Time off for your employee

If an employee is off sick for more than seven calendar days, they’ll need to show a fit note. These are issued by a GP. If the fit note says that the employee cannot work, they should be allowed sick leave according to the company’s policy. Your organisation should have clear information on sick leave entitlements.

Employees who are off sick for four or more days should be paid Statutory Sick Pay (SSP) from that fourth day onwards. SSP can be paid for up to 28 weeks. If your company offers occupational sick pay, this can be given on top of SSP.

You may need to arrange for cover if your employee is away for a long time. You should discuss this openly with them. They may worry you have no confidence in their treatment. It’s also important to keep in touch with your employee during their absence. This will make them feel valued and help them know what is going on at work. It’s a good idea to discuss with your employee when and how you’ll contact them first.

Fit note

During the first seven calendar days of sickness, an employee can self-certify that they are unable to work. After this time, a doctor may issue a ‘fit note’ (this replaces the old ‘sick note’). A fit note allows doctors to advise whether someone ‘may be fit for work’ or is ‘not fit for work’. In either case, the GP will include evidence for the advice they have given.

If the note states that someone “may be fit for work”, the GP will include information about the functional effects of the person’s condition. They will also give advice about what may be done to help the person be able to work. The information is intended to encourage a discussion where the employer and employee consider and agree any changes that would help the person return to work.

If the note states that someone is unable to work, then the organisation’s sick leave policy will come into use – see below.

Time off for appointments

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.

Sick leave and Statutory Sick Pay

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. However, you may need to exercise your discretion occasionally, depending on the number and frequency of appointments your employee needs to attend.

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 gov.uk or nidirect.gov.uk (for people living in Northern Ireland), or call the free Benefit Enquiry Line on 0800 882 200.

Occupational or company sick pay

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.

Cover for an absent employee

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. You should try to:

  • discuss this honestly with your employee
  • be clear about your reasons for hiring temporary cover
  • 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
  • follow your organisation’s standard procedures for employing temporary workers.

Additional sources of information

For more information about managing absence and other employment issues, you can refer to the Chartered Institute of Personnel and Development (CIPD) website – cipd.co.uk.

Carers UK offers advice on employment issues and rights, including time off – visit carersuk.org.

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. Visit acas.org.uk or phone their free, confidential telephone helpline on 0845 747 4747.

Keeping in touch

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:

  • Do they want to receive newsletters and key emails.
  • Do they want to hear from colleagues? If so, how (by phone, email), and how often?
  • Is there 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.

Back to If you're an employer

Policies and resources

If one of your employees has cancer or is caring for someone affected by cancer, we have information to help you support them.

Managing cancer in the workplace

In the UK, over 700,000 people of working age are living with cancer. Managers play a fundamental role in supporting employees affected by cancer.

How cancer affects people

Your employee’s ability to work may change after a cancer diagnosis. To support them, it’s helpful to understand how treatment may affect them.

How to talk about cancer at work

Although it may be difficult for your employee to discuss their cancer diagnosis, open communication may enable you to support them.

Occupational health advice

Occupational health advisers can help employers assess whether a role needs to be adjusted in light of an employee’s health.

Supporting carers

Carers who need to look after a dependant are allowed to take emergency time off. They may also wish to request flexible working.

Legislation about work and cancer

In the UK, there are laws that protect employees with cancer from being treated unfairly in the workplace. This includes discrimination, harassment and victimisation.


Although many people survive cancer, your employee or the person they are caring for may die from their illness.