Long Term Health Absence

Dealing with long term absence because of health can be costly, complex, time consuming, emotionally draining and confusing and if not managed effectively, can pose significant risks to a business.

A report from the Centre for Economics and Business Research (CEBR)1 estimates the cost of long-term sickness absence – absences of six months or more – at £4.17 billion to private sector businesses in the UK.

Where to start?

There are two stages to managing an employee’s long-term sickness absence. The first is to manage the employee’s absence from work and the second to manage their return to work as soon as possible.

The line manager should normally carry out regular reviews of the employee’s length of absence, state of health and readiness to return, as well as whether or not anything can be done to facilitate their return. This should be done in discussion with HR, an occupational health specialist and, where appropriate, with the absent employee.

The starting point will be for the line manager to have a supportive conversation with the employee as soon as it is known that his or her absence is likely to be long term. The aim of this conversation will be to identify how the organisation can support the employee and take care of his or her inevitable employment concerns.

What is long-term?

It is difficult to define and it will depend on the nature of the business and the job. As a guide, many employers work on absence in excess of 3 – 4 weeks.

How should you manage it?

It is not appropriate to use disciplinary warnings, however, case law provides the key to the type of procedure that the employer should adopt.  The main emphasis is on supporting the employee and consulting with them at all stages and the following ‘procedure’ should be considered:

  • Visit the employee to find out how they are progressing and how long they are likely to be absent. Take their manager or a colleague with you.  Such a visit would normally be to their home but, if they will not agree to this, book a meeting room in a hotel near their home. A hotel foyer or coffee shop is not ideal as personal and confidential information will need to be discussed
  • At this visit, it is sensible to ask for their written permission to obtain a medical report (available on our Online HR Toolkit) from their doctor in accordance with the Access to Medical Reports Act.
  • Make notes of the meeting and then write and confirm the conversation and agreed on actions to the employee.
  • Sometimes it is necessary to consult with the employee’s doctor; however, this can be tricky as often GP’s / Consultants can take quite a time to respond and when they do it can be full of medical terms that make it very difficult for a layperson to understand. It also requires the employee to give their consent for this to happen by completing an Access to Medical Reports Form (available on our Online HR Toolkit).
  • This is often where an Occupational Health Advisor can support the employer, they will be able to meet with the employee and then, with the employee’s consent, consult with the Doctor on behalf of the employer.
  • Once you have a report, then it is likely that you will meet with the employee to discuss it with a view to identifying what specific further action they should instigate.
  • You should always make it clear to the employee that your ultimate aim is to see them return to work, however, you must tell them that dismissal by reason of capability could be an outcome if this cannot be achieved within a reasonable time frame.

To consider what is reasonable, the following factors should be borne in mind:

  • The employee’s age and length of service
  • The length of future employment
  • The nature of the job
  • Whether or not the job can be covered temporarily
  • The effect of the absence on the business
  • Is it reasonable to wait any longer?
  • Depending on the prognosis, you may need to make an assessment of their capability to return to their role; however take care – you cannot just decide that they are not capable of returning and dismiss them for capability.

 Avoiding Disability Discrimination

An employee who is off sick for a lengthy period of time may be disabled for the purposes of the Equality Act 2010. If this is the case the employee will be entitled to protection against discriminatory treatment and to expect the employer to make reasonable adjustments.

The Act contains a very broad definition of disability, which includes both physical and mental impairments that last, or are expected to last, 12 months or more and are substantial in terms of their effects on the person’s day-to-day life.

A wide range of physical and mental conditions and illnesses may amount to disabilities, depending always on whether or not the effect of the condition on the person is substantial and long term.

An important point to note is that a condition may amount to a disability even if, as a result of medication or another form of support, the person experiences no adverse effects on a day-to-day basis. The question that determines whether or not an employee is disabled is how the condition would affect the employee if he or she did not take the medication or use the support.

Again this is where a great Occupational Health Advisor can assist as they will be sure to have taken the time to understand your industry and what type of role that employee performs so that they can help to identify what steps you can reasonably take.  They should offer honest and practical feedback and resolution whilst maintaining confidentiality, respect and fairness.


Visit the employee regularly and discuss their future. Confirm all meetings and the agreed outcome in writing and ensure you follow a fair procedure and obtain legal advice first, where appropriate.

If you need a hand managing your long term sick absences, feel free to give us a call on 01473 360160.  Alternatively, you can book a free, one hour, face-to-face consultancy or telephone consultation with one of our experts.

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1 Cebr Report The benefits to business and the economy of early intervention and rehabilitation Report for UNUM, October 2015