Written by Nicola Gater | 9th July 2026
Supporting an employee with a long-term health condition can feel daunting, even for experienced managers. You may worry about saying the wrong thing, asking a question that feels too personal or unintentionally making a difficult situation harder. But often, the most helpful thing you can do is show that you are listening and willing to support them.
Long-term health conditions, physical and fluctuating illnesses as well as mental health conditions, are becoming increasingly common in UK workplaces, and awareness is also growing of neurodevelopmental conditions such as ADHD and autism, which bring their own workplace needs. At the same time, the highest number of people ever are on long-term sickness leave – around 2.8 million people in the first quarter of 2026. Good management can make a big difference in helping people stay well and do their best work.
Your role as a manager is to build trust, keep communication open, understand what support may help and know when to bring in specialist advice. With the right approach, you can support employees while still managing performance, attendance and business needs fairly and consistently.
Start with the right approach
One of the biggest reasons managers hold back is fear. You might worry about asking something too personal, saying the wrong thing or unintentionally treating someone unfairly. That is completely understandable, but avoiding the conversation altogether rarely helps the employee or the wider team.
Most employees value a manager who shows genuine interest, listens properly and is willing to talk things through. A simple “How are you feeling?” can open up a helpful conversation about what is working, what is difficult and what support might make a difference.
There is also a legal side to think about. Under the Equality Act 2010, some long-term physical or mental health conditions may be classed as disabilities if they have a substantial and long-term impact on someone’s ability to carry out normal day-to-day activities. This means employers have a legal duty to consider reasonable adjustments that help remove or reduce workplace barriers – see ‘practical support’ section for more detail on this.
Not every long-term condition will meet the legal definition of disability, so it is best not to make assumptions either way. If you are unsure, speak to an HR expert. We can help you decide the right approach and whether advice from occupational health would be useful.
Practical support – occupational health, phased returns and reasonable adjustments
Managers often think about occupational health only when a situation has become complicated. But it can be helpful much earlier than that.
Occupational health does not make management decisions for you. Instead, it gives independent medical advice so you can make more informed decisions about attendance, performance, adjustments and ongoing support. An early referral can also reassure both you and the employee, especially where it is not clear what support would be appropriate.
If someone has been off work, a phased return may also help. Rather than expecting them to go straight back to their normal hours and workload, a phased return gives them time to build things back up gradually over an agreed period.
For example, they might start with reduced hours, avoid certain physically demanding tasks or temporarily step back from responsibilities that feel particularly stressful. Regular reviews help you both see how things are going and make changes if needed. The aim is to support a return that lasts, rather than rushing someone back too quickly and risking further absence.
It is also worth remembering that phased returns can affect Statutory Sick Pay (SSP), depending on how they are structured and whether the employee is receiving normal pay during the phased return. Our blog explains the new SSP rules under the Employment Rights Act 2025, including the removal of waiting days and changes to eligibility.
Reasonable adjustments are another key part of supporting someone well – removing barriers that make it harder for someone to do their job. What is reasonable will depend on the employee’s situation and the needs of the business. Adjustments may be temporary or permanent, and might include changing working hours, allowing home or hybrid working where appropriate, providing specialist equipment, reallocating some duties, offering additional training or making changes to the working environment. Sometimes, even small adjustments can make a big difference.
Supporting neurodiversity and mental health
When people hear “long-term health condition”, they often think first about physical illness. But mental health conditions and neurodivergence matter just as much, even though they can be harder to see.
Conditions such as anxiety and depression are not always visible, but they still affect how someone experiences work. With the right support and understanding, employers can create the environment where everyone can perform well.
Neurodivergent conditions such as ADHD, autism and dyslexia are different again, and no two people experience them the same way. What matters is the same care and openness in understanding what helps someone work at their best.
Try not to make assumptions based on a label or diagnosis. Everyone experiences things differently, so the focus should always be on the individual and what helps them work at their best.
One practical tool many of our clients use is a Wellness Action Plan. It gives employees and managers a simple way to talk about what helps someone stay well at work, what early warning signs to look out for and what support may be useful. Rather than waiting until there is a problem, it helps start the conversation early.
If you would like to explore this further, take a look at our blogs on supporting mental health and supporting neurodiversity in the workplace, where we share more practical management approaches. You can also read our guide to neurodiversity at work.
Building confidence in managing health conditions
It can be reassuring to know that you are not expected to have all the answers.
Good management is about listening, keeping communication open and knowing when to bring in HR or specialist support. You don’t need to become a medical expert!
When managers listen, show empathy and review support regularly, it usually leads to better outcomes for both the individual and the organisation.
You should still have expectations around performance, behaviour and attendance, but these issues should be approached consistently, sensitively and with any agreed adjustments in mind. Getting that balance right can be challenging, particularly where health issues fluctuate, or are complex. This is where experienced HR advice can help
We’re here to help
We work with managers every day to help them handle complex employee situations with confidence and care. If you need advice on a specific case, support with reasonable adjustments, guidance on occupational health referrals or help reviewing your absence management processes, we are here to help.
Speak to one of our HR consultants or book a free 30-minute call to talk through how we can support your business. Email us at info@realityhr.co.uk or call 01256 328 428
About the author: Nicola Gater, Head of Product and Process
Nicola has vast experience in a broad range of sectors and expertise in the employment implications of mergers and acquisitions, including the challenges of TUPE regulations. Nicola also works on diversity and inclusion projects, company culture exercises, rewards and performance management programmes, and day-to-day HR.