leave-and-absence

Managing sickness absence and return to work: employer guide

A practical guide to sickness reporting, appropriate contact, return-to-work meetings, absence reviews and reasonable adjustments.

02/11/2026By HRHeaven Editorial TeamReviewed 02/11/2026Reviewed by HRHeaven Editorial Team6 min read

Sickness absence should be managed with consistency, privacy and appropriate support. The aim is not simply to reduce an absence figure. Employers need to understand what has happened, administer pay correctly, identify workplace causes or disability-related needs and help the employee return safely where possible.

An employee reporting sickness while the manager records the absence sensitively — Make the reporting route easy to use and collect only the information needed to manage the absence.

Create a clear sickness absence policy

The policy should explain who the employee contacts, when they must make contact, what information is reasonably required and how updates will be agreed. Include evidence requirements, sick-pay arrangements, return-to-work meetings, medical or occupational-health referrals, review points and the possible process for persistent or long-term absence.

Keep the process practical for different working patterns. A night worker or remote employee may need a different reporting contact from an office employee. Provide an alternative if the normal manager is unavailable or the employee's concern involves that manager.

Employees can usually self-certify sickness for the first seven calendar days. A fit note may be needed after that period. A fit note stating that someone “may be fit for work” can identify possible changes, but the employer and employee still need to discuss whether the suggested support is practical and safe.

Explain statutory and contractual sick pay separately. Payroll should apply the current eligibility and payment rules and record the reason for any non-payment. HRHeaven's Statutory Sick Pay changes guide covers the April 2026 changes in more detail.

Respond to the initial report

Record the date, expected duration if known, immediate work handover and an agreed contact point. Do not pressure the employee to disclose a diagnosis beyond what is reasonably necessary. If there is an urgent safety, safeguarding or operational matter, explain why a particular question is relevant.

Managers should avoid diagnosing the employee, questioning whether the illness is “genuine” without evidence, or treating every absence as misconduct. If the absence may be work-related, consider whether a risk assessment, incident investigation or other immediate action is needed.

If the employer instructs someone who considers themselves fit to go home or not work, Acas advises that the time should not automatically be treated as sickness absence; the employee would usually receive normal pay because the employer made the decision. Check the circumstances before coding payroll.

Keep in touch appropriately

Agree how often contact will occur, who will make it and which channel is suitable. Short absences may need little more than confirmation of a likely return date. Longer absences may justify planned updates about wellbeing, fit-note recommendations, workplace developments and possible support.

A manager holding a planned and supportive video check-in during sickness absence — Agree contact rather than repeatedly calling, and keep the conversation focused on support and practical planning.

Contact should be supportive, not surveillance. Too little contact can leave the employee isolated; excessive contact can impede recovery or feel coercive. Adjust the arrangement if the medical situation, disability or employee's communication needs require it. Record factual actions and agreements rather than subjective comments about attitude.

Avoid sharing health information with colleagues. Agree what the team may be told, such as likely availability or temporary cover, without disclosing medical details. Restrict health records to people with a genuine need to know and apply suitable retention and security controls.

Use absence review points fairly

Review points can prompt a conversation, but they should not operate as automatic warnings. Check the accuracy of the record and consider the pattern, reasons, duration and individual circumstances. Identify whether absences may relate to disability, pregnancy, maternity, workplace injury, stress, domestic abuse or another protected or sensitive factor.

Treat comparable situations consistently while allowing justified adjustments. For example, it may be reasonable to modify an absence trigger where disability-related absence places the employee at a substantial disadvantage. Pregnancy-related sickness should be recorded separately and must not be used to disadvantage the employee.

Look for organisational patterns as well. Concentrated absence in one team, shift or season may indicate workload, management, safety or scheduling problems. Addressing the cause is more effective than repeatedly managing individual symptoms.

Hold a return-to-work meeting

Acas describes a return-to-work meeting as good practice rather than a universal legal requirement. Hold the conversation promptly and privately. Confirm that the employee is ready to return, explain significant workplace updates and ask whether any support is needed.

An employee and manager discussing a supported return to work — Use the meeting to identify support and agree next steps, not to challenge the employee for having been unwell.

Review fit-note advice and any occupational-health information the employee has authorised the employer to receive. Discuss a phased return, temporary duty changes, altered hours, additional supervision or equipment where appropriate. State how the arrangement will be reviewed and what happens if it is not working.

The meeting can also correct the absence record and remind the employee of the policy. If there is separate evidence of misconduct, such as dishonest reporting, investigate it through a fair process rather than turning the return meeting into an unannounced disciplinary hearing.

Consider disability and reasonable adjustments

An illness may amount to a disability under the Equality Act 2010 if the legal test is met. The employer should not wait for the employee to use a particular label before considering support when it knows, or could reasonably be expected to know, about a disability.

Possible adjustments include changes to hours, duties, equipment, communication, targets, workplace or absence-review arrangements. The appropriate response depends on the role, disadvantage, effectiveness, practicality, cost and organisational resources. Discuss options with the employee and obtain specialist advice where needed.

An employee, manager and occupational-health adviser considering workplace adjustments — Record each proposed adjustment, the decision, responsibility and review date.

Occupational health can help the employer understand functional effects, likely timescales and possible support. Ask focused questions about work rather than requesting an unrestricted medical history. Obtain the employee's consent where required and explain who will see the report.

Long-term absence and capability

Where an employee remains unable to perform the role, explore support, adjustments, a phased return and suitable alternative work. Maintain consultation and review updated evidence. Dismissal for capability should be a last resort after a fair process, not an automatic consequence of reaching an absence threshold.

Consider the employee's length of service, prognosis, operational impact, previous efforts, available alternatives and equality obligations. Follow the organisation's procedure and allow an appeal. Complex long-term health cases justify specialist legal advice.

Build a reliable absence process

An employee handbook can give employees a clear sickness-reporting and return-to-work process. Ensure managers are trained to apply it sensitively and consistently. The policy must remain aligned with the employment contract and any enhanced sick-pay promise.