If handled appropriately, long-term sickness absence does not have to result in the end of the employment relationship. In many cases, it is possible to support an employee’s recovery and facilitate a successful return to work.
For employers and managers, however, the challenge lies in managing the situation fairly, sensitively and in accordance with the law. Below is a step-by-step guide to best practice when managing long-term sickness absence.
-
Monitoring Absence
Effective absence management begins with consistent and accurate monitoring. A clear sickness absence policy should be in place and communicated to all employees.
Absences should be recorded accurately, with separate categories for disability-related or pregnancy-related absences. This distinction is vital to avoid breaching the Equality Act 2010 by inadvertently treating such absences as comparable to general sickness.
Employers must ensure that the data collected is handled in compliance with UK GDPR requirements, as it will likely constitute sensitive personal data.
-
Maintaining Appropriate Contact
Initial contact when an absence begins should be made in line with the organisation’s reporting procedures, typically via the employee’s line manager. For longer absences, maintaining regular and appropriate contact is essential.
The frequency and nature of contact should be agreed with the employee and approached sensitively. The goal is to provide support, not to pressure or monitor unduly. Employers should keep a written record of conversations and send a follow-up summary to the employee confirming what was discussed and any agreed next steps.
Prolonged silence may make reintegration harder and damage trust, so keeping communication open is key.
-
Obtaining Medical Evidence
If an absence becomes prolonged or the employee’s return date is uncertain, the employer should seek up-to-date medical evidence. This may be in the form of:
- a fit note from the employee’s GP;
- a medical report under the Access to Medical Reports Act 1988 (with the employee’s written consent);
- an occupational health report.
The report should ideally address the nature of the illness, prognosis and any adjustments that may enable a return to work.
-
Occupational Health and Second Opinions
In many cases, referring the employee to occupational health is appropriate. An independent specialist may be able to assess whether the employee is fit to return, whether adjustments can facilitate a return, or if the condition is likely to qualify as a disability.
Consent must be obtained before any referral, and the employee should be informed of what information will be shared.
If the employee refuses to attend a medical assessment without good reason, the employer may still proceed with decisions based on the available evidence. However, this should be approached cautiously and legal advice sought before treating non-cooperation as a disciplinary matter.
-
Consulting the Employee
Before any decisions are made, the employer should invite the employee to a formal consultation meeting to discuss medical evidence and options. The employee should be given advance notice, the right to be accompanied and the opportunity to respond to any concerns raised.
If the prognosis is unclear or could change in the near future, it may be appropriate to postpone a final decision until more information is available.
-
Planning a Return to Work
If the employee is fit to return, reintegration into the workplace must be carefully planned. A return-to-work interview is advisable, and a risk assessment should be carried out if required.
Where the absence relates to a disability, employers have a legal duty under the Equality Act 2010 to make reasonable adjustments to avoid substantial disadvantage.
This duty arises where:
- a provision, criterion or practice places the disabled person at a disadvantage;
- a physical feature of the premises causes disadvantage;
- the absence of an auxiliary aid causes disadvantage.
Reasonable adjustments may include:
- A phased return to work
- Changes to working hours
- Reallocating certain duties
- Providing equipment or assistive technology
Employers must keep the adjustments under review and ensure they are practical, proportionate and tailored to the individual’s needs.
-
Assessing Ongoing Viability
Despite the employer’s best efforts, there may come a point where the employee is unable to return to work or their level of absence becomes unsustainable.
Before any decision is taken, employers should consider:
- Adjustments to the existing role
- Alternative suitable roles
- Whether the employee is eligible for ill-health retirement, a permanent health insurance scheme, or other benefits.
All avenues should be explored, particularly where the employee is disabled, to ensure compliance with the duty to make reasonable adjustments.
-
Business Considerations
The effect of long-term absence on the business should also be considered. Managers may need to weigh the costs and practicalities of continuing to cover the role versus the implications of recruiting and training a replacement.
This is a legitimate factor when assessing whether ongoing employment is sustainable, but it must not override the employer’s legal obligations to act fairly and reasonably.
-
Dismissal on Ill-Health Grounds
Where all other options have been exhausted and a return to work is not feasible, the employer may consider dismissal on grounds of capability due to ill health.
A fair dismissal process must be followed, including:
- a thorough review of medical evidence;
- meaningful consultation with the employee;
- consideration of reasonable adjustments;
- consideration of alternative roles;
- a final meeting and the opportunity to appeal.
Employers are not legally required to wait until contractual or statutory sick pay is exhausted before considering dismissal. However, any dismissal must be a proportionate response to the circumstances and based on a reasonable belief formed after a reasonable process.
For disabled employees, additional scrutiny will apply. The employer must demonstrate that dismissal was a last resort after complying with the Equality Act 2010.
Final Thoughts
Supporting employees with long-term illness is a sensitive and legally complex process. Employers must strike the right balance between compassion, business needs and legal compliance. Taking the time to get it right will reduce the risk of claims for unfair dismissal, discrimination, or failure to make reasonable adjustments.
If you are unsure about any stage of the process or facing a difficult decision, our employment law team is here to help. We can guide you through your obligations and assist you in protecting both your business and your people.