Long-term sick leave is generally defined as an absence lasting more than 28 consecutive days — the point at which statutory sick pay (SSP) typically ends. Managing long-term absence is one of the most complex areas of UK employment law, involving overlapping obligations under employment contracts, health and safety law, the Equality Act 2010, and the ACAS Code of Practice. Employers must balance their duty of care with the business need for the employee’s role to be covered.

This guide covers what happens after SSP ends, occupational health referrals, reasonable adjustments, and the capability process.

Key takeaways

  • SSP runs for a maximum of 28 weeks — after that, the employee may be eligible for Employment and Support Allowance (ESA).
  • You must manage long-term absence through a structured process — regular contact, OH referrals, and documented adjustments.
  • The Equality Act 2010 requires reasonable adjustments for disabled employees — failure to make them is discrimination.
  • Dismissal for long-term illness is a last resort — only after all reasonable adjustments have been explored.
  • Capability dismissals for long-term illness require a fair process and proper notice.

What happens after SSP ends

When SSP reaches its 28-week limit, your statutory payment obligation ends. The employee may then be eligible for Employment and Support Allowance (ESA) through the DWP — you should provide them with a Statement of SSP to support their claim.

However, your obligations do not end when SSP stops:

  • Contractual sick pay may continue beyond 28 weeks — check the employee’s contract.
  • The employment relationship continues — the employee remains employed even when receiving no pay.
  • Holiday continues to accrue — statutory holiday accrues during periods of incapacity (for up to 54 weeks under the Working Time Regulations 1998).
  • Equality Act obligations continue — you must still make reasonable adjustments for disabled employees.

Managing long-term absence

ACAS recommends a structured approach to managing long-term absence:

1. Regular contact

Maintain regular, supportive contact with the employee. The frequency should be agreed with the employee — typically every 2–4 weeks. The purpose is to:

  • Check on the employee’s health and wellbeing.
  • Discuss any expected return date.
  • Provide updates on workplace changes.
  • Explore adjustments that might facilitate a return.

Contact should be supportive, not interrogatory. The employee is not required to disclose their diagnosis — only their functional capacity.

2. Occupational health referral

Refer the employee to occupational health (OH) when:

  • The absence exceeds 4 weeks (or earlier if appropriate).
  • You need advice on adjustments or the expected duration of the absence.
  • There are concerns about the employee’s fitness to perform their role.

The employee must consent to the OH referral. OH will provide functional advice on what the employee can and cannot do, without disclosing the diagnosis.

3. Reasonable adjustments

Under the Equality Act 2010, s.20–21, you must make reasonable adjustments for disabled employees. Common adjustments for long-term illness include:

  • Modified duties — removing tasks the employee cannot perform.
  • Adjusted hours — reduced hours, flexible start/finish times.
  • Phased return — gradually increasing hours over several weeks.
  • Workplace changes — ergonomic equipment, changed location, working from home.

Failure to make reasonable adjustments when you know or ought to know the employee is disabled is unlawful discrimination.

4. Capability process

If the employee remains unable to return despite adjustments and support, you may need to commence a capability process. This should:

  • Follow your disciplinary policy (capability is treated as a form of incapacity, not misconduct).
  • Be managed through formal hearings with proper notice.
  • Consider the employee’s length of service and any disability discrimination risks.
  • Offer rehabilitation and return-to-work support where possible.
  • Only result in dismissal as a last resort.

Disability discrimination

The Equality Act 2010 defines a disability as a physical or mental impairment that has a substantial and long-term adverse effect on the employee’s ability to carry out normal day-to-day activities. “Long-term” means lasting or likely to last 12 months or more.

If the employee qualifies as disabled, you must:

  • Make reasonable adjustments to the workplace or working arrangements.
  • Not dismiss the employee because of their disability without exploring all alternatives.
  • Not treat them less favourably because of something arising from their disability.

Disability discrimination claims carry no cap on compensation — they are among the most expensive claims an employer can face.

Managing the business impact

Long-term absence creates a significant business impact. You can:

  • Recruit a temporary replacement — for absences likely to exceed 4–6 weeks.
  • Redistribute work — among the existing team (with caution to avoid burnout).
  • Use agency workers — for short-term cover needs.
  • Consider restructuring — only as a last resort and with proper legal advice.

For more UK context, see our guides to fitness to work, disability leave, and sick pay.

Frequently asked questions

How long does an employee have to be off sick before I can dismiss them?

There is no fixed period. Dismissal must be a last resort after all reasonable adjustments have been explored and a fair capability process has been followed. Short service may reduce redundancy pay entitlements, but does not reduce discrimination risk.

Do I have to keep the employee’s job open indefinitely?

No. You can dismiss for long-term capability after following a fair process. However, the longer the absence and the stronger the disability argument, the higher the legal risk.

Does holiday accrue during long-term sick leave?

Yes. Statutory holiday continues to accrue for up to 54 weeks during periods of incapacity, even when the employee is not working and is receiving no pay.

Can I ask for a medical report?

Yes, with the employee’s consent. Under the Access to Medical Records Act 1988, the employee must consent to a medical report from their GP or consultant. You can request a report from occupational health without separate consent if the employee has agreed to the OH referral.

What is the difference between capability and misconduct?

Capability relates to the employee’s ability to perform their role — including health-related absence. Misconduct relates to the employee’s behaviour. Long-term illness is managed through a capability process, not disciplinary proceedings.

Putting it into practice

Five steps keep your long-term absence process fair and legally compliant:

  1. Maintain regular, supportive contact with the employee throughout the absence.
  2. Refer to occupational health early — do not wait until the absence is critical.
  3. Document all reasonable adjustments explored and implemented.
  4. Follow a structured capability process before considering dismissal.
  5. Seek legal advice before any dismissal decision — disability discrimination risk is significant.
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Sources

Last updated: 26 July 2026. This article is general information, not legal advice. Long-term absence and capability dismissals carry significant legal risk — seek legal advice before making any decisions.