It has long been recognised that employees who go off sick for longer than four weeks can end up being off work for a huge length of time; occupational health can help manage the situation providing much needed advice and a defence to employers should ultimately they be faced with a possible employment tribunal if the employee is dismissed. 

In my work as an HR consultant, I have always recommended to my clients that when they receive a fit note that indicates the employee requires more than two weeks off sick that they seek occupational health support asap with the agreement of the employee.  The quicker the situation is dealt with in this manner the quicker the employee can be brought back to work in my experience. The worst thing to do is to ignore the problem as it will only escalate.   

The first step would be to set up a meeting with the employee which could be in their home, in the company office or in a neutral venue.  They should have the opportunity to be accompanied and should they choose a family member or friend, this should not be discouraged.  They may feel they need that extra support if they are truly experiencing difficulties.

The employee should cooperate with the company requirements to find out more information about their health with the support of occupational health.  If the employee refuses to sign the consent form required under the Access to Medical Records Act 1988 that will allow the occupational health advisor to contact their GP then they need to be made clearly aware that their persistent absence could result in their termination.  Employers should beware of conducting hasty terminations in such circumstances and should wait until sick pay has been exhausted otherwise could be faced with a breach of contract claim.

Occupational health can be used to determine whether the employee is covered by the Equality Act 2010 in terms of disability and whether any reasonable adjustments need to be made.   They can provide an assessment on the prognosis of the likelihood of return to work perhaps recommending a phased return.  They will produce a written report, that is shared with the employee, which will provide the basis of a next meeting with the employee with a view to getting them back to work.

Their service can also be invaluable with cases of intermittent absences eg Monday/Friday syndrome.  They can help decide whether an employee is "swinging the lead" or may have a genuine underlying problem. 

An independent occupational health advisor is more preferable than an employer contacting an employee’s GP with their agreement.  Whereas occupational health will act in the interests of the employer, the GP will act only in the interests of their patient; the GP might not be forthcoming with information requested of them.     

According to the government only 50% of large companies and 10% of small companies have access to an occupational health service, however, there are many independent occupational health advisors in the UK who provide an excellent service to help employers with managing difficult sickness absence cases. Many HR consultants work closely with preferred occupational health providers who they trust.  For a minimal cost their services are invaluable compared to managing a costly employment tribunal case due to badly managed sickness absence. Employers can terminate employees who have been experiencing severe sickness absence under capability, but the process must be managed fairly and legally.