As long-term health conditions can have an impact on an individual’s productivity at work, and their ability to stay in work, supporting people’s health and wellbeing is also the right thing to do and is part of ensuring that people feel safe and valued at work. If an employee is given the support they need to manage their symptoms, they are more likely to perform at their best and help to achieve the team’s objectives. 

A long-term health condition is a condition that cannot be cured at present but can be controlled by medication and therapies. Millions of employees work while managing at least one ongoing health condition. 

According to the CIPD’s 2022 Health and Wellbeing at Work report some prevalent health conditions responsible for long-term absence in the UK could be:

• mental ill health (such as clinical depression and anxiety) 
• musculoskeletal conditions (such as neck strain and repetitive strain injury, including back pain) 
• stress 
• acute medical conditions. 

According to the CIPD’s 2022 Health and Wellbeing at Work report the most common problems reported by people with long-term health conditions of working age in the UK relate to mental health (42%), mobility (41%), or stamina/breathing/fatigue (32%). Many also experience difficulties with impaired dexterity, memory, hearing, vision, learning or social activity.

Many people have more than one health condition. As our physical and mental health are closely linked, someone’s mental health can deteriorate as a result of the symptoms or impact of a physical illness and vice versa. Mental health impacts can result from changes in capacity or a sense of identity, or when someone faces the uncertainty of living with a new or fluctuating illness.

A number of people are experiencing ongoing symptoms from COVID-19 known as post-COVID syndrome or ‘long COVID’. In the UK, NICE defines long COVID  as ‘signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis’.

We are still learning about the true impact of long COVID on an individual’s physical and mental health. Symptoms vary between individuals, are overlapping and affect multiple systems in the body. The three most common debilitating symptoms reported are fatigue, breathing issues and cognitive dysfunction, that is, memory loss, brain fog and concentration and speech difficulties.

Recovery can be slow and the fluctuation of symptoms means that employees often need to increase their activity and work slowly over time. This means some employees may need work adjustments or job modifications (including reduced hours or flexible work) over many months.

The number of employees experiencing ongoing symptoms following a COVID-19 infection is likely to increase over the coming months and years. As a new condition, people with long COVID often face a period of great uncertainty as they await diagnosis and an effective management plan. As employees, there is the double burden of uncertainty regarding how best to manage their work when experiencing ongoing, often unpredictable, symptoms. Supporting these individuals to return to, and remain at, work will be an ongoing concern.

See our research report and guidance for more information and advice on managing and supporting employees with long COVID.

It’s important when managing someone with an ongoing, fluctuating health condition to take a flexible, individualised and compassionate approach. This relates closely to the behavioural area Building and sustaining relationships. Exercise 5 offers advice on how to develop these behaviours.

Everyone has a role to play in helping employees with long-term health conditions look after and get support so they can thrive at work. The IGLOO framework for thriving at work, developed by the University of Sheffield and Affinity Health at Work, outlines the different resources at the individual level, the group level, the leader/manager level and the organisational level that can help an employee when managing a long-term health condition.

As a manager, you can help employees access the work adjustments and support that they need to manage their health and work safely and effectively. What you do and how you behave can affect: 

• whether the employee feels able to take steps to manage their condition in work 
• how early action is taken to help prevent symptoms worsening or recurring 
• ultimately, whether someone is able to stay in work.

This is because managers: 

• are usually the employee’s first contact point if they have a work or health issue 
• are responsible for the day-to-day management of the employee and the tasks required of them 
• are key to providing access to work adjustments, such as a change in duties or a new flexible working arrangement 
• can help to prevent additional stress or anxiety, particularly in those who are feeling less confident in their abilities due to the impact of their health condition.

Make sure you understand your organisation’s framework for managing and supporting employees with a long-term health condition. This includes its health and people management policies, procedures for making workplace adjustments and managing sickness absence, and the support available in terms of occupational health, an employee assistance programme or counselling services if available.

Related manager behaviour 

This relates closely to the behaviour area Providing knowledge, clarity and guidance. Look at Exercise 4 for advice on how to develop this area.

As soon as you are aware that someone you manage has a long-term health condition, it’s important to have a sensitive and supportive discussion about their needs. Many people find it challenging to tell others about their health. Whether someone is experiencing menopausal symptoms, chronic back pain or another condition, many people are unsure of what to say and afraid that others will see them differently. They may also be afraid that their position and future with the organisation could be at risk.

Everyone’s experience of a long-term health condition is unique and individual to them. Often, someone’s symptoms can be hidden to others. Symptoms can vary from mild to severe, and some require no changes to the way they work, while others require changes to their job or working pattern. Therefore, a conversation will help to identify what workplace support, if any, is needed to help the employee to manage their condition and carry on working.

A regular catch-up is an opportunity to start the conversation, which should always be in a private, confidential setting where the employee feels equal and at ease. Ask simple, open and non-judgmental questions to give the employee ample opportunity to explain their health situation in their own words. Developing your capacity to build and sustain relationships, particularly around showing concern for people and interacting with them in a friendly way, can help with this.

Related manager behaviour

This relates closely to the behaviour area Building and sustaining relationships. Look at Exercise 5 for advice on how to develop this area.

Empathy and compassion are vital, as is the ability to have sensitive and supportive ongoing conversations. You might find the conversation checklist below helpful for this.

Conversation checklist

• Avoid interruptions: switch off phones and ensure colleagues can’t interrupt. 
• Be caring and show concern for their wellbeing. 
• Ask simple, open questions, such as, ‘How are you doing at the moment?’ 
• Ask, ‘What support do you think might help?’ 
• Avoid judgemental or patronising responses. 
• Speak calmly. 
• Maintain good eye contact. 
• Listen actively and carefully. 
• Encourage them to talk. 
• Be prepared for some silences and be patient. 
• Focus on the person, not the problem. 
• Avoid making assumptions or being prescriptive – they are the best person to know what support, if any, may help them. 
• Thank them for talking to you about their health condition. 
• Follow up in writing, especially agreed actions or support.

This checklist has been adapted from the CIPD and Mind’s People Manager’s Guide to Mental Health .

Related manager behaviour

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area.

It’s also important to discuss what information about their health situation employees would like communicated.

Related manager behaviour 

This relates closely to the behaviour area Building and sustaining relationships. Look at Exercise 5 for advice on how to develop this area.

Some employees may require adjustments to their job role, work environment or work schedule. Ensuring employees have access to work adjustments can help them to continue to be productive at work.

The type of adjustment(s) will differ depending on many factors, including the nature of the employee’s job and their unique needs. As the symptoms of many long-term health conditions fluctuate over time, different work adjustments may be needed at different times. Providing that the employee’s agreement has been given, it may also be helpful to contact their GP or consultant for advice about the employee’s medical condition and the most appropriate work adjustments that can enable them to remain in work.

It’s important to recognise that you do not necessarily need to be knowledgeable about the person’s health condition. It is more important to show good people management skills, including sensitivity, empathy and understanding for the individual.

Many people with a long-term health condition learn over time about the most effective ways to manage their symptoms. This means the employee is often in the best position to know what adjustments or support can help them in their job. You should discuss and agree any adjustments. These can include a combination of approaches, for example: 

• changes to an employee’s work schedule (for example, short breaks, leave for appointments) 
• flexible working arrangement (for example, working from home, reduced hours or extended leave) 
• changes to an employee’s role or responsibilities (for example, a reduced workload or temporary change in duties) 
• changes to the work environment (for example, relocation of desk to a quiet space or close to toilet facilities) 
• additional support or assistance (for example, supervision or skills training) 
• redeployment to a more suitable role 
• additional physical resources (for example, a screen reader).

Absence and return to work are often managed as a one-off event, but many employees with long-term health conditions will need to take multiple absences as their condition fluctuates over time. Taking a flexible, compassionate and individualised approach to sickness absence can help prevent unhealthy presenteeism (working when unwell) and avoid unfairly penalising employees with ongoing health conditions.

The CIPD guide on Managing a Return to Work after Long-term Absence sets out the guiding principles to follow when navigating the key steps to managing an effective return to work:

1. maintaining communication while absent 
2. preparing for a return to work 
3. supporting the employee and manager during the immediate return 
4. supporting the employee and manager on an ongoing basis on return.

Employees are more likely to return to work safely and productively following a period of sickness absence if they are well supported during their absence and on their return. How you manage these situations will make a difference to whether the individual returns effectively and sustainably to work.

Related manager behaviour 

All the line manager behaviours identified by the CIPD research mentioned above will help you manage absence effectively to support the individual and help them to achieve a safe and productive return to work. The behavioural areas that are particularly important in this context are: 

Building and sustaining relationships: see Exercise 5. 

Being open, fair and consistent: see Exercise 1 and Exercise 2.

Providing knowledge, clarity and guidance: see Exercise 4.

Someone with a long-term health condition will likely have ongoing symptoms and therefore the support that you and the organisation provide will also need to be ongoing. 

• Have regular conversations: Ask employees about how they are coping and what support they might need. Discuss how any support or adjustments are helping the employee to manage the impact of their symptoms on work. 
• Wellness action plans are a simple but empowering tool for an individual to look after their wellbeing while working, and to help employers know how best to support them. Anyone can complete one and they set out how an individual feels and behaves when they are well, what they need to do to maintain their wellness, any signs or triggers known to impact health, and the preferred action or response if these signs are noticed by others. Mind has downloadable wellness action plans that can be readily adapted for any condition. 
• Take health into account when considering performance: Approach performance conversations supportively and positively. Take any health-related issues fully into account where there is underperformance on the part of an individual. Identify any extra support the person may benefit from, such as more training or supervision. 
• Consider the impact on other members of the team: Consider the impact on other members of the team that sick leave/a phased return or changes in duties might have. Make sure that other team members are being supported if they have additional work to do. 
• Listening, treating people with respect, and bringing kindness and consistency will help you provide this support, as will your capacity to build and sustain relationships, while skill at handling conflict and people management issues may also be needed.

Related manager behaviour

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area.

It’s important to understand what your role is for supporting and managing people with health conditions. This also means maintaining clear boundaries. For example, you are there to support employees’ health and to put in place any workplace adjustments they might require, but you are not a medical expert or counsellor, a best friend or confidant.

A manager is not there to provide advice but to form part of the individual’s support network. This means helping someone with the work aspects of the situation and ensuring that work is not part of the problem. It also means signposting to specialist sources of support, such as occupational health or an employee assistance programme, and making helpful adjustments where needed. 

Supporting someone with an ongoing health condition can be challenging for you as a manager. It is worth considering what specific support is available within your organisation that you can draw upon if needed, like expert advice from HR on people management policies or from occupational health on medical issues if available. You might also want to explore how to develop your capability to remain calm under pressure and your capacity for self-compassion and self-care. 

Debrief sessions with your own manager might also be helpful (with confidentiality and no specific case details) as well as regular wellbeing conversations and catch-ups.

Related manager behaviour 

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area. 

Providing knowledge, clarity and guidance. Exercise 4 offers advice on how to develop this behaviour.

Receiving a terminal diagnosis can obviously be a devastating experience for someone and extremely difficult to come to terms with. Many of us find it very uncomfortable to talk about end-of-life illness and death, and there can be considerable stigma and silence around these issues. While respecting confidentiality and people’s individual wishes, it’s vital that organisations, and managers, are ready to provide compassionate and practical support for someone who is facing a terminal diagnosis. 

Some key points include: 

• Recognise the differences in experiences – some people will want, or need, to carry on working, while others may not want to. 
• Recognise the unpredictability of a terminal illness – it’s likely that the individual won’t know how long they might live for and therefore might not know what they want to do about work. 
• Agree with the employee what information they would like to be shared with colleagues and clients, and when. Remember, it is their decision whether to tell others or not, but many people find that because of the effects of treatment, or being absent from work, telling colleagues can help them understand the reasons behind any changes to the employee’s role or working pattern. 

If an employee sadly dies during employment, there could be a significant impact on their close colleagues in the team, and the organisation should be prepared to provide compassionate bereavement support for those affected and grieving. See the CIPD’s guidance for compassionate bereavement support .

Related manager behaviour 

The behavioural areas that are particularly important in this context are: 

Building and sustaining relationships. Exercise 5 offers advice on how to develop this behaviour. 

Providing knowledge, clarity and guidance. Exercise 4 has guidance on developing this.