Long Term Sickness Absence: 2026 UK Employer Guide

Long-term sickness absence is one of the most sensitive and legally complex workforce issues UK employers face. While many absences begin as short-term illness, situations can quickly evolve into extended periods away from work, creating operational strain, financial cost and potential legal exposure.

Handled poorly, long-term sickness absence can lead to unfair dismissal claims, disability discrimination allegations, breach of contract disputes and reputational damage. Handled properly, it can preserve employment relationships, reduce litigation risk and protect business continuity.

This guide provides a comprehensive, legally accurate overview of how UK employers should manage long-term sickness absence in 2026. It is written for HR teams, managers and business owners who need practical, defensible processes aligned with UK employment law.

What this article is about

This article explains the legal framework governing long-term sickness absence and provides practical, risk-managed guidance for employers. It addresses pay, fit notes, occupational health, reasonable adjustments, dismissal risks and data protection obligations. It is designed to help employers make structured, evidence-based decisions while balancing operational needs with employee rights.

Section A: Understanding Long-Term Sickness Absence

Long-term sickness absence is not defined in statute. However, most UK employers treat continuous absence of four weeks or more as “long-term” for internal management purposes. This four-week point is not a legal threshold for dismissal or capability action. It is a practical trigger for formal review.

Long-term absence requires employers to move beyond day-to-day sickness absence administration and adopt a structured management approach. That approach must take into account overlapping legal duties under employment law, discrimination law, statutory sick pay rules, health and safety duties and data protection obligations.

1. What counts as long-term sickness absence?

There is no statutory definition of long-term sickness absence under UK employment law.

In practice, many organisations treat an absence of four consecutive weeks as long-term, although some employers operate review triggers at two, four or eight weeks depending on the role, operational impact and the nature of the condition. The label is less important than the management response. Once absence extends beyond the short-term stage, employers should initiate a formal absence review process to assess prognosis, confirm pay arrangements and create a clear plan for ongoing communication and evidence collection.

Employers should avoid treating the four-week point as a decision point for capability action. It is the point at which structured review becomes necessary and where a well-run process begins to protect the organisation if the absence becomes prolonged.

2. The legal framework employers must consider

Long-term sickness absence engages several legal regimes simultaneously.

First, ill health may fall within the potentially fair reason of capability for dismissal under the Employment Rights Act 1996, but any dismissal must be reasonable and procedurally fair. A capability outcome that is not supported by evidence, consultation and consideration of alternatives is vulnerable to challenge, particularly where the employee has qualifying service for unfair dismissal protection.

Second, under the Equality Act 2010, if the employee’s condition amounts to a disability, the employer must avoid unlawful discrimination and must consider reasonable adjustments. Discrimination claims do not require two years’ service and compensation can be uncapped, so employers must treat Equality Act risk as a central compliance issue and not a secondary consideration.

Third, employers have statutory health and safety duties to ensure, so far as reasonably practicable, the health, safety and welfare of employees at work. This duty applies while employees are at work. It does not impose a general obligation to manage recovery outside the workplace, but employers should not require employees to return before they are medically fit or ignore risks associated with an unsafe return.

Fourth, statutory sick pay legislation governs minimum payment obligations, while many employers also operate contractual or policy-based sick pay arrangements. Poor administration at this stage often creates avoidable disputes about entitlement and process.

Fifth, medical information is special category data under UK GDPR. Employers must handle it lawfully, securely and on a need-to-know basis, ensuring that sensitive health information is not over-shared, retained unnecessarily or used without proper controls.

Employers that fail to recognise how these obligations interact often lose control of the process, either by drifting without structure or by progressing too aggressively without evidence.

3. Early management priorities

As absence approaches the long-term stage, employers should move into a more structured, documented approach. A clear sickness absence policy will usually set out trigger points, reporting obligations and review steps, but employers should also tailor responses to the circumstances of the case and the role.

Early priorities typically include:

• Confirming medical certification is in place and up to date
• Reviewing sick pay status and clarifying statutory and contractual entitlements
• Agreeing an appropriate communication plan and review cadence
• Considering whether an occupational health referral may be required to obtain role-specific advice
• Documenting discussions, decisions and next steps to evidence fairness and reasonableness

At this stage, employers should also ensure managers understand that the organisation is managing a process, not chasing an outcome. A defensible approach focuses on evidence, consultation, support and proportionality from the outset.

Section A Summary

Long-term sickness absence is not defined by statute but is commonly treated as starting at four weeks for management purposes. It requires a structured, legally informed response rather than reactive decision-making. Employers should recognise that capability, Equality Act duties, health and safety and data protection obligations may all apply at the same time. Early, documented and evidence-led management strengthens operational planning and significantly reduces legal risk later in the process.

Section B: Pay, Fit Notes and Medical Evidence

Once an absence becomes long-term, employers must ensure that pay arrangements, medical certification and evidence gathering are handled correctly. Errors at this stage frequently undermine later capability decisions and increase the risk of unfair dismissal or discrimination claims.

Managing long-term sickness absence is not simply about monitoring absence. It requires careful administration of statutory sick pay, clear handling of fit notes and, where necessary, properly authorised medical assessment. Employers should also ensure the approach aligns with any internal sickness absence policy so expectations are clear and applied consistently.

1. Statutory Sick Pay (SSP) and contractual sick pay

Eligible employees are entitled to Statutory Sick Pay (SSP) if they meet the qualifying conditions, including being classed as an employee for SSP purposes, earning at least the Lower Earnings Limit and being off sick for four or more consecutive days, including non-working days. SSP is payable for up to 28 weeks, with rates and earnings thresholds reviewed annually.

Employers should ensure that SSP is calculated and paid correctly, records are maintained and payroll treatment is consistent across comparable cases. Where SSP entitlement ends, employers must issue the appropriate notification so the employee can explore alternative state support where applicable.

Employers should also be aware that SSP entitlement can be affected by the “linking rules”, meaning separate periods of incapacity for work can be treated as linked where they are separated by eight weeks or less. This can impact how much SSP remains available and should be factored into pay administration and planning where absence patterns are complex.

Many employers offer enhanced sick pay through contractual arrangements or an occupational sick pay scheme. Where contractual sick pay applies, employers must follow the precise terms of the contract or policy, including any conditions around evidence, notification and review. If an employer reserves discretion to withhold contractual sick pay, that discretion must be exercised reasonably and consistently, and not in a way that creates Equality Act risk. Employers cannot pay less than SSP where an employee is eligible.

Incorrect administration of sick pay can create separate legal exposure, including unlawful deduction of wages claims or breach of contract disputes, and it often damages trust at a point where constructive engagement is needed most.

2. Fit notes and ongoing medical certification

Employees may self-certify sickness for the first seven calendar days. After this period, they must provide a fit note from a GP or other authorised healthcare professional.

A fit note will state either that the employee is not fit for work or that they may be fit for work subject to recommendations. Those recommendations may include a phased return, amended duties, altered hours or workplace adaptations. While fit note recommendations are not legally binding, employers should give them proper consideration and document how they have assessed feasibility. This is especially important where the employee may meet the legal definition of disability, as dismissing or disadvantaging an employee without properly exploring adjustments can increase the risk of discrimination claims, including claims for failure to make reasonable adjustments.

If a fit note expires and the employee remains absent, further certification is required. Employers are entitled to request up-to-date medical evidence throughout long-term absence and should ensure certification is tracked and stored securely in line with internal controls.

3. Occupational health referrals and medical reports

For prolonged or complex absences, an occupational health referral is often appropriate. Occupational health assessments can provide role-specific evidence on prognosis, likely timeframe for return, functional impact, recommended workplace adjustments and whether the employee is likely to be able to return to their role with support. This can be critical in long-term sickness cases because it supports evidence-led decision-making rather than assumptions.

Employers should ensure that any occupational health brief is properly framed around the employee’s role and duties, and that the questions asked relate to fitness for work, functional limitations and adjustments. Occupational health advice should not be treated as determinative, but it should be treated as a key input into a reasonable employer decision.

Where an employer seeks a medical report from a clinician responsible for the employee’s clinical care, the Access to Medical Reports Act 1988 can apply. In those circumstances, the employer must obtain the employee’s written consent and the employee has rights relating to access to the report. Employers should note that the Act does not generally apply to occupational health practitioners engaged directly by the employer, but consent and appropriate data handling remain essential in all cases.

Medical evidence should always be relevant, proportionate and role-specific. Employers should share the substance of the evidence with the employee and allow the employee to comment before decisions are made.

4. Maintaining appropriate contact and running absence reviews

Employers are entitled to maintain reasonable contact during long-term sickness absence. There is no statutory rule governing frequency. However, contact must not be excessive or intrusive and should not create undue pressure on the employee to return prematurely.

A defensible approach usually involves agreeing expectations early and then maintaining structured review points, with flexibility to adjust communication frequency to the employee’s circumstances and medical advice. Employers should keep the tone supportive and professional, focusing on welfare, evidence and next steps rather than outcomes.

Where the employee disengages, employers should document reasonable attempts to make contact and invite participation. Decisions should not be rushed purely because communication is difficult, but a tribunal will expect employers to have attempted genuine consultation and to have kept records that demonstrate fairness.

5. Documentation and evidence control

Long-term sickness absence cases often succeed or fail based on documentation. Employers should maintain clear, accurate records of fit notes and other medical evidence, review meeting invitations and notes, communications with the employee, options considered and the rationale for decisions. This is essential not only for procedural fairness, but also to demonstrate that the employer acted within a range of reasonable responses and properly considered adjustment duties under the Equality Act.

Where absence is prolonged, employers should also ensure managers understand that evidence and process must be handled consistently. This includes aligning any actions with the organisation’s sickness absence arrangements and ensuring that decisions are supported by objective evidence rather than informal views.

Section B Summary

Managing pay, fit notes and medical evidence properly is foundational to lawful long-term sickness absence management. Employers must ensure SSP compliance, apply contractual sick pay terms fairly, secure appropriate medical evidence and maintain structured, reasonable contact. Evidence-led administration and careful record keeping strengthens the employer’s position in later stages, including where capability action is considered, and reduces the risk of unfair dismissal and discrimination claims.

Section C: Disability, Reasonable Adjustments and Discrimination Risk

Long-term sickness absence frequently moves beyond a capability issue and into discrimination risk territory. Employers who fail to recognise when a medical condition may amount to a disability under the Equality Act 2010 significantly increase their exposure to tribunal claims.

Disability discrimination claims do not require two years’ service and compensation is uncapped. For this reason, identifying and managing Equality Act risk early is central to lawful long-term sickness absence management.

1. When does long-term sickness amount to a disability?

Under the Equality Act 2010, a person is disabled if they have a physical or mental impairment that has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities.

“Substantial” means more than minor or trivial. “Long-term” generally means that the impairment has lasted, or is likely to last, 12 months or more. In this context, “likely” means that it could well last that long, not that it is more probable than not.

Certain conditions, such as cancer, HIV and multiple sclerosis, are automatically treated as disabilities from the point of diagnosis. Progressive conditions can also amount to a disability before they have a substantial adverse effect, if that effect is likely to develop.

Not every case of long-term sickness absence will meet this definition. However, many chronic physical or mental health conditions will. Once an employer has information suggesting that a condition may fall within the statutory definition, the duty to consider reasonable adjustments is engaged. Employers cannot avoid liability by failing to make reasonable enquiries.

2. The duty to make reasonable adjustments

Where an employee is disabled, employers must take reasonable steps to remove disadvantages caused by workplace practices, physical features or the absence of auxiliary aids.

In long-term sickness cases, adjustments may include:

• A phased return to work following medical clearance
• Temporary or permanent reduction in working hours
• Modification of duties or performance targets
• Home working or hybrid arrangements where feasible
• Provision of equipment or workplace adaptations
• Adjustments to absence trigger application, including discounting disability-related absence

Employers must actively consider adjustments. The duty is anticipatory in the sense that employers must assess disadvantage and not simply wait for the employee to propose solutions. When assessing reasonableness, tribunals will consider factors such as cost, practicality, business impact, available resources and the effectiveness of the proposed adjustment.

If an employer rejects an adjustment, the rationale should be documented. A blanket refusal or failure to consider adjustments at all may result in liability for failure to make reasonable adjustments.

3. Discrimination arising from disability and indirect discrimination

Long-term sickness absence cases can give rise to discrimination claims even where the employer’s intentions are commercially driven.

Discrimination arising from disability occurs where an employee is treated unfavourably because of something arising in consequence of their disability, such as absence levels. For example, dismissing an employee because of disability-related absence may amount to unlawful treatment unless the employer can show that the action was a proportionate means of achieving a legitimate aim and that it did not know, and could not reasonably have been expected to know, of the disability.

Indirect discrimination can arise where a provision, criterion or practice applies to all employees but places disabled employees at a particular disadvantage compared with non-disabled employees, and the employer cannot objectively justify the policy. This is particularly relevant where absence trigger systems are applied rigidly.

Employers must ensure that absence policies allow for discretion and individual assessment. Automatic sanctions without review significantly increase risk.

4. Absence triggers, the Bradford Factor and policy discretion

Many employers use trigger systems or the Bradford Factor to monitor attendance patterns. While lawful in principle, these tools must be applied with care in long-term sickness cases.

Rigid application of absence scoring mechanisms can amount to indirect discrimination or discrimination arising from disability if disability-related absence is not treated appropriately. Employers should consider whether absence attributable to a disability should be adjusted, discounted or reviewed separately.

Policies should expressly allow discretion and individual assessment. A neutral policy applied inflexibly may still be unlawful in practice.

5. Pregnancy-related sickness absence

Pregnancy-related illness must be treated separately from other forms of sickness absence. Employers must not penalise employees for pregnancy-related absence or count it towards absence triggers.

Where appropriate, employers should carry out a risk assessment and consider suitable alternative work or adjustments. Failure to treat pregnancy-related illness separately may constitute unlawful discrimination. Employers should ensure managers understand the distinct legal framework governing pregnancy-related illness to avoid avoidable claims.

6. Harassment and victimisation risks

Insensitive comments, undue pressure to return to work or dismissive treatment of a health condition can amount to workplace harassment. Employees who raise concerns about discrimination or request adjustments are protected from victimisation.

Employers should ensure that managers are trained to communicate professionally and sensitively when managing long-term sickness absence. Poor communication often escalates matters into formal disputes.

Section C Summary

Long-term sickness absence frequently engages disability discrimination risk. Employers must assess whether a condition may meet the Equality Act definition, actively consider reasonable adjustments and apply absence policies with discretion. The greatest legal exposure arises not from absence itself, but from failure to manage disability-related issues fairly, proportionately and in accordance with statutory duties.

Section D: Capability Procedures and Dismissal for Long-Term Sickness Absence

Dismissal for long-term sickness absence is legally possible, but it carries significant risk if handled prematurely or without proper evidence. Ill health falls within the potentially fair reason of capability under the Employment Rights Act 1996. However, fairness is determined not only by the reason for dismissal, but by the process followed and the reasonableness of the decision.

Employers must approach capability dismissal cautiously, ensuring that decisions are evidence-based, proportionate and procedurally sound.

1. When can capability proceedings begin?

There is no fixed minimum period of absence before an employer can begin capability proceedings. The appropriate timing depends on the nature of the medical condition, the prognosis for recovery, the impact of absence on the organisation and whether adjustments have been explored.

A small employer with limited resources may reach a decision point sooner than a large organisation with greater capacity to absorb temporary absence. Tribunals will assess whether the employer acted within the range of reasonable responses open to a reasonable employer in the circumstances.

Before commencing formal proceedings, employers should ensure they have:

• Up-to-date medical evidence
• Clear understanding of prognosis
• Considered adjustments and alternatives
• Consulted meaningfully with the employee

Proceeding without clarity on likely return significantly increases the risk of a finding of unfair dismissal.

2. The importance of medical evidence before dismissal

A fair capability process requires appropriate medical evidence. Employers should rely on fit notes, occupational health reports and, where necessary and lawfully obtained, specialist medical opinion.

The evidence should address whether the employee is likely to return, the estimated timeframe, whether the condition is permanent and whether adjustments would enable return. Employers should avoid basing decisions on assumptions or informal impressions.

Where medical evidence indicates that a return is unlikely within a reasonable timeframe, or that the employee is permanently incapable of performing the role even with reasonable adjustments, dismissal may be within the range of reasonable responses. However, the employee must be given the opportunity to comment on the evidence and provide their own input.

3. Consultation and fair procedure

A fair process for dismissal for sickness absence typically involves:

• Written invitation to a capability meeting
• Right to be accompanied
• Discussion of medical evidence and prognosis
• Consideration of reasonable adjustments
• Exploration of alternative roles or redeployment
• Written outcome and reasons
• Right of appeal

Consultation must be genuine. Employers should be able to demonstrate that they considered whether more time would assist recovery, whether alternative duties were feasible and how the absence was affecting operations. A dismissal decision must be one that a reasonable employer could have reached in the circumstances.

Employers should also consider whether the employment contract includes permanent health insurance or income protection benefits. Dismissing an employee in a way that deprives them of access to such benefits may expose the employer to breach of contract claims and should be approached with caution.

4. Alternatives to dismissal

Before dismissing, employers should consider whether alternatives are viable. This may include a structured return to work plan, a phased reintroduction of duties, redeployment to a suitable vacancy or adjustment of hours.

In disability cases, the duty to make reasonable adjustments may extend to transferring the employee to an appropriate alternative role where one exists. Employers are not required to create a new role, but they must properly consider suitable vacancies.

Dismissal should follow consideration of alternatives and must be reasonable in the circumstances. It does not have to be literally the last conceivable option, but it must be proportionate and supported by evidence.

5. Balancing business impact

Tribunals recognise that employers are not required to hold a role open indefinitely. However, the employer must demonstrate real operational impact, attempts to manage workload and reasonable tolerance of absence before deciding that continuation of employment is no longer viable.

Relevant factors include the size and resources of the organisation, the importance of the role, the cost of temporary cover and the likelihood of return. Each case turns on its own facts, and a structured assessment of business impact should be documented as part of the decision-making process.

6. Notice, appeal and documentation

If dismissal proceeds, statutory or contractual notice must be given. In some cases, statutory notice may need to be paid at full normal pay where statutory minimum notice exceeds contractual notice and the employee is incapable of work due to sickness, subject to the relevant statutory provisions.

Employers must provide a right of appeal and ensure the appeal is conducted impartially. Written confirmation of the dismissal should clearly set out the evidence relied upon, adjustments considered, alternatives explored and the reasons why dismissal was considered reasonable.

Clear, contemporaneous documentation is often decisive in defending claims for unfair dismissal or discrimination.

Section D Summary

Capability dismissal for long-term sickness absence is lawful where handled fairly, proportionately and on the basis of medical evidence. Employers must consult meaningfully, consider reasonable adjustments and assess operational impact before reaching a decision. Dismissal should follow careful consideration of alternatives and be supported by clear documentation and a fair procedure.

Long-Term Sickness Absence FAQs

Employers frequently raise the following questions when managing long-term sickness absence. The answers below reflect current UK employment law and best practice guidance.

How long does an employee need to be absent before it is considered long-term sickness absence?

There is no statutory definition of long-term sickness absence. Most employers treat four consecutive weeks of absence as long-term for management purposes. This is an internal trigger point rather than a legal threshold for dismissal or formal capability action.

Is long-term sickness absence automatically a disability?

No. A condition must meet the legal definition under the Equality Act 2010. It must be a physical or mental impairment with a substantial and long-term adverse effect on normal day-to-day activities. “Long-term” generally means lasting, or likely to last, 12 months or more. Not every extended absence will meet this threshold, but employers should assess the issue carefully and seek medical input where appropriate.

How long is Statutory Sick Pay payable?

Statutory Sick Pay is payable for up to 28 weeks if the employee meets eligibility criteria. Rates and earnings thresholds are reviewed annually. Employers should also consider the SSP linking rules where there are repeated periods of incapacity separated by eight weeks or less.

Can an employer contact an employee during long-term sick leave?

Yes. Employers are entitled to maintain reasonable contact for welfare and absence management purposes. However, contact must not be excessive, intrusive or amount to harassment. Communication expectations should be agreed where possible and handled professionally.

Do employers have to follow fit note recommendations?

Fit note advice is not legally binding. However, employers should give serious consideration to recommendations, particularly where the employee may be disabled under the Equality Act 2010. Ignoring medical advice without justification may increase the risk of claims, including failure to make reasonable adjustments.

When should occupational health be involved?

An occupational health referral is advisable where absence is prolonged, prognosis is unclear or workplace adjustments may be required. Decisions about capability should not be made without appropriate medical evidence.

Can an employee be dismissed while on long-term sick leave?

Yes, dismissal may be lawful on capability grounds. However, the employer must follow a fair process, obtain medical evidence, consult meaningfully, consider reasonable adjustments and assess operational impact. Failure to do so may result in unfair dismissal or discrimination claims.

Do employees need two years’ service to challenge dismissal?

For ordinary unfair dismissal claims, two years’ continuous service is generally required. However, discrimination claims and certain automatically unfair dismissal claims do not require two years’ service. Employers should not assume that short service eliminates legal risk.

Can absence trigger disciplinary action?

Employers may operate absence trigger systems, including use of the Bradford Factor, but they must apply discretion. Disability-related absence may need to be adjusted or treated differently to avoid discrimination.

What if an employee refuses to engage with absence reviews?

Employers should document reasonable attempts to communicate and invite participation. If the employee fails to engage despite reasonable efforts, decisions may need to be made based on the available evidence. The key is demonstrating fairness, proportionality and genuine consultation attempts.

Conclusion

Long-term sickness absence requires careful, structured and legally informed management. Employers must balance compassion with commercial reality, ensuring decisions are supported by medical evidence and aligned with statutory obligations.

The principal risks arise where employers fail to recognise potential disability, apply absence triggers rigidly, dismiss without adequate consultation or ignore reasonable adjustments. Early intervention, appropriate medical input and documented, fair capability procedures significantly reduce the likelihood of tribunal claims.

Handled properly, long-term sickness absence can be managed in a way that protects business continuity while respecting employee rights and maintaining compliance with UK employment law.

Glossary

Useful Links