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There are many simple actions that will minimise the impact of daily operations and effectively support your employee.
See how an employer made temporary changes to an employee’s work duties to help them remain in work during treatment.
Agreeing some time off work will be one of your employee’s most pressing needs. They should try to give you advance notice so you can arrange cover if necessary, but this may not always be possible.
People living with and after cancer will need to attend medical appointments. Some may need to stay in hospital for treatment. They may also benefit from receiving complementary therapies and may need time off for these appointments too.
Your organisation should have clear policies about sickness leave – this forms an essential part of an employment contract. Your sickness leave policy should include information on how time off for medical appointments is dealt with.
Employers are obliged to pay Statutory Sick Pay (SSP) to qualifying employees who are off sick for four or more days in a row, including weekends and holidays. It is not payable for the first three days in any period of entitlement but thereafter is payable for up to 28 weeks at a weekly rate subject to current limits.
When SSP is due to end, your employee should check their entitlement to Employment and Support Allowance. This benefit provides financial help to people who are unable to work because of illness or disability. It also provides personalised support to those who are able to work.
For more information about SSP and Employment and Support Allowance, visit direct.gov.uk or nidirect.gov.uk (for people living in Northern Ireland), or call the free Benefit Enquiry Line on 0800 882 200.
Watch our video showing how one manager handled the death of a colleague and the impact it had on the team. The video also includes advice from a bereavement counsellor.
Your employee may be entitled to occupational or company sick pay on top of SSP under their employment contract. We also encourage organisations to look at the possibility of reasonably adjusting their occupational sick pay to cover extended periods over and above the standard statutory or contractual obligations.
If your employee is a carer, they are legally entitled to take ‘reasonable’ time off to deal with an emergency affecting a dependant. Whether this is paid or not will depend on your organisation’s policy (see our section on legislation).
Other options you can explore with your employee include:
The above options aim to provide your employee with sufficient time off to look after their own health or the person they care for, keep your organisation running smoothly, and protect the employee as much as possible from financial hardship.
You may need to arrange cover, for example, if your employee is unable to work for a long period, or if they choose to reduce their hours. This should be discussed upfront with your employee. Be clear about your reasons for hiring temporary cover and be sensitive to their views and concerns. They may feel you don’t have confidence in their treatment programme. Let them know that the extra resource is temporary. You should then follow your organisation’s standard procedures for employing temporary workers.
There is more information about sick leave in our guide to benefits and financial help, Help with the cost of cancer. Order through be.macmillan.org.uk|, call 0808 808 00 00 or visit our financial information section|.
For more information about managing absence and other employment issues, you can refer to the Chartered Institute of Personnel and Development (CIPD|).
Carers UK| offers advice on employment issues and rights, including time off.
Employers and employees can contact the Advisory, Conciliation and Arbitration Service (ACAS|) for help on any employment issue, including absence management. The website also has useful information about this and other relevant topics. Phone its free, confidential telephone helpline on 0845 747 4747.
People living with cancer often feel ‘out of touch’ with work during their absence. It’s important to maintain appropriate contact with your employee during periods of sick leave. This contact can be maintained through their line manager or a nominated buddy. Handle communication carefully so that your employee still feels valued but doesn’t feel you are pressuring them to return too soon.
If possible, discuss arrangements for keeping in touch with your employee before their absence. Ask them if they want to receive newsletters and key emails. Do they want to hear from colleagues? If so, how (by phone, email), and how often? Ask your employee to identify a good time to get in contact. Cancer treatment may make it difficult for your employee to be in contact at certain times, and this may only become apparent after treatment has started. If you have agreed to call at a certain time on a certain day, keep that arrangement as your employee may have made the effort to be ‘up and about’.
Sometimes an employee may not want any contact. Explore their reasons and reassure them you just want to be supportive. It may simply be a reflection of how they are feeling at that point in time. You can revisit their decision at a later date when they may find the prospect of contact from work less daunting.
Your employee and your organisation may benefit from the help of an occupational health adviser. This is a health professional, such as a nurse or doctor, who specialises in workplace health issues. Occupational health advisers draw on their clinical knowledge and an awareness of the specific duties and demands of the employee’s role. You may consider consulting an occupational health adviser at an early stage, before going ahead with important changes or decisions affecting policies or individuals.
Most occupational health advisers serve in an advisory role for managers and employees. They can help you understand your responsibilities under employment and health and safety law. They can also inform business decisions about:
Occupational health advisers can also assist managers in undertaking an appropriate and specific risk assessment for individual employees with a chronic health problem, such as cancer. This is to ensure, from a health and safety perspective, the appropriateness of the work the employee returns to.
When an employee has a cancer diagnosis, occupational health involvement is most likely to arise in relation to:
Occupational health services are not provided free under the NHS and are offered at the discretion of employers. Some large organisations have occupational health expertise in-house. Medium-sized and smaller organisations often access this expertise through external contracts, although some haven’t instituted any occupational health arrangements. Many commercial companies offer occupational health consultancy or you can opt for NHS Plus|, an occupational health service (that charges fees) for small and medium-sized businesses.
Macmillan has a work and cancer e-learning module for occupational health advisers. Working with cancer: the occupational impact of cancer is a two hour module designed to refresh existing knowledge and provide new information about the occupational impact of a cancer diagnosis on working age adults. Visit Macmillan's Learn Zone website| and look under ‘health and social care professionals, then ‘e-programmes and videos’.
If your employee has been away from work having treatment, it can be difficult to know when they are ready to return. Macmillan’s research into work and cancer found most employees surveyed received little or no worthwhile medical advice about returning to work at the right time. Many people are left to make this decision alone, based on when they feel it’s the right time to return.
Many employees choose to share their cancer diagnosis with their employer. As a manager, you have no legal right to know the diagnosis or the clinical details of an employee’s condition. In fact, employees have a right of confidentiality under the Human Rights Act 1998. However, civil law and medical ethics recognise that managers may legitimately seek information relating directly to operational matters. For example, you could ask an occupational health provider for advice about the individual’s health in relation to their ability to carry out their role. This conversation may cover:
If you seek occupational health advice about an employee’s condition (with their permission), you should frame your requests for information around questions that are relevant to running your organisation.
This is where both you and your employee discuss and agree the best way forward. Cancer can be unpredictable so plans should be flexible, allowing for changes along the way. The possibility of flexible working and a gradual, phased return-to-work are potentially helpful ways of easing someone back into the workplace. It’s important to fully involve the employee in these conversations to ensure it’s a shared decision-making process.
It’s a good idea to schedule a meeting with your employee before they start their first day back at work. This gives them a chance to visit the workplace, hear important updates and raise any concerns. It also allows you to find out how they are feeling and sort out any potential problems before they occur.
It will help you plan any reasonable adjustments you might need to make in the workplace or to the employee’s working day (see below).
For a successful return-to-work, you can try these specific steps:
Most of the points above can also apply to carers. However, carers may have additional difficulties re-entering the workforce, particularly if they have been bereaved. Their confidence and skills may have been affected by absence from work but they may also have emotional and practical issues to deal with following the death of a loved one. A carer may require help in overcoming these issues, although some people may want to work through problems themselves.
Under the Equality Act 2010, employers have a duty to make reasonable adjustments where premises, working arrangements or the lack of auxiliary aids put a disabled person at a substantial disadvantage compared with others. People with cancer in England, Scotland and Wales are protected by this law from the point of diagnosis. People in Northern Ireland are protected by the Disability Discrimination Act.
There is no fixed definition of ‘reasonable’. What is reasonable will depend on the circumstances, including practicality, cost, and the extent to which the adjustment will be effective in alleviating any disadvantage, the extent to which business may be disrupted.
Any planned adjustments should be discussed with and approved by the employee concerned.
Reasonable adjustments for someone with cancer may include:
Allowing a gradual, phased return-to-work is another adjustment you can make. Research commissioned by Macmillan has shown that a phased return-to-work is an important predictor of a successful adjustment back to work. Agreeing a lighter workload or using holiday entitlement accrued during time off to shorten the working week could be one way of doing this.
You can take many practical steps to help your employee meet their potential at work. Here are some key examples:
Remember, changes to your employee’s working conditions can be temporary or permanent and may have an impact on their terms of employment. Make sure the employee and the people responsible within your organisation are clear on this issue before substantial changes are agreed. Review your organisation’s policies to determine what support can be offered. Any substantial and/or permanent changes should be confirmed in writing, and your employee should sign to indicate their agreement to the change.
These measures don’t have to be expensive or disruptive. Many of these ideas are just common sense. Sometimes, small changes can make a big difference for your employee.
Line managers are important in the return-to work process for many reasons:
Their behaviour can either cause the employee stress or prevent additional stress, and stress or anxiety is likely to be felt more by those returning following a period of sickness absence.
Occupational health and HR professionals should aim to be easily accessible to line managers and ready to provide the information and support managers need. This may include guidance about the return-to-work process, the employee’s health condition and the work adjustments needed by the absent or returning employee. Managers will value you being available to discuss their concerns throughout the process.
Macmillan has designed top 10 tips to guide them and support their employee through the cancer journey, from diagnosis through treatment and living with cancer.
Download our top 10 tips for line managers [PDF, 85kb]| for more help and advice. If you would like to order copies for your line managers, visit be.macmillan.org.uk|
Access to Work (AtW) is a government funded programme that supports people with long term health conditions. AtW gives practical support and help to meet additional costs associated with work related obstacles. The main elements of support are:
AtW provides grants towards the total cost of approved support whether you are employed or self employed and regardless of the length of your employment.
For more information please see www.direct.gov.uk|
If your employee wants to resign, it’s important to understand their reasons. Sometimes important decisions are made when emotions are at an all-time low. Additional support and an explanation of all the options may lead to a different decision – and help you retain a valued member of staff. Of course, for some people, leaving work is the best choice. If that is their decision, make sure your organisation’s leaving procedures are followed.
Stopping work because of cancer can have serious financial implications. Resigning or retiring early can change a person’s entitlement to state benefits, pensions and insurance (see section 4 of this guide for more information about personal finances). It’s a complex area and every person’s situation is unique. Because so much is at stake, encourage your employee to seek expert advice and establish what their position is, before any formal action is taken on either side.
As an employer you will be responsible for practical steps. These might include:
Although many people now survive cancer treatment, your employee or the person they are caring for may die from their illness.
If your employee is a carer, they will need time off work to grieve and see to the needs of their family. This is sometimes known as compassionate leave. If there are children, your employee will need to give them extra emotional support. It may not always be easy to predict when they will be needed at home. They may also need time off work to sort out practicalities, such as arranging the funeral and dealing with financial or legal matters.
This is obviously an emotional time for everyone concerned. Some people at work won’t want to talk about their feelings, but it helps if you can provide an appropriate opportunity anyway (section 2 has more details on how to talk about cancer).
Even if the team has known that a colleague is terminally ill, it can be extremely difficult to come to terms with their death. People will react differently and some team members will need your support, personally as well as professionally. This could be an exhausting time for you. Remember to look after your own needs and be aware of where you can get support from too.
If anyone at work needs someone to talk to, they can contact the Macmillan Support Line on 0808 808 00 00 for emotional support. They can also contact Cruse Bereavement Care|.
Content last reviewed: 1 May 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
If you have any questions about Macmillan we would love to hear from you| .
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© Macmillan Cancer Support 2013
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