Support hidden health conditions to combat soaring absence

Managers must help employees with hidden health conditions come forward for support – before they become too sick to work.

New figures released by the ONS show that record numbers are falling out of the workplace due to long-term sickness.

Nearly half a million (464,225) more people went long-term sick between April and June 2023, taking the total figure to 2.6 million.


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A major factor is that hidden health conditions, ranging from anxiety and depression to menopause and heart conditions, now affect one in four people.

Yet a third of these choose not to tell their employer. This means 8% of employees are not getting the support they need to stay in work.

Essential to keeping more people in work is empowering managers to have ‘courageous conversations’ to encourage those with hidden health conditions to come forward for support before they become too sick to work.

Data analysis carried out for The Benefits of Early Intervention Report found that two thirds of employees could be prevented from going absent in the first place with reasonable adjustments and help to manage their condition at work.

Even slight adjustments, such as allowing someone with depression who’s struggling to sleep to start their working day a bit later, or someone who is on cancer medication to have more short breaks during the day, can make a huge difference.

To help people with hidden health conditions feel safe opening up, managers need to see beyond ‘I’m fine masks’ by looking for the warning signs that someone might be struggling.

These might include constant tiredness, increased forgetfulness, changes to physical appearance, emotional outbursts, a reduction in performance and unexplained absences.

Left unsupported, these individuals will almost inevitably slide into long-term absence. However, even when managers can see that someone is struggling, it can still be daunting for them to ask someone if they’re okay, for fear of seeming intrusive or becoming personally involved.

To help them overcome this fear, make sure managers know what their responsibilities are (and what they’re not) when it comes to managing health and absence, and ensure any company policies are aligned to these.

For example, if you have a policy saying that people should be offered support after six weeks of absence, but you want managers to support people to stay in work, make sure your sickness prevention policy stresses the importance of referring people at the first sign of a problem.

This is especially important given research shows 91% of people referred into occupational health, while still in work, were expected to be in work a month later, compared to just 53% of those referred after a month of absence, and only 27% of those referred after six months of absence.

Instead of waiting for underlying health conditions to manifest as performance or absence issues, it can also be useful to encourage managers to talk to employees about any support they might need as soon as they join the organisation.

They should explain what support services the organisation offers and give examples of reasonable adjustments that could be offered to help them continue to work with those health conditions.

Most companies now invest heavily in wellbeing benefits, such as physiotherapy and mental health support – but these are woefully underutilised because they are seen as a means for managing absence, rather than a means of helping people to stay in work.

By empowering managers to talk to employees about any upfront support they might need, and signposting them to use these services, you can dramatically reduce absence and skills shortages.

Critical to success is educating managers how to reassure employees that these services are there to help them, not to catch them out or manage them out of the business.

Managers also need to be discreet and take the time to talk to employees on a one-to-one basis, about how they’re feeling, instead of just talking about work and deadlines.

Kathy Cox is a manager trainer and wellbeing consultant for PAM OH Solutions