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.

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