New NHS England figures reveal a dramatic increase in sick notes issued, with over 11 million distributed in the past year. A significant proportion of these notes lack a recorded diagnosis, raising concerns about the true extent of health-related workforce absence and the potential strain on the welfare system.
New data released by NHS England reveals a significant surge in the number of sick notes issued to patients across the country. In 2025, over 11 million fit notes were distributed, marking more than a doubling since 2015 when 5.3 million were issued.
This represents a nearly 500,000 increase in the last three years alone, from 2022. A concerning aspect of these figures is that over eight million of these notes – a substantial majority – did not include a recorded reason or diagnosis, obscuring the true extent of specific health issues contributing to workforce absence. The leading documented cause for sick leave was 'mental and behavioural disorders,' encompassing conditions like anxiety and depression, accounting for 932,100 notes.
This significantly outpaced 'diseases of the musculoskeletal system and connective tissue,' which accounted for 468,010 notes. While there was a slight decrease in notes for musculoskeletal issues compared to the previous year, there was a notable 10.8% increase in notes issued without a specified cause since 2022. Other areas showing increases include 'congenital malformations, deformations and chromosomal abnormalities' (up over 17%) and 'diseases of the respiratory system' (up 14.53%).
The data also highlights regional disparities, with NHS North East London Integrated Care Board issuing the highest number of notes (454,757), followed by NHS North West London (390,467). The rise in sick notes has prompted concern from government officials, with Health Secretary Wes Streeting acknowledging the need to address the issue, stating that '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 both patients, the NHS, and the economy. 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.
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. The lack of detailed diagnoses on a large proportion of the notes further complicates efforts to understand and address the underlying causes of workforce absence
Sick Notes NHS Mental Health Workforce Absence Welfare System
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