Keep Britain Working: managing employees on long-term sick leave

The recent Keep Britain Working report by the former John Lewis Chairman, Sir Charlie Mayfield, commissioned by the Department for Work and Pensions (DWP) and Department for Business and Trade (DBT), highlights a pressing challenge for UK employers: the growing number of working-age adults out of work due to ill-health and disability.

With over one in five working-age people out of work and projections suggesting another 600,000 could fall into this category by 2030, the implications of employees on long-term sick leave for businesses are significant.

According to the report, UK employers face an estimated £85bn annual cost, including £10bn in sick pay, £47bn in lost output, and £21bn in reduced productivity. Beyond the numbers, prolonged absence disrupts teams, creates unplanned costs, and often leads to expensive recruitment exercises when employees cannot return.

So, what can employers do to try and support their employees on sick leave effectively? Here are some top tips for employers which we have drawn from the report’s recommendations.

Act early: the first few weeks matter

The report states that employees absent for four to six weeks have a 96% chance of returning to work, but this drops to less than 50% after a year. Early intervention is therefore critical. Employers should:

• maintain regular, sensitive contact with the employee from the outset. Silence can feel like abandonment and may worsen anxiety;
• agree a communication plan that respects the employee’s health needs; and
• explore adjustments early, even if temporary, to facilitate a phased return.

Create a culture of openness

The report highlights a mutual “culture of fear” that prevents employees from disclosing health conditions and employers from intervening at an early stage, for fear of doing the wrong thing or causing issues that escalate into grievances. Employers can counter this by:

• promoting inclusivity so that employees feel safe to share without fear of discrimination; and
• being proactive in staying in touch with absent employees, keeping a dialogue with them which reduces fear on both sides and keeps employees connected to work.

Rethink fit notes

Currently, 93% of GP-issued fit notes declare employees “not fit for work”, often without any consideration of workplace adjustments. This can inadvertently create a barrier to dialogue. Employers should:

• encourage employees to discuss “fit for work with adjustments” with their GP;
• seek occupational health input early, but ensure recommendations are tailored to the actual working environment; and
• avoid treating fit notes as the end of the conversation – they should be a starting point for planning support.

Offer support, but make engagement a condition

Large employers often provide access to occupational health (OH), Employee Assistance Programmes (EAPs), and rehabilitation services—but these only work if employees engage. The report recommends:

• linking contractual sick pay to participation in support measures, such as attending OH assessments or following agreed return-to-work plans; and
• communicating clearly that these conditions are designed to help recovery, not penalise absence.

Remove barriers for disabled employees

Disabled employees frequently face structural challenges, with the burden of advocating for adjustments typically falling on their shoulders, causing further barriers and anxiety. Employers should:

• take proactive responsibility for adjustments, rather than leaving employees to advocate for themselves; and
• review adjustments regularly, recognising that needs may change over time.

Train managers and build confidence

Fear of “getting it wrong” can lead managers to avoid conversations about health and absence, which only compounds problems. Practical steps include:

• providing training on legal obligations and best practice under the Equality Act 2010; and
• equipping managers with scripts and guidance for sensitive conversations.

The report highlights some helpful tips for employers facing long-term sickness in their workforce and shows that a proactive, open, and engaged approach can go a long way to building a more resilient and healthier workforce.

For top tips on managing short-term, persistent absence, see our blog "All absences are not equal: why employers must treat persistent short-term absences on a case-by-case basis".

Many thanks to Bijou Kay, current trainee, for her help preparing this blog.

This publication is a general summary of the law. It should not replace legal advice tailored to your specific circumstances.

© Farrer & Co LLP, November 2025