Return to work (RTW) after sickness absence

The guidance below provides information on areas of consideration following an employee's return to work, following any period of sick leave.

Return to work (RTW) discussions

Return to work discussions (or 'interviews') offer the opportunity to discuss with the employee their sickness absence from work, and any issues and/or concerns related to it.  The discussion should be based on the information provided on the Sickness Absence Record form(s) or the Fit Note (statement of fitness for work) issued by the doctor. Any support needs or work adjustments that aid the return to work can also be addressed. Key information should be recorded using the sickness absence record pro-forma (found on the right-hand side).

Return to work discussions should take place following any sickness absence period, but especially so where the employee has had three or more separate periods of absence within the last six months, has been absent for more than two weeks, or if the manager has any other concerns related to the absence. This can help identify problems early on, and allows for reasonable and practical remedial steps to be taken, which can help prevent or minimise any future absence. Such discussions should not be time consuming and should remain informal. Managers must take a consistent and fair approach in all cases. Advice from Personnel Services may be sought if the line manager has any concerns. If the return to work discussion takes place following an episode of persistent short-term absence, please see the additional guidance on holding an 'informal discussion' with an employee to address any absence concerns, which refers to specific areas to think about when holding the return to work discussion in such cases.

Where medical input is necessary (in order to reach a decision about a member of staff), a "management referral" of an individual can be made to the Occupational Physician so that a medical report can be obtained. This should be done by the head of department, or by a senior administrator, or HRBP, acting on the head of department's behalf. Further guidance (including the referral form) on referrals can be found here. Where an employee has a known existing medical condition, or may be undergoing a medical treatment/monitoring, careful consideration should be given in the approach to such cases and further advice sought from the UOHS or Personnel Services.

Fit Notes

What are Fit Notes?

The ‘Fit Note’ (introduced in 2010), is a statement of fitness for work, which is issued by a doctor to indicate whether the employee is “not fit for work” or "may be fit for work” taking into account the doctor’s recommendations (one of four options listed on the Fit Note). Doctors can also make further comments. The note is additionally used for Social Security and Statutory Sick Pay (SSP) purposes.

During the first six months of sickness, each Fit Note can only cover a maximum period of three months.

How to use the form

Where a “may be fit for work” (taking account of the doctor's advice) Fit Note is issued by the doctor and one of the four options has been selected as a suggestion  to facilitate a return to work, i.e. a phased return to work, altered hours, amended duties, or workplace adaptations, further discussion with the employee will be necessary to establish appropriate and reasonable measures to assist with the return to work. Advice should be sought from Personnel Services and/or the University Occupational Health Service (UOHS) before a return to work can be fully agreed by the department.

The form will indicate the period of time for which this assessment is valid, and whether or not the GP needs to assess the employee’s fitness again at the end of this period. If the statement does not refer to a subsequent consultation date, the employee will normally be expected to resume their usual full duties at the end of the statement period.  Any concerns related to the working conditions and duties following the employee’s return to work must be discussed with the UOHS.

Further information on adjustments to facilitate a return to work may be found on the Occupational Health website and in the 'Occupational Health Guidance' document (found on the right- hand side).

Return to work adjustments and Phased Return to Work programmes

The University has responsibility for deciding whether or not it is able to accommodate any changes suggested to facilitate a return to work. Any adaptations or adjustments required should be reasonable and proportionate, and decisions about what can be accommodated should include a risk assessment of the effect of the changes on the employee and others in the workplace. If a return to work is possible, the department should agree any temporary changes to the job or hours and what support will be provided and for how long. This should be recorded in writing; and can be done by filling in the 'Sickness Absence Record pro-forma (found on the right-hand side). Typically, a phased RTW programme will last up to six weeks. Extended or repeated phased RTW programmes should not be undertaken without discussion with the UOHS and/or the relevant HRBP.

There may be occasions where it is not practicable to accommodate the adjustments, in which case the Fit Note should be used as if it had advised ‘not fit for work’. In such cases, and in all cases where the ill-health may have a work-related cause, it will be particularly important to seek advice from UOHS and/or Personnel Services before reaching a final decision and discussing this with the employee.

The Fit Note is not binding on the employer: unless and until the department has agreed that the employee may return, and any necessary support is in place, the employee will remain on sick leave.

Fit Notes do not affect the University’s current obligations in relation to the Equality Act (previously Disability Discrimination Act).


Where the doctor has certified that the employee is not fit for work, individuals will not be covered during the specified period by the University’s insurance and should not carry out work for the University. Where a doctor has certified that an individual “may be fit for work taking account of the following advice”, the individual will be covered for insurance purposes as long as the medical (GP or UOHS) advice is followed. In cases where an individual’s recovery allows them to return to full duties earlier than indicated by the GP it will be important that clear agreement is reached with the individual, and that this is recorded. It is advisable to seek advice from the UOHS before allowing a return to work of an employee in all cases.