How SMEs can manage long-term sickness absence

12 min read  |   11 September, 2023   By Aimée Brougham-Chandler

A woman sits in her kitchen, tipping some pills from a medication bottle into her hand. There's a blister pack of tablets near her, as well as another bottle of medicine. She appears to be suffering from a long-term health condition.

We know that managing long-term sickness can be difficult, for both employers & employees. ONS research shows that there are now at least 2.5 million people in the UK suffering from long-term sickness. 

In a small business, sickness absence can have a real impact on smaller teams, where employees have multiple responsibilities within their roles. 

In this blog, we’ll look at how SMEs can manage the wellbeing of employees with long-term illnesses, with HR insights from two of our valued HR Partners.

Founder & owner of enlightenHR and CIPD Fellow, Alison Benney, shares a 5-step action plan for SMEs in managing long-term sickness. 

Robert Burden, Managing Consultant of Kane HR, provides practical advice for small businesses on dealing with return-to-work interviews & best practice. 


What is considered long-term sickness?

5-step action plan for SMEs managing long-term sickness 

How to support employees suffering from long-term sickness

What you need to include in your sickness absence policies

How SMEs can manage the business impact of long-term sickness absence

HR tips for managing return-to-work interviews

Managing sickness absence


What is considered long-term sickness?

There’s no actual definition of long-term sickness, although it’s generally considered around 4 weeks or more of an employee being off sick from work.


5-step action plan for managing long-term sickness

Alison Benney, founder of enlightenHR and CIPD Fellow, has provided a clear 5-step action plan for SMEs dealing with long-term sickness absence:

  1. Agree a communication plan with the employee

  2. Agree [with] for someone else to act as liaison if the employee is unable or unwilling to stay in touch. HR has a duty of care to balance being in contact with the employee but not hounding them

  3. Have clear policies before the situation arises and make sure they're overt & clear

  4. Ensure you're receiving GP certificates to make sure the employee is actually seeking & receiving help

  5. Provide reviews with the employee on a regular basis

How to support employees who are suffering from long-term sickness


Breathe’s People Assistant, Tracey Conte, advises of the importance of communicating with your people, whilst balancing the need to give them appropriate time to recover.

“Communication is vitally important. Keeping in touch with employees whilst they are on long term sick & ensuring this is balanced with giving employees the space and time they need to recover, whilst also providing employees with any support they need throughout is crucial.”

As Tracey mentions, SMEs should offer support as much as reasonably necessary to the employee, ensuring communication lines are kept open (although not too much as this can have an adverse effect).


Occupational health referral

Whilst this can be costly in some cases, Tracey advises the value of having access to an occupational health service.

“Usually in a small business, occupational health referrals would be through an external company but [the occupational health referral] can be very useful to assess a return-to-work plan for an employee i.e. a phased return on reduced hours.”


Employee Assistance Programmes

There are a range of Employee Assistance Programmes (EAPs) available today. EAPs offer support from an impartial third party and there are many to suit different budgets. Most programmes can also offer counselling sessions and mental health support, too.

Managing expectations around long-term sickness

It’s important to manage the expectations of the employee off sick, as well as their manager. Robert Burden of Kane HR emphasises the importance of taking a thoughtful & compassionate approach. 

We’ve put together some key HR tips that Robert has advised on, collating crucial information that SMEs need to know. 

Key HR advice: 

  • Outline communication plans & the process within your sickness absence policy.  

  • Make sure you’re transparent around available support 

  • Realistic expectations prevent unnecessary stress with long-term sickness – sometimes managers underestimate how long people can be off for.  

  • Remember that every situation is unique – whilst the same framework should be applied to all cases for equity, approaching each case with empathy will go a long way towards maintaining a good working environment.  


What to include in your sickness absence policies

There are certain areas that are non-negotiables for your sickness absence policies. 

Firstly, consider what the purpose of your policy is – essentially, most policies are educating both parties (employees and managers) about the process when someone falls ill. 

Robert Burden, Managing Consultant of Kane HR, has offered some key HR advice on the essential features of a sickness policy: 


  • Notification timeframes & requirements 

> Set out the process of how and when employees need to notify their line manager/HR/designated person of their illness. It’s also important to state how long employees can self-certify their absence for (7 calendar days, including weekends).  

> On the 8th calendar day of a sickness absence, employees will need to provide evidence in the form of a fit note (from their GP/medical practitioner).  

  • Be clear on sick pay 

Do you offer Statutory Sick Pay, or do you offer enhanced sickness pay? If an employee is on long-term sick, is there an amount of weeks where enhanced pay ends, or is this linked to length of service? The eligibility criteria should be clear. (Our sick pay calculator can also help with this). 

  • Additional support & resources 

Robert advises that there are often missed from absence policies – but where is there a better place to cover what additional support you offer your people? Employee Assistance Programmes (EAP) can help those that are struggling.  


How SMEs can manage the business impact of long-term sickness absence 

Whilst it’s always important to put your people first, there’s no getting away from the fact that absenteeism costs small businesses money – especially when employees often cover a range of duties within their day-to-day roles.

Here are some tips that small businesses can use to manage (and prevent) the impact caused by long-term sickness absence.


Reactive vs. proactive sickness management

Thinking proactively about long-term sickness can prevent problems further down the line. SMEs can implement formal sickness policies, covering sickness reporting procedures and training for line managers on how to manage sickness absence, as well as the procedure if any absences become longer-term. ACAS offer further guidance on absence policy.


Line manager training

Ensuring you equip and support line managers with the tools & resources to deal with long-term sickness is crucial for any SME. Areas to cover within your policy or training could include:

  • proactively encouraging employee wellbeing as an organisation

  • when to ask for fit notes from GPs

  • what records need to be kept

  • how to manage complex cases

  • how to perform return to work interviews & support an employee returning to work

Skills mapping

If your SME is feeling the impact of an employee off with a long-term sickness, do you have a plan in place for covering their responsibilities within your organisation? Find out what skills mapping is and how it could help.


HR tips for managing return-to-work interviews

Robert Burden, Managing Consultant of Kane HR, has shared 6 key steps for how to manage return-to-work interviews: 

  1. Empathy – essential for a successful transition back to work, expressing a genuine concern for the employee & what they’ve been through is a firm first step.  

  2. The return to work process – covering what the process will be, along with any adjustments, gradual returning plans for a phased return etc.  

  3. Asking for only the relevant details - enquiring around their state of health & only around any medical needs or restrictions that might impact work is important – there’s a fine line between gathering the relevant details and prying. If it doesn’t impact their ability to do the role, the manager/person asking doesn’t need to know.  

  4. Documentation or medication– anything that could impact the employee in their role should be raised & noted.   

  5. Set expectations around performance – it’s important to be realistic –employers have to demonstrate that they’re accommodating the employee as much as they can. This includes & signposting to EAPs, additional resources, counselling, or additional training, for example.  

  6. Schedule a follow-up meeting – employers need to demonstrate that they’re addressing any ongoing needs or support. 


Managing sickness absence, the easy way

Breathe’s sickness monitoring system can help SMEs to track sickness absence – giving you one less thing to think about.

The system allows managers to view & track their employees’ sickness (and even allows employees to log their own sickness records) - reducing HR admin and freeing up time for the important stuff.

For key information on what small business need to know, our quick guide to long-term sickness management has you covered. 

Alison Benney is the founder of enlightenHR, and Robert Burden is the Managing Consultant of Kane HR. Find out more about receiving professional HR advice from our network of HR Partners today. 



Author: Aimée Brougham-Chandler

An IDM-certified Digital Copywriter (2023) & English Language & Literature graduate (BA Hons), Aimée is Breathe's Content Assistant. With 3 years' content marketing experience, Aimée has a passion for writing - and providing SME HR teams with solutions to their problems. She enjoys delving into & demystifying all things HR: from employee performance to health and wellbeing, leave to company culture & much more.

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