Managing Long-Term Sickness Absence

Reviewing Long-Term Sickness Absence

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.
The management of an employee's absence should be carried out proactively with the primary aim of supporting the employee and facilitate a return to work as soon as possible.

To achieve these aims, the 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 a return.  This should be done in discussion with the relevant HR Business Manager or their team, Occupational Health and, where appropriate, the absent employee.

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

Obtaining Medical Advice

As soon as it becomes clear that an employee's absence will be long-term, the manager should speak to the employee about a referral to Occupational Health for an assessment of the effects of the condition, the likely duration of the illness or condition and whether or not there are any steps that the manager could take to facilitate the employee's return to work.  Where an employee does not consent to an Occupational Health referral it may be necessary for the University to make decisions without the benefit of further information.  On receipt of the Occupational Health assessment the manager should consider it carefully with a view to identifying what specific further actions should be taken.

In the event that the manager believes further medical information is required from an employee's own doctor, specialist or consultant, they should speak to Occupational Health in the first instance.  Managers should be aware that the Access to Medical Reports Act 1988 places certain restrictions on employers that wish to obtain medical information about employees from their own doctor and also gives individuals a range of rights in relation to any such medical report.

Maintaining Contact with the Employee

An employee on long-term sick leave may feel isolated and miss the social contact that work usually affords.  It will be very important for the employee to know that, even though he or she is off sick, support is available from the University.  The manager should take positive steps to keep in touch so that the employee knows that the organisation is interested in his or her health and wellbeing, and that support is available.

Some managers may, understandably, feel uncomfortable about the prospect of contacting an employee who is off sick in case the contact might be perceived as unfair pressure.  The manager should, however, also reflect on how the employee might feel if no contact is made.

The first step would be for the manager to telephone or write to the employee indicating a desire to maintain contact and asking the employee whether he or she would prefer telephone contact, email communication or a combination of these.

It should be clarified that the contact is as a result of concern about the employee's welfare and progress and in order to offer any support that is reasonable and practicable.  Keeping in touch personally will also allow the manager to keep up-to-date with the employee's state of health and progress and his or her perspective on the likelihood of a return to work.  This in turn will allow the manager to organise and maintain temporary cover more effectively.

In the event that the manager is unable to make contact with the employee, the manager should contact the relevant HR Business Manager or their team who may advise, for example, that the employee’s next of kin be contacted.

Managing the Employee's Return to Work

As time goes on, the manager should seek to obtain further medical advice about the employee's fitness to work and continue to discuss the situation with the employee directly where this is possible.

Once Occupational Health or the employee's doctor or specialist has indicated that the employee may soon be ready to return to work, the manager should turn his or her attention to the steps that might reasonably be taken to support the employee's return.  The manager should take account of the doctor's advice in a fit note that could help to identify any appropriate steps that the employer could take to help the employee return to work, which might include:

  • Considering a phased return to work and discussing the options with the employee (and Occupational Health where appropriate);
  • Discussing with the employee (and Occupational Health where appropriate) whether he or she will be fit to perform all the duties of the job or whether some adjustments may need to be made;
  • Checking if the employee is still taking any medication and whether or not there are any likely side effects, for example tiredness;
  • If possible, arranging a social visit for the employee shortly before the proposed return date so that the employee can meet informally with colleagues and be brought up to date on a range of matters;
  • Discussing the employee's capabilities with him or her, either when the employee returns to work or just prior to this, and reviewing if any special arrangements or support need to be provided initially;
  • Planning to give the employee meaningful work to do so that he or she quickly feels useful;
  • Making sure that the employee is not overloaded with work or faced with a mountainous backlog;
  • Agreeing with the employee what support will be available during the first weeks or months after his or her return, and how progress will be monitored;
  • Considering arranging for one of the employee's colleagues to act as his or her "buddy" for a period, taking responsibility for helping the employee with any difficulties in the first few weeks after his or her return;
  • Taking positive steps to ensure that the employee feels that his or her return to work is welcomed; and/or
  • Actively monitoring the situation for a period of time to make sure that the employee is coping adequately with the day-to-day work and its associated pressures.

The manager should take into account that the employee may feel very anxious about returning to work after a lengthy period of absence and worried about how he or she will be perceived and treated by colleagues and management. This may be a particular concern if the employee's absence was the result of a mental illness.

It will therefore be extremely important for the manager to take positive steps to make the employee feel at home and facilitate his or her reintegration into the workplace rather than just expecting the employee to get on with things.

Phased Returns

Phased returns can be implemented to help facilitate an employee's return to work after long-term sickness absence.  Legally, it could constitute a "reasonable adjustment" that an employer must make where an employee has a disability under the Equality Act 2010 and, in practice, a phased return can be beneficial for both the employer and the employee when trying to achieve a successful return to work.

A phased return to work will not be suitable in every situation.  The premise of a phased return is that the employee is well enough to carry out some work, and is likely, given time, to recover sufficiently to return to his or her previous role (or previous role with some adaptations).  Where the employee is not capable of any work, the question of a phased return will not arise.

A phased return to work should be based on medical advice, either in a fit note from the employee's doctor, or in an Occupational Health assessment.  In the case of a fit note, in addition to ticking the "phased return to work" box, the doctor is required to provide details of what the employee is or is not capable of doing.  If a phased return is recommended on fit note, the manager should always seek advice from Occupational Health in the first instance.

In the event that a phased return has been recommended and is supported by Occupational Health, the manager should discuss the following with the employee:

  • When the phased return is to start;
  • With what work and hours the employee will start the phased return;
  • At what location the employee will start the phased return (e.g. at home or in the office);
  • Whether or not there are any other changes to the working arrangements that might need to be made (e.g. a special chair or computer equipment to help support an employee with a disability);
  • What changes in work, hours and/or location are thereafter expected to occur, and when they are expected to occur;
  • What arrangements will be put in place to monitor the employee's progress and any difficulties;
  • What will happen to the employee's pay during the phased return to work; and
  • To whom the employee should report if he or she has any difficulties with the arrangements.

Arrangements should take into account the individual circumstances and addressed on a case by case basis.  However, a phased return should normally be for a period of no more than six weeks and would be on full pay.  Where a six-week phased return has been agreed, it is recommended that the manager and employee make contact at the four-week stage to discuss progress and whether the employee is ready to resume their full contractual hours at that stage or if the phased return should continue for the full six weeks.

At the end of a phased return, if an employee is fit for work but does not feel ready or able to resume their full contractual hours, he or she may wish to consider the following options:

  • To reduce his or her contractual hours on either a temporary or permanent basis, with an associated reduction in pay;
  • To take annual leave either in one block or staggered over a period of time; and/or
  • To take unpaid leave.

There is no guarantee that a request for a reduction in contractual hours, annual leave or unpaid leave will be granted.  Before making a decision, the manager will need to consider the impact on service provision, budgets and colleagues.