Managing Long Term Sickness Absence UK: Employer Guide (2026)

Long-term sickness is one of the most challenging situations for employers to manage. You want to support your employee, but you also need to keep the business running. Getting the balance wrong can lead to employment tribunal claims, damaged team morale, or an employee who feels abandoned. This guide explains the practical steps to handle long-term absence fairly and legally.

What counts as long-term sickness?

There is no legal definition, but most employers and insurers consider absence of 4 weeks or more to be long-term sickness. Common causes include musculoskeletal conditions (back pain, joint problems), mental health conditions (depression, anxiety, stress), surgery and recovery, cancer treatment, and chronic illness flare-ups.

Keeping in touch during absence

Maintaining regular, supportive contact with the employee is essential. This is not about pressuring them to return. It is about making sure they feel valued and informed.

Best practices for keeping in touch:

• Agree the contact method: Some employees prefer phone calls, others prefer email or text. Ask them what works best.
• Set a frequency: Weekly or fortnightly contact is usually appropriate. Less frequent and the employee feels forgotten. More frequent and it feels intrusive.
• Assign one contact person: Usually their line manager or an HR contact. Avoid multiple people calling at different times.
• Share workplace news: Keep them informed about team changes, social events, and company updates so they still feel connected.
• Document every contact: Record the date, method, and a brief summary of the conversation.

Obtaining medical information

Fit notes

Employees can self-certify for the first 7 calendar days of sickness. After that, they need a fit note from a GP or hospital doctor. The fit note may say the employee is "not fit for work" or "may be fit for work" with adjustments. If the fit note suggests adjustments, you should consider them carefully.

Occupational health referral

For long-term cases, a fit note alone is rarely sufficient. An occupational health (OH) assessment provides a much more detailed picture. The OH professional will advise on:

• The likely duration of the absence
• Whether the condition is likely to be covered by the Equality Act 2010
• What adjustments could support a return to work
• Whether a phased return is appropriate
• Whether the employee is likely to be able to return to their role at all

You need the employee's consent to make an OH referral. Most employees agree when the purpose is explained clearly. An OH report is not a diagnosis. It is workplace-focused advice for the employer.

Reasonable adjustments and the Equality Act

If the employee's condition meets the definition of a disability under the Equality Act 2010, you have a duty to make reasonable adjustments. A condition qualifies as a disability if it has a substantial and long-term adverse effect on the person's ability to carry out normal day-to-day activities. "Long-term" means it has lasted, or is likely to last, 12 months or more.

Examples of reasonable adjustments:

• Phased return with reduced hours, building up gradually
• Temporary reallocation of certain duties
• Changes to working hours or location
• Providing specialist equipment
• Allowing additional time off for medical appointments
• Adjusting absence trigger points (not counting disability-related absence in the same way as general sickness)

Planning a phased return to work

A phased return means the employee comes back on reduced hours or duties, gradually increasing over a set period (usually 4 to 8 weeks). This is often recommended by occupational health or mentioned on a fit note.

Key decisions to make:

• Duration: How long will the phased return last? Set a clear end date.
• Hours: What hours will they work each week, and how will these increase?
• Duties: Are there any duties they should avoid initially?
• Pay: Will they receive full pay or pay proportional to hours worked? There is no legal requirement to pay full pay during a phased return, but many employers do.
• Review points: Schedule regular check-ins to assess progress.

When can you dismiss for long-term sickness?

Dismissal for long-term sickness can be fair, but only if you have followed a proper process. A tribunal will consider whether:

1. You obtained up-to-date medical evidence (usually an OH report)
2. You consulted with the employee about their condition and prognosis
3. You considered and implemented reasonable adjustments
4. You explored alternative roles if the employee cannot return to their original job
5. The business genuinely cannot sustain the absence any longer
6. You followed a fair procedure, including the right to be accompanied and the right to appeal

There is no fixed period after which dismissal becomes automatically fair. It depends on the circumstances: the nature of the role, the size of the organisation, the impact on the team, and the medical prognosis.

SSP and company sick pay

Statutory Sick Pay (SSP) is paid for up to 28 weeks at £116.75 per week (2025/26 rate). After SSP ends, the employee may be able to claim Employment and Support Allowance (ESA) or Universal Credit. If you offer company sick pay, your policy should state how long it lasts and how it interacts with SSP.

Return-to-work interviews

When the employee returns, conduct a return-to-work interview. This is a brief, supportive conversation covering:

• How they are feeling
• Whether any workplace adjustments are needed
• Updating them on changes during their absence
• Confirming any phased return arrangements

How Leavely helps manage long-term absence

Leavely gives you the tools to manage long-term sickness properly:

• Fit note tracking: Record fit note dates, recommendations, and expiry dates against the employee's absence record.
• Return-to-work interviews: Log RTW conversations with dates and notes, creating an audit trail.
• Absence patterns: See total days absent, frequency, and Bradford Factor scores at a glance.
• Document storage: Attach OH reports, fit notes, and correspondence to the employee profile.
• Trigger point alerts: Get notified when absence reaches your policy thresholds so you can take timely action.