Among the many types of leave to which employees in the UK are entitled (bereavement leave, dependants' leave, etc.), medical leave is perhaps the most common reason for absence.
It allows employees to take time off when health issues prevent them from working safely or effectively. In the UK, medical leave is governed by sick leave rules, Statutory Sick Pay, and employer obligations under employment law.
This article will help you to understand how medical leave works in the UK. Find out what employees are entitled to and what employers must do to stay compliant while supporting well-being for your workforce.
Key takeaways
- Medical leave is treated as sick leave under UK employment law, not a separate statutory entitlement
- Employees can self-certify sickness for up to 7 days; a fit note (a Statement of Fitness for Work) is required from day 8
- Statutory Sick Pay (SSP) is paid by employers from day 4 of sickness for up to 28 weeks
- SSP currently requires average earnings of at least £125 per week, with this threshold removed from April 2026
- Pregnancy-related sickness and qualifying mental health absence are legally protected and must not result in unfair treatment
Medical leave definition under UK employment law
UK employment law does not define “medical leave” as a separate category. Instead, it is treated as sick leave or sickness absence and applies when an employee is unable to work due to illness, injury, or a health condition.
Medical leave needs to be consistently reported, recorded, and reviewed. Many organisations therefore focus on how they manage employee leave and absence as part of workforce planning and employee well-being.
How medical leave works for employees in the UK
Employees on medical leave are entitled to receive Statutory Sick Pay from day 4 for up to 28 weeks if eligible. Eligibility depends on earnings and the duration of absence.
When an employee can take medical leave
An employee can take medical leave when illness prevents them from working. They can self-certify for up to 7 consecutive days or provide a fit note for longer absences.
Common reasons include:
- Short term illness (flu, cold or infection)
- Recovery from surgery or injury
- Pregnancy related sickness
- Stress related or mental health conditions
Employers should avoid questioning the legitimacy of illness without evidence.
Short term medical leave vs long term sick leave
UK employment practice usually distinguishes between short and long term absence. Explore the difference between both types of leave in the table below.
| Type of medical leave | Typical duration | Medical evidence required | Management approach |
|---|---|---|---|
| Short term medical leave | Up to 7 calendar days | Self certification | Usually managed informally by line managers |
| Long term sick leave | More than 7 days | Fit note from a medical professional | Often involves HR review and ongoing communication |
Medical leave for part time employees in the UK
Part time employees have the same rights to medical leave as full time employees. Employment status and average earnings are the determining factors for whether you are eligible for Statutory Sick Pay, not contracted hours.
Medical leave pay and Statutory Sick Pay (SSP)
Pay during sick leave depends on statutory entitlements and the company’s policies.
What Statutory Sick Pay covers
SSP is paid when an employee is off work due to illness for 4 or more consecutive days. It is paid at a fixed weekly rate set by the government. Eligible employees can receive SSP for up to 28 weeks.
Some employers offer enhanced sick pay schemes. These go beyond statutory requirements but must be applied consistently.
Eligibility conditions for SSP
Currently, employees must earn at least the lower earnings limit to qualify for SSP, which is £125 per week. However, from April 2026, SSP eligibility will no longer depend on earnings. Agency workers and temporary staff may qualify depending on their employment status.
Medical leave and unpaid sick leave scenarios
Not all medical leave is paid. Unpaid sick leave may apply when SSP eligibility is not met.
This can occur when:
- Earnings fall below the threshold
- SSP entitlement has been exhausted
Medical certificates and fit notes in the UK
Unlike shorter health-related absence (7 or fewer consecutive days), long-term absences require evidence in the form of a medical note from a GP or another practitioner.
When a medical certificate is required
If sickness lasts longer than 7 days, employees must provide a medical certificate, also called “Statement for Fitness for Work”, or a ‘fit note’.
What a fit note is and how it works
A fit note is issued by a GP or hospital doctor. It confirms whether an employee is not fit for work or may be fit with adjustments.
Employer responsibilities when receiving a fit note
Even though employers must consider the advice provided on a fit note, they are not required to follow it automatically.
However, they should assess whether reasonable adjustments are possible and practical, in line with the fit note guidance for employers and line managers published by the UK government.
Medical leave during pregnancy in the UK
Pregnancy can affect people in very different ways. Some employees feel well throughout. Others experience sickness that makes working difficult or impossible for periods of time.
Medical leave versus maternity leave
Medical leave during pregnancy and maternity leave serve different purposes. Maternity leave follows a set statutory timeline and usually starts close to the birth.
Medical leave during pregnancy applies when illness or pregnancy-related conditions prevent someone from working before maternity leave begins. This could be due to severe sickness, fatigue, complications, or conditions worsened by pregnancy.
Pregnancy related sickness and absence rules
Normally, employers track sickness absence to spot patterns. For example, frequent short absences might trigger warnings or reviews.
Pregnancy-related sickness must be excluded from this process. Records should be kept separate to ensure pregnancy does not count against employees.
Pay and protection during pregnancy related medical leave
SSP may apply during pregnancy related absence. Employment protections remain in force throughout the absence.
Medical leave for burnout and mental health
According to a 2025 CIPD report, mental ill health is among the most common causes for both short- and long-term absence.
Is burnout recognised for medical leave in the UK?
Burnout itself is not classed as a medical diagnosis under UK law. However, doctors may issue fit notes for related conditions such as anxiety, depression, or stress-related illness. When supported by medical evidence, these conditions can form a valid basis for medical leave.
The focus is not on the label, but on whether the employee is fit to work.
Stress related illness and sick leave rules
Stress-related illness follows the same sick leave rules as physical illness. Employees may be signed off work or advised to return with adjustments.
Fit notes often recommend:
- reduced hours
- temporary changes to duties
- phased returns
Employers should be cautious about assumptions. Stress-related absence is not a reflection of commitment or capability.
Employer duty of care and reasonable adjustments
One of employers’ duties is to care for and protect the well-being of their employees. This includes making reasonable adjustments for mental health conditions. In practice, reasonable adjustments may involve changes such as:
- adjusting working hours or start and finish times
- temporarily reducing workload or pressure
- modifying duties during recovery
- offering flexible or hybrid working arrangements
- allowing a phased return after medical leave
If they fail to do so, it could expose the organisation to discrimination claims and worsen relations with the employee.
Medical leave extension and long term absence
Some employees need more time to recover, whether due to surgery, serious illness, or ongoing health issues. UK law recognises this reality and allows medical leave to continue, with appropriate management.
How long can medical leave last in the UK?
There is no fixed legal limit on how long an employee can be on medical leave. What often causes confusion is sick pay rather than entitlement to time off.
SSP is available for up to 28 weeks. Once this period ends, payment stops, even though the employee may still be employed and unwell. At that point, other benefits may apply depending on the individual’s situation.
Extending medical leave with a fit note
When medical leave continues beyond the short term, ongoing medical evidence is usually required. Fit notes confirm whether an employee is unfit for work or may return with adjustments.
Many employers use review meetings during longer absences to discuss recovery, next steps, and realistic timelines, helping both sides stay aligned.
Managing long term sick leave compliantly
Employers need to handle long-term absence with consistency and care.
Medical capability procedures should:
- follow a fair and documented process
- consider medical advice carefully
- explore adjustments before conclusions are drawn
Employer obligations when managing medical leave
Employers are central to managing sick leave in line with the law. A useful question to ask is, “Am I ready for an audit?” Reviewing how your organisation currently handles the following aspects will help you stay compliant.
Legal responsibilities during medical leave
The safest way to comply and avoid discrimination is to stick to sick pay legislation. Confidentiality is essential. Employers can achieve confidentiality by carefully handling medical information and sharing it only where necessary.
Record keeping and absence tracking requirements
Accurate records support both compliance and fairness. This includes dates of absence, reasons for leave, and medical documentation. Centralised absence tracking reduces administrative risk and helps ensure consistency. Using structured tools such as absence management software supports accurate reporting and audit readiness.
Avoiding discrimination and unfair treatment
Unfair treatment arises when medical leave leads to negative consequences at work.
Employers should base decisions on medical evidence, explore reasonable adjustments, and assess capability carefully before reaching conclusions.
Managing medical leave efficiently with HR systems
When an organisation grows, processes also need to scale in tow. When documentation is handled manually, the risk of error and inconsistency increases. HR systems are an alternative which provides clearer oversight while supporting compliance.
Challenges of manual medical leave management
Spreadsheets and email chains often pile up, and that’s where problems start to occur. They may lead to:
- limited visibility
- lost or duplicated information
- inconsistent decision-making across teams
Why structured absence tracking matters for compliance
Structure is what brings order to the chaos. Using an HR system improves accuracy and transparency. But furthermore, they create a simple flow that everyone in the organisation can follow. Within Kelio for example, an HR manager can manage absence alongside payroll alignment and legal reporting.
How HR software supports medical leave management
The most helpful aspect of HR software like Kelio is the all-in-one access to absence records and documentation. One system stores fit notes, tracks absence duration and applies the same rules across teams and departments. All to ensure the process of handling medical leave stays compliant and consistent.
