Doctors from Dartford, Gravesham and Swanley Clinical Commissioning Group signed 96 fit notes, on average, every day in the last financial year, according to NHS figures.

Across the Dartford, Gravesham and Swanley CCG, GPs issued a total of 35,047 between April 2017 and March this year.

That’s up on the previous 12 months, despite a technical error that meant the figures for February were under recorded, pushing down the total.

People in work need a fit note, previously called a sick note, if they are off work for more than seven days.

Up to that point they can self-certify that they are unwell.

Across England, 5.3 million fit notes were handed out in the 12 months.

The most recent monthly data, for March, shows that highest rate of notes given to working age patients was in Halton, Cheshire.

The lowest rate was in Camden, London.

Despite being called fit notes, most of those issued classify people as unfit for work.

This was the case for 94% of the notes.

However, fit notes are also used to advise patients and their employers on getting back to work. This includes: recommendations for an employee to make a phased return or work reduced hours or with limited duties.

The most common reasons that doctors signed people off work were mental and behavioural disorders, particularly stress, and back problems.

Women were signed off sick more than men. They received 57% of the fit notes in the 12 months.