New figures from NHS England show a significant increase in the number of sick notes, also known as fit notes, issued to patients across the country.

Record Number of Sick Notes Issued

In 2025, over 11 million fit notes were distributed, more than doubling the 5.3 million issued in 2015. This represents a substantial increase of nearly 500,000 compared to 2022.

Lack of Diagnosis a Growing Concern

A concerning trend is that over eight million of these notes – a significant majority – did not include a recorded diagnosis. This obscures the specific health issues contributing to workforce absence.

Leading Causes for Sick Leave

The most frequently documented reason for sick leave was ‘mental and behavioural disorders,’ including anxiety and depression, accounting for 932,100 notes. This surpassed ‘diseases of the musculoskeletal system and connective tissue,’ which accounted for 468,010 notes.

Since 2022, there has been a 10.8% increase in notes issued without a specified cause. Other areas showing increases include ‘congenital malformations, deformations and chromosomal abnormalities’ (up over 17%) and ‘diseases of the respiratory system’ (up 14.53%).

Regional Disparities and Government Response

The data also reveals regional differences, with NHS North East London Integrated Care Board issuing the highest number of notes (454,757), followed by NHS North West London (390,467).

Health Secretary Wes Streeting acknowledged the issue, stating, “we simply cannot afford to keep writing people off.” The increasing number of individuals absent from work due to health conditions – currently at 2.8 million – is seen as detrimental to patients, the NHS, and the economy.

Financial Implications

Forecasts indicate a substantial increase in the annual bill for Personal Independence Payment (PIP), potentially reaching £44.9 billion by the end of the decade. Despite acknowledging the need for welfare reform, there are currently no plans for related legislation.

GP Practices and Mental Health Notes

A recent survey of GPs revealed that a significant proportion (540 out of 752 respondents) had never refused a patient a mental health-related sick note, raising questions about the criteria and processes involved in issuing these certificates.