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Altered states

From Comic Relief to local practitioners, we talk to finance professionals about the difficulties of returning to work after an extended absence for illness, and their advice for others

Mark Wildig, director of finance at Comic Relief, says: “My first day back was daunting – like all the first days I had ever experienced and their cumulative anxieties rolled into one, with a dose of how I imagine re-entering from space might feel. I was nervous, stressed and full of self-doubt – could I do still do my job? Could I have ‘normal’ conversations? Could I even make it through the day? My employer was brilliant, but I was still racked with anxiety. I felt so exposed and raw and delicate.”

Wildig is talking about the difficulties of returning to work after an extended absence for illness – in his case, stage 4 double-hit lymphoma, an aggressive cancer that affects just 12 people in every million and is rarely seen in anyone as young as he is: he was only 40 when he was diagnosed last July. His gruelling treatment meant he was off work from August 2018 to April 2019, when a phased return, planned in consultation with his doctors, brought him back for one day per week to begin with, increasing to three days by the time of this interview, in June. He doesn’t think Comic Relief could have handled his absence or return any better. While he was away, the charity briefly hired an interim head of finance, but then decided it would be better if the finance team covered.

His managers contacted him and his wife regularly, ensuring that he felt supported and included, and the staff benefits package gave him the necessary financial security. He knows from having met others with cancer that this is sadly not always the case. “I wanted to raise awareness of how little employers are obliged to do legally and how important it is for everyone to make provisions for ill health,” he says. “That’s why I proposed this feature. Since becoming ill, I’ve met many people who, on top of all else, are struggling financially or not getting adequate support from their employers. Everyone should have critical illness cover: it’s the most useless thing in the world until you need it, when it becomes the most valuable thing in the world.”

While many businesses go beyond their legal obligations, some stick to the statutory minimum – £94.35 per week for a maximum of 28 weeks. “When people fall ill, they and their families have so much to deal with,” says Wildig. “There is a huge amount of information to process and often life-dependent decisions to make. They’re already overloaded by the magnitude of it all, of having to cope with becoming disabled or ill, or of seeing their life expectancy shrink to a fraction of what they’d hoped for. The last thing they need is money or job insecurity worries. “No one can protect against illness, but adequate insurance can at least safeguard household income, and that’s a massive weight off the mind.”

For Craig Chapman, an audit manager at PwC, the return to work following three and a half months off with mental illness also brought with it concerns about how he would be viewed by his colleagues. “Mental health is still stigmatised. I didn’t want my colleagues to think they’d have to carry me, or that they’d have to walk on eggshells around me. But those anxieties were unfounded. Everyone was pleased to see me. I decided to be totally honest about my illness – it’s the only way to increase awareness, and also to help others, so I answered any questions head on. The good thing about that is that colleagues who are struggling know they can speak to me.”

PwC is a leader in inclusion, with cohesive strategies for staff who have mental or physical health issues, and Chapman benefited from that. At no stage did he fear for his job, and he felt well supported, through meetings with occupational health, and therapy – covered by his work health scheme. His return to work was very carefully staged – increasing gradually from three afternoons per week to five days over a 10-week timeframe. Martin Quinn, senior lecturer in accounting at Queen’s Management School, Belfast, also had a good experience when he was ill. Good health benefits at work were supplemented by private health insurance, which meant that he didn’t have to worry about his finances when he had to have open-heart surgery two years ago, when he was in his early 40s.

DCU (Dublin City University) – his employer at the time – paid 100% of his salary for the first six months, and 50% for the rest of the year, which was topped up by income protection. “In Ireland most people have private health cover, and I was so glad I did,” he says, “because it paid for my heart surgery, and also for a carer when I needed one.” He says the emotional fall out of being ill was enormous and should never be underestimated. “It left me feeling so vulnerable and scared that I couldn’t be alone in the house – that’s why I had a carer who’d sit with me while my wife was at work. Serious illness detaches you from your life. You’ll be the same age but will feel much older: you’ll doubt your capabilities and your abilities even to make simple decisions. Most of us wake up expecting our bodies and minds to do what we need them to, but illness takes that trust away from you.” Like Wildig and Chapman, Quinn suffered a pronounced loss of confidence after his illness. “This is one of the biggest issues people have after serious illness,” says Kelly Feehan, service director, CABA – the charity that supports past and present ICAEW members, ACA students and their families.

“Communication with managers and team members is essential. Certain treatments can affect cognitive function – at least temporarily – so people should tell their colleagues that they might need to have things explained to them differently, or that they won’t be able to work as fast as before. There’s no shame in asking for help and reassurance. Many employers have structures in place to ease employees back in gently and some provide additional training or counselling; sadly, there are just as many who don’t, and who expect people to pick up from where they left off. “Regaining confidence is difficult, but there are certain techniques that can help – such as remembering past achievements, recognising skills and tackling a few easy tasks just to get started. And of course, we’re always here to help, too.” For Quinn there was no gentle re-entry. Once his doctors said he was well, he went straight back to the job and hours he’d done before.

“I’d been deemed fit for work, so I didn’t need any concessions, but I certainly didn’t have the energy I’d had before. Being ill changed the way I viewed life and helped me redefine what was important. I wanted to make some changes – even down to my commute, as I’d had enough of driving into Dublin each day – so I got a new job at Queen’s Belfast.” His advice to employees is to make sure they have adequate health and income support and to change things they’re not happy with. “It took heart surgery to show me that I wanted to take my career in a different direction. I think I’d known it for a while, but felt settled and reluctant to move. Illness changed my perspective and tolerance levels.”

And his advice for employers? “Make sure the absence doesn’t leave you with a skills gap. I have an accountant’s brain so I always work ahead and with full transparency. I leave the office knowing that if I fell under a bus, my employer could assign my projects to someone else. I don’t know if enough companies have that kind of contingency plan. They really should, they should be ahead of themselves, particularly when it comes to having cover in place for key personnel. Will the team pick up the slack, or will they bring in someone else? If they’re hiring someone else, how are they going to pay for it? These are questions every business, big or small, should have the answer to.”

City-based accountancy practice Gerald Edelman had just this situation arise a few years ago when a senior manager collapsed in the office with heart failure and was off for several months. Though the firm didn’t have key personnel insurance cover, they paid full salary throughout. “It’s discretionary,” says Deval Patel, one of the partners, “but people are our greatest asset, so we do our best to look after them.”

The manager’s work was covered by his team: most accounts have at least three people working on them so business could carry on as usual. Helping staff return to work is also handled differently each time, depending on the needs of the employees and the firm. “In this case,” says Patel, “we had to adapt his workload to ensure his transition back into the workplace did not compromise his recovery; he couldn’t work at the same pace, but his salary remained the same. In these situations company ethics are of paramount importance, and this was the right thing to do.”

Legal picture

Emily Kearsey, associate in the employment team at commercial law firm Goodman Derrick LLP explains the key legal rights and obligations Employers have a duty to ensure their employees’ safety at work, which covers physical and mental health. Employment contracts include an implied term of ‘mutual trust and confidence,’ which can’t be breached in cases of long-term sick leave; employers must strike a balance between including the employee in company news without pressurising them to return.

Employees are entitled to Statutory Sick Pay (£94.25 per week) for up to 28 weeks. However, many employers offer enhanced contractual or discretionary sick pay, in many cases paying the employee’s full basic salary for a given period. Holiday accrues while an employee is on sick leave, and people can’t be forced to take or deemed to have taken their allowance while unwell. Employees can carry over at least four weeks’ holiday from one holiday year to the next when they’ve not been able to take it due to illness, but must take it within a certain timeframe.

Heightened obligations apply where an employee is disabled – defined as a physical or mental impairment that has a substantial and longterm adverse effect on an individual’s ability to carry out day-to-day activities. Conditions such as blindness, HIV and cancer automatically constitute disability. If an employee is disabled or becomes disabled while on sick leave then the employer must make reasonable adjustments to facilitate the employee’s return to work.

Contingency planning

Sustained employee absence can have a major impact on a business and those who work for it – particularly if the company is small. So have contingency plans in place says Sue Andrews, business and HR consultant at KIS Finance.

The main issue: An employee’s absence can create a skills gap that can’t be filled by other staff. Larger organisations often have the resources to provide cover, but this is less likely within small companies. The absence may also affect colleagues who have to pick up the slack, which can affect productivity and morale. Without appropriate action, this can have a negative impact on the quality of work, staff relations and customer service.

Safeguarding against the financial impact of prolonged absence: Employers may need to think about taking on someone new to cover. The additional costs can be significant – companies can sometimes pay double, and may even incur recruiters’ fees. Key person insurance can protect against this to some degree. Policies usually pay out a sum to the company when the individual is away, normally after an agreed period of time. This can help cover the cost of additional staff or help to make up for any fall in profits. Some plans even provide occupational health and recovery support to help the person return to work sooner.

Managing the return to work: The employee will need appropriate support when returning to work, and the employer may need professional advice. A fit note from the GP will state what the person can and can’t do, but usually only in general terms. Pay an occupational health specialist to give more specific advice.

Review regularly and offer support: Where a phased return is in place, the arrangements should be reviewed regularly. Obviously employers don’t want to overload the person too soon, but it’s important to settle them in their role in a reasonable time timeframe.

Loss of confidence is a problem: Employers should provide training, and managers should help bring employees up to speed.

Originally published in Economia on 6 September 2019.