Long-term or recurrent sickness absence: top tips for GP Surgeries

Long-term sickness absence can be a major challenge for GP practices — especially in small teams where every role is vital to smooth operations. While compassion and support are essential, GP employers also need to balance this with legal obligations, regulatory requirements and service continuity. It’s often a difficult balancing act and there comes a time when action needs to be taken.

While there’s no strict legal definition, long-term absence is usually considered to be continuous sickness lasting four weeks or more. It might involve physical illness, mental health issues, or recovery from surgery. In some cases, the absence may be linked to a long-term or fluctuating condition classed as a disability under the Equality Act 2010. In fact, where absence is recurrent or long-term, it’s usually best to assume there is an underlying disability, and act accordingly (not that we’re suggesting for a second you admit this publicly).

Managing long term or recurrent absence usually involves the following:

1. Keeping in touch

Maintain regular, sensitive contact with the employee. This helps show support, keeps communication open, and avoids claims of isolation or unfair treatment. That said, be mindful of too much contact and being accused of harassment (sometimes you can’t win, hey?!). It’s best to agree parameters for contact and ensure the purpose is clear.

2. Request medical evidence

GP surgeries are entitled to request fit notes and, where needed, a report from the employee’s GP or occupational health. This is key to understanding their condition and future ability to return to work. Although you are a GP surgery and your Partners are understandably more qualified that most employers to comment on the employee’s condition, the Tribunal will still expect contact with the employee’s own GP or an independent occupational health professional.

3. Consider disabilities

If the employee has a condition which could amount to a disability, the practice must consider reasonable adjustments — such as reduced hours, altered duties, or phased returns. Remember, the obligation is on the employer to make the adjustments needed, not for the employee to request them. Occupational Health input is often crucial to determining what is needed. Rules, practices and requirements on the employee must be objectively justified and proportionate too.

4. Hold absence review meetings

Invite the employee to discuss their prognosis, any workplace support needed, and potential timelines for return. These meetings should be handled with care, and notes should be taken.

5. Consider redeployment or phased return

If the employee is able to return with support, agree a phased return to work or explore adjustments to their role. Support should be genuine and tailored — a one-size-fits-all approach won’t be sufficient legally or practically.

6. When medical retirement or dismissal is considered

If a return to work isn’t possible even with adjustments, ill-health retirement (for eligible NHS pension scheme members) or capability dismissal may be appropriate. However, this must follow a fair process:

• Medical evidence must support that the employee cannot return or return in a meaningful way even after adjustments have been made
• Alternatives must have been considered
• The process must include meetings, warnings, and the right to appeal

You must consider if you need to refer the clinician to the GMC if their health affects their fitness to practise.

Best Practice for GP Surgeries

• Have a clear sickness absence policy that outlines how long-term absence is managed.
• Keep written records of all communications and meetings.
• Be consistent across all staff but remember that the cornerstone of disability discrimination requires an assessment of the individual’s needs. Beware the ‘floodgates’ argument; it’s not a good one!
• Take occupational health advice seriously. Some providers are better than others so don’t be afraid to shop around.
• Beware of work-related stress, especially where it is linked to ongoing disciplinary or performance management issues. The stress won’t resolve until the issue resolves, in our experience so take advice about how to move things forward positively. You don’t have to stay in limbo, but you do need to exercise caution.
• Treat the employee with dignity and empathy
• Don’t overlook the potential for a settlement. In some cases, a settlement is best for both the employee and the Practice. Extreme care is needed when broaching the subject to avoid increasing the risk of a claim. Take advice if you are thinking of this or wishing to explore the potential.

Conclusion

Long-term or recurrent sickness absences are part of working life — but how they are managed speaks volumes about your practice culture and professionalism. Taking a structured, fair approach helps reduce disruption, support staff well-being, and avoid costly legal mistakes.

To discuss this topic further, please get in touch with Sarah Young - sarah.young@porterdodson.co.uk