Managing a new employee with long-term sickness

This probably isn’t how you expected your new hire to start.

You’ve just recruited someone you really wanted. They’ve got the skills, the attitude and felt like a strong addition to the business.

Then, during onboarding, they let you know that they’ve been managing a long-term condition that may affect their attendance at times.

Suddenly, what should feel like a positive moment starts to feel complicated.

You want to do the right thing by the individual.

You also need the business to run.

And, in a small business, those two things are closely linked.

That tension is very real and very common.

First things first: this doesn’t automatically mean a problem

A long-term health condition doesn’t automatically mean ongoing absence, poor performance or disruption.

Many people manage health conditions successfully at work, especially when expectations are clear and support is handled well from the start.

The difficulty for small businesses is that there’s less slack in the system.

One person being off regularly, struggling to settle or needing ongoing adjustments can have a much bigger impact than it would in a larger organisation.

That’s why how you handle this early on matters so much.

Understanding your responsibilities

Some long-term health conditions, including certain mental health conditions, may be classed as a disability under the Equality Act.

You don’t need to diagnose anything or make legal judgments yourself.

What matters is being aware that health-related issues may require a more considered, flexible approach, particularly around absence, probation and performance.

Rushing decisions or treating sickness and performance as the same thing is where many small businesses unintentionally get themselves into difficulty.

Why early conversations are so important in a small business

In most small businesses, there isn’t a dedicated HR team.

How situations are handled usually comes down to:

• the business owner

• a senior team member

• someone managing people alongside their main role

That makes early, open conversations essential.

Not to lower standards, but to:

• understand what support might realistically help

• be clear about what the business needs

• avoid assumptions on either side

Avoiding the conversation often creates more uncertainty, not less.

Reasonable adjustments need to work for both sides

Adjustments don’t have to be complex or permanent.

For a new starter, they might include:

• some flexibility around hours

• regular check-ins

• clearer priorities during probation

• easing pressure while someone settles in

The key point is that adjustments should be reasonable and sustainable.

In a small business, it’s okay to think about:

• the impact on the rest of the team

• whether adjustments are temporary or ongoing

• what happens if things don’t improve

Supporting someone doesn’t mean committing to arrangements the business can’t realistically maintain.

Be careful with probation, performance and absence

One of the most common pressure points is probation.

If someone is struggling because of illness, it’s important to pause and look at the full picture before taking action.

Decisions that appear to penalise someone for health-related absence can create risk quickly.

At the same time, probation is there to assess whether the role and the individual are a workable fit.

This is where careful documentation, consistent conversations and early advice make a real difference.

When support has limits

This is the part many small business owners worry about but don’t always feel able to say out loud.

Doing the right thing doesn’t mean the business has to absorb unlimited impact indefinitely.

Sometimes, despite support, adjustments and open conversations:

• attendance remains unpredictable

• the role can’t be fulfilled reliably

• the impact on the business and team becomes too great

When that happens, it’s not about blame.

It’s about recognising whether the role, the support available and the needs of the business are still aligned.

Handled properly, these situations can be managed fairly and sensitively, but they do need careful handling.

A balanced approach protects everyone

Managing a new employee with long-term sickness isn’t about choosing between compassion and commercial reality.

In a small business, you need both.

Handled early, openly and with the right support, many situations work well for everyone.

And when they don’t, having approached things fairly, consistently and thoughtfully puts you in the strongest possible position to make the right decision for both the individual and the business.

If you’re dealing with something similar and want help with thinking it through before it becomes more difficult, we can support you.