Managing long-term sickness absence in a small business

Someone in your team has been off sick for five weeks. The fit notes keep arriving, nobody has a return date, and their work is being done by whoever has a spare hour. You want to stay in touch without hounding them, and to know what you can ask for.

Most of what happens next is a sequence of conversations and records. The order matters more than the number of weeks, and neither the legislation nor Acas's guidance gives a number of weeks after which ending employment becomes fair.

As checked on 30 October 2026, the rules below are in force in England, Scotland and Wales, and two dated changes touch them. The fall in the unfair dismissal qualifying period from two years to six months is scheduled for dismissals with an effective date of termination on or after 1 January 2027, set by regulation 3 of SI 2026/559. A new right to unpaid statutory bereavement leave, including pregnancy loss, is listed for April 2027 in the government timeline, updated 22 October 2026, and by Acas, updated 30 October 2026. The timeline says all future dates "remain subject to parliamentary processes and may change", and no regulations setting out that leave had been published on legislation.gov.uk on the check date.

Agree how you will keep in touch, and cover the work yourself

No statute sets how often you contact someone who is off sick. Acas recommends that you and the employee agree it together: how often, by what means (email, phone or meetings), and who the contact will be. Acas on keeping in touch during absence, last updated 7 April 2026.

Where someone is off with a mental health problem, Acas says to agree the purpose, type and level of contact so that it is useful and not overwhelming. If they find contact too difficult, you could ask whether there is someone else you can check in with, such as a family member or close friend.

Keep them informed about job opportunities, redundancies and reorganisations that could affect their job. Acas says that if someone off sick because of a disability misses the chance to apply for a promotion, this could be disability discrimination.

Covering the work is your job, not theirs. None of the Acas or GOV.UK guidance cited here asks someone on sick leave to arrange their own cover. Acas's guidance for employers on long covid lists making sure the work "is covered and shared out appropriately" among the employer's tasks. Acas on long covid, last updated 4 December 2025. When someone tells you about a death, Acas suggests you ask "if there's any important work they need someone else to cover, if appropriate", which is one question, not a handover. Acas on supporting someone after a death, last updated 28 April 2026. If they do work on a day, it may stop being a sick day: GOV.UK says a day cannot count as a sick day if the employee worked for a minute or more before going home sick. GOV.UK on SSP entitlement. The pay rules, including the 28-week limit and the linking rule, are in our statutory sick pay checklist.

If the absence started with a bereavement, be clear what kind of absence it is. Parental bereavement leave covers the death of a child under 18 or a stillbirth after 24 weeks of pregnancy. GOV.UK on parental bereavement leave. For other deaths, section 57A of the Employment Rights Act 1996 gives an employee a reasonable amount of time off during working hours to take action that is necessary in consequence of the death of a dependant, such as a parent, if they tell you the reason as soon as reasonably practicable and, unless they cannot do so until they are back, how long they expect to be away. Section 57A. Beyond that, Acas suggests talking about sick leave, holiday or unpaid leave if you cannot offer more paid leave. Do not plan around the April 2027 leave until its regulations are made.

Write down the contact you agreed and a line after each call.

Use the fit note, then ask for more evidence with consent

The fit note is advice. The DWP guidance for employers, updated 6 October 2023, says fit notes may be issued by doctors, nurses, occupational therapists, pharmacists and physiotherapists. Where the note says "may be fit for work", it may tick a phased return, altered hours, amended duties or workplace adaptations. DWP fit note guidance for employers.

You are not obliged to agree to that advice, though the DWP recommends you take it into account. If you cannot make any of the changes, the same fit note is evidence for your sick pay procedures and the employee does not need a new one. Take a copy for your records; the employee keeps the original. Acas adds one exception: you must put the recommendations in place if they are reasonable adjustments for a disabled employee. Acas on "might be fit for work", last updated 6 January 2025.

When the fit note does not tell you enough, there are two routes. Acas lists occupational health as a service an employer might use for someone who has been off sick for a long time or is returning after sickness absence. Acas on using occupational health, last updated 17 December 2025. The other route is a report from the employee's own doctor.

The law requires consent before you apply for that report. Under section 3 of the Access to Medical Reports Act 1988, you must tell the employee you plan to apply, and they must consent. Your notice must tell them that they can refuse, and set out their other rights under the Act: to see the report before it is supplied and for six months afterwards, to refuse consent to it being supplied, and to ask the doctor to correct it, as well as the doctor's limited right not to show them parts of it (section 7). If they ask to see it first, the doctor may not supply it until they have seen it and consented, or until 21 days from the application have passed without the doctor hearing from them about arranging access (sections 4 and 5). The Act covers reports by a medical practitioner who is or has been responsible for the person's clinical care, and it does not extend to Northern Ireland. Access to Medical Reports Act 1988.

A practical approach is to use the Acas templates and ask only what you need, such as how long they are likely to be off and what might help them return. If the employee refuses consent, Acas says you will have to decide on what they have told you, the fit note and any occupational health report. Acas on getting a doctor's report, last updated 20 May 2025.

Then decide who sees it. The ICO says health information is special category data, so you need a lawful basis and a special category condition. That is a separate question from the consent the Access to Medical Reports Act requires before you apply for a report. It advises against relying on consent unless you can show it is freely given, which the power imbalance at work makes hard, and says not to share health details with other workers unless they genuinely need them for their roles. ICO on workers' health information; ICO on sharing it. The ICO notes this guidance is under review after the Data (Use and Access) Act. In a business your size, that usually means you and the line manager, not the team.

Check whether the absence is disability-related

A long absence can be the first sign that someone is disabled. Under section 6 of the Equality Act 2010, a person is disabled if they have a physical or mental impairment with a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. Section 6. An effect is long-term if it has lasted at least 12 months, is likely to last at least 12 months, or is likely to last the rest of the person's life. Schedule 1, paragraph 2. So "likely to last" can bring someone within the definition after weeks, not a year.

Two duties follow. Section 20 requires reasonable adjustments where a provision, criterion or practice, a physical feature or the lack of an auxiliary aid puts a disabled person at a substantial disadvantage. Section 20. Section 15 makes it discrimination to treat a disabled person unfavourably because of something arising in consequence of their disability, unless you can show it is a proportionate means of achieving a legitimate aim. It does not apply if you did not know, and could not reasonably have been expected to know, about the disability. Section 15.

Absence is a common route into both. Acas gives examples of adjustments for absence: not counting some or all disability-related sickness absence towards trigger points, raising the number of absences that triggers a review, or recording it separately as disability leave. It says the employer should talk with the person and could get medical advice, such as an occupational health report, to decide. Acas on disability-related absence, last updated 10 September 2024. The test of what is reasonable is in our guide to who decides what is a reasonable adjustment.

Before you apply an absence policy's triggers to this person, write down whether you have considered disability and what the medical evidence said.

Plan the return, the pay and the holiday

Acas says a return to work meeting is not a legal requirement, but recommends a chat as soon as possible after the return: check they are ready, share work updates, agree a plan such as a phased return, and talk about what they would like colleagues to know and what they want kept confidential. If they are disabled, review their reasonable adjustments. Acas on return to work meetings, last updated 1 October 2026. Acas publishes a return to work meeting template for after sickness absence.

A phased return builds up gradually, for example on reduced hours or a lighter workload. Acas says you and the worker should agree how long it lasts, even where a fit note suggests a length, and review it regularly. Acas on phased returns, last updated 1 October 2026.

On reduced hours the worker gets their usual rate for the hours they work. For the rest, it depends on what you agree or your policy says: full pay, company sick pay, or statutory sick pay, if they are eligible and neither is offered. Statutory sick pay can only be paid for full non-working days, not the unworked hours of a partly worked day. Acas's example: someone who usually works 7 hours a day for 3 days returns for 2 hours on 2 days and cannot be paid statutory sick pay for the remaining 5 hours, but can on the day they do not work. On a lighter workload, you and the worker agree the rate and you should put it in writing.

Holiday keeps building up during sick leave. A worker can ask to take paid holiday while off sick, and you cannot force them to. Acas on sick pay and holiday pay, last updated 30 June 2026. If they could not use their holiday because of long-term sick leave, Acas says they can carry it over, and our Christmas closure and carry-over guide sets out the four-week and 18-month rule.

Keep the meeting notes and the letter confirming the phased return pattern and pay.

Take the steps in order before ending employment

Ill health can be a fair reason for dismissal. Section 98 of the Employment Rights Act 1996 lists capability, assessed by reference to "skill, aptitude, health or any other physical or mental quality", and the tribunal then asks whether you acted reasonably, taking account of the size and administrative resources of your business. Section 98.

Acas says an employer should take steps to avoid a capability dismissal, looking at ways to support a return such as changing the role or a phased return, and must make reasonable adjustments if the employee is disabled. Acas on sickness and ending employment, last updated 21 November 2024. For capability generally, Acas says to try changing duties or finding a different role before dismissal, which should be a last resort. Its page on capability dismissals also says the procedure must be in line with the Acas Code of Practice, which describes disciplinary situations as misconduct or poor performance. Acas Code of Practice. Acas on dismissals for capability or conduct, last updated 23 June 2026.

Built from those pages, the order for a small business is: agreed contact with notes; up-to-date medical evidence; a meeting to discuss it and what the person thinks would help; a recorded check of adjustments, changed duties and any other role; and only then a decision, with reasons in writing.

As checked on 30 October 2026, an employee needs two years' service to claim ordinary unfair dismissal. The drop to six months is scheduled for dismissals with an effective date of termination on or after 1 January 2027. SI 2026/559. Acas says a discrimination claim does not need two years' service. Acas on unfair dismissal, last updated 27 October 2026. Our guide to the six-month unfair dismissal qualifying period covers that change, and the capability process guide covers someone who is at work and not meeting the standard.

On records, GOV.UK's payroll record-keeping page lists employee leave and sickness absences among the records to keep for three years from the end of the tax year they relate to. GOV.UK on keeping payroll records. The ICO says you must not keep health information for longer than you need it, and must record your retention schedules. ICO on workers' health information. Give one person ownership of the file and the next contact date. Seek appropriate advice before a dismissal. Acas says its helpline gives confidential, free advice to employees and employers. Acas on disability-related absence.

Common questions

Can I contact an employee who is off sick?

Yes. No law sets how often, and Acas recommends you agree with the employee how often contact happens, how, and who it is with. Where the absence is for a mental health problem, Acas says to keep the contact useful and not overwhelming, and to ask about someone else to check in with if contact is too difficult. Acas on keeping in touch during absence.

Do I have to follow the adjustments on a fit note?

Not as such. The DWP guidance says the advice is not binding, though you should take it into account, and if you cannot make any of the changes the same fit note is evidence for sick pay. Acas says you must put the recommendations in place if they are reasonable adjustments for a disabled employee. DWP fit note guidance.

Can an employer get a report from an employee's GP?

Only with the employee's consent. Under the Access to Medical Reports Act 1988 you must tell them you plan to apply and of their rights, including the right to see the report before it is supplied and to ask for corrections. If they refuse, Acas says you decide on what you already have. Access to Medical Reports Act 1988.

How long can someone be off sick before they can be dismissed?

Neither the legislation nor Acas's guidance gives a number of weeks. Ill health can be a capability reason under section 98 of the Employment Rights Act 1996, but Acas says to look first at ways to support a return, and adjustments must be made for a disabled employee. Seek appropriate advice before a dismissal. Acas on sickness and ending employment.