When someone on your team is off sick for a day or two, it's disruptive but manageable. When it stretches to weeks or months, it becomes one of the more difficult situations you'll face as a small employer.
Long-term sickness absence sits at the intersection of legal obligation, genuine human compassion, and practical business reality. You want to support the person. You also need to keep things running. And you need to make sure you're not accidentally exposing yourself to a tribunal claim.
This guide walks through what long-term sickness absence actually means in UK law, what your obligations are, and how to handle it sensibly from the first week through to resolution.
What counts as long-term sickness absence?
There's no single legal definition, but in practice most employers and HR advisors treat any absence lasting four weeks or more as long-term. ACAS uses this threshold, and it's a useful working definition.
Up to that point, you're dealing with standard short-term absence: self-certification for the first seven days, a fit note from a GP after that. Long-term absence is a different situation that calls for a different approach.
Your legal obligations
Before getting into the practical stuff, it's worth being clear on what the law actually requires.
Statutory Sick Pay (SSP)
Employees who meet the eligibility criteria are entitled to SSP for up to 28 weeks. As of 2026, the weekly rate is £116.75. After 28 weeks, SSP ends. If you offer company sick pay above SSP, your own policy will determine what applies.
Some employers have contractual sick pay schemes that are more generous. Check your contracts and any staff handbook before you do anything else.
Fit to work assessments
After seven days off, employees need a fit note from their GP. The fit note may say "not fit for work" or "may be fit for work" with suggested adjustments. The second option is worth taking seriously: it's an invitation to have a conversation about whether there's something you can offer.
Reasonable adjustments
If the condition causing the absence could be classed as a disability under the Equality Act 2010, you have a legal duty to make reasonable adjustments. This might mean a phased return, different hours, adjusted duties, or changes to the working environment. "Reasonable" depends on the size of your business and what's practicable, but the duty is real and ignoring it is a risk.
Dismissal
Yes, you can eventually dismiss someone for long-term sickness absence, but only if you've followed a fair process. Skipping steps is how employers end up at tribunal. More on this below.
Staying in touch: how to do it well
One of the biggest mistakes small employers make is going silent. The employee is off, things are awkward, you don't want to seem like you're pressuring them, so you just... wait.
This usually makes things worse. The employee feels forgotten or anxious about what's happening to their job. You lose visibility on when or whether they might return. And if things eventually escalate, a complete absence of communication during the sick period looks bad.
You don't need to call every week, but you should stay in contact. A few principles:
Keep it light and genuinely supportive. "Just wanted to check in and see how you're doing" is the right tone. Not "we need you back" or "have you got any update on a return date" in the first few weeks.
Agree a contact cadence. Early in the absence, agree with the employee how often you'll be in touch and in what format. Some people prefer a text, others a call. Respect their preference. Every two weeks is a reasonable default.
Document the contact. Keep a brief record of when you spoke, what was said, and any updates on expected return dates. This matters if things become contentious later.
Don't contact them too often. Frequent check-ins when someone is genuinely unwell can feel like harassment, even when that's not the intent. Two or three times a month is usually enough.
Occupational health referrals
If an absence is going on for more than four to six weeks, and particularly if you don't have a clear picture of the prognosis, an occupational health (OH) referral is worth considering.
Occupational health professionals sit independently of the GP. They assess fitness to work, not just fitness in general, and they can advise on what adjustments might enable a return. Their reports are typically more useful for employers than GP fit notes, which often say very little.
You'll need the employee's consent to refer them. Most employees agree, especially if you frame it as "we want to support you in coming back when you're ready, and this helps us understand what that might look like."
OH referrals aren't free, but they don't need to be expensive. Several providers offer single-referral services at reasonable rates, which is more proportionate for a small business than an ongoing contract.
Return-to-work planning
When a return starts to look realistic, it's worth thinking about how to make it work rather than just assuming they'll come back and pick up where they left off.
A phased return is often the right approach after a long absence. This means starting back on reduced hours or lighter duties and building back up over a few weeks. It's not a legal requirement in most cases, but it's good practice, and it's sometimes a reasonable adjustment if the condition is disability-related.
A few things to sort out before they return:
- Talk to them about how they're feeling about coming back. Anxiety is common after a long absence.
- Agree the return plan in writing, including hours, duties, and how long the phased period will last.
- Brief their line manager (if that's not you) so there are no awkward silences on day one.
- Check whether there are any reasonable adjustments that need to be in place before they start.
When absence continues and a return looks unlikely
If weeks turn into months and there's no clear return date in sight, you'll need to think about whether the situation is sustainable. This is the harder part.
At this point, a formal process is appropriate. This doesn't mean you're moving straight to dismissal, but it does mean sitting down with the employee, getting a clear picture of the medical position, and discussing what options exist.
A fair process typically looks like this:
- Hold a formal absence review meeting. Give the employee reasonable notice and the right to be accompanied by a colleague or trade union rep. The purpose is to understand the situation, not to put pressure on them.
- Get up-to-date medical information. You may want to obtain a report from the employee's GP (with their consent) or commission an OH assessment. You need to know whether a return is realistic and, if so, on what timescale.
- Consider all reasonable options. Could adjustments enable a return? Could the role be adapted? Is there suitable alternative work?
- Make a decision. If a return genuinely isn't possible within a reasonable timescale, and you've exhausted reasonable adjustments, dismissal on capability grounds may be the outcome. But it must follow a fair process, and it must be genuinely a last resort.
ACAS has detailed guidance on this process and it's worth reading before you start. Getting the process right matters.
Keeping records throughout
Good record-keeping is your best protection if things ever go wrong.
You should be keeping track of:
- All absence dates, including start and end dates
- Fit notes received and their content
- Contact log with dates and a brief summary of what was discussed
- Any OH referrals and the resulting reports
- Meetings held and what was agreed
- Any adjustments offered or put in place
A dedicated leave management system makes this significantly easier. With Absently, sickness is tracked alongside all other leave types, so you've always got a clear record without hunting through email threads or spreadsheets. It won't replace formal HR documentation for a serious absence, but it keeps the day-to-day record tidy and accessible.
A few things to avoid
For the sake of completeness, here are the most common mistakes small employers make when dealing with long-term sickness absence:
Ignoring it and hoping it resolves. It rarely does on its own, and the longer you leave it, the harder the conversation becomes.
Acting too quickly. Dismissing someone after a few weeks without a proper process is a significant legal risk. Take the time to do it right.
Treating sickness as a performance issue. Long-term absence should be handled as a capability matter, not as misconduct, unless there's clear evidence of dishonesty.
Not checking whether the condition is disability-related. Some employers skip this step and end up facing an Equality Act claim on top of an unfair dismissal claim.
Failing to document anything. If you can't show what you did and when, you're in a weak position if things are challenged.
A note on smaller teams
Everything above applies whether you have five employees or fifty, but the reality is that long-term absence hits smaller teams disproportionately hard. When one person is out of five, you're immediately at 80% capacity, and the remaining team feel it.
It's worth being honest with your team about the situation in general terms, without disclosing anything about the individual's medical condition. Something like "Sarah is unwell and we don't expect her back for a while" is usually enough. People can fill in gaps for longer when they have some context.
And if the absence is genuinely unsustainable for the business, that's a factor you're allowed to take into account. You have legal obligations, but you also have a business to run. The two things aren't in conflict if you handle the process fairly.
Long-term sickness absence isn't straightforward, but it's manageable when you have a clear process and keep good records. If you need to manage sickness alongside other leave for your team, Absently keeps everything in one place and makes it easier to see what's going on at a glance.
You might also find these posts useful: