In this second article on dealing with sickness absence in your care home, Martin Hodgson discusses how to manage individual cases, concerns with long-term absence, how to conduct return-to-work interviews and training for managers.

Managing sickness absence cases

In both short- and long-term sickness cases, early intervention is important. The sooner action is taken, the better the chances are of an employee making a full return to work.

Suggested methods for improving the management of both short- and long-term absences include:

  • ensuring staff always report short-term absences directly to a manager — this ensures recording and allows for work re-allocation and identification of any assistance required by the employee

  • conducting return-to-work interviews in all cases — these are often considered just for longer-term absence but should also be used for short-term absence, as when they are held routinely and consistently they will discourage non-genuine sickness absence and provide an opportunity to identify workplace causes of ill health

  • ensuring employees are told if their level of short-term sickness absence may be putting their job at risk

  • actively managing support for staff with long-term sickness problems, preferably in conjunction with an occupational health service.

It is advisable for all care homes to have some level of occupational health provision at work. Many employers believe that occupational health provision is also something only relevant to long-term sickness. However, occupational health interventions are just as effective in dealing with persistent short-term illness as they are in supporting people with more serious concerns. Human resources expertise in employment law is also recommended.

Measures to counter absenteeism, such as the odd day off work with illness given as the reason or excuse, will include a formal talk with the line manager to seek an explanation. Disciplinary action may need to be invoked in cases such as this.

Specific management concerns relating to long-term absence

Long-term sickness absence can present a particularly complex problem for a manager. This may stem from a conflict between the need to replace an employee in order to get the job done and the wish to help the sick person’s recovery by maintaining their job security.

Long-term sickness issues can best be resolved by:

  • maintaining regular contact with the employee to show interest and concern and enquire about prospects for a return to work

  • asking employees to complete a consent form to allow the employer to obtain medical information from the employee’s GP

  • asking the employee for permission to refer them to an occupational health or medical advisor and obtain a report that includes:

    • the likely date of any return to work

    • any “reasonable adjustment” required to assist the employee with a disability

    • whether the employee is likely to be able to fulfil his or her current job requirements in the future

    • whether a period of rehabilitation is needed

    • whether re-deployment should be considered.

A phased return to work is a commonly successful approach to helping someone return to work. Such an approach could entail a full-time employee being started back on a part-time basis and gradually building their hours. Other staff may be started back on “light” duties. Making simple adjustments such as these can enable workers to return to work safely before their symptoms completely disappear and before they are 100% fit.

Every effort should be made to help a member of staff return to work, but in some cases this may not be possible. Contracts can be terminated where there is no reasonable prospect of the employee returning to normal duties and where suitable alternative employment is unavailable or inappropriate or unacceptable to the employee. In this context, termination is most often achieved by:

  • ill-health retirement

  • dismissal by reason of medical incapacity

  • a mutually agreed termination process on the grounds of capability.

Any procedures to dismiss on the grounds of ill health must be fair and reasonable, and in all cases expert human resources advice should be obtained and long-term sickness cases kept under active review.

Return-to-work interviews

A “return-to-work interview” should be arranged as soon as an employee starts back at work after sickness.

Key points to be covered include:

  • welcoming the employee back to work

  • ensuring the employee is fully fit to return to work

  • establishing the reasons for the absence

  • identifying any work problems and agreeing any reasonable adjustments

  • completing paperwork such as the fitness-to-work note from the GP or occupational health reports

  • updating the employee on any changes in the organisation and agreeing a new work plan

  • arranging any retraining necessary or future occupational health involvement.

The interview is a good place to discuss any adjustments that need to be made. For instance, the GP or occupational health service may recommend:

  • a phased return to work

  • amended job duties

  • altered hours of work

  • workplace adaptations

  • any other suggestion that would be helpful to the employee.

Interviews should be held in private and employees should be given plenty of advance notice of the date and time. The approach should be supportive, and boundaries for confidentiality should be set. If stress at work is a contributory factor to the sickness, the manager conducting the interview should approach the interview with appropriate sensitivity.

Addressing workplace health issues

Poor employment conditions or workplace stress are often the root causes of high levels of sickness absence. Good physical working conditions, ergonomic factors in workplace design, and rigorous health and safety standards, on the other hand, are vital elements in ensuring that the workplace represents a healthy and happy environment where staff will want to come to work. Improvements in these areas often result in lower sickness rates as well as better morale and performance.

Return-to-work interviews and sickness patterns should be checked to identify any patterns that might relate to the workplace and, where this is the case, joint action should be taken with health and safety representatives.


All care home managers should be trained in the management of both long-term and short-term staff sickness.

Line managers and supervisors who deal with absent employees on a day-to-day basis should be trained to:

  • understand the regulations relating to sickness absence and related topics such as Statutory Sick Pay and employment law

  • understand the importance of accurate record-keeping

  • conduct interviews and support staff as appropriate during and after sickness absence.

If a home has its own human resources staff, they should be trained to set up and continually update reporting and monitoring systems covering staff sickness. Where they act as advisors to managers, they should understand the legal process that must be followed if contemplating dismissing or taking relevant disciplinary action against an employee.

Last reviewed 15 May 2012