Managing sickness leave in the workplace: complete guide for employers

We explain how to write an empathetic, and legally-compliant, sickness absence policy to help employees with health problems stay in, or return to, work.

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Written and reviewed by:
Helena Young

You can’t expect workers to have a clean bill of health every day. Employees get ill – sometimes seriously. As an employer, you have certain obligations you must fulfil to ensure you are prioritising the health and safety of the workforce, and this can be one of the most delicate aspects of HR management to understand.

UK workers are among the healthiest in Europe. Research has shown we take an average of just 5.8 days of sick leave per year. But employers shouldn’t crack out the celebratory champagne just yet.

Behind this ‘low’ figure hides a concerning statistic. The average small business with a team of five is losing just under 30 days each year to staff illnesses – impacting productivity and cash flow at a time when SMEs are already struggling with limited resources.

Below, we’ll go through the causes, costs, and considerations for managing sickness leave. We’ll tell you how to make a sickness policy – including how to calculate Statutory Sick Pay – and offer tips on how to support and reduce the number of staff taking sick days.

What is sick leave?

Sick leave is where an employee takes time off work because of sickness or ill health. In low doses, it is often barely a concern. But, when occurring frequently, it can signal an underlying issue that needs to be addressed.

Because sick leave tends to be an unauthorised absence – unlike leave for holidays, care duties, or training – it is arguably the most damaging to startups. The unpredictability has the potential to throw your carefully-laid growth plans off course.

Repeated absences can impact your team’s ability to work together, stalling productivity and output. Projects may be delayed or left unfinished, potentially causing missed deadlines and backlogs.

In industries with shift patterns, such as hospitality or manufacturing, staff absences might even disrupt the whole production line. Likely, this will increase the workloads for colleagues, leading to decreased morale and potentially elevated stress levels.

Long-term vs. short-term sickness

HR experts typically divide sickness leave into two distinct categories: short-term absences and long-term absences.

Short-term sick leave refers to employees taking odd days off due to common, non-threatening colds and flus.

Long-term sick leave is a different matter. This is for employees who are off work for more than four weeks in a row due to a health issue, such as if they are dealing with a cancer diagnosis.

These two cases are important to distinguish between. Those with long-term sickness may count as having a disability in law, which means they will have legal protections against discrimination at work.

How to craft an effective sickness leave policy

The first step to managing sickness absence is to design a sickness leave policy that considers both short-term and long-term sick leave.

This should be clearly laid out in your employee handbook, so staff can see the rules and procedures for managing, recording and reporting sickness leave, and include the following four elements:

  • Reporting procedures
  • Medical certification requirements
  • Payroll information
  • Return-to-work protocols

What to include in a sickness absence policy1. Reporting procedures

An employee who is off work due to sickness must notify their line manager or another relevant member of staff as soon as possible on the first day of leave.

Companies might specify a time of day that the employee must inform managers, for example before 9am. However, it’s best to be lenient when it comes to enforcing this rule, as you don’t want to be perceived as forcing an ill employee to come into work.

The employee should, however, provide a reason for absence, and (where possible) give an indication of the date they expect to be back at work.

Ensure that all personnel are aware of what communication channel they should use to send and receive sick leave requests. For example, you may choose to let them report via a messaging tool like Slack, or through a dedicated employee portal in your HR software.

2. Medical certification requirements

If an employee on short-term sick leave has been off work for more than seven days in a row (including non-working days like bank holidays or weekends) their boss is legally entitled to request medical evidence to confirm their leave.

If the employee will be paid Statutory Sick Pay, the employer should ask them to confirm they’ve been off sick. This is called ‘self-certification’ and can be done using the government form SC2.

If the employee is on long-term sick leave (they need or have had more than four weeks off work) the process looks different.

“Often long-term absences are related to a serious medical condition, surgery or illness,” says Sarah King, Employment Partner at Excello Law.

“As a result, it is more usual for employers to obtain a medical report to ascertain what support an employee will need when they return and also how long they may be off for. This is usually an occupational health referral and report.”

3. Payroll information

Statutory Sick Pay is the minimum amount employers must pay to staff members while they are away on sick leave. It is only given to employees who are unable to work because of illness for over four days in a row (including non-work days like weekends).

Some employers might choose to pay workers more than the statutory amount, and from the first day of leave. Information on what the employee can expect to be paid during their time off must be written into their contract or workplace policy.

It should also say in the contract or the organisation’s policy whether the first three days of sickness absence will be paid or unpaid.

4. Return-to-work protocols

You may wish to include guidelines on when employees on short-term sick leave should return to work. For example, specify they should do so only when they are physically and mentally capable of performing their role effectively.

The policy should also outline the procedure an employee needs to follow when returning to work after a long term sickness leave. This might involve a return-to-work interview with their manager or HR, confirming fitness for work, and any necessary accommodations.

Take note of what a person on long-term sick leave might have missed while away, and provide any necessary training or refreshers to help them catch up.

Legal rights for addressing excessive sick days

Sick leave is an inevitability when you’re running a business. The idea that you can stop your workforce from getting sick is just wishful thinking. If the COVID-19 pandemic has taught us anything, it’s that employers have to prepare for sickness absences to occur at any moment.

Occasionally, however, a time will come when a staff member begins to take an excessive amount of sick leave and action must be taken by management.

How many is ‘too many’ sick days?

There is no legal upper limit to the number of days an employee can take off from work due to short-term sick leave. That makes defining ‘excessive’ sick leave a tricky task for HR managers.

However, teams can create their own explanation of what is ‘acceptable’ sick leave using the Bradford Factor formula. This is a mathematical formula used in HR to measure and understand patterns in employee unplanned absences.

To use the Bradford Formula, you should times the total number of absences (not including statutory leave like carer’s leave) for an individual in a year (S) by two. Then, multiply this figure by the total number of days absent (D).

For example, if the employee is absent twice in 52 weeks, each period lasting for five days, their Bradford factor score would be 40, because (2 x 2) x 10 = 40.

When defining what makes a ‘good’ Bradford factor score, versus a ‘bad’ score, HR teams should work from the basis that:

  • Over 100 = threshold for concern
  • Over 150 = managers should begin monitoring the situation
  • Over 200 = action should be taken

Can I fire an employee for taking too many sick days?

Businesses do have certain rights and options when addressing excessive sick leave. But they must approach the situation carefully and within the boundaries of the law.

As we’ve explained above, employers have the right to ask for evidence, like a medical certificate, if an employee is off sick for more than a certain number of days. Staff who take regular sick days without a fit note or disability could be in breach of an employment contract if it is felt they are not genuinely unwell.

You can instigate formal disciplinary procedures if an employee appears to be misusing sick leave benefits. Sometimes, this may even lead to termination of a contract. However, bosses should exercise caution before taking such extreme steps.

“Dismissing an employee for long-term sickness or frequent absences is possible,” says Mike Smith, Head of Public Relations at BusinessExpert.

“Still, you must ensure the decision is fair and justified and that all possible accommodations or adjustments have been considered. Make sure to also seek legal counsel when considering such decisions.”

Another key point to remember is that all discussions with employees must be fully documented. Ensure that whatever warnings made or feedback given are paper-trailed so that the employee understands the process and to prevent disputes arising down the line.

Dismissing a long-term sick employee

In some cases, the employer will not be able to sustain the long-term sickness absence of an employee indefinitely, and a return to work will become impossible.

In this scenario, managers should seek to dismiss the employee for medical capability. However, make clear in the sickness absence policy that dismissal will only be considered once all reasonable attempts have been made to facilitate a return to the workplace.

Not to do so risks the employee choosing to take their case to an employment tribunal if they think they’ve been unfairly dismissed.

What is Statutory Sick Pay (SSP)?

Statutory Sick Pay (SSP) is a payment made by the employer when a staff member goes off work because of ill health. SSP is paid out in the same way as wages – just as with other statutory leave payments like maternity pay and paternity pay.

As of April 2023, employees claiming SSP will get up to £109.40 per week, up to 28 weeks, if they are too ill to work.

As an employer you’re responsible for paying SSP to staff members who meet certain conditions (although many businesses choose to offer full pay as a perk for staff).

To qualify for SSP, the employee must:

  • Be an employee (or an employed agency worker) at your company
  • Be incapable of working for at least four days or more in a row – also known as the ‘period of incapacity for work’ (PIW)
  • Work at least one Qualifying Day (QD) in each week
  • Earn at least as much as the lower earnings limit (LEL) for National Insurance contributions (NICs), currently £123 a week.
  • Have self-certified as sick – either within your own time limit or within seven days of the first day of sickness

When do I pay SSP?

An employee telling you they are sick is the starting point for SSP. However, you won’t start to send SSP straight away.

The first three QDs that a person is off sick are called ‘Waiting Days’. SSP is payable from the first QD after the three Waiting Days.

Statutory Sick Pay SSP when to pay

Remember that if an employee has worked for even one minute before they go home sick – even if they just log on to send an email before signing off early – then you cannot count this as their sick day. Sick leave will instead begin the day after.

How to check eligibility for SSP

To check if the employee is eligible for SSP, HR teams need to first work out their ‘relevant period’. All earnings made in this time will be divided by the number of days, weeks or months in that ‘relevant period’.

Regulations define the ‘relevant period’ as the period starting eight weeks before the first complete day of sick absence.

For an employee who is paid weekly, the employer should work out Average Weekly Earnings (AWE), by dividing their total earnings during this time by eight (the number of weeks in the relevant period).

Example: an employee is paid weekly every Friday. Their first full day of sick absence 07/11/23. The relevant period is therefore from 08 September to 2 November.

£1,500.00 (total earnings) ÷ 8 = £187.5

For an employee who is paid monthly, the employer should work out Average Weekly Earnings (AWE), by dividing their total earnings during this time by two (number of months in the relevant period), multiplying by 12 (number of months in the year), and then dividing by 52 (number of weeks in the year).

Example: an employee is paid monthly on the last working day. Their first full day of sick absence 11/11/17. The relevant period is therefore 1 September to 31 October.

£1,500.00 (total earnings) ÷ 2 = £750.00

£750.00 x 12 = £9,000

£9,000 ÷ 52 = £173.07

In both of the above cases, the employees would qualify for SSP as they have earned at least £123 a week.

How to calculate SSP

Once you know if the employee is eligible for SPP, it is time to calculate how much their payment will be. This can be done using two calculations:

SSP weekly rate ÷ total qualifying sick days = SSP daily rate

SSP daily rate x eligible sick days = total to pay in SSP

Example: an employee has a total of seven days off sick from work. They can be paid SSP for four of those days. In total, they will receive £62.48 in SSP. Here’s how we worked that out:

£109.40 ÷ 7 = £15.62

£15.62 x 4 = £62.48

Payroll teams should treat SSP just like any other wage payment, and make deductions for PAYE, NICs, pension contributions, and Student Loan deductions.

When do I stop paying SSP?

SSP usually stops being issued once the employee returns to work. Calculate if any SSP is still owed to them for days of sickness before they return to work and pay it on their next normal payday.

If your employee is long-term sick, and still off work when you have paid SSP for 28 weeks, fill in form SSP1. Send it to your employee no later than seven days after the day on which their entitlement ended.

Your employee will need to use form SSP1 to claim Employment and Support Allowance (ESA).

How do I record SSP?

Businesses do not need to keep records of SSP paid to employees, but you can do so if you wish. Record keeping may prove helpful if there’s a dispute over payment of SSP, as HMRC may ask to see evidence of any sick leave payments made.

🚨 Employers failing or refusing to issue statutory payments to staff could incur a civil penalty of up to £3,000.

How to support employees on long-term sick leave

Employees facing serious and ongoing health concerns will likely feel stressed about the impact on work, or anxious about how their employer may respond to their period of absence.

Here are four examples of measures that a company could introduce to help support employees struggling with long-term sickness

  1. Design clear policies and a communication plan: a thorough and supportive sickness absence policy that outlines the requirements, expectations, and available support, will help to keep information transparent and ensure long-term sick employees feel supported.Third-party support partners, such as Kiteline Health, can help employers to better support the wellbeing of their most vulnerable staff, by accessing training for line managers and distributing expert information from a professional health coach.
  1. Health and wellbeing initiatives: Implement programs that promote physical and mental wellbeing such as wellness workshops, stress management seminars, and access to an Employee Assistance Program (EAP). Request regular medical updates (with the employee’s consent) to stay informed about their condition and progress, which can help in planning for their return.
  1. Maintain an open dialogue: An open and supportive work environment will ensure employees feel comfortable discussing health concerns with their managers or HR. Managers should engage in regular communication with the employee to show concern. Ensure the individual still feels connected to the workplace, and don’t exclude them from invites to company events, newsletters, or team updates.
  1. Introduce new working arrangements: The employer should also make changes to an employees’ work environment or pattern in order to accommodate their return. Known as ‘reasonable adjustments’, the most common tweaks include introducing flexible work arrangements, or adapting equipment employees use at work.

If necessary, collaborate with the employee’s healthcare provider to develop a plan that outlines necessary accommodations, adjustments to workload, and a phased reintegration.

Tips for reducing short-term sick days amongst staff

According to official government figures, an increasing number of sick days are due to mental health, including depression and anxiety, as growing levels of workplace stress lead to poor employee health and wellbeing.

Rob Fisher is Managing & HR Director at Strategi Solutions. Fisher advises: “Managing absence should always be seen as remedial not punitive. Creating an environment where people are supported will mean that people feel more likely to want to attend work regularly.”

Here are four measures you can take to reduce the risk of staff taking excessive short-term sick days:

  1. Review employee workloads: Bosses and managers should adopt an empathetic leadership style when managing sickness absence. If you are concerned an employee may be taking excessive leave, review their workload before taking any formal action. Encourage them to raise concerns if they feel under too much pressure.
  2. Encourage holidays: All employees can get up to 5.6 weeks’ paid holiday pro-rata. Encourage workers to use this time, and take regular rest breaks throughout the year to ensure they do not feel burnt out or overwhelmed by their workload.
  3. Review your benefits package: Stephen Woodhouse, an employment law solicitor at Stephensons, recommends teams seek to introduce employee benefits and perks to alleviate the problem.“Introduce a mental health day that an employee can use at some point in the year. Agile working may help employees to juggle other commitments, health needs, or a gruelling commute. Even small changes can make a significant difference,” says Woodhouse.
  4. Invest in ergonomic furniture: This might sound like a curveball, but labour market figures also show that musculoskeletal problems caused 10.5% of sickness absences in 2023. Purchasing health and safety conscious furniture – particularly for home workers – could have a positive impact on reducing sickness absence.

Discouraging presenteeism in the workplace

One challenge for small employers is to avoid combating sickness absenteeism in the workplace by encouraging presenteeism. This is where staff don’t take time off because they feel like they’ll be in trouble or will affect their future career prospects.

Presenteeism is an issue because it does not lead to a more productive workforce. Staff may be turning up at their desks, but if they feel ill or burnt out, they could end up doing more damage by taking a longer amount of sick leave down the line.

Organisational culture is a factor here. Employees working within a supportive environment where managers seem to care about their wellbeing will be much less likely to misuse their sick leave allowance.

“An engaged and motivated workforce will have a healthy sense of loyalty to the business,” explains Mandy Watson, Managing Director at Ambitions Personnel. “In return, the business values their health and wellbeing and that they won’t be penalised for genuine time off.”


Sickness absence is a delicate issue for employers to handle. No-one wants to be seen as penalising staff for ill health, but the risks of repeated absenteeism – such as reduced productivity and heightened stress for colleagues – are too great for employers to ignore.

As industries struggle with a tightened labour market, employers need to strike a delicate balance between their productivity demands and the wellbeing of personnel.

Approaches should encompass clear communication, adaptable policies, and a genuine empathy for the individuals involved. This will foster an environment where both employee rights, and business continuity, are protected – building a healthier, more resilient workforce.

Sickness leave FAQs
  • Can a manager refuse a sick leave request?
    As the employer, you cannot stop an employee from taking sick leave. However, if they do not comply with their requirements for reporting sickness, as laid out in your sick leave policy, then you can take disciplinary action against the individual for breaching the terms of their employment contract.
  • Can an employer sack me for being off sick?
    If you are suffering from a long-term illness that makes it impossible to do your job, your employer can terminate your contract. However, before this, they must provide evidence that they have made all reasonable attempts and adjustments to facilitate a return to the workplace, or they could be found guilty of employee discrimination.
  • Can you get sacked for lying about being sick?
    If an employee is found to have been dishonestly taking sick leave at work, this will usually amount to misconduct or gross misconduct. This likely end result is an investigation and disciplinary measures.
Written by:
Helena Young
Helena is Lead Writer at Startups. As resident people and premises expert, she's an authority on topics such as business energy, office and coworking spaces, and project management software. With a background in PR and marketing, Helena also manages the Startups 100 Index and is passionate about giving early-stage startups a platform to boost their brands. From interviewing Wetherspoon's boss Tim Martin to spotting data-led working from home trends, her insight has been featured by major trade publications including the ICAEW, and news outlets like the BBC, ITV News, Daily Express, and HuffPost UK.

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