- Five million people now claiming benefits with no requirement to work, including 300,000 under-24s.
- Ministers ditched Tory plans to end ‘sick-note culture’ earlier this year.
Over 40,000 people were signed off work every day by GPs over the last year, a new analysis reveals.
In total, an estimated 11 million fit notes were issued over the course of 2025, according to the research by the Centre for Social Justice (CSJ).
The think tank warns that the scale of fit note issuance is driving Britain’s worklessness crisis, with the health system increasingly acting as a gateway to benefit dependency rather than a route back into work.
Fit notes replaced ‘sick notes’ in 2010 and were originally intended to help people remain connected to employment through adjustments or phased returns.
But CSJ research shows that over 90 per cent of fit notes certify people as unfit for work, often for extended periods, with little structured employment or health support attached.
Mental health conditions account for a growing share of fit notes, particularly anxiety and depression. Earlier research has shown that once individuals are signed off and onto sickness-related benefits, their chances of returning to sustained employment fall sharply, especially for young adults, despite overwhelming evidence that worklessness only exacerbates mental ill-health.
The CSJ warns this approach is failing patients, overstretching GPs, and driving up welfare costs.
With over five million people now claiming benefits with no work requirements, including more than 300,000 16-24-year-olds, Britain risks locking a generation out of work, wasting millions of individuals’ potential.
The CSJ argues that responsibility for fit notes should be taken off overstretched GPs and transferred to a dedicated Work and Health Service, bringing together occupational health, employment support and mental health services.
Under this model, decisions about fitness for work would focus on what people can do, not simply whether they are unwell, with early intervention to support adjustments, retraining and phased returns to work.
This would build on and expand existing £64 million WorkWell pilots, ensuring that health and employment support operate together rather than in silos.
Earlier this year, DWP minister Baroness Sherlock told the House of Lords: “The Government has no current plans to reform the fit note (Statement of Fitness for Work) in terms of the content of the form or the healthcare professionals who are legally allowed to issue them.”
The CSJ is calling on ministers to:
- Move fit note responsibility out of GP surgeries and into a new Work and Health Service focused on maintaining work attachment.
- Embed employment and occupational health support at the point of sign-off to stop the flow of people moving onto benefits.
- Treat good work as a health outcome, particularly for common mental health conditions.
Joe Shalam, Policy Director at the CSJ, said:
““Thousands being nudged every day along a conveyor belt to worklessness is a scandal, but overstretched GPs are being asked to manage a crisis they are not equipped to solve.
“We need a dedicated Work and Health Service that helps people recover and return to work, rather than a system that risks wasting the potential of millions.”
Notes to editors
Methodology: The CSJ estimate is based on NHS Digital quarterly publications on fit notes issued by GP practices in England up to June 2025. Quarterly totals of approximately 2.6 to 2.8 million fit notes have been observed consistently in recent years. The CSJ projects forward using recent trends to estimate a full-year total of around 11 million fit notes in 2025. Daily figures are calculated dividing 11 million by 252 working days per year.
Official NHS Digital statistics count fit notes issued rather than individuals, and many people have multiple fit notes during the same sickness absence. For example, in recent quarterly data roughly 2.6 million fit notes corresponded with about 1 million sickness episodes, implying an average of more than two notes per episode.
