Managing Sickness and Absence in the Workplace: A Practical Guide for Employers

This blog provides a practical guide for employers and managers to understand their legal duties around sickness absence, avoid costly mistakes, and build an approach that is fair, consistent, and actually works.

UK employees are now off sick for an average of 9.4 days per year, the highest level recorded by the CIPD since it started tracking absence in 2010. That is up from 5.8 days before the pandemic and 7.8 days in 2023. (see sources 1, 2)

The ONS puts the figure at 4.4 days per worker and 148.9 million working days lost in 2024. The difference in the two numbers comes down to methodology, but both agree on one thing: absence is a significant and growing management challenge. (see source 3)

For small businesses, the impact hits harder. The median cost of sickness absence for SMEs is now just under £28,000 per year, equivalent to 1.7 percent of average turnover. For micro businesses, nearly half have no wellbeing budget at all. (see source 4)

Most of this is not caused by employees taking the odd sick day. Mental ill health is now the leading cause of both short-term and long-term absence. Workload is the number one driver of stress-related absence. Plus, many employers are still managing sickness the same way they did ten years ago, which is creating legal risk, losing good people, and costing more than it needs to. (see sources 1, 2)

If you are dealing with an employee who has mental health difficulties right now, read My Employee Has Mental Health Issues: What Should I Do? for immediate practical guidance.

This guide covers the language, the law, what good looks like at each stage of absence, and what recent tribunal cases are telling employers right now.

If you want your managers to handle absence with confidence, there is a practical toolkit and training option at the end.

This is an updated and expanded version of our earlier guide, Managing Staff Sickness: A Comprehensive Guide for Employers, reflecting the Employment Rights Act 2025, new Statutory Sick Pay rules (SSP) rules from April 2026, and the latest tribunal decisions.

Start With the Language

Getting the terminology right matters. Use the wrong word in a meeting or a letter and you create confusion, or worse, legal risk. It also signals to employees whether you take absence management seriously or whether you are just going through the motions.

Here are the key terms you and your team should feel confident using:

•       Short-term absence is usually defined as a period of sickness lasting up to four weeks. Most policies set trigger points based on the number of short-term absences or total days lost over a rolling period. These are the absences most likely to create patterns that need a conversation.

•       Long-term absence is usually defined as a continuous period of sickness lasting four weeks or more. These cases need a different approach: welfare contact, occupational health referrals, and a structured plan for return or next steps.

•       Self-certification is how employees confirm the reason for absence during the first seven calendar days. No fit note is needed for this period. Most employers use a self-certification form on the employee’s return to work.

•       A Statement of Fitness for Work (sometimes still called a sick note or fit note) is issued by a GP or other healthcare professional after seven calendar days of illness. It can say the employee is either ‘not fit for work’ or ‘may be fit for work’ with adjustments. A ‘may be fit’ note, is in agreement with the employer and a suggestion. It is a professional medical opinion that should trigger a conversation about what the employer can do. (see source 5)

•       Statutory Sick Pay (SSP) is the legal minimum an employer must pay to eligible employees during sickness absence. From 6 April 2026 the rate is £123.25 per week, and SSP changes significantly under the Employment Rights Act 2025. More on that below. (see sources 6, 7)

•       A return-to-work conversation is a short, structured meeting held when an employee comes back after any period of absence. It is not a disciplinary. It is a chance to welcome them back, check they are well enough to be there, and note anything that needs follow-up.

A simple rule of thumb for managers: if someone is off for a few days, self-certification covers it. If they are off for more than seven days, they need a Statement of Fitness for Work. If they are off for four weeks or more, you need a proper plan to manage long term sickness. And at every stage, the return-to-work conversation matters.

This is not pedantry. Using the right language builds trust with employees and protects you if things end up in front of an employment tribunal.

Why This Is Not Just a Wellbeing Issue

Sickness absence is sometimes treated as an unavoidable cost. It is not. It sits right in the middle of several things that directly affect business performance, legal risk, and team morale.

•       UK employees took an average of 9.4 sick days per year in 2024/25, the highest in 15 years. (see source 1)

•       148.9 million working days were lost to sickness or injury in 2024. (see source 3)

•       The average annual cost of sickness absence for SMEs is just under £28,000 per year. Across the UK SME population, that adds up to £28.9 billion in lost output. (see source 4)

•       Mental ill health is now the leading cause of both short-term and long-term absence, with 64 percent of employers reporting stress-related absence in the last year. (see sources 1, 2)

•       Only 29 percent of employers train their managers to support staff with mental health difficulties. (see source 1)

•       The public sector sickness absence rate (2.9 percent) remains nearly double that of the private sector (1.8 percent). (see source 3)

•       Women, older workers, those with long-term health conditions, and part-time workers all have higher absence rates. (see source 3)

When absence is managed well, organisations spend less time firefighting and more time running the business. Consistent processes reduce resentment among the team who are covering sickness absence, keeps good employees from burning out, and avoids the kind of reactive decisions that lead to employment tribunal claims.

When it is managed badly, the costs multiply: not just in SSP and lost productivity, but in replacement costs, grievances, discrimination claims, and damaged team culture.

The link between poor absence management and staff turnover is well established. If you are also losing people you want to keep, read How Do I Keep My Best Employees? for practical retention strategies.

Sickness absence also touches every part of people management: from policies and pay, to performance, mental health, disability, and exits. It is not a standalone HR task. It is how you manage people fairly when things get difficult.

The Legal Framework You Need to Understand

You do not need to be a lawyer to manage sickness absence properly. But you do need to understand the basics, because getting it wrong can be expensive.

Statutory Sick Pay (SSP)

Before 6 April 2026, SSP was paid at £118.75 per week from day four of absence, for up to 28 weeks, and employees earnt at least £125 per week to qualify. (see source 6)

From 6 April 2026, the rules changed significantly under the Employment Rights Act 2025:

•       SSP will be payable from day one of absence. The three-day waiting period is removed.

•       The lower earnings limit is being removed. All eligible employees will qualify regardless of earnings. The government estimates this will bring 1.3 million additional workers into SSP eligibility. (see source 7)

•       For lower earners, SSP will be paid at 80 percent of average weekly earnings or the flat rate (£123.25 from April 2026), whichever is lower. (see source 7)

•       A new Fair Work Agency will have powers to enforce SSP payments. (see source 8)

What this means for employers: update your payroll systems, review your contracts HR policies and employee handbooks for references to waiting days or earnings thresholds, and make sure your HR and payroll teams understand the new calculation method from April 2026.

A Statement of Fitness for Work

A fitness for work statement (fit note) is required after seven consecutive calendar days of illness. It can state that the employee is ‘not fit for work’ or ‘may be fit for work’ with suggested adjustments such as amended duties, altered hours, phased return, or workplace adaptations. (see source 5)

If a fit note says ‘may be fit for work’, the employer should have a conversation with the employee about whether those adjustments are reasonably possible. If they are not, the employee is treated as not fit for work for the duration of the note. (see source 9)

Employers should not ignore fit notes, but they should not treat them as the last word either. A fit note is a starting point for a conversation, not a rigid instruction. ACAS guidance is clear on this. (see source 9)

The Equality Act 2010

This is where sickness absence and disability intersect, and where a lot of tribunal claims come from. If an employee’s absence is related to a disability (a physical or mental condition that has a substantial and long-term effect on the employees ability to carry out normal day-to-day activities), the employer has a duty to make reasonable adjustments. (see source 10)

That means you cannot simply apply your absence policy mechanically. Disability-related absences may need adjusted trigger points. You may need to adjust roles, hours, or working conditions. And you must not dismiss someone for disability-related absence without first exploring what reasonable adjustments could be made. (see source 10)

The key word is ‘reasonable’. No employer is expected to do the impossible. But tribunals will look at whether you tried.

If your employee’s absence is linked to a neurodivergent condition such as ADHD, autism, or dyslexia, read Creating a Neuroinclusive Workplace: A How To Guide for Employers for detailed guidance on reasonable adjustments and what recent tribunal cases expect.

Unfair Dismissal

From 1 January 2027, the qualifying period for unfair dismissal claims drops from two years to six months under the Employment Rights Act 2025. The cap on unfair dismissal compensation is also being removed entirely, making it unlimited in the same way as discrimination claims. But even now, employees with less than two years’ service can bring discrimination claims from day one, and those claims have no cap on compensation. (see sources 7, 11, 15)

If you dismiss someone for sickness absence, a tribunal will look at whether you followed a fair process, whether you obtained up-to-date medical evidence, whether you considered alternatives to dismissal, and whether you gave the employee a chance to improve or return. Getting this right matters more than most employers realise.

What Good Absence Management Looks Like in Practice

Good absence management is not a single policy, a ‘tick box’ return to work meeting or a one-off training session. It is a set of consistent practices that reduce risk and support people at each stage. Here is what that looks like.

Day One: Set Clear Expectations

Most absence problems start with unclear expectations. From the first day of employment, make sure every employee knows:

•       Who to contact if they are unwell, and by when.

•       What information they need to provide (reason for absence, expected duration).

•       When a fit note is required (after seven calendar days).

•       What the company sick pay arrangement is, and how SSP works.

•       That a return-to-work conversation will happen after every absence.

Put this in writing. Include it in your HR policies and employee handbook. Cover it in induction. Do not assume people know.

Short-Term Absence: Spot Patterns Early

Short-term, frequent absences are the ones most likely to affect team morale and workload. They are also the ones most likely to slip through without a conversation.

Practical steps:

•       Use trigger points (for example, four absences in a rolling 12-month period, or a set number of days) to prompt a review.

•       Hold a return-to-work conversation after every absence, even short ones. Keep it brief, supportive, and documented.  Make it meaningful, not just a ‘tick box’ exercise.

•       If a pattern emerges, have an informal conversation first. Ask whether there is anything the employer can do to help. Many issues, from caring responsibilities to underlying health conditions, surface at this stage if the conversation is handled well.

•       Only move to formal action if the pattern continues after support has been offered and informal steps have been tried.

Long-Term Absence: Stay in Touch, Get the Right Advice

Long-term absence requires a different approach. The biggest mistakes employers make here are either going silent or rushing to dismiss.

Practical steps:

•       Maintain regular, reasonable welfare contact. Agree the method and frequency with the employee. Do not just disappear for weeks.

•       Refer to occupational health early. Do not rely solely on fitness for work notes. An occupational health report can tell you whether the condition is likely to meet the definition of disability under the Equality Act, what adjustments in the workplace might help, when a return is realistic, and what the long-term outlook is.

•       If the employee is signed off with a ‘may be fit’ note, explore the suggested adjustments seriously.

•       Hold structured welfare meetings at agreed intervals. Record what was discussed and what was agreed.

•       Consider a phased return where appropriate, with reduced hours or adjusted duties for a defined period.

•       Only consider dismissal as a last resort, after a fair process, up-to-date medical evidence, and genuine exploration of alternatives. Take advice before you act.

Return to Work Meetings: Get It Right Every Time

The return-to-work conversation is the single most effective tool in absence management. Research consistently shows that organisations that hold return-to-work conversations after every absence see a measurable reduction in absence levels. (see source 2)

A good return-to-work conversation:

•       Welcomes the employee back.

•       Checks they are well enough to be at work.

•       Asks if there is anything the employer can do to support them.

•       Notes the reason for absence and updates the absence record.

•       Flags any patterns or concerns for follow-up.

It should be brief, private, supportive and non-confrontational. It is not a disciplinary meeting. But it does signal that absence is noticed and managed.

What Recent Tribunal Cases Are Teaching Employers

Cases do not replace good HR practice. But they do show what tribunals look for in the real world: process, medical evidence, reasonable adjustments, and whether the employer acted fairly. Here are three recent UK cases worth understanding.

Wright-Turner v London Borough of Hammersmith and Fulham (2024): £4.58 Million Award

The claimant developed PTSD after working as a humanitarian assistance lead during the Grenfell Tower tragedy. She took sickness absence and was subsequently dismissed. The tribunal found that her dismissal amounted to disability discrimination. The process was poor, alternatives to dismissal were not properly considered, and the council’s conduct was found to be oppressive. (see source 11)

The claimant’s health was so significantly damaged that the tribunal found she would be unlikely to ever work again. The total award was £4,580,587, including exemplary damages of £15,000, one of the highest employment tribunal awards ever made.

The takeaway: Disability discrimination claims can be brought from day one of employment, and there is no cap on compensation. If sickness absence is related to a disability, the same duties apply regardless of length of service. Poor process and a failure to consider alternatives to dismissal can turn a costly situation into a catastrophic one.

Kitching v NHS Trust (2025): Cherry-Picking Medical Evidence

The claimant had significant mental health difficulties, including bipolar disorder, anxiety, and depression, as well as injuries from domestic abuse. She had extended periods of sickness absence over several years. Two occupational health reports were prepared. The first said she was disabled under the Equality Act. The second did not. Her line manager relied on the second report. (see source 12)

The tribunal found the employer had failed to make reasonable adjustments and described the decision to rely on the second report as ‘irrational’. Ms Kitching was awarded £49,147 for disability discrimination and unfair dismissal.

The takeaway: You cannot cherry-pick medical evidence that suits the outcome you want. If two reports disagree, the responsible thing to do is seek further clarification, not ignore the one that creates obligations for you. Tribunals will look at what you knew, when you knew it, and what you did with it.

Cairns v Royal Mail Group (2024): When Dismissal Was Upheld

Not every absence-related dismissal leads to a finding against the employer. In this case, the employee had anxiety and depression, had made a bullying complaint found to be in bad faith, was disciplined, and then went on long-term sick leave. The employer ultimately dismissed on the basis of an irretrievable breakdown in the employment relationship. (see source 13)

The EAT upheld the tribunal’s finding that there was no discrimination arising from the sickness absence process, even though the employer had failed to comply with its duty to make reasonable adjustments. The key factor was that no reasonable adjustments would have enabled a return to work given the complete breakdown in the relationship.

The takeaway: Employers can dismiss fairly in long-term absence situations, but only where they have followed a proper process, obtained medical evidence, and explored alternatives. The fact that the employer in this case had some procedural failings but still succeeded shows that tribunals look at the whole picture, not just whether every step was perfect.

The Five Management Behaviours That Make the Biggest Difference

If your managers only change five things about how they handle sickness absence, make them these:

•       Hold a return-to-work conversation after every absence. This is the most effective absence management tool available, and managers often skip it because they are unaware how much it matters.

•       Follow the sickness/absence policy consistently. The fastest way to lose an employment tribunal is to show that you applied the rules to one employee but not another. Consistency is fairness.

•       Get medical evidence before making decisions. Do not guess. Do not assume. Refer to occupational health when absence is complex, recurring, or potentially disability-related.

•       Document everything. Every conversation, every welfare check, every adjustment agreed. If it is not written down, it did not happen, as far as a tribunal is concerned.

•       Know when to get advice. Most absence management mistakes happen because a manager tried to handle something alone, that needed professional input. A ten-minute call to an HR consultant can save you a £50,000 tribunal claim.

If you suspect your management approach needs a broader reset, not just on absence, read Are You Managing People Totally Wrong? for a wider look at what good people management actually looks like.

What Is Changing from April 2026

The Employment Rights Act 2025 brings the most significant changes to Statutory Sick Pay in decades. From 6 April 2026: (see sources 7, 8)

•       SSP is payable from day one. The three (unpaid) waiting days are gone.

•       The lower earnings limit is removed. All eligible employees qualify.

•       For lower earners, SSP is paid at 80 percent of average weekly earnings or the flat rate (£123.25), whichever is lower.

•       The new Fair Work Agency will have enforcement powers over SSP payments.

For small businesses and organisations, this means more employees will be eligible, SSP costs will start from day one of every absence, and your payroll systems and policies need updating to reflect these changes in April 2026.

This is also a good time to review your entire absence management approach. If your policy still references waiting days, earnings thresholds, or outdated SSP rates, it needs updating. If your managers have never been trained on absence management, now is the time.

“Suggestions were given and it was up to me to make a choice. All correspondence was provided for me to edit. Kate helped me correctly follow a long-term absence procedure, and I came away satisfied that everything had been dealt with correctly and lawfully. She understands your business needs and restraints.”

Lisa Hooper, Preschool Manager

Ready to Get Your Absence Management Right?

If you want to give your managers the tools to handle sickness absence consistently and confidently, The HR Hero’s Absence Management Toolkit gives you everything you need to get the basics right straight away.

What you get:

•       Absence Management Policy template

•       Return-to-work meeting form

•       Self-certification form

•       Welfare meeting (long-term absence) template letter

•       Staff Absence Record form

•       Short video: a manager’s guide to managing absence

The documents are in Word format and can be easily customised to suit your business. Everything you need to successfully manage staff absence and sickness.  Updated with the April 2026 employment legislation changes.

To find out more click here: https://www.thehrhero.co.uk/product-page/managing-staff-absence-and-sickness

We’re offering 25% discount on this toolkit throughout April, use code: Easter2026 

at checkout.

Alternatively you can email support@thehrhero.co.uk or visit https://www.thehrhero.co.uk/

You can also call Kate directly on 07704 037136.

Note: This blog post is general guidance and is not legal advice. For advice on a specific situation, contact Kate at The HR Hero.

Sources

1. CIPD (2025). Health and Wellbeing at Work Report 2025. Available at: https://www.cipd.org/uk/about/press-releases/workplace-absence-soars-nearly-two-working-weeks-each-year/

2. British Safety Council (2025). Sick days highest for fifteen years, says CIPD. Available at: https://www.britsafe.org/safety-management/2025/sick-days-highest-for-fifteen-years-says-cipd-with-mental-health-ill-cited-as-the-main-reason

3. ONS (2025). Sickness Absence in the UK Labour Market: 2023 and 2024. Available at: https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2023and2024

4. Verve Healthcare (2025). The Real Cost of Absenteeism to UK Employers in 2025. Available at: https://www.vervehealthcare.co.uk/blog/the-real-cost-of-absenteeism-to-uk-employers-in-2025-a-complete-analysis/

5. GOV.UK (2025). Getting the most out of the fit note: guidance for employers and line managers. Available at: https://www.gov.uk/government/publications/fit-note-guidance-for-employers-and-line-managers/getting-the-most-out-of-the-fit-note-guidance-for-employers-and-line-managers

6. ACAS (2025). Statutory Sick Pay. Available at: https://www.acas.org.uk/checking-sick-pay/statutory-sick-pay-ssp

7. FCSA (2026). Statutory Sick Pay Reforms: What Changes in April 2026. Available at: https://www.fcsa.org.uk/statutory-sick-pay-reforms-what-changes-in-april-2026/

8. GOV.UK (2025). New laws bring the world of work into the 21st century. Available at: https://www.gov.uk/government/news/new-lawsbringthe-world-of-work-into-the-21stcentury

9. ACAS (2025). Fit notes when off sick. Available at: https://www.acas.org.uk/fit-notes-and-proof-of-sickness

10. Equality Act 2010. Reasonable adjustments for disabled workers. Analysis available at: https://www.gov.uk/reasonable-adjustments-for-disabled-workers

11. Blake Morgan (2024). Employment Tribunal award of almost £4.6 million for disability discrimination and harassment. Available at: https://www.blakemorgan.co.uk/employment-tribunal-award-of-almost-4-6-million-for-disability-discrimination-and-harassment/

12. Menzies Law (2025). Case update: Sickness absence, long-term illness and dismissal. Available at: https://www.menzieslaw.co.uk/case-update-1-sickness-absence-long-term-illness-dismissal/

13. Bird & Bird (2025). Frontline UK Employment Law Update. Available at: https://www.twobirds.com/en/insights/2025/uk/frontline-uk-employment-law-update-edition-38-2025-case-updates

14. Brodies LLP (2025). Employment Rights Act 2025: changes to statutory sick pay from April 2026. Available at: https://brodies.com/insights/employment-and-immigration/employment-rights-act-2025-reforms-to-statutory-sick-pay-from-april-2026/

15. CIPD (2025). Employment Rights Act 2025 and Make Work Pay plan changes. Available at: https://www.cipd.org/uk/knowledge/employment-law/proposed-changes-under-labour-government/