Managing sickness absence: getting the balance right

Managing sickness absence is rarely straightforward. Employers need to balance compassion for employees with the operational demands of running a business, all while navigating the legal risks of unfair dismissal, disability discrimination and data protection.

Many absences can be managed informally through regular communication, return-to-work discussions, and informal support. However, where absence levels disrupt operations, employers should consider taking formal action.

Formally managing short-term absences will usually differ to handling long-term sickness.

Repeated short-term absence 

When managing the disruption caused by intermittent absences, employers should consider whether any pattern may point to an underlying medical condition, workplace stress, mental health concerns or even issues with management or workload.

Return to work meetings should thus seek to understand the underlying cause before moving toward formal absence management. Sometimes the issue can be resolved without the need for formal action. For example, if absences are caused by child-care issues and amended hours of work can be agreed that may informally resolve the issue. Where attendance remains unacceptable, any formal warning should form part of a fair process, setting clear expectations, review periods and the consequences of failing to improve.

Before dismissing for short-term absences… 

• Ensure reasonable warnings and targets for attendance have been set;
• Consider steps taken by the employee to improve attendance;
• Consider any medical evidence. If medical treatment or reasonable adjustments may resolve poor attendance it may be reasonable to wait for a further review period;
• Consider any mitigating circumstances;
• Ensure any pregnancy related absences have been discounted.

Managing long-term absence

One of the biggest mistakes employers make is doing nothing.

Managers are often reluctant to engage with employees who are seriously unwell or awaiting diagnosis, but delaying difficult conversations rarely improves the position. By the time action is eventually taken, dismissal may appear to be the only option, significantly increasing the risk of unfair dismissal and disability discrimination claims.

Employees often feel isolated during a long-term absence. Some employees welcome regular contact from their employer but others resent contact. It’s helpful for an employer to clarify at an early stage what contact the employee would appreciate, if any.

Conducting welfare meetings enables the employer to both support the employee and obtain information to assess when formal action may be required. Early consultation should focus on practical questions, including:

• when a return to work might realistically be expected;
• whether a referral to occupational health should be made;
• whether the employee may be disabled under the Equality Act 2010;
• whether reasonable adjustments could facilitate a return;
• whether a phased return, amended duties or redeployment might be appropriate; and
• whether longer-term options, such as ill-health retirement or permanent health insurance (PHI), should be explored.

Keeping these issues under regular review demonstrates that the employer has taken reasonable steps before considering dismissal.

Employers should avoid expressing their own opinions about managing long-term illness. Employment Tribunals expect employers to have sought advice from medical professionals rather than relying on their own beliefs about a medical condition.

Occupational health reports provide advice regarding prognosis, fitness for work and recommended workplace adjustments. Once medical advice has been obtained, employers should carefully consider any recommendations and should follow the advice if reasonable to do so. When assessing what is “reasonable” an Employment Tribunal will usually seek a balance between the impact on the individual employee and the impact on the employer of following the advice.

Medical information also attracts enhanced protection under UK GDPR as special category data. HR should ensure that employees understand why the information is being obtained, how it will be used and who will have access to it.

The employee should be invited to a formal absence management meeting if the medical advice suggests that the absence will continue for an extended period. The employer should consider at this stage whether it would be reasonable to wait for an extended period before considering dismissal.

Where formal meetings could lead to warnings or dismissal, employees should be notified in writing in advance and reminded of their right to be accompanied. This is usually contained in the invite letter.

Before dismissing for long-term absences… 

• Consider any medical evidence. If medical evidence suggests that the employee may be able to return within 4-8 weeks it could be reasonable to review again after this timescale has lapsed;
• Ensure that the employee is aware from previous meetings when dismissal may be considered;
• Ensure any reasonable adjustments have been made;
• Ensure suitable alternative roles have been considered. For example it may be reasonable to redeploy a manual worker to an office based role;
• Review any entitlement to PHI or ill-health retirement benefits; and
• Consider contractual sick pay entitlement. The impact of dismissal on an employee could be minimal if the employee’s sick pay has been exhausted and there is no foreseeable prospect of a return to work.

Reasonable adjustments

Where the employee has a disability, employers must actively consider reasonable adjustments.

These may extend beyond physical workplace changes and include altered duties, amended hours, phased returns, hybrid working, redeployment or even adjustments to the sickness management process itself, such as allowing additional preparation time or holding meetings remotely.

Importantly, employers should not simply ask employees what adjustments they require and stop there. They should investigate what adjustments are available and assess whether they are reasonable in the circumstances.

When assessing if an adjustment is “reasonable” Employment Tribunals usually seek a balance between the impact on the individual employee and the impact on the employer of making the adjustment. For example if the employee can’t realistically undertake the role remotely, it may be reasonable to not make an adjustment even if recommended by occupational health.

Some situations require more caution

Pregnancy-related sickness absence must not be treated in the same way as ordinary sickness absence and should generally be excluded from attendance trigger calculations.

Employees with terminal illnesses will often be protected under the Equality Act 2010 and may require significant adjustments, flexibility and ongoing support. Early discussions about benefits, insurance, pensions and workplace adjustments can make a considerable difference to both the employee’s experience and the employer’s legal position.

When is a medical capability dismissal likely to be unfair?  

An Employment Tribunal is more likely to find that a dismissal is unfair where the employer has not:

• sought occupational health or other medical advice;
• followed their written absence management policy;
• considered redeployment;
• previously warned the employee that dismissal is a possibility;
• considered the background of any grievances that could be resolved; and
• produced evidence that the absence is causing operations problems.

Our experienced team of employment lawyers can help minimise the risk of an unfair dismissal.

Key takeaway

Good absence management is not about finding the quickest route to dismissal. It is about gathering the right evidence, maintaining open communication and demonstrating that every reasonable option has been explored.

For HR teams, the strongest defence to any future claim is a well-documented process that shows fairness, consultation and careful consideration at every stage. Employers who act proactively, rather than allowing situations to drift, are far more likely to achieve positive outcomes for both the business and the employee.

(September 2026)