Managing Sickness Absence: What Should UK SMEs Do When an Employee Keeps Calling in Sick?
Sickness absence is one of those issues that most business owners will have to deal with at some point.
One employee being off for a few days may be manageable. But when someone is regularly calling in sick, or an employee has been absent for weeks or months, the impact on a small business can quickly become significant.
Work gets delayed. Other employees have to pick up the slack. Customers may be affected. Managers spend valuable time trying to cover shifts and rearrange workloads.
And, understandably, business owners can start asking:
“What can I actually do about it?”
The answer is that employers can manage sickness absence — but they need to do it carefully.
There is a balance to be struck between supporting an employee who is genuinely unwell and protecting the needs of the business.
For SMEs without a dedicated HR department, knowing where that line sits can be difficult.
When does sickness absence become a problem?
There isn’t a magic number of sick days that automatically means an employer can take action.
One employee might have three separate periods of absence in a year because of unrelated illnesses. Another might have one underlying medical condition that causes repeated absences.
The important thing is to look at the overall pattern and circumstances rather than simply counting days.
For example, you may start to have concerns where an employee:
- Is regularly absent for short periods
- Has a pattern of absence around particular days or shifts
- Has increasing levels of sickness absence
- Has been absent for a prolonged period
- Is not following the company’s sickness reporting procedure
- Has not engaged with reasonable requests to discuss their absence
- Is affecting the ability of the business or team to operate effectively
At this point, ignoring the issue is rarely the best option.
The biggest mistake SMEs make: doing nothing
For many small businesses, sickness absence is uncomfortable to address.
A manager may think:
“They’re genuinely ill, so I don’t want to put pressure on them.”
Or:
“Let’s give them another couple of months and see what happens.”
This is understandable — but it can create a much bigger problem later.
The longer an absence continues without proper management, the more difficult it can become to understand the situation, plan for the employee’s return and make appropriate decisions.
The same applies to repeated short-term absence.
If an employee has had six separate periods of sickness but nobody has ever sat down with them to discuss their attendance, the employer may eventually find itself trying to deal with a significant problem without a clear record of what has happened.
Early, supportive conversations are usually much easier than trying to resolve a long-standing problem.
Start with a return-to-work conversation
One of the simplest and most effective tools available to an SME is the return-to-work meeting.
This doesn’t have to be a formal disciplinary meeting.
In many cases, it can be a short conversation between the employee and their manager.
The purpose is to establish:
- Why the employee was absent
- Whether they are now fit to return
- Whether there is an underlying health issue
- Whether anything at work is contributing to the absence
- Whether any support may be appropriate
- Whether there is a developing pattern of absence
It also gives the manager an opportunity to remind the employee of the company’s attendance expectations.
Perhaps most importantly, it shows that the business is actively managing attendance rather than simply recording sickness days.
What if the employee keeps calling in sick?
This is where things can become more challenging.
Suppose an employee has had:
- Three days off in January
- Two days off in March
- A week off in May
- Two days off in July
- Another three days off in September
Each individual absence might be relatively minor.
Collectively, however, the pattern could be having a substantial impact on the business.
The answer isn’t necessarily to accuse the employee of taking advantage.
Instead, the employer should arrange an absence review meeting.
The conversation could be as simple as:
“We’ve noticed that you’ve had a number of periods of sickness absence recently. We wanted to talk to you about this, make sure you’re okay and understand whether there is anything we can do to support you.”
That opens the door to a much more productive conversation.
Don’t assume someone is abusing sick leave
Repeated absence can be frustrating, particularly when the business is under pressure.
But employers should be careful about making assumptions.
There could be an underlying health condition that the employee has not previously disclosed.
There could also be a disability for the purposes of the Equality Act 2010.
Disability is not limited to obvious physical conditions. Certain long-term mental and physical health conditions can meet the legal definition of disability.
If disability may be involved, the employer needs to consider whether reasonable adjustments are required.
This is one of the areas where getting HR advice early can make a significant difference.
Reasonable adjustments could change the situation
If an employee is disabled, an employer may have a legal duty to make reasonable adjustments to remove or reduce a disadvantage they experience at work.
Depending on the circumstances, this might involve:
- Altering working hours
- Changing shift patterns
- Adjusting duties
- Providing additional breaks
- Changing the way work is organised
- Providing equipment
- Allowing homeworking where appropriate
- Introducing a phased return
- Changing supervision arrangements
There is no standard list of adjustments that every employer must provide.
What is reasonable will depend on the individual circumstances and the employer’s resources.
For an SME, it is particularly important to have a sensible conversation about what can realistically be done.
Sometimes a relatively small adjustment can make the difference between an employee being unable to remain in work and being able to continue successfully.
Managing long-term sickness absence
Long-term sickness absence requires a different approach from repeated short-term absence.
If an employee has been away from work for several weeks or months, the employer should maintain reasonable contact and understand the likely prognosis.
This doesn’t mean calling every day asking:
“When are you coming back?”
It means keeping communication open and agreeing appropriate contact arrangements.
Depending on the circumstances, employers may want to discuss:
- How the employee is doing
- Whether their health situation has changed
- Whether they have an expected return date
- Whether they may be able to return with adjustments
- Whether a phased return could work
- Whether occupational health input would be useful
- Whether there are alternative duties that could be considered
The objective is to understand the situation and establish a realistic way forward.
Occupational health can be invaluable
For SMEs, occupational health advice can be particularly helpful where there is uncertainty.
For example:
“Will they be able to return to their existing role?”
“When might they realistically be able to return?”
“What adjustments might help?”
“Could this condition amount to a disability?”
“Is there a risk of further absence?”
An occupational health assessment can provide a work-focused medical opinion that helps an employer make informed decisions.
It is important to remember that occupational health doesn’t make the employer’s decision for them.
It provides information that can help the employer understand the situation and consider the options.
What if there is no foreseeable return?
This is one of the hardest situations for an employer.
A business may be carrying a vacant role for months while paying for temporary cover or asking other employees to take on additional responsibilities.
Eventually, the employer may need to consider whether it is sustainable to keep the role open.
That does not mean an employee can simply be dismissed because they have been off sick for a certain period.
Before considering dismissal on capability grounds, an employer should normally consider the medical evidence, the likely prognosis, the impact on the business, possible adjustments, alternative roles and the employee’s views.
The process needs to be fair and reasonable.
This is precisely where professional HR advice can help an SME avoid making an expensive mistake.
What about employees who are regularly off for one or two days?
This is another common problem.
Long-term sickness is visible.
Frequent short-term absence can be much harder to manage because every individual period may appear relatively insignificant.
The solution is to monitor the overall pattern.
An SME might use an absence trigger within its policy — for example, a certain number of absences or days within a specified period — to prompt a review.
However, triggers should not be treated as an automatic instruction to discipline or dismiss someone.
They are a starting point for a conversation.
Once the trigger is reached, the employer should investigate the reasons for the absence and consider whether there is an underlying medical explanation.
What if you suspect the employee isn’t genuinely ill?
This is where the distinction between capability and conduct becomes important.
If an employee is genuinely unable to attend work because of ill health, the issue is generally one of capability.
If an employee is deliberately dishonest about being ill, that may be a conduct issue.
But suspicion isn’t proof.
For example, seeing an employee out shopping while they are off sick does not automatically mean they are abusing sick leave.
The employer needs to understand the circumstances and investigate appropriately before reaching conclusions.
If there is a genuine concern about dishonesty, the employer should follow an appropriate disciplinary process rather than simply dismissing the employee.
Don’t forget Statutory Sick Pay changes
There has also been an important recent change for employers.
From 6 April 2026, Statutory Sick Pay became payable from the first day of sickness, rather than after the previous waiting period. The lower earnings threshold was also removed, expanding SSP eligibility. The SSP calculation was also changed.
For SMEs, this makes effective absence management even more important.
Businesses should ensure that their payroll arrangements, contracts and sickness absence policies reflect the current SSP rules.
A practical approach for SME employers
If sickness absence is becoming a problem in your business, a structured approach can make the situation much easier to manage.
1. Have a clear sickness absence policy
Employees should know how to report sickness, when they need to make contact and what happens when absence becomes a concern.
2. Record absence consistently
Don’t rely on memory or informal conversations.
Keep accurate records of dates, duration and relevant information.
3. Hold return-to-work meetings
Use them to check the employee is okay and identify any underlying issues.
4. Look for patterns
Repeated short-term absences can be just as disruptive as one long absence.
5. Speak to the employee early
Don’t wait until the problem becomes unmanageable.
6. Consider medical advice
Where appropriate, occupational health can provide valuable information.
7. Consider reasonable adjustments
Particularly where there may be a disability.
8. Set clear expectations
If attendance needs to improve, the employee should understand what is expected and what support is available.
9. Review progress
Set clear review dates and keep the process moving.
10. Get HR advice before taking significant action
Particularly where dismissal, disability or potential discrimination is involved.
Don’t let sickness absence become an unmanaged problem
For a small business, there is often a temptation to deal with HR issues informally.
After all, you know your employees and you don’t want to turn every conversation into a formal process.
But there is a difference between being informal and being unstructured.
You can still have a supportive conversation with an employee while following a sensible process.
In fact, good HR management often means dealing with problems earlier, not making everything more complicated.
The aim isn’t to punish employees for being ill.
It is to create a fair and consistent process that supports employees while protecting the business.
How a HR consultant can help
Sickness absence can become particularly difficult when you’re trying to manage it alongside everything else involved in running a business.
An HR consultant can help you take a step back, understand the situation and decide what to do next.
That could include:
- Reviewing your sickness absence policy
- Advising on a particular employee’s absence
- Supporting absence review meetings
- Advising on reasonable adjustments
- Arranging and interpreting occupational health referrals
- Managing long-term sickness cases
- Managing repeated short-term absence
- Supporting capability procedures
- Advising on potential disciplinary issues
- Supporting a return-to-work or phased-return plan
- Advising on the risks before dismissal
- Helping managers have difficult conversations
For an SME, this can provide access to experienced HR support without the cost of employing a full-time HR department.
Final thoughts
Sickness absence is a fact of working life.
The question for employers isn’t whether employees will ever be absent — it’s how effectively the business manages absence when it happens.
If someone is genuinely unwell, they should be treated fairly and supported appropriately.
But supporting employees does not mean ignoring the impact their absence is having on the business.
Likewise, managing absence does not mean looking for reasons to dismiss someone.
The best approach sits somewhere in the middle:
Be supportive. Be consistent. Keep good records. Address concerns early. Understand the medical position. Consider reasonable adjustments. And get professional advice when you’re unsure.
For SMEs, having the right HR process in place can turn a stressful and potentially risky situation into one that is much easier to manage.
If sickness absence is becoming a problem in your business, you don’t have to deal with it alone. Professional HR support can help you understand your options, manage the process fairly and protect your business.
If you would like a call to discuss how this is affecting your business, or need help with your polices and processes, please get in touch.
Neil Blackwood
Adept HR Services
0330 401 2152
hr@adeptgroup.org
***This article provides general information about UK employment law and should not be treated as legal advice. ***