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Project #84:
Fit notes in primary care post-COVID

  • Type: Research
  • Topic areas: Post-COVID health impacts [e.g. long COVID]

Fit notes (sometimes called “sick notes”) are issued by GPs in the UK where a person needs to demonstrate to their employer that they are unable to work for health reasons for more than 7 days. Given the large number of patients living after being diagnosed with COVID-19, it is important to know the degree to which recovering from COVID affects people’s ability to work. Coding of fit notes by GPs should provide a window on the scale of the continuing public health and economic burden for those recovering from COVID-19. This in turn can assist policy makers in prioritising resources for COVID recovery services.

In parallel with this, measuring the diagnoses that are associated with fit note coding would provide important insights into the types of conditions that are causing substantial continued problems for people recovering from COVID-19. This could provide important information for the continued care of these patients.

This study examines to what extent (rate and duration) fit notes are given to patients with COVID (identified through three routes—those testing positive for SARS-CoV-2, those with a probably diagnostic code in primary care, and those hospitalised with a diagnostic code for COVID) and compare against general populations from 2019 and 2020, as well as an active comparator (patients hospitalised with pneumonia in 2019 for comparison with hospitalised COVID patients). It also evaluates what diagnoses are commonly coded alongside the recording of a fit note. The study also analyses what type of patients get a fit note, according to demographic, clinical, and organisational factors.


  • Study leads: Alex Walker
  • Organisation: University of Oxford and London School of Hygiene and Tropical Medicine