Managing long-term sickness absence

Let’s talk about something no employer enjoys dealing with but absolutely has to get right—long-term sickness.

In UK employment law terms, long-term sickness generally means continuous absence from work lasting four weeks or more. Whether someone’s recovering from surgery, managing a chronic illness, or experiencing serious mental health issues, long-term sick leave can cause a real operational headache.

Not to mention the legal risks if it’s mishandled.

So, let’s walk through what you need to know to manage long-term sickness absence the right way. From paperwork to people skills, and everything in between.

Keep in touch the right way

One of the biggest mistakes employers make is either going completely silent or going in too strong. You need to strike a balance.

Yes, you can contact employees on long-term sick leave. But it should be an agreement between yourself and the individual employee.

Think, support, not surveillance. And always keep a record of what’s said and when. It’s not about being suspicious, it’s about being smart.

If you’re worried that you might cross the line into harassment, read our article on Contacting staff on sick leave.

Understand your legal duties

Here’s where a lot of employers fall into hot water. Under UK employment law, you must ensure your handling of long-term sickness absence is lawful, fair, and non-discriminatory.

That means:

• Statutory Sick Pay (SSP): Employees are entitled to SSP for up to 28 weeks (if they meet eligibility).

• Disability considerations: If the illness amounts to a disability under the Equality Act 2010, you’re legally obliged to consider reasonable adjustments.

• Protection from unfair dismissal: You can’t dismiss someone simply for being off sick long-term, you need to follow a fair process.

Fail to do any of this, and you could be looking at claims for unfair dismissal or disability discrimination. Learn more about employment law and sick leave entitlements in our article.

Understand your requirements to make reasonable adjustments

If your employee’s condition qualifies as a disability, the law says you must consider and, where reasonable, make adjustments to support them returning to or staying in work.

The adjustment needs to be reasonable in the context of your business size and resources. If something isn’t feasible, you’ll need a good, well-documented reason for saying no.

Read our guide to reasonable adjustments at work to fully understand your duty.

The key here is consultation. Talk to the employee, ask what they feel would help, and consider input from occupational health if needed.

Use occupational health support wisely

Occupational health assessments can help you understand your employee’s condition from a clinical point of view and advise on:

• Whether they’re fit to return to work

• What adjustments may be needed

• Whether the condition is likely to be long-term or permanent

However, there are rules to using an occupational health assessment and you must get consent from your employee before you schedule one.  More information about occupational health in the workplace can be found in our article.

Use welfare meetings to help

Welfare meetings are essential for managing long-term sick leave. But let’s be clear: they’re not about cornering your employee or grilling them about when they’ll be back.

Done well, they’re simply a structured check-in to show support, share updates, and plan next steps. A good welfare meeting might include:

• Asking how the employee is and what support they need

• Discussing medical updates (fit notes, OH reports)

• Exploring reasonable adjustments

• Talking through the potential timeline for returning to work

• Keeping them in the loop on workplace changes

Make sure to hold the meeting at a time and place that suits them (including offering a virtual option) and always follow up with notes in writing. If they decline the meeting? Respect that but keep a record and try again later.

To learn how to hold a supportive welfare meeting you can read our guide to welfare meetings at work.

Have a clear long-term sickness absence policy

Here’s where you turn good intentions into solid, defensible action. A long-term sickness policy sets the ground rules and gives everyone clarity. From your managers to your employees.

You may have an absence management policy that covers long-term sickness but if not your policy should cover:

• When and how to keep in touch during sick leave

• When welfare meetings will take place

• How and when to request medical or OH input

• The process for exploring adjustments or phased returns

• What happens if the employee is unable to return

• Clear signposting to any company sick pay arrangements

• How capability or dismissal processes would be handled

A clear policy ensures consistency, transparency, and legal compliance, and shows employees you’ve got a fair process in place, not a panic response.

Plan for a return

Don’t wait until the day before someone’s due back to start planning. As soon as there’s a realistic chance of return, you need a structured plan.

Often, a phased return to work is the way forward. Think, reduced hours, lighter duties, or gradual reintegration into their role.

This benefits everyone:

• The employee returns safely and confidently

• You reduce the risk of relapse

• You show you’re meeting your duty of care

More information can be found about planning a return to work in our article.

What if they can’t return?

Sometimes, even after support and adjustments, it becomes clear the employee isn’t going to be able to return to their role.

If that happens, you may need to consider dismissal on grounds of capability due to ill health.

But (and this is crucial) you must:

• Seek medical evidence

• Explore all possible adjustments

• Consult with the employee (multiple times if necessary)

• Follow a clear, fair capability procedure

• Consider alternatives to dismissal

Dismissal is always the last resort and only after a reasonable process.

Don’t forget the rest of the team

While you’re supporting the individual, don’t neglect your wider workforce. Long-term sickness absence often puts extra pressure on colleagues picking up the slack.

Keep communication open, explain what’s happening where appropriate (while respecting confidentiality), and be realistic about workloads. You may need to bring in temporary cover or adjust expectations.

Keep detailed records

In any case involving long-term sick leave, documentation is your safety net. You should keep:

• Fit notes and GP letters

• Occupational health reports

• Records of communication

• Notes from meetings

• Copies of any adjustments offered

If a dispute arises, this is your evidence that you acted reasonably and fairly. It’s advisable to keep all your documents in one place, like a secure online document storage system.

Your role as an employer

Managing long-term sick leave isn’t about tiptoeing around legal landmines or trying to rush someone back to work. It’s about:

• Following the law

• Showing compassion

• Acting reasonably

• Protecting your business and your people

Handled correctly, it builds trust, reduces legal risk, and supports a healthier workplace culture.