Phased return to work after sickness absence

Written by: Fit for Work team | Posted in: Blog

phased return to workAfter a person has been absent from work due to illness, especially when the person has been absent over a prolonged period of time, a phased return to work may be the best way of helping the person to re-adjust to full attendance/performance at the workplace.

The phased return to work, which is included as an option on the fit note, offers employees the opportunity to return to work at an earlier stage of recovery from illness (they may not yet be fully fit) by allowing them to do fewer hours and/or modified duties based on a structured return to work plan. The main benefit of the phased return to work for employees is that it allows them to return to work much sooner and settle back into a normal routine, and this has been shown to improve overall wellbeing.

How a return to work programme is developed will depend to a large extent on the reason for the person’s absence, as recuperation rates vary greatly. Those who return to work too soon after illness may not be able to work to their full capacity even though they may appear sufficiently medically fit to return to their jobs. It would be easy for managers to misconstrue issues such as difficulty concentrating, remembering things or making decisions as poor performance, so it’s important for employers to find out about a person’s condition and their expected rehabilitation rates.

Not all organisations have their own occupational health departments for advice on employee health matters, however. In addition, getting advice on the effect that work might have on a person’s health and, conversely, the effect that a person’s health issues might be having on their ability to work, is particularly important when employees are returning to work after sickness absence. This is why Fit for Work offers free, expert and impartial work-related health advice to GPs, employers and employees to help those who are struggling in work with a health condition, or have been off work for four weeks or more due to sickness.


  1. Anna


    My mom has returned to work after 4 months absence – after her operation. Her colleague had advised that she is entitle to work for 50% of her normal time instead her full hours for some time at the beginning of her return to work. Could someone please advise how true it is ?

    I would appreciate any advice.

    Kind regards,

    • Fit for Work team

      Hi Anna,
      What you are describing is a phased return to work, whereby an individual can return to work on reduced hours which would increase gradually over what is usually a short period. This is not an entitlement, but is something that some employers may consider in order to help an employee back to work following a long absence. Perhaps your mum should discuss this with her manager, who could advise on the position of her particular company.
      The Fit for Work Team.

  2. John

    I’m a teacher. I’ve been on a phased return now since early March this year after a period of illness of more than 12 months. Our “sick year” runs from the start of April to the end of March. My employer is telling me that as I have not yet started teaching full time yet I am considered to have not resumed my duties and consequently am effectively still sick. As a result, should I go sick again this year I will not be paid sick pay because I exhausted my entitlement over the last year. Is this possible?

    • Fit for Work team

      Hi John,

      If you are referring to sick pay in accordance with your employers organisational sick pay scheme then you would need to make enquiries about their specific rules – payroll departments are generally very knowledgeable and should be able to provide accurate advice. Employers/organisations are responsible for their own policies on organisational sick pay, and will have differing rules. There is no legislation which determines what can or cannot be paid by an employer in relation to company sick pay.

      With regard to Statutory Sick Pay, if a period of absence starts within eight weeks of the end of a previous period of absence, the periods are linked and count as one period of sickness. SSP is only payable for 28 weeks in any one period of absence (including linked periods). If you are off sick more than once with more than eight weeks in between, the periods you were off sick are not added together and the 28 weeks starts being counted again each time. Citizens Advice provide some useful information on their website

      The Fit for Work Team.

  3. shannon

    hi I have just had 10 weeks off due to an injuered hip that will need a major operation early next year I have this week been cleared by my doctor to return to full work as being a full time employee who only took 2 weeks non paid leave in that ten weeks does my employer have to return me to full time hours or do they have the right to only roster me on 3 x 6 hour shifts.

    • Fit for Work team

      Hi Shannon,

      This will be entirely dependent upon the terms and conditions of your employment. If you are a full time employee with a permanent contract, then usually your employer would allow you to return to your full time contract. However, if you are contracted on differing hours or, for example, zero hours contract, then your employer is able to adjust your hours to suit business needs.

      I would advise that you contact your employer to discuss this further and establish the reasons for the change in hours, it may be that they are simply trying to ease you back into the workplace gently.

      The Fit for Work Team.

  4. Layla Hammond

    Im returning to work after 4 months off work my return date is 1/06/2015 my doctor has said i need a phase return to work and said i need to discuss the hours with my employer but my manger is saying that if the doctor doesn’t specify the hours i need to do they won’t accepted my phase return and they need my doctor to write down the hours. I told my doctor this and he said it is usually something that i discuss with my HR dept not with my doctor. Who is right in this situation? I would be grateful of any help thank you.

    Layla Hammond.

    • Fit for Work team

      Hi Layla,

      There is no legislation which would cover this. While a GP can indicate on the Fit Note the hours to be worked, this would be unusual. A GP would usually only indicate the period the adjustment is required. This is because the GP would not have a working knowledge of every organisation and its needs. Therefore, it is a matter best discussed with your employer, if possible. That way, you and your employer can identify the specific needs of the organisation, and work out hours that suit both you and the organisation you work for. The Fit for Work website offers a selection of resources, which might help you and your employer reach a mutually beneficial agreement (e.g. this guidance sheet on the phased return to work: If the Fit for Work referral service has begun in your area (see the roll out map), you could ask your GP for a free referral in order to discuss your return to work.
      The Fit for Work Team

  5. Maria

    I had a gynaecology operation in March and I’m due to return to work in 2 days time. Despite chasing occupational health for a return to work appointment, they have not yet organised the appt. Should I return to work without having occupational health appt?

    Maria S

    • Fit for Work team

      Hi Maria,
      Thank you for your enquiry. If you feel able to return to your normal work, then it would be quite acceptable to return to work without undergoing an occupational health assessment. One alternative might be for you to speak with your manager about any adjustments you feel you might require in order to ease you back into the workplace. If for some reason you feel that you need the input of occupational health I would advise you contact your manager and explain your situation, it may be that they can speed up the referral on your behalf or amend some of your duties pending the assessment. If the Fit for Work referral service has begun in your area (see the roll out map), you could ask your GP for a free referral in order to discuss your return to work.
      The Fit for Work Team

  6. Shimon Forman

    my wife returned to work after a heart attack. Her line manager had made adjustments to the work plan to compensate for her absence. He has not reverted to the previous plan now that she has returned, leaving her with very little to do. She raised the matter with him but he prefers the new arrangement. Does she have any redress?

    • Fit for Work team

      Hi Shimon,
      Thank you for your query – it is generally for an employer to make decisions about the distribution of work, it may be that in re-allocating some of your wife’s work her manager is trying to protect her and avoid overloading her during the initial phases of her return to work. I would advise that she approaches her manager again and explain that she is finding the lack of work quite stressful, and feels that she is ready to take on more responsibility. Even if her manager prefers the current work plan it maybe that they can discuss other activities which she can become involved in. A good way of identifying limitations and needs is to look at the six principles within a stress risk assessment as these can help both employee and manager to agree suitable duties The following link lists these principles and might provide some guidance: Additionally ACAS may also be able to offer additional advice on employment rights.
      The Fit for Work Team

  7. Linda Walker

    I have just had a ocpational assessment and they said I need a phase to work but I have just got a sick note for three week what shall I do

    • Fit for Work team

      Hi Linda,
      You can return to work on a phased return despite your fit note recommendation and do not need to wait for the 3 week period to elapse. You should agree a phased return with your manager along with any other recommendations from occupational health. You do not require a further note from your doctor with an amended date or fitness statement.
      The Fit for Work Team.

  8. Henry Bennett

    My brother returned to work after having a heart attack; this was a role which was 50:50 manual and admin. His HR discovered that he had the HA several months later and sent him home for three months and are now saying that he has to return to work in a role which is predominantly manual or they will let him go. There are roles which are more admin based and it had been inferred that he would be offered one with the training required; this option has now disappeared as they are not hiring for those type of roles.
    What can he do? Have his employers followed the law? Have they followed the general approach that should be taken?
    Any thoughts would be appreciated.

    • Fit for Work team

      Hi Henry,
      You indicate that your brother’s employer does not currently have a vacancy in an administrative role, and they are under no legal obligations to create one, so in this respect they have not broken any law. A return to a role with some element of physically demanding work is possible after a heart attack and in many cases, an increase in physical activity is helpful rather than harmful. It may be appropriate in some instances to offer adjusted duties but it is for the employer to decide if adjustments are reasonable, taking into account any considerations of the Equality Act 2010, should it apply. With regard to what your brother can do, could he consider asking his employer to refer him for an Occupational Health assessment in order to determine his fitness to undertake the role as it currently stands? If the Fit for Work referral service has begun in his area (see the roll out map), he could ask his GP for a free referral in order to discuss his return to work. This would also determine if he could meet the requirements of the Equality Act 2010, which may require some adjustments to his role, and although this would guide his employer it still remains their responsibility to determine if adjustments are reasonable.
      The Fit for Work Team.

  9. Sarah

    Hello my husband was off work for nearly two years after an accident at work he has gone back on reduced hours work has been a pain in the back side trying to get him on a personal improvement plan , he is still on reduced hours but has got to have a different op on his foot and will be off for a period of 6-12 weeks but is now classed as disabled for his foot should he get full sick pay or only sick pay for the 3 days that he’s been working for the last nearly 8 months

    • Fit for Work team

      Hi Sarah,
      With regard to your husband’s sick pay, SSP (Statutory Sick Pay) is payable for 28 weeks, and if he has been paid SSP for the days he did not work during the phased return period, it is possible that he has exhausted his entitlement. If his company operate a company sick pay scheme it is likely they will have a policy which covers what they will pay and when. I would advise that he contacts the payroll department to ask if he is still entitled to SSP – his manager should be able to advise on the company sick pay policy. If your husband is still entitled to statutory sick pay, then this should be paid at his contracted hours, however, company sick pay will be at the discretion of the company, and dependent on their policy. If all sick pay has been exhausted he should receive a form from his employer which he can use to apply for alternative benefits as appropriate.
      The Fit for Work Team.

  10. Lee

    I’ve had carpal tunnel surgery and my doctor has given me 6 weeks off sick note. The occuptional therapist at work recommends I go back on phased returned to work and is giving recommendations of jobs I could perform not using my affected hand. I have 3 more weeks to go before my sick note is finished. I do not want to go back to work before then. Can my employer force me to go on this phased return to work? Can I tell them that without the risk of losing my job?

    • Fit for Work team

      Hi Lee,
      For your own enquiry – if your company have sought the opinion of their Occupational Health provider, and they have assessed you as fit for work with adjustments, then your company can choose to accept the opinion of the Occupational Health provider and expect a return to work. If you do not feel able to return because your recovery has not gone as expected, we would suggest you discuss this with your manager, and request a further appointment with Occupational Health.
      The Fit for Work Team.

  11. Steve

    Hi, my wife and I were involved in a serious car accident last year. As a result my wife, who works in Care, has been off work since August 2014 with a prolapsed disc. In April 2015 she received a phased back to work from her doctor, providing her employer made necessary adaptations for her to come back to work. Since then her employer have not facilitated any adaptations, and although my wife received full pay for her first month of ‘phase back to work’, she has not received any further payments, and doesn’t have any income whatsoever. Would she be eligible for any benefits from the state, and is there a limit of how long a ‘phase back to work’ should take?

    • Fit for Work team

      Dear Steve,
      Thank you for your enquiry. Unfortunately because state benefits are dependent upon personal circumstances, we are not able offer specific advice in this regard, but would advise that your wife contact either her local job centre or Citizens Advice Bureau who will be able to advise more accurately. With regard to the Phased Return to Work these tend to be arranged around a relatively short period of time, for example 4 – 6 weeks, which gives the individual time to rehabilitate themselves back into the workplace. However, it is possible that some longer term adjustments to the persons duties at work could be required. Any adjustments would need to be agreed with the employer, and there is no obligation on the employer to agree to them if they do not consider them to be reasonable and manageable. Our Web Site does offer guidance on workplace adjustment, phased return to work and adjustments for employees with back pain which you may find helpful. I hope you have found this information to be useful, please do not hesitate to contact us further if we can be of further assistance.
      The Fit for Work Team.

  12. Mrs R

    I’m 32+3 weeks pregnant and suffering with back pain at work. My doctor has given a fit for work note recommending reduced hours. My employer would normally pay full pay for sick pay but has said that if I reduce my hours for the three weeks indicated, they will reduce my salary. Is this allowed?

    • Fit for Work team

      Although there are set criteria for payment of statutory sick pay (SSP), companies can outline their own criteria for payment of company sick pay. If you work for a larger company that has a Human Resources department, they should be able to advise you further. Employers would not usually be obliged to pay for hours not worked, and the decision whether or not to provide a period of amended duties including restricted hours on full pay, would be entirely at their discretion.

  13. H Meyers

    Hi there.

    Are employers allowed to schedule you without telling you and without your doctors Fit to Work form that they requested?

    • Fit for Work team

      No – this would only be provided after your surgery as planned surgery can be cancelled or postponed from time to time and the absence may not be required.

  14. jayne

    I am currently signed off work -now into my 6th week off due to the sudden death of my mother and two weeks later my father.i am off with acute stress.i feel as though i can go back to work but perhaps on reduced hours for a few weeks rather than full i discuss this with my GP or my manager

    • Fit for Work team

      Dear Jayne,
      I’m very sorry to hear you have experienced these bereavements so close together but pleased to hear that you feel ready to make a return to work. You do not need to see your GP before you return and can discuss this with your line manager if they can accommodate a phased return for you. If you were to see your GP, you may be given a ‘fit with restricted duties’ that may advise that you would be fit for reduced hours for an agreed period – this does often make return easier. Policies and what each business can accommodate can differ, so it would be worth first checking with your line manager and discussing your return.
      The Fit for Work Team.

  15. Mr P

    Hi I’ve just returned to work on a phased return requested by my GP after a heart op and four months off with pay. This will mean working two days the first week, three days second week and so on up to a month before returning to full time. all this info was sent to HR with the relevant paper work. I have been told by HR for me to be paid for the full week whilst on this phased approach I will have to use my holiday time to cover the days that I’m off, is this correct?

    • Fit for Work team

      Dear Mr P,
      All companies vary in how they manage a phased return, but there may also be the option of you being paid your salary for the days that you work, and statutory sick pay (SSP) for any full days you do not work during your phased return.
      The Fit for Work Team.

  16. Pamela Richards

    I am a teacher who is currently of work as a result of a severe flare up of rheumatoid arthritis brought on by a withdrawal of medication due to a bout of pneumonia. I am aiming to return to work in the autumn term but am concerned about future flare ups. I received 28 weeks of SSP which finished in May. If I have to take more time off sick when I return, will I be entitled to claim further SSP?

  17. Jan Howe

    I have been off work 4 months due to hip replacement, G.P put phased return on my fit note, company say it’s their policy to only pay what I work. I was previously advised that pay is topped up with ssp how does this work ? I am now on greatly reduced wages,I wouldn’t have done a phased return Please could you advise me. Thank you

  18. Emma Joseph

    I had 2 weeks off for having horrific pain caused by gall stones. I need to have my gallbladder removed.
    I have returned to work asking for less hours as I am still in pain. My employer agreed these terms and wrote them on my back to work form.
    Now she has just gone from the back to work form and given me a lot more hours.
    I don’t know what to do as I am not sure if sheis breaking terms of return to work or if she can just do it. Or whether i can go to doctors and get a note stating I can only do so many hours.
    Just confused and feel like leaving my job.

    • Fit for Work team

      Dear Emma,
      Thank you for your enquiry, adjustments to working hours or work are at the discretion of the employer. If your employer agreed to adjust your work or hours for a period to assist you, I would suggest you discuss this with your manager, and explain that you are still in pain and struggling with your normal work. It may be that he/she has simply not realised that you continue to require assistance. You can go to your GP and request a fit note stating adjustments, but again your employer is under no legal obligation to provide this. It would be for the business to decide if this is a reasonable and manageable adjustment.
      The Fit for Work Team.

  19. lolita boiko

    after carpal tunnel release and left shoulder tendonitis i ask occupation doctor change 1 task because cant gripping and wrapping big flowers bouqets,and want 8h shift,but doctor no support and i work in busy 12 h and do all tasks,but when start pain my hand more i ask GP doctor 1week with light duties ,but company no support my recquest and no give me job from 12.03.2015 i work for company 8year,occupation doctor in my face tell she work for company ,but no for workers,very please help me return to work i want independant occupation health assesment,GP doctor tell all my problem need sort with companys health occupation doctor,but i no agree because cant believe this doctor,i have stress all period ,cry every day because i feel discrimination,last week i no get sick pay,when finish my sick pay from 12.03.2015,please help

    • Fit for Work team

      Dear Lolita,
      Thank you for your enquiry. Having a company occupational health assessment is much more valuable than sourcing outside occupational health as they are aware of the duties involved in your job role. This does not mean that you are unable to seek an independent occupational health assessment, but you would have to pay for this. Ultimately your employer does not have to undertake these recommendations if they are not seen as reasonable, necessary, or within the business scope of the company. Here is some further information about occupational health
      If there is an aspect of your job that you are struggling with I would encourage you to speak with your employer so they are aware of what support you might need. Discuss any issues around increased pain and how you are looking to work shorter hours with lighter duties for a short period of time. However you should be aware that any adjustments will be at the discretion of your manager.
      It is also unclear as to why you feel you have been discriminated against, but here is a link about discrimination that you may feel is helpful: You can also contact ACAS who deal with aspects of employment law if you feel that you need further assistance.
      Please also see this link regarding guidelines for sick pay
      The Fit for Work Team.

  20. Sharon Louise

    Hi, we have an employee who has become disabled and is due to return to work. He has asked for a meeting in order to discuss his return. What should I expect from the meeting and how should I prepare for the meeting?

  21. Ollie Hall

    Hi, I’ve recently returned to work following a hernia operation. During a meeting prior to my return with the Companies occupational health representative it was suggested that a phased return with adjustments would be appropriate as some of my duties consist of heavy repetitive lifting . I was told that I would be paid for my full shift regardless of how many hours my phased plan was (I am a full time contracted employee ).i have just discovered that they are only paying me for the hours that I actually worked. When I queried this they said it was because I didn’t have a fit note that specified a phased return or the medical limitations. My GP had previously advised me there was no requirement for a fit note as he was not fully familiar with my company or my duties and that it was my companies responsibility to asses the risks to me. Also if I do eventually get paid for the remainder of my contracted hours during my phased return should it be wages or SSP/CSP as I am actually at work. Thanks

    • Fit for Work team

      Dear Ollie,
      Thank you for your enquiry. You would not need to have a fit note in order to return to work. Regarding you contracted hours and SSP you would need to contact your HR department as each business will have their own policy for payment of contracted hours. However, SSP is only payable for days where you have not worked at all, so if you have attended work on any day, then SSP is not payable. Please read the following guidance and information that may be helpful around understanding sick pay:
      And more information here about the phased return
      If you require further assistance with your enquiry please contact our advice line by visiting the Fit for Work website at
      The Fit for Work Team.

  22. Carmen

    I’ve been in light duties due to back pain since January. Since February my employer offered me another position which I’m not qualified or trained for. Now I want to come back to work and I have been deemed “Fit for work” by my GP. My question is: who decides that I can come back to work, my GP or Occupational Health?

    • Fit for Work team

      Hi Carmen,
      Thank you for your enquiry. It is great to hear your recovery is going well and you now feel well enough to return to work. Either your GP or your Occupational Health provider can determine if you return to your role. I suspect your employer will be trying to ensure that you are fit for your role, particularly if a degree of manual handling is required. Essentially it is up to your employer to decide, but when the role has specific risks it would not be unusual for the employer to require a specific risk assessment.
      The Fit for Work Team.

  23. Petronel Paun

    Hello. I was on medical leave for six months after a bypass operation and on Monday 3 august I was supposed to return to work but my employer said I need to be deemed ‘fit for work’. I asked my GP but they said these are no longer issued. I’m not sure what to do. Thanks.

    • Fit for Work team

      Hi Petronel,
      Thank you for your enquiry. I think there is some confusion here about whether you require a Fit Note which states you are fit to return to work or whether you need a Fit for Work assessment. Try to clarify with your employer which one they require. If they are requesting a Fit Note which states you are fit to return to work, then your GP is correct – these do not tend to be issued/required now and once a fit note has expired you are free to return to work, indeed if you feel well enough and your employer is satisfied that you are and do not pose a risk to your self or others then you may return to work at any time during a Fit Note. However, if your employer requires a Fit for Work assessment, then you can ask your GP to refer you to Fit for Work, details of the referral process can be found on our web-site
      The Fit for Work Team.

  24. Jacqueline B

    I have been signed off work for 17 months due to bi-lateral golfers elbow and I had an operation on each which failed. I have been advised by my health care provider that I have a chronic illness, which has also been backed up by my consultant surgeon, my doctor, the company’s doctor, and my physiotherapist. My works insurers have recently had me assessed by an independent physiotherapist, who has advised that I am capable of a phased return to work, and that they are no longer prepared to support my claim, therefore I no longer have any income with the only alternative but to go back to the same job which is what is on offer. I am incapable of doing this job as it is the reason for my illness, caused by repetitive strain of the job requirements.

    • Fit for Work team

      Hi Jacqueline,
      We are sorry to hear of your on-going health problems. Did you have a specific questions which you wanted us to answer? If you feel that the independent physiotherapist has offered advice which you do not feel is appropriate, can you establish if there is an appeals process which you can follow? If so – take any and all documentation from the surgeon/GP and company doctor to support this. Alternatively, consider if there is any way you can return to your role, with some adjustment if necessary, and ask if the company doctor can make any recommendations of what adjustments you may need.
      The Fit for Work Team.

  25. Ohmesh

    My partner suffered a stress reaction in mid May following harsh treatment by her managers. Her sick note has expired saying that her doctor no longer needed to see her, the employer insisted she see an occupational health specialist which took some weeks to arrange, the report from the specialist arrived two weeks later (in mid June) which stating that my partner had suffered a ‘normal stress reaction’ given the treatment she received and that she could return to full time work and ‘a meeting should take place as soon as possible for issues to be discussed’. This meeting did not not place until the end of July and at the meeting no return to work date was proposed, another meeting was arranged for the first week in August but for some reason the employer said the meeting had not been confirmed and rescheduled the meeting as a ‘grievance investigation meeting’ with a date yet to be confirmed. The company asked my partner to get a sick note to cover her up to the date of the grievance meeting otherwise they would not pay her SSP.
    Can an employer continue to prevent an employee from returning to work and not pay them even though they are considered fit to return to work by their occupational therapist and their doctor?
    Surely my partner should be receiving full pay from the day her sick note ran out or when the occupational therapist said she was fit to return to work?
    Can a company force an employee to sign themselves off sick when they have been told they are fit to work?
    The company are clearly using the fact that my partner has raised a grievance against her manager as an excuse to exclude her from work without pay (Two months so far and counting).

    • Fit for Work team

      Dear Ohmesh,
      Thank you for your enquiry. We are sorry to hear of your partners issues at the present time and would suggest that your partner speak with Human Resources to establish why she is being prevented from returning to work. If your partner is fit for work, then her GP should not issue a Fit Note. We would suggest you speak to ACAS regarding whether or not the employer should be receiving SSP or whether she should actually be on full pay. The telephone number for ACAS is 0300 123 1100 or you can ‘Ask a Question’ via their website
      The Fit for Work Team.

  26. Bobby Chancellor

    I have been off work since January this year, due to having Cancer. I have been undergoing chemotherapy since then till now, I have spoken to my employer about a staged comeback to work and they have said that a staged return is set between 4-6 weeks! After I return part time? is this true??
    Any help would be greatly appreciated.


    • Fit for Work team

      Dear Bobby,

      It is great that you are recovering well and beginning to plan your return to work. It is really at the discretion of companies to decide how long they can support a phased return to work, and most of the medical evidence suggests that four to six weeks would meet the needs of most employees returning to work from a range of illnesses. The assumption is really that if an employee is not well enough to increase their hours over a 4-6 week period – they may not yet be well enough to consider a return. There are however always exceptions, and a return to work on shorter hours after chemotherapy can be really helpful physically and mentally if carefully planned.
      If your company does not have access to occupational health services, you could ask your GP to refer you to Fit for Work and we could help you plan the return to meet your needs.
      The Fit for Work Team.

Leave a Reply