work.
  3. Support HCPs in negotiating and developing an agreed plan with the patient about their health and work, including advice about self-management and workplace modifications (where appropriate).
  4. Enable HCPs to complete the technical steps required in the process of completing a fit note and understand options for next steps after a fit note has been certified. For example, signposting.

Before you begin this training, it is recommended that you complete the Work and Health training which will give you a general introduction to this area Work and Health – elearning for healthcare (

There are 4 sessions in the fit note programme:

  • An enabling approach which explains the aims and importance of the fit note
  • Key legislation and guidance to help understand the context and dispel any myths
  • Making recommendations using case studies and examples of completed fit notes
  • Application of the fit note which brings together the knowledge gained to apply to case studies and the final assessment of your knowledge.

The learning takes a case study approach in exploring the common scenarios that present in GP surgeries and how the fit note can be used most effectively. The case studies are not real cases, but are illustrative examples of potential scenarios.

To complete the programme, you are required to do each session in order, before completing the final assessment.

This training course along with the supporting guidance will provide healthcare professionals with the knowledge and understanding of how to complete an effective fit note and who is best placed to do so.

Meet the team

  • Toni Hazell

    Toni Hazell

    GP in London and a freelance medical writer, blogger and editor
  • Naz Kamal

    Naz Kamal

    Fit Note Policy DWP
  • Conor Jackson

    Conor Jackson

    Fit Note Policy DWP
  • Bekka Campbell

    Bekka Campbell

    Programme Manager, HEE, elearning for healthcare
  • Ailsa McGinty

    Ailsa McGinty

  • Moz Cammack

    Moz Cammack

    elfh Project Manager
  • andi blackmore

    Andi Blackmore

    elfh Programme Manager
  • Angelina Montinaro

    Angelina Montinario

    elfh Lead Learning Designer
  • Jo Bloom

    elfh Learning Designer
  • Cath Moran

    Catherin Moran

    elfh Graphic Designer
  • Rachel Gowland

    Rachel Gowland

    elfh Stakeholder Manager
  • Dave Beardmore

    Dave Beardmore

    Senior Project Manager, HEE, elearning for healthcare


Grateful thanks for the valuable contributions from:

Genevieve Smyth, Royal College of Occupational Therapists

Wendy Preston, Royal College of Nursing

Natalie Beswetherick and Abigail Henderson, Chartered Society of Physiotherapy

Jennifer Aston, Royal College of General Practitioners

Dr Emily Tucker, Department for Work and Pensions

Thomas Kearney, NHS England & Improvement

Richard Collier, HEE

Danielle Fisher, Royal College of General Practitioners

How to access

In order to access the Fit Note programme, you will need an elfh account. If you do not have one, then you can register by selecting the Register button below.

Register >

To view the Fit Note programme, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

View >

NHS healthcare staff in England

The Fit Note programme is also available to NHS healthcare staff via the Electronic Staff Record (ESR). Accessing this elearning via ESR means that your completions will transfer with you throughout your NHS career.

Further details are available here.

Not an NHS organisation?

If you are not an NHS health or care organisation and therefore do not qualify for free access elfh Hub, you may be able to access the service by creating an OpenAthens account.

To check whether or not you qualify for free access via OpenAthens, you can view the eligibility criteria and register on the ‘OpenAthens’ portal.

Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the Work and Health programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

Please select the following link for more information on how to use the elfh Hub.


elfh is a NHS England programme in partnership with the NHS and professional bodies