I had a message in my inbox this week. A business owner, completely exasperated, about an employee who seems to be off sick almost every month.
Over 20 days in two years. Always just under the seven-day threshold. Never enough to trigger a doctor’s note. And the manager? At their wit’s end.
Persistent sickness absence is one of the most common things I help with. And almost every time, the same mistakes are being made.
Here’s what you should actually be doing.
1. Check your policy
Most businesses already have a sickness absence policy. They just never look at it or follow it.
A good policy will have trigger points built in. Something like three separate absences in 12 weeks or more than X days in a rolling period. When those triggers are hit, the policy tells you exactly what happens next.
At minimum, it gives you the right to hold a formal absence review meeting if things are getting excessive.
No policy? Get one. Not sure how to get one? Get in touch.
2. Have a return to work meeting. Every single time.
I cannot stress this enough. A return to work meeting after every absence is one of the most effective tools you have, but most managers skip it entirely!
It doesn’t need to be long. Five minutes. “You were off yesterday – how are you? Are you fit to be back?” That’s it.
But here’s why it matters.
First, it’s a genuine duty of care. You’re checking in, making sure your employee is well enough to return, and opening the door to a proper conversation if something’s going on.
Second, it signals that you’re paying attention. For anyone taking liberties, that conversation alone is often enough to make them think twice.
And sometimes it opens the door to something you’d never have found otherwise. I once managed someone who called in sick with sickness and diarrhoea so regularly it had become almost predictable. A couple of times a month, every month.
In the end I sat down with him and said: “If I had sickness and diarrhoea as often as you do, I’d be really worried. I’d be at the doctor’s. Why haven’t you been?”
Turns out he was struggling with a drug problem and had been using sickness as a cover. He’d never expected anyone to actually ask.
That’s what a five-minute conversation can do.
3. If it’s escalating, have a proper absence review meeting
If absence has hit excessive levels, it’s time to sit down formally. Be clear about what you’ve observed. Explain the impact on the business. And give them the opportunity to respond.
Something like: “You’ve been absent for 23 days in the past year. That’s not sustainable for you or for us. I want to understand what’s going on.”
This conversation also helps you work out whether you’re dealing with a conduct issue or a capability issue. And that distinction matters a lot.
Conduct vs capability: what’s the difference?
Persistent sickness absence can fall under either:
- Conduct – if the absence looks like a choice (repeated Mondays, patterns around events, nothing medically substantiated)
- Capability – if the employee genuinely cannot maintain attendance due to ill health
Both can, ultimately, lead to dismissal. But the process is different, and you have to follow it correctly.
I have disciplined someone for persistent sickness absence before. Period pain one week, sprained ankle the next, headache the week after. When there’s no underlying condition and the pattern doesn’t stack up, that’s usually a conduct matter.
But if a disability is involved – or might be involved – you need to tread very carefully.
Long-term or health-related sickness? Get occupational health involved
If the absence is health-related, or you think there might be something underlying, you need proper medical guidance before making any decisions.
My advice: refer to occupational health rather than waiting on a GP report. It’s quicker, it’s more practical, and it gives you the kind of workplace-focused assessment you actually need.
Occupational health can tell you:
- Whether the employee is fit to work
- What reasonable adjustments might help
- Whether a phased return is appropriate
- Whether the absence is likely to continue long-term
Tribunals take a dim view of employers who dismiss someone for sickness-related absence without an occupational health assessment. Particularly where disability discrimination is claimed. Don’t skip this step.
What about doctor’s notes?
One of the most common questions I get asked.
For absences of seven days or less, employees can self-certify. You cannot require a GP note. After seven days, a fit note is required.
Asking for a GP letter for shorter absences won’t work – most GPs won’t provide one, and the ones who do may charge the employee for it. It also risks creating a grievance. Follow your policy and use return to work meetings instead. That’s what they’re there for.
Good processes prevent sickness absence abuse
Almost every sickness absence problem I see has one thing in common: no one has ever had a proper conversation.
Employers let it slide, hoping it’ll improve. It rarely does. And by the time they call me, it’s already messier than it needed to be.
You don’t have to accept excessive sickness absence. You do have to follow the right process.
And if you’re dealing with persistent sickness – especially where a disability or long-term condition might be involved – please don’t handle it alone. This is exactly the kind of situation where getting proper HR advice early saves you a significant amount of time, money, and stress.
Get in touch and let me know what you’re dealing with so I can help.