Managing Long-Term Sickness Absence | Employer Guide
A comprehensive employer guide to managing long-term sickness absence. Covers the capability process, occupational health referrals, reasonable adjustments, disability discrimination risk, and when dismissal is lawful. ERA 2025 updated.
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Bolton, Manchester, North WestManaging long-term sickness absence requires a fair capability process, not a misconduct process. The employer must obtain occupational health evidence, genuinely consider reasonable adjustments, consult the employee, and follow a documented procedure before any dismissal decision. From January 2027 under ERA 2025, unfair dismissal protection applies after just six months of service, making a defensible process for managing long-term sickness absence more important than ever for North West employers.
What Counts as Long-Term Sickness Absence?
There is no single statutory definition, but in UK employment practice long-term sickness absence is generally understood to mean a continuous period of absence lasting four weeks or more. CIPD research consistently defines long-term absence using this threshold, and most employer absence policies across the North West adopt the same benchmark. Managing long term sickness absence starts with understanding what you are dealing with: a sustained period where the employee is medically unfit to perform their role, as distinct from short-term or intermittent absence.
Short-term absence, the odd day or two for a cold or stomach bug, is managed through attendance triggers and return-to-work interviews. Long-term sickness absence requires a fundamentally different approach: welfare-led contact, occupational health involvement, and a capability process rather than a disciplinary one. The employer who confuses the two routes creates tribunal risk before they have even started. Under ERA 2025, the qualifying period for unfair dismissal claims has been reduced to six months, meaning the employer's exposure arises far earlier than it did under the old two-year rule.
The employer also needs to consider from the outset whether the condition may amount to a disability under the Equality Act 2010. A condition that has lasted, or is likely to last, twelve months and has a substantial adverse effect on day-to-day activities will meet the statutory definition. Cancer, HIV, and multiple sclerosis are automatically deemed disabilities. Where the Equality Act applies, the employer has a duty to make reasonable adjustments, and disability discrimination claims carry no qualifying period and no compensation cap at tribunal.
When Does Absence Become a Management Issue?
Every employer in the North West we work with asks the same question: at what point does managing long term sickness absence shift from a welfare matter to a management issue? The answer is that it is always both. The employer has a duty of care to the employee throughout, but also a legitimate business interest in understanding when or whether the employee will return to work. An occupational health referral is the bridge between the two. It gives the employer an independent medical opinion on the prognosis, likely timescale for return, and any adjustments that could facilitate it.
Under ERA 2025, Statutory Sick Pay is now payable from day one of absence, removing the previous three waiting days. This reflects the policy direction of treating sickness absence as a welfare matter first, but it does not remove the employer's right to manage the absence through a fair capability process where the absence is prolonged and there is no clear prospect of return.
Common Long-Term Conditions
Employer's Rights
Request medical evidence and fit notes from day one of absence
Refer the employee to occupational health for an independent assessment
Require the employee to attend review meetings at reasonable intervals
Set a reasonable timescale for reviewing the absence and considering next steps
Ultimately dismiss on capability grounds where there is no reasonable prospect of return and a fair process has been followed
Employee's Rights
Receive Statutory Sick Pay from day one of absence under ERA 2025 changes
Not be dismissed without a fair process, medical evidence, and genuine consideration of alternatives
Request reasonable adjustments where the absence is connected to a disability under the Equality Act 2010
Be kept informed and consulted throughout the process rather than managed out in silence
Bring a companion to any formal meetings under the Acas Code of Practice
Managing Long-Term Sickness Absence: The Process
Six steps that every employer must follow when managing long term sickness absence. Skip any one of them and the dismissal, however justified on the medical evidence, risks being found procedurally unfair.
Welfare Contact and Keeping in Touch
The employer should make early, sensitive contact with the employee. This is not a chase-up call demanding a return date. It is a genuine welfare check: how are they, what support do they need, is there anything the employer can do. The Acas Code of Practice expects the employer to maintain reasonable contact throughout the absence. For North West employers we advise, we recommend a first welfare contact within the first week, then regular check-ins at agreed intervals. Document every contact. A tribunal will want to see that the employer behaved as a reasonable, compassionate employer throughout.
Occupational Health Referral
Once the absence reaches four weeks, or earlier if the prognosis is uncertain, the employer should refer the employee to occupational health. The referral letter matters: ask specific questions. What is the likely timescale for return? Is the condition likely to amount to a disability under the Equality Act? What adjustments could facilitate a return? Could the employee perform a different role? Occupational health gives the employer the independent medical evidence they need to make informed decisions. Without it, any subsequent dismissal is likely to be found unfair at tribunal. North West businesses often delay this step, which creates unnecessary risk.
Review Meeting with the Employee
Once the employer has the occupational health report, arrange a formal review meeting with the employee. Share the report in advance. The purpose is to discuss the medical position, explore what the employer can do to support a return, and understand the employee's own view of their situation. The employee has a right to be accompanied. This is not a disciplinary hearing: it is a capability review, but it must still be conducted fairly. Document the discussion and any agreed actions. Under ERA 2025, employees gain unfair dismissal protection at six months, so the employer must ensure this process is robust from an early stage.
Consider Reasonable Adjustments
If the condition is or may be a disability, the employer has a legal duty to consider reasonable adjustments before taking any action towards dismissal. This could include a phased return, amended duties, a change of hours, redeployment to a suitable alternative role, or workplace modifications. The employer must engage genuinely with this process. A tribunal will scrutinise whether the employer actually explored adjustments or simply paid lip service to the duty. CIPD guidance emphasises that early, creative adjustment discussions produce better outcomes for both employer and employee.
Formal Capability Review
Where the absence continues and the medical evidence does not support a return within a reasonable timescale, the employer may move to a formal capability review. Write to the employee setting out the position: the length of absence, the medical evidence obtained, the adjustments considered, and the fact that dismissal is now being considered as a potential outcome. Give them at least five working days' notice. The Acas Code requires that the employee is told the case against them and given a genuine opportunity to respond before any decision is made. This is the step where the employer builds or breaks their defence to a tribunal claim.
Making the Dismissal Decision
The decision to dismiss should only be taken where the employer has exhausted the process: obtained up-to-date medical evidence, genuinely considered adjustments and alternatives, consulted the employee, and concluded that there is no reasonable prospect of a return to work within a reasonable further period. The dismissal must be on grounds of capability, not misconduct. The employer must confirm the decision in writing, explain the reasons, and offer a right of appeal to a more senior manager. Under ERA 2025, dismissal for long-term sickness at any point after six months' service carries unfair dismissal risk, and North West tribunal panels apply this standard rigorously.
Common Mistakes Employers Make with Long-Term Sick Leave
Seven mistakes that turn a defensible capability dismissal into an unfair dismissal finding. Every one of them is avoidable with the right process and advice.
Dismissing without obtaining medical evidence
The single most common failing we see in North West employers managing long term sickness absence. The employer becomes frustrated with the length of absence and dismisses without ever obtaining an occupational health report or up-to-date medical evidence. A tribunal will almost certainly find this unfair. The employer cannot form a reasonable belief about the prospect of return without independent medical input. A GP fit note alone is not sufficient: it tells you the employee is currently unfit, not whether or when they are likely to recover.
Not making an occupational health referral
Closely related to the first mistake, but distinct. Some employers obtain GP reports under the Access to Medical Reports Act 1988 but never commission an occupational health assessment. GP reports address the clinical condition. Occupational health addresses the functional question: can this person do this job, and if not now, when? The employer needs both perspectives, but the occupational health report is what a tribunal will look for when assessing whether the employer took reasonable steps to understand the position before dismissing.
Failing to consider reasonable adjustments
Where the condition amounts to a disability under the Equality Act 2010, the employer has a duty to consider reasonable adjustments before dismissal. This is not a tick-box exercise. The employer must genuinely explore what could be done: phased return, amended duties, redeployment, workplace modifications. Employers who dismiss without evidence that they considered and, where possible, trialled adjustments expose themselves to disability discrimination claims at tribunal, which carry no compensation cap and no qualifying service requirement.
Not keeping in touch during absence
Some employers take a hands-off approach, leaving the employee entirely alone for months. While the employer must not harass a sick employee, complete silence is equally damaging. A tribunal expects the employer to maintain reasonable, sensitive welfare contact throughout the absence. Regular check-ins show that the employer cared about the employee and took reasonable steps to understand the evolving position. The Acas Code of Practice emphasises the importance of ongoing dialogue. Employers in the North West who go silent during long-term absence find it much harder to defend a subsequent dismissal.
Treating long-term sickness as misconduct
Long-term sickness absence is a capability issue, not a conduct issue. The employer who issues warnings for absence, uses a disciplinary procedure rather than a capability procedure, or frames the dismissal as being for misconduct has used the wrong process entirely. A tribunal will find the dismissal procedurally unfair regardless of the underlying medical position. The distinction matters: capability processes are welfare-led and require medical evidence. Disciplinary processes are evidence-and-allegation-led. They are different routes for different problems.
Ignoring the Equality Act and disability discrimination risk
Not every long-term sickness absence involves a disability, but many do. The employer who fails to consider whether the Equality Act applies is walking into a trap. Under ERA 2025, the reduced six-month qualifying period makes unfair dismissal claims more accessible, but disability discrimination claims have never had a qualifying period at all. An employee dismissed on day one of employment for a disability-related absence can bring a claim. The employer must assess disability risk early and act accordingly, including obtaining medical evidence and considering adjustments.
Not following a fair capability process
Even where the medical evidence supports dismissal and the employer has considered adjustments, the process itself must be fair. That means: writing to the employee to explain the position, giving them the medical evidence, inviting them to a formal meeting with the right to be accompanied, genuinely considering their representations, and offering a right of appeal. Employers who shortcut the process because the medical evidence is clear lose at tribunal on procedural fairness grounds. The Acas Code applies to capability dismissals just as it applies to misconduct dismissals.
When Can You Dismiss for Long-Term Sickness?
Dismissal for long-term sickness absence is lawful. It is one of the five potentially fair reasons for dismissal under the Employment Rights Act 1996: capability. The employer is entitled to say that an employee who cannot perform their role due to ill health, and who has no reasonable prospect of returning within a reasonable timescale, can be fairly dismissed. But the route matters. This is a capability dismissal, not a misconduct dismissal. The Acas Code of Practice on Disciplinary and Grievance Procedures applies, and the employer must follow a process that a tribunal would regard as fair and reasonable in all the circumstances.
The tribunal test for fairness in a long-term sickness dismissal asks four questions. Did the employer obtain adequate medical evidence? Did the employer consider reasonable adjustments and alternative employment? Did the employer follow a fair procedure, including consultation with the employee? And was dismissal within the range of reasonable responses open to a reasonable employer in those circumstances? An employer who can answer yes to all four has a strong defence. An employer who falls short on any one of them is exposed.
ERA 2025 has changed the risk landscape significantly for employers across the North West and beyond. The reduction of the unfair dismissal qualifying period to six months means that employees on long-term sick leave gain protection far earlier. Previously, an employer could dismiss an employee with under two years' service without unfair dismissal risk. That buffer has largely gone. Every employer managing long term sickness absence now needs to follow a fair process from the outset, regardless of the employee's length of service.
The employer obtained up-to-date occupational health or specialist medical evidence before making the decision
The employer genuinely considered reasonable adjustments including phased return, amended duties, and redeployment
The employer followed a fair capability process: formal meeting, disclosure of evidence, right to be accompanied, written outcome
The employer consulted the employee throughout and gave them a genuine opportunity to respond before deciding
The employer concluded, based on medical evidence, that there was no reasonable prospect of a return to work within a reasonable further period
The employer offered a right of appeal to a more senior manager not involved in the original decision
The employer dismissed without obtaining any occupational health or medical evidence beyond fit notes
The employer failed to consider or even discuss reasonable adjustments with the employee
The employer used a disciplinary procedure instead of a capability procedure, treating sickness as misconduct
The employer made no welfare contact during the absence and gave no opportunity to discuss the situation
The employer dismissed because a fixed absence trigger was hit, without any individual assessment of the case
The employer offered no right of appeal or conducted a sham appeal with the same manager
Disability Discrimination Warning
Where the employee's condition amounts to a disability under the Equality Act 2010, a dismissal that would otherwise be fair on capability grounds can still amount to unlawful discrimination if the employer failed in the duty to make reasonable adjustments. Disability discrimination claims at tribunal carry no qualifying period of employment and no cap on compensation.
This means an employer in the North West, or anywhere in England and Wales, can face an uncapped discrimination award even where the employee has only weeks of service. The employer must assess disability risk at the earliest stage and ensure every step of the process demonstrates genuine engagement with the duty to adjust. ERA 2025's day-one rights agenda reinforces rather than replaces this existing protection.
ERA 2025: What Changes for Long-Term Sickness Absence
SSP payable from day one of sickness absence. The three-day waiting period is removed. Every employer managing long-term sickness absence must update absence policies and payroll.
Tribunal claim window doubles from 3 to 6 months. Employers must retain all records relating to long-term sickness absence management for at least six months from the end of employment.
Unfair dismissal protection after 6 months. Every capability dismissal for long-term sickness absence carries full tribunal risk after just six months of service. Build your processes now.
Compensation cap removed. A poorly handled dismissal for long-term sickness absence of a senior employee could result in significantly larger tribunal awards.
DaisyHR helps North West employers build ERA 2025 compliant sickness absence management processes that reduce tribunal risk and support a healthy, productive workforce.
Read our full ERA 2025 guide for North West employersFrequently Asked Questions
There is no single legal definition, but most employers and employment tribunals treat continuous absence of four weeks or more as long-term sickness absence. Your absence policy should define the threshold clearly so that both the employer and employee know when the formal capability process begins.
Yes, through a fair capability process. The employer must obtain occupational health evidence, consider reasonable adjustments, consult the employee about their prognosis and any return-to-work options, and follow a documented sickness absence management procedure. The Acas Code of Practice applies.
It is not a strict legal requirement, but failing to obtain medical evidence before dismissing for long-term sickness absence almost always makes the dismissal unfair at tribunal. Employers are expected to understand the medical position before making a dismissal decision.
The employer must consider reasonable adjustments under the Equality Act 2010 before dismissing. Disability discrimination claims have no qualifying period and no compensation cap. Managing long-term sickness absence where disability is involved requires specialist HR advice.
Yes, and you should. Reasonable welfare contact is expected by tribunals and is a core part of managing long-term sickness absence. Agree frequency and method with the employee at the start. Failing to keep in touch weakens the employer’s position.
SSP from day one (April 2026), unfair dismissal after 6 months (January 2027), doubled tribunal window (October 2026), and removal of the compensation cap. Every North West employer managing long-term sickness absence must have robust processes in place.
Always capability. Long-term sickness absence is not misconduct. Using a disciplinary process for genuine illness will almost certainly be found procedurally unfair by a tribunal. The Acas Code requires the employer to use the appropriate procedure for the circumstances.
There is no fixed period. It depends on the medical prognosis, the impact on the business, whether reasonable adjustments could enable a return, and the employer’s resources. Most employers move to formal review after 3–6 months of long-term sickness absence, guided by occupational health advice.
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Sickness absence management advice for employers across Bolton, Manchester and the wider North West. · Last reviewed: March 2026