Return to work after long-term sickness absence | Insight


According to official figures from 2019, one-in-25 employees had recorded a period of long-term sickness absence (greater than four weeks) over the course of a year.  

More than 100,000 people leave work following a spell of long-term sickness absence (LTSA) each year – and the longer an absence persists, the greater the likelihood of an individual not returning to work.  

LTSA is not just costly for employers, there is also substantial evidence that work is beneficial for employees' physical and mental wellbeing. Whereas unemployment and long-term sickness absence is often found to have a harmful impact. 

Did you know? 

  • 1.4m working-age people in the UK amassed a total of 1.8m spells of LTSA in the 12 months to July 2019  
  • In 2020, the most-common reasons given for long-term absence were stress, acute medical conditions and mental ill health 

Key takeaways 

  • Make health and wellbeing a core priority among top management  
  • Have a sickness absence policy in place, or at least clear and accessible procedures for reporting and managing sickness absence - allowing both employer and the employee to feel comfortable  
  • Train managers on sick leave and return-to-work interviews  
  • Stay in contact with workers on sick leave  
  • Consider workplace adjustments to help employees return to work, reviewing risk assessments to identify relevant measures  
  • Equality legislation may apply, depending on the medical issues involved  
  • Consider a workplace visit where relevant, for example DSE assessment if discomfort at a desk is contributing to musculoskeletal issues  
  • Monitor and review workplace adjustments over time, repeating risk assessments as needed  
  • Ensure employee is aware of other available services, e.g. EAP/counselling service, referral to psychological services for CBT, or physiotherapy  
  • Seek occupational health advice on issues such as fitness to work, considering referral after four weeks of absence. 

Who is at risk? 

The likelihood of having at least one spell of long-term sickness absence each year increases with age. People aged 55-64 were more than three times as likely (7%) to have at least one spell of LTSA every year, compared to those under 25 (2%).  

Disabled people were five times more likely to have a spell of LTSA than non-disabled people. Figures show that 15% of disabled people had at least one spell of LTSA over a year, compared to 3% of those who are not disabled.  

People with disabilities also face greater challenges maintaining employment, reinforcing the need for occupational health advice and other employment supports.  

A well-managed and early return to work can reduce the risk of an absence becoming long term. 

Staying in touch 

Keeping in regular contact with your absent employee helps to keep them engaged - and provides the opportunity to plan a return to work in due course.  

Occasionally, an employee may be too unwell or distressed, so that this is not practical or appropriate. If GP advice is that an employee does not remain in contact with their employer, consider seeking occupational health advice.  

Return-to-work discussions will clearly be guided by the underlying health issue(s). In the case of stress-related illness, whether work or non-work related, a sensitive return to work discussion with the person may help to identify what caused them to take absence - and what adjustments can be made to support them. 

Phasing the return 

When the employee feels ready to work again, a 'phased return' can be helpful. For example, working part-time hours for the first few weeks, since fatigue can be an issue initially - or temporarily reducing workload if that is a concern.  

If the employee has found it difficult to cope with particular tasks involved in their job, temporary adaptations and/or changes may provide valuable breathing space. 

People who have been off work with stress often prefer a period of stability on their return. If changes are unavoidable, the employee needs to be fully involved and consulted.  

Support your employee in attending follow up medical appointments - which may be critical in terms of their ongoing recovery or maintaining their health. 


Remember - occupational health can offer expert advice on supporting return to work after long term absence no matter what the underlying cause. 

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