Learn how to measure sickness absence, the main components of an absence policy, and how to address short- and long-term absence in an organisation.
COVID-19: Businesses and people professionals need to keep rapidly adapting their practices and procedures to keep pace with the pandemic but also to plan for the future. The nature of the virus means that employers have probably had to adapt many of their usual processes, including those for managing absence. The information below deals with the impact of COVID-19 where appropriate.
For more specific questions relating to Coronavirus issues, visit our Coronavirus hub.
No one piece of legislation deals exclusively with absence management. However, numerous pieces of legislation have an impact on this area. For more information see our Absence procedures Q&As.
Absence management continues to be a vital issue for organisations. According to the latest Health and Well-Being at Work report (published by the CIPD and Simply Health), the average rate of employee absence is 5.8 days per employee or 2.6% of working time lost.
Some absence is always inevitable. Motivation, good health and job satisfaction is crucial, and is the best way to manage short term absences. The following factors will help:
- Pro-active manager led absence systems and procedures.
- Good physical working conditions.
- High health, safety and welfare standards.
- Pro-active measures to support staff.
- Training and teamwork.
- Improving absence record-keeping systems.
- Providing facts and figures on absence to line managers.
- Pro-active absence management policies, including return to work interviews.
- Enforcement of policies on equal opportunities and discrimination.
- 'Work-life balance' policies including flexible working hours and varied working arrangements, if compatible with the needs of the organisation.
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How should employers treat short-term absence?
COVID-19: In addition to self-isolation issues dealt with below, employees might also be absent from work due to Coronavirus if, for example, they have become stuck abroad and are unable to travel back. If an employee has become unwell whilst travelling, then they would be entitled to the usual sick leave and pay provisions (see below for changes to payment of SSP as a result of Coronavirus).
However, if an employee is stuck abroad but is not unwell, then they will have no entitlement to SSP, as they are technically fit for work. In this situation organisations should consider whether the employee can work remotely and, if so, they should be paid in the usual way. If this is not possible, they will have no legal entitlement to pay, unless their employment contract or a company policy says otherwise.
For information on the effect of coronavirus on sick pay and obtaining evidence of illness, please see the question below on 'When do employees need to complete self-certification forms and when is statutory sick pay applied?'
For more details on dealing with pandemic, see our Coronavirus FAQs.
In order to manage sickness absences issues it is important to fully understand the extent of the problem. Employers need to distinguish between lateness, short-term absences and long-term absences.
Where the absence consists of lateness or short but persistent and apparently unconnected absences then, after suitable investigation, disciplinary action may be appropriate in some cases. For information on disciplinary and grievance procedures see our Q&As on Discipline and grievance procedures.
The key steps in pro-actively managing short-term absence are:
- Investigating the level, causes and reasons for absence.
- Carefully monitoring trends in the particular workplace. Keeping records with accurate information and statistics to fully understand the pattern and reasons for absences.
- If employers need employees at specific times of the year they must provide for this in their contracts of employment and communicate this clearly to everyone in advance of the period of required working.
- Employers should take a sensible view of minor unauthorised absences.
- Discussing any particular problems with the employees concerned. Considering the use of return-to-work interviews with line management and completion of self-certification forms even for one day of absence.
- Consider praise and financial rewards for employees with the best attendance rates.
- Authorise reasonable absences to cover medical appointments, including ante-natal care. All pregnant employees, regardless of service, are entitled to reasonable, paid time-off for ante-natal care (prospective fathers or the mother's partner can also have time off to accompany the mother on to up to two ante-natal appointments).
- Allow for authorised absence whenever appropriate to cover specific religious observances of minority groups.
- Consider requesting a medical report to establish if there is any underlying medical condition to support the level of absence; there may be a hidden condition and links to disability discrimination which may not be immediately apparent.
- Working with employees in connection with GPs' advice to help the employee get back to work where appropriate.
- If there are no good medical reasons for the absences, the employee should be counselled and told what improvement is expected and warned what the consequences will be if none is seen.
- If there are grounds to suspect that the employee’s reasons for the absence are not genuine, investigate carefully, discuss with the employee, pursue formal disciplinary action where appropriate, including written warnings and compliance with the organisation’s own procedure and the Acas Code of practice on disciplinary and grievance procedures (Acas Code).
- Disciplinary action in accordance with the organisation’s procedure, the Acas Code and in compliance with any provisions relating to disciplinary issues in the employee's employment contract may be appropriate, but always treat each case on its merits. For example, if absences were due to domestic problems now resolved it is unlikely that the level of absence will continue, so is it appropriate to discipline?
- Consider what can be done to assist employees with personal or family problems - would counselling help?
- If there are medical reasons for the absence, consider any links to the disability discrimination provisions of the Equality Act 2010. For example, does the absence relate to hospital appointments or treatment required? If this is the case, the Act requires an employer to make reasonable adjustments which includes allowing time off for treatment.
- If the employee has a recognised illness or medical condition that is not a disability but their absence rate is unacceptably high, it may be possible to dismiss fairly for some other substantial reason after following due process. The employee's length of service and the availability of suitable alternative employment are relevant factors to consider before reaching a decision.
How should employers manage long-term sickness absence?
Managing long-term sickness absence is a difficult process and has the potential to result in claims for unfair dismissal, disability discrimination, stress related personal injury, breach of contract or a payment to settle such claims.
Long-term absence is nearly always the result of physical or mental ill health. High absenteeism or large staff turnover, frequent interpersonal conflicts or complaints by workers are signs that may also indicate a problem of work-related stress. Large organisations may be able to address these problems through more flexible working policies. Carefully monitor trends in the particular workplace. As with all types of absence it is important to keep records with accurate information and statistics to fully understand the pattern and reasons for absences. In smaller organisations there may be a real need to replace the employee which must be handled cautiously and by following both the company's own capability, disciplinary and dismissal procedures and the Acas Code of practice on disciplinary and grievance procedures. The issues to be considered during the process and in meetings with the employee include:
- Just how much damage is being caused by this absence?
- How long will the absence continue for?
- What was the employee’s GP's initial advice on the fit note and what is the GP's or the organisation's doctor's prognosis now?
- Will there be a full recovery or will a return to the same work be imprudent?
- Is alternative work available, with re-training if necessary?
- How long has the employee been working for the organisation?
- Have all possibilities been discussed with the employee and their representative?
Employers often wonder if it is appropriate to contact employees when they are off sick. If reasonable contact is kept with an absent employee this may facilitate a return to work as soon as the employee has recovered. Evidence suggests that early intervention and support is likely to assist in a return to work at an appropriate time as part of the recovery process. However an employee may feel harassed or bullied by their employer if contact is made too often. In order to maintain contact as part of a pro-active absence management procedure the following points should be borne in mind:
- The sickness absence procedure should govern how often the employer will make contact with someone on sick leave.
- Medical advice should be obtained in appropriate cases and the organisation’s policy should explain this.
- Employers should be appropriately pro-active in keeping in touch with employees throughout their absence.
- The sickness absence procedure should specify that employees must maintain reasonable contact with the company during absences. If employees know what to expect, they will not think that the company is harassing them by maintaining regular contact.
- Employers need to be tactful, sensitive and use common sense. Some employees may resent the intrusion (or be genuinely too ill to come to the telephone); others may feel abandoned if the employer never gets in touch at all.
- Line managers should be the main point of continuity and contact for an employee telephoning in sick.
- In some cases home visits may be appropriate.
- Matters to discuss with the employee include referrals for medical reports and if any temporary adjustments would help the employee return to work.
- Employers should be up to date with the disability discrimination legislation and make reasonable adjustments where appropriate.
When do employees need to complete self-certification forms and when is statutory sick pay applied?
COVID-19: Employees who are absent from work, and have either been diagnosed with Coronavirus or are unwell with Coronavirus symptoms, will be entitled to the employer’s usual sick leave and pay provisions, including SSP.
Usually, SSP is only payable after the third day of absence. However, a new regulation, effective from 13 March 2020, has meant that SSP is payable from the first day of absence for employees who are unable to work due to Coronavirus related illness. Although some of the special sick pay measures have been changed back to how they were before the pandemic, it appears that COVID-19 SSP remains payable from the first day of absence. The normal three-day rule (which was suspended temporarily at the start of the pandemic) remains suspended for COVID related absences. For further detail see Q: Is SSP payable on day one or day four of a COVID related absence?
If an employee is not actually unwell but self-isolating in-line with medical or government advice, and is able to work remotely, they are entitled to their normal pay. This would include an employee who has been notified to self-isolate by a contact tracer but who feels healthy and is showing no symptoms.
If they are unable to work, they will be entitled to SSP. This will cover employees who are self-isolating because they have been instructed to do so via the Test and Trace scheme. Employees will be entitled to SSP regardless of whether they are displaying symptoms.
Employers with fewer than 250 employees on 28 February 2020 who paid out SSP due to absence related to COVID-19 could previously recover up to 14 days of SSP per employee from the government. However, the Coronavirus Statutory Sick Pay Rebate Scheme ended on 30 September 2021. Employers can only claim for employees who were off work on or before 30 September 2021.
Employers who provide company sick pay need to consider whether to apply similar rules to the statutory ones to their company sick pay policy. Some company sick pay schemes might be linked to the payment of SSP, whereas others might have a requirement that the employee is actually unwell. Employers should also consider whether providing enhanced pay will encourage employees to comply with the government guidance to stay away from the workplace if they have Coronavirus symptoms. Although those who have symptoms or live in a household where someone has symptoms, or other close contacts of a positive coronavirus case, are advised to get a PCR test as soon as they can. In any event it is important that this is dealt with on a consistent basis.
The basic system of statutory sick pay envisages that employees will complete self-certification forms for the first seven days of absence and that employers should not normally ask for medical evidence for this initial period. Weekends and bank holidays (when the employee may not normally work) are included when counting the seven days.
As explained below, actual statutory sick pay only applies for absences of four days or more, so only part of the first seven days absence are paid unless the employer adopts a more generous policy.
Self-certification forms usually include details such as:
- information about the sickness or illness
- the date the sickness started and ended.
The relevant Statement of sickness form is available on the GOV.UK website.
If an employer pays contractual sick pay, or if an employee is frequently sick, some employers unusually request medical evidence during those first seven days of sickness absence. An employer’s policy on sick leave should specify how many days sick leave applies before proof of illness or a fit note is required.
If employers request a fit note for absences of seven days or less, the GP’s practice may charge to provide a fit note and it is usually the employer’s responsibility to pay for this.
For more than seven days absence employers will usually ask for evidence, or proof of the illness, by suggesting the employees obtain a fit note from their GP.
If an employee is under the care of a hospital, the fit note may be issued by the hospital, rather than a GP.
There should not be a charge from an NHS doctor for providing a fit note if an employee is off work sick for more than seven days.
Despite the removal the three-day waiting period for payment of SSP for COVID-19 related incapacity, SSP is only payable if the employee has self-isolated for at least four days. SSP is payable from day one for any sickness absence of four days or more provided that the employee meets the qualifying conditions. Difficulties may arise where a GP has advised that an employee may be fit for work, but the employee remains off work because the employer cannot provide the necessary support. In such cases employers should treat the note as a ‘not fit for work’ note and pay SSP in the same way.
The Government emphasise in their guide for employers that SSP is only a minimum provision and that if an employer is considering a return to work which involves reduced hours due to sickness, it may be cost effective for the employer to consider paying voluntary sick pay for the hours not worked due to illness or injury, even when SSP does not apply.
The Percentage Threshold Scheme which allowed smaller employers to reclaim SSP was abolished on 6 April 2014.
What is a fit note and how should they be managed?
COVID-19: Given the current Government guidance that individuals should refrain from going to GP surgeries, it may necessary for employers to relax requirements for evidence of illness. This is because it may not be possible for employees who are absent for more than 7 days to obtain a fit note. The government has launched an online system whereby employees can obtain an 'isolation note' if they have been absent from work for more than 7 days due to Coronavirus symptoms. Employees can access this by using the NHS 111 online service.
For more on dealing with the pandemic, see our Coronavirus FAQs.
Fit notes (or fitness for work statements) are intended to encourage employees back to work more quickly and ultimately reduce the numbers receiving incapacity benefit.
It is important to emphasise that employers should also be aware of their duties to pay statutory sick pay and make reasonable adjustments under the disability discrimination provisions of the Equality Act 2010. Employers should be wary of contravening these provisions if the employee’s health problems qualify as a disability.
Fit notes focus on the work employees can do, rather than what they cannot do.
GPs can advise that the employee is either:
- not fit for work, or
- may be fit for work taking account of the’ following advice’.
An employee may have some health problems, but this does not necessarily prevent them from working. If the GP opts for the second option this means the GP’s view is that the employee’s condition does not necessarily prevent them working. The aim of the fit note is to give employers and employees’ greater flexibility in managing sickness absence. The GP should try to suggest ways of helping an employee get back to work, outlining on the note the work that patients can do in spite of their illness. The GP should give advice about the effects of the employee's health condition and some suggestions about the types of adjustment the employer could consider to help the employee back to work.
The employer can then discuss with the employee appropriate adjustments such as:
- a phased, gradual return to work
- altered hours (for example, varied start and finish time)
- flexible hours
- time off for treatment
- amended duties, and/or
- workplace or equipment adaptations
- relocating place of work.
Obviously if any of these variations amounts to a variation in the employee's contract then their agreement must be obtained to the change.
Employers are not bound to follow the GP’s advice and if it is not possible for an employer to provide support for the employee to return to work the employer can use the statement for sick pay purposes as if the GP had advised ‘not fit for work’.
The fit note does not include the option for GPs to advise an employee that they are fully fit for work. The Government emphasises that it is a myth that an employee needs to be fully fit for work; employees do not need to be ‘signed back’ to work by a GP. If an employer does want a medical opinion stating that an employee is fit for work this is a matter for a private arrangement with a GP or occupational health specialist.
On the fit note the GP should have stated how long their advice will last for. The employer should then agree a return to work plan with any appropriate adjustments in place for a temporary period. If the employee cannot then return to their normal duties, long term changes may be necessary taking into account the provisions of the disability discrimination legislation. In the first six months of any health condition, the maximum period a GP can issue a fit note for is three months (reduced from the previous six months).
There have been some problems with fit notes which include:
- GPs having difficulties making the judgements between 'unfit for work' and 'may be fit for some work' as they may not know enough about the nature of the work
- disagreements between employees and employers concerning the nature of adjustments which are appropriate
- employees refusing to return to work once adjustments have been made, leaving the employer to decide whether to invoke disciplinary or capability processes, or stop paying statutory sick pay
- other employees may feel disadvantaged if another employee achieves a variation to their working schedule on what the other employees see as spurious health grounds
- disability discrimination claims may be generated as a result of refusals to carry out adjustments in appropriate cases
- possible increased risk of personal injury claims from members of staff who injure themselves while back at work following a fit note saying they may be fit to return.
To try and minimise the risk of the problems highlighted above occurring, employers should have reviewed their absence, return to work and flexible working policies to ensure they are compatible with the fit note system. There should be an appropriate emphasis on returning to work as soon as is practicable. Other documentation which may need checking or amending include standard contract clauses on sickness absence reporting, self-certificate forms, letters inviting an employee to attend a meeting following a period of sickness absence and structures for return-to-work interviews.
Line managers should also be trained in dealing with fit notes, particularly on how to manage the need for appropriate adjustments and the length of time those should last for and managing other employees' expectations or concerns over such arrangements.
There is a range of guidance and advice, including a sample fit note, available on the GOV.UK website.
What is the Fit for Work service?
A government Fit for Work service was set up in 2014 across England, Scotland and Wales, offering free, mostly telephone-based assessments of employees’ fitness to work. Most referrals to the service were by the employee’s GP, but employers were also able to refer employees if a GP had not done so. The service was intended to help employees who had been on sick leave back in to work by providing a ‘return to work plan’. All referrals required employee consent.
Employees had to be absent from work for four weeks or more in order to be eligible (the assessments were not available to employees who were still at work, the self-employed or agency workers). A website and telephone advice line was set up alongside the service to supply independent, work-related health advice.
The occupational health assessment service was withdrawn on 31 March 2018 – this was attributed to low referral rates. The Fit for Work service now only provides online guidance and a free telephone advice line (see Fit for work for more details).
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