Sickness absence is likely one of the most common (and challenging) issues employers are faced with. Sickness absence rates in the UK have been steadily climbing in recent years, with a cost to the economy now estimated at over £100 billion per year. To put that into perspective, in 2025/26 the UK government is budgeting to spend £83 billion on defence.
The ONS reports that in 2022 alone, 44.3 million days of work were lost in the UK through sickness absence, with minor illnesses making up 23.9%. Mental health conditions were close to overtaking musculoskeletal problems as the stated reason for absence at 10.0% and 12.6% respectively.
No workforce is immune to illness, so sickness absence will always exist and, as such, must be properly managed. Employers handling sickness absences poorly run the risk of:
- Genuinely unwell workers being made to feel unsupported or, worse still, harassed and untrusted; or
- Unscrupulous workers ‘gaming the system’ to take time off when they are able to work.
What kind of situations might this come up in?
Employers tend to face to two types of sickness absence challenges:
- Frequent, short-term sickness absences (i.e., absences of less than one month); and
- Long-term sickness absences (i.e., more than one month).
The HRExpress team at Stephens Scown regularly advise on both types of absence.
Managing frequent, short-term sickness absence
The easiest way to explain this is probably through an example:
- An employer manages a small team;
- There is no defined process for handling sickness absence, so absences are reported in myriad ways; some workers just passing a message via a colleague;
- The employer starts to notice that certain employees seem to take much more time off than others. They also seem more prone to sickness on Mondays and Fridays and before and after periods of holiday;
- With only a small team, these frequent absences are seriously impacting the business;
- The employer needs to know how to improve the situation.
What should we be considering?
There is no one-size-fits-all approach to managing sickness absence. By its nature, the steps needed are fact-specific but there are some steps that are proven to help reduce frequent, short-term sickness absence i.e. having a written sickness absence policy.
Do we need a written sickness policy?
We always recommend implementing a sickness policy if one is not already in place. Where one is in place already, it should be reviewed and kept up to date. The HRExpress team can assist with implementing a sickness policy, reviewing a sickness policy and/or keeping such policies up to date.
A well written sickness policy allows employers to be clear with their workers on what their expectations are, including:
- How, and by when, to report sickness absence
- What processes sickness absence might trigger; and
- What problematic sickness absence might look like.
How should sickness absence be reported?
In all but the most exceptional circumstances, a worker should be reporting their own sickness absence and should do so with a telephone call. Otherwise, it is far too easy for someone who perhaps just doesn’t fancy going to work that day to send a text message / email, or to pass a message through a colleague, claiming to be sick.
Do we need to keep a record of sickness absence?
Without keeping accurate records of sickness absence, it is almost impossible for an employer to identify patterns that might otherwise emerge e.g., someone regularly being off work on one side (or both sides) of a weekend.
It is also important to record the reasons for absences. This is especially so where a worker has a disability; there being various instances where disability-related absence should be ignored. Absences that are unrelated to disability might also need to be considered as part of a scoring exercise in a redundancy situation.
Being able to identity patterns in sickness absence early on puts an employer in a position of strength. Discussion can then be had with the worker about:
- Whether anything is causing the sickness absences;
- Whether further sickness absences are expected; and
- What the employer’s expectations on sickness absence going forward will be.
Sometimes, just bringing the issue to a worker’s attention can be enough to resolve matters.
Should we hold return-to-work meetings?
There is no legal requirement to hold return-to-work meetings but doing so is a great opportunity to check in and ensure a worker is truly ready to return to work, to update them on what has been happening in their absence and to understand what support, if any, they might need going forward. The HRExpress team can provide advice on, and support, with conducting return-to-work meetings.
These meetings are also a great opportunity for an employer to identify if there is anything contributing to sickness absence that they might address e.g., if a worker’s absences are being triggered by stress, an employer can:
- Arrange for a stress risk assessment to be completed;
- Consider whether some of the individual’s workload can be allocated to their colleagues; and
- Identify any training needs.
All of the above options may help to address the stress and, in turn, reduce the sickness absences.
It can be helpful to make an employee aware that their frequent, short-term absences are impacting on the business and/or their team and will therefore need to be monitored going forward.
If frequent, short-term absences continue, it may be appropriate to issue a formal warning but advice should be taken beforehand and this is something the HRExpress team can assist with.
Managing long-term sickness absence
The easiest way to explain this is also through an example:
- An employer manages a small team;
- A worker has been off work with stress for the last 4 weeks (Fit Note provided);
- They are then signed off for another 4 weeks, making it a long-term absence;
- The only contact from the worker has been the sending of their Fit Notes;
- The employer needs to know how to address the situation.
How can we know when/if someone is likely to return to work?
As with short-term absences, a well-written sickness absence policy provides an important framework for how long-term absence is managed. The policy not only informs the absent worker what to expect, and what is expected of them (so they should be provided with a copy once their absence is known to be long-term) but will also guide a line manager on how to manage the absence.
An important element in identifying when/if a return to work is likely is often an occupational health (OH) assessment report.
What if an employee refuses a medical report?
A good contract will provide for a worker to agree to a medical examination at the request (and expense) of their employer. It should also provide for any medical report produced to be disclosed to the employer.
However, no one can force a worker to undergo a medical assessment. Where a worker refuses an assessment, it should be explained to them that decisions will still need to be made about their ongoing sickness absence, they will just need to be made without the benefit of medical advice. Making that clear can often help manage any initial reluctance.
What will a medical report tell us?
An OH assessment report will provide a medical opinion on a worker’s current situation, and their prognosis. It should include detail on when/if the worker is expected to be well enough to return to work, what that return to work might look like e.g., any phased return, and recommend any other support or changes that might help facilitate a sustained return to work.
What do we do after we receive a medical report?
A sensible next step after receiving an OH assessment report is to arrange to meet with the worker to discuss the content, especially any recommendations made. The HRExpress team can discuss the content of an OH assessment report and advise on the key implications of such a report and advise on the specific elements that should be discussed with the employee.
During a meeting to discuss an OH assessment report, an employer should check whether the worker agrees with the content of the report and, if not, clarify exactly what it is they disagree with. This is an important dialogue that should hopefully allow for the development of a plan, be that for:
- A return to work in the near future and a plan for the logistics around that;
- An agreed date for a further review so the worker can continue their recovery in the meantime; or,
- A possible exit from the business, if the report indicates the worker is too unwell to return in the reasonably foreseeable future.
What if the report indicates a disability?
Only an Employment Judge can definitively determine whether someone meets the legal definition of disability under the Equality Act 2010. However, some OH practitioners will indicate as to whether the Equality Act is likely to apply.
Where a disability is suspected, an employer will be under a legal obligation to make reasonable adjustments to help mitigate the effects on the worker of that disability. This could include (but is not limited to) making changes to the employee’s working arrangements or being more flexible around what level of absence will trigger a formal process.
Employers have greater legal obligations where a disability exists and, in turn, a worker has greater legal protection. Legal advice should be sought in this situation.
What if the report indicates that the employee is unlikely to be able to return to work?
If an OH assessment report indicates that a worker is unlikely to be well enough to return to work in the reasonably foreseeable future, an employer may need to consider a capability dismissal; being a potentially fair reason for dismissing someone. Given the potential complaints that can be made in response to being dismissed for being off sick, perhaps most seriously complaints of disability discrimination, it is even more important for employers to discuss the content of the report with the worker and to take legal advice before making any final decisions.
Summary
People can be off work for myriad reasons, some genuine and some not. It is a common misconception that frequent, short-term sickness absence is only addressed where the genuineness of the absence is doubted. This is not our experience. The impact on businesses of frequent, short-term absences exists irrespective of whether that absence is genuine or not. It is therefore reasonable for an employer to have a plan in place to address it where and when it arises.
Another common misconception is that long-term absence is only addressed where an employer intends ending employment. Again, this is not our experience. By tackling long-term absence at an early stage, an employer strikes an important balance between giving its workers the best opportunity to get well again and getting them back to work as soon as possible. Once enough time has passed, it can often be the absence itself, rather than an illness, that proves the hardest barrier for a return to work. Good communication with an absent worker throughout their absence is therefore key, but there is a careful balance to be struck here too, and the level and method of communication should be agreed with the absent worker, wherever possible. Again, no two cases are identical.
Given the potential legal and employee relations issues that can arise from getting a sickness absence process wrong, taking appropriate advice is an important step and can take a lot of pressure off an employer. The HRExpress team is perfectly placed to provide this advice and to support employers to avoid potential pitfalls.
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