You put off the conversation for four months. You rehearsed it, you kept it fair, you had examples rather than feelings, and you offered support rather than an ultimatum. It went about as well as those meetings go. Then at 8.40 the next morning an email arrives with a fit note attached: unfit for work, work-related stress, four weeks.
The first reaction is almost always the same, and almost always wrong. It feels like a tactic. Sometimes it is. Far more often it is a person who has been quietly aware for months that this was coming, has been sleeping badly about it, and has finally been given the confirmation that tipped them over. You will rarely know which, and the process you follow has to be the same either way.
What follows is illustrative rather than one employer's story, but the sequence and the obligations are real.
The process pauses. It does not disappear
You cannot run a performance meeting with someone who is signed off unfit for work, and you should not try. But an absence does not end a performance process either, and treating the fit note as the end of the matter is how employers find themselves two years later managing a problem that has now become custom and practice.
The correct posture is boring: pause the process, acknowledge the absence properly, keep the file complete, and resume when the employee is fit — with adjustments if adjustments are needed. Write to them saying exactly that, in neutral language. Confirm the process is on hold, confirm what happens about pay, and set out how and how often you will stay in touch.
An absence pauses a performance process. It does not delete the evidence, and it does not oblige you to pretend the meeting never happened.
What you owe them while they are off
The first seven calendar days can be self-certified; after that a fit note is required, and these can now be issued by nurses, occupational therapists, pharmacists and physiotherapists as well as doctors, so do not reject one because it is not signed by a GP.
Statutory sick pay changed materially on 6 April 2026. It is now payable from the first qualifying day of sickness rather than the fourth, the three unpaid waiting days having been removed, and the lower earnings limit no longer applies, so low-paid staff who were previously excluded now qualify. The rate is £123.25 a week, or 80% of the employee's normal weekly earnings if that is lower, payable for up to 28 weeks. If you have your own contractual sick pay scheme, that sits on top and its rules are whatever your contract says.
Holiday continues to accrue throughout sickness absence. That is worth planning for, because a long absence ending in autumn tends to arrive back with a substantial untaken balance attached.
Keep in contact, and agree the rules of it
Silence is the failure mode. Employers who go quiet out of politeness end up with an employee who believes they have been abandoned, and a tribunal narrative that writes itself. Employers who ring twice a week end up accused of harassing someone who is unwell.
The fix is to agree the contact in advance and put it in writing: a call or email every fortnight, at a time that suits them, from one named person — usually not the manager who ran the performance meeting. Keep it about welfare and practicalities, not about the process. Ask what would help. Note what they say.
Occupational health is the step most small employers skip
An occupational health referral is the single most useful thing you can do, and small businesses avoid it because it feels corporate and costs money. It is neither. A referral gives you an independent view on whether the employee is likely to return, when, and what adjustments would help — which is the information you need to make any decision that follows.
You need the employee's consent to refer them, and if you want a report from their own doctor rather than an occupational health provider, the Access to Medical Reports Act 1988 gives them the right to see it first. Ask specific questions in the referral. A generic request produces a generic report that tells you nothing you can act on.
The bit that changes everything: is this a disability?
Under the Equality Act 2010 a disability is a physical or mental impairment with a substantial and long-term adverse effect on someone's ability to carry out normal day-to-day activities, with long-term meaning 12 months or more, or likely to last that long. Mental health conditions can and frequently do meet that definition.
If it applies, you have a duty to make reasonable adjustments — and that duty extends to the performance process itself, not just the job. In practice that can mean putting questions in writing, allowing longer to respond, holding shorter meetings, meeting somewhere neutral, permitting a companion beyond the usual statutory right, or phasing the return before the process restarts. It also means being careful that the performance concerns themselves are not a consequence of the impairment, because if they are, dismissing for them is a discrimination claim rather than a capability one.
You do not need a diagnosis in hand to start behaving as though the duty might apply. Behaving as though it does costs very little and protects you if it turns out it did.
Resuming, and the two roads out
When the employee is fit to return, restart the process properly: fresh invitation, current evidence, the right to be accompanied, adjustments in place. Do not pick up mid-sentence from four months ago as though nothing happened, and do not quietly inflate the original concerns with everything that has annoyed you since.
From there it usually goes one of two ways. Either performance improves under a proper plan with adjustments, which happens more often than pessimists expect, or it does not and you are into a capability dismissal — a route that requires genuine consultation, up-to-date medical evidence, consideration of adjustments and of any suitable alternative role, and a real answer to the question of how much longer the business can reasonably wait. The qualifying period for unfair dismissal is changing too, which makes fair process matter for far more of your staff than it used to; six months, not two years sets out what that means for a small employer.
The version that costs money is the third road: doing nothing for eight months out of discomfort, then dismissing abruptly when patience runs out. That produces an unfair dismissal claim with a disability discrimination claim stapled to it, and the file will show an employer who went silent. If you want the groundwork done properly, managing staff sickness absence and how to give an employee a written warning properly are the two things to get right before any of this ever happens.
Common questions
Can I continue a disciplinary or performance process while someone is signed off sick?
Not in the normal way. If an employee is unfit for work, they are generally unfit to attend a hearing, so the process should be paused and resumed when they are well enough. There are middle routes worth exploring first: an occupational health opinion on whether they are fit to participate even if not fit to work, holding the meeting in writing, allowing a representative to attend on their behalf, or meeting somewhere other than the workplace. Pushing ahead regardless is what turns a defensible performance case into an unfair dismissal finding, because the unfairness sits in the process rather than in the underlying concerns.
How long do I have to wait before I can act on a long-term absence?
There is no fixed period in law, which is the answer employers least want to hear. What matters is whether the employer acted reasonably in all the circumstances, judged on the size and resources of the business, the nature of the role, the impact of the absence, the medical prognosis and whether adjustments could enable a return. A small firm with one person doing a critical job can reasonably act sooner than a large employer with cover available. What is never reasonable is acting without up-to-date medical evidence, without consulting the employee, and without considering adjustments or an alternative role first.
Does work-related stress on a fit note mean I have done something wrong?
No. A fit note records what the employee reported and the issuer's clinical judgement about fitness for work; it is not a finding of fault against the employer. It is common for a fit note to cite work-related stress after any difficult workplace conversation, including entirely fair ones. What it does do is put you on notice, and how you respond from that point is what a tribunal would examine. Take it seriously, ask what would help, consider an occupational health referral, and check whether anything in the working arrangements can reasonably be changed. Dismissing the wording as tactical, in writing or in a meeting, is the response that causes damage.
Do I have to pay company sick pay as well as statutory sick pay?
Only if the contract, staff handbook or an established custom in your business says so. Statutory sick pay is the legal minimum: since 6 April 2026 it is payable from the first qualifying day, the lower earnings limit has gone, and the rate is £123.25 a week or 80% of normal weekly earnings if lower, for up to 28 weeks. Anything above that is contractual and entirely a matter for your own policy. If you do offer enhanced sick pay, apply it consistently, because paying it to some employees and not others in comparable situations is a straightforward route to a discrimination claim.
