Last reviewed 20 October 2023

October is Breast Cancer Awareness Month and a time to raise awareness of cancer and its impact on the lives of those with it, their friends and family and their work and home life. Each year, around 55,000 women and 370 men are affected by breast cancer. Overall, Macmillan Cancer Support estimates that around three million people are living with cancer in the UK, and this is likely to rise to 3.5 million by 2025. Cancer, and other serious illnesses, can happen to anyone. Employers therefore should have a plan in place for supporting and managing an employee with a serious illness, as it is likely that someone in the workforce is currently going through this or will be in the future.

Stacie Cheadle, Croner-i Content Consultant and employment law researcher, looks at what employers need to think about when an employee has a serious illness.

1. Some serious illnesses are automatically a disability under the Equality Act 2010, and others may meet the definition of disability

Serious illness can include the following (this is not an exhaustive list).

  • Physical impairments or injuries.

  • Mental impairments or injuries.

  • Progressive and terminal illnesses.

Impairments that are automatically treated as a disability under the Equality Act 2010 include:

  • cancer

  • multiple sclerosis

  • HIV.

The core definition of “disability” is a physical or mental impairment, which has a substantial and long-term adverse effect on someone’s ability to carry out normal day-to-day activities. “Long term” means that the impairment has lasted, or is likely to last, for at least 12 months. “Substantial” means more than minor or trivial.

2. Where the illness is a disability, employers are under a duty to make reasonable adjustments to accommodate the employee

What those adjustments may be will vary depending on the individual, the impact the illness is having on them and the nature of the work they are doing. Reasonable adjustments should be discussed with the employee and given serious consideration. It is usually recommended to also get the opinion of an occupational health practitioner or the employee’s GP or specialist, as to the employee’s ability to perform their duties and what adjustments may be appropriate.

Adjustments can be made to an employee’s workstation, their workload, how their work is performed and where their work is performed (some employees may benefit from hybrid or home working to better manage their serious illness).

Whatever adjustments are agreed, they should be kept under review and adapted as the impact of the illness on the employee changes.

3. A welfare meeting should take place to discuss the illness and what it means for the employee

Once an employee has disclosed a serious illness, their line manager should arrange to meet with them. All conversations should be approached with empathy and support to create an open and comfortable space for the employee to discuss their health. Line managers should be trained in managing these conversations, to get the most out of them. The employee and line manager will need to discuss how the illness is affecting them, what this means for their work and if there are any adjustments that can be made.

When inviting the employee to attend the meeting, they should be asked if they would like to bring a friend, family member or colleague to any discussions. Whilst a welfare meeting would not usually come with the right to be accompanied, this may help the employee to feel more comfortable in discussing their situation. A private space should be arranged to hold the discussion without distractions or interruptions. Where appropriate, consider providing tissues or a glass of water to make the environment more comfortable.

Whilst the conversation should be natural and genuine, not pre-scripted, it is beneficial to prepare some key questions or topics to discuss. This can help keep things on track during emotional and difficult conversations. It’s important that the manager doesn’t make assumptions about the employee’s health or their needs but is prepared to lead the conversation and think in advance of what reasonable adjustments could be suggested.

In the meeting, it should be confirmed to the employee how they will be supported and agreed how often the arrangements put in place for them will be reviewed. It should also be agreed if and when the manager should check in with the employee, and whether they would like their colleagues to be informed of the situation. This is also an opportunity to make the employee aware of any other internal resources, eg an employee assistance programme (EAP), a mental health first aider, private healthcare provision and an income protection scheme, and to signpost external charities or local support groups.

The meeting should conclude with reassurance that the health of the employee is a priority. An agreement should be made as to what adjustments will be put in place and when they will be reviewed. Writing to confirm what has been discussed will help the employee to remember what has been said and show the organisation’s commitment to implementing the measures, by putting it in writing.

4. Some processes might need adjusting to accommodate the employee’s illness

Some of the adjustments that are agreed might involve organisational processes. One example of this is the absence reporting procedure. It may be that on particularly poor health days, the employee is not physically or mentally able to call in sick, as might be required under the absence reporting procedure. Where that is the case, an alternative might be arranged, such as permitting, under these specific circumstances, that a text message or contact from an agreed person (such as a partner or parent) would be acceptable.

It may also be necessary to adjust absence trigger points, especially where the illness is a disability. Absences connected to an ongoing health issue may be excluded from overall absence statistics to ensure the employee is not placed at a disadvantage because of their disability.

5. Providing a private space

Finally, while an employee continues to work through a serious illness, they may need to undertake treatments or take medication during the working day. Reasonable arrangements should be made for this, such as allowing extra breaks and providing a secure and private place to store equipment or medication and administer the treatment or medication.

The employee may also need a private space for phone calls in relation to their illness, especially where the conversation might be of a sensitive or upsetting nature. Allowing them to use a spare office or meeting room for these calls will help the employee to feel more comfortable at work and better able to manage their illness whilst there.


When an employee has a serious illness, it can be a distressing time for them. Anything that can be done to support them, in a way they want to be supported, should be provided, within reason. This can include treating them as they would usually be treated, as they may not want to feel any more different to their colleagues than they already do as a result of the illness. Being led by the employee will help in achieving this.