Sickness and absence · 5 min read

Managing sickness absence fairly

Return-to-work conversations, trigger points, short-term patterns, long-term absence, occupational health, the Equality Act, and the capability route when nothing else works.

Reviewed September 2026. Guidance, not legal advice: employment law moves, so check the current position before relying on any of it.

Absence management fails in two directions. Employers who never talk about absence find they have a person off one Monday in three and no record of ever having noticed. Employers who treat every absence as a disciplinary matter find themselves in a tribunal explaining why a disabled employee was warned for being disabled. The fair route runs between them: notice, talk, record, support, and only then decide.

This guide sets out a process that works for a small employer: the return-to-work conversation, trigger points, how short-term and long-term absence differ, when to involve occupational health, where the Equality Act changes everything, and how a capability dismissal is done if it comes to that.

The return-to-work conversation

Every absence, however short, ends with a two-minute conversation on the first day back: how are you, what was it, is it sorted, is there anything we need to know or do. Record it in a line. It is the single most effective absence tool there is, because it tells the person their absence was noticed and gives them the chance to tell you what is really going on. It also builds the record that every later step relies on.

Trigger points

A published trigger (for example, three separate absences or eight working days in a rolling 12 months) turns "I have a feeling about him" into a process that applies to everyone the same way. When the trigger is reached, a formal absence review meeting follows, with a letter, and a supportive first tone. Some employers use the Bradford Factor (occasions squared, times days) to weight frequency over duration; it is a flag, not a decision, and it must never be applied mechanically to disability-related absence.

Short-term intermittent absence

The pattern of Mondays, or of the day after pay day, or of an absence every time a difficult job comes round. The review meeting asks what is behind it. If the answer is a health condition, the process moves to adjustments and, if needed, occupational health. If the answer is nothing medical, the meeting sets an expectation and a review period, in writing, and if the pattern continues the absence policy's formal stages follow: usually a first and final warning for attendance, then dismissal, each with a meeting, a letter and an appeal. The warnings are for a level of attendance the business cannot sustain, not for being ill.

Long-term absence

Once an absence passes four weeks it is a different problem: not a pattern but a prognosis. Keep in touch every week or two, by the means the employee prefers; do not go silent. Get medical advice (occupational health or, with consent, the GP) that answers the questions you actually have: when, in what capacity, with what adjustments. Meet to discuss the advice and the options, honestly, including how long the role can be held. Consider adjustments, alternative roles and a phased return. Only when a return is not foreseeable within a period the business can reasonably sustain does the capability route begin, and the employee must know that is where things are heading before the meeting where it is decided.

Occupational health

Refer when you need advice to decide fairly: long-term absence, a pattern that may have a medical cause, a return that may need adjustments, a question of fitness for safety-critical duties. Tell the employee what you are asking and why, get consent, share the report. A telephone assessment from a provider costs a modest fee and is the best money in absence management, because it replaces your guess with a professional view.

The Equality Act

A physical or mental impairment with a substantial, long-term (twelve months or more, or likely to be) adverse effect on day-to-day activities is a disability, and the definition catches more than employers expect: depression, anxiety, diabetes, back conditions, long Covid in some cases. Once you know, or ought reasonably to know, you must consider reasonable adjustments (to hours, duties, equipment, absence triggers, the workplace) and must not treat the person unfavourably because of something arising from the disability unless you can justify it. Counting disability-related absence towards a warning without adjustment is the classic breach. Ask, record, adjust.

The capability route

A dismissal on grounds of ill-health capability is fair when the employer has consulted the employee, obtained up-to-date medical evidence, considered adjustments and alternatives, and concluded reasonably that the business cannot wait longer for a return that is not in sight. Each of those is a step with a letter. Notice, or pay in lieu, is due even where sick pay has run out, and an appeal is offered. The letters on this site walk through it.

The checklist

  1. Return-to-work conversation after every absence, recorded in a line.
  2. A written absence policy with notification rules, self-certification, fit notes, triggers and stages.
  3. Trigger reached: review meeting with a letter and a supportive first tone.
  4. Ask what is behind it; where it is health, adjust and refer before anything else.
  5. Long-term: weekly contact, medical advice, honest meetings, alternatives considered.
  6. Disability considered explicitly, and adjustments recorded, before any warning counts disability-related absence.
  7. Capability dismissal only after consultation, evidence, alternatives and a warning that it is possible; notice paid; appeal offered.

What the law says

  • Employment Rights Act 1996 s.98(2)(a) and (4): capability as a fair reason and the reasonableness test.
  • Equality Act 2010 ss.6, 15, 20 and 21, and Schedule 1: disability, discrimination arising from disability, reasonable adjustments.
  • Acas guidance on managing absence and the Acas Code of Practice on disciplinary and grievance procedures, which applies to misconduct-based absence stages.
  • Access to Medical Reports Act 1988 and UK GDPR Art.9: medical evidence and health data.

Questions people ask

Can I discipline someone for too much sick leave?

For genuine sickness, no. For a level of attendance the business cannot sustain, with no underlying condition and after a fair review process, your absence policy can lead to warnings and ultimately dismissal on capability or, where the absences were not genuine, conduct. The record of the review meetings is what makes that fair.

How many absences before I can act?

Whatever your policy says the trigger is, applied to everyone. The first action is a conversation, not a sanction, so there is no reason to wait for a high number. Three occasions in a year is a common trigger for a review meeting.

An employee will not consent to occupational health. What now?

You cannot force it. Tell them in writing that without medical advice you will make decisions on the information you have, then do so fairly. A tribunal generally accepts that if the refusal was unreasonable and the employee understood the consequence.

How long do I have to keep a job open?

There is no fixed period. It depends on the prognosis, the size of the business, the cost and difficulty of covering the role, and what the employee says. A small firm with no cover can reasonably decide sooner than a large one. Take advice before a dismissal, and make sure the medical evidence is recent.

The admin this guide describes, done for you

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