It's Monday morning and your phone buzzes. One of your team is calling in sick. They sound rough, they won't be in today, and they're not sure about tomorrow either. What happens next?

If you're running a small business, this scenario can feel surprisingly stressful. Not because you don't want your employee to recover — of course you do — but because you're suddenly navigating a web of legal obligations, pay calculations, and record-keeping requirements that you may not have thought about since the last time someone was off.

Sick leave in the UK comes with clear rules, and April 2026 brings significant changes to Statutory Sick Pay that every employer needs to understand. This guide covers everything: from what to do when the phone call comes in, to how SSP works, to managing long-term absence without putting your business at legal risk.

When an employee calls in sick — the basics

The first thing to know is that your employee has a duty to notify you. If you've set a specific timeframe in your absence policy — such as calling before 9am on the first day of sickness — that's what they should follow. If you haven't set a policy, the default expectation is that they notify you within seven days.

For the first seven calendar days of sickness, the employee can self-certify. This means they don't need a doctor's note. They simply tell you they're unwell, and that's sufficient for legal purposes. You can ask them to fill in a self-certification form when they return, but you can't demand medical evidence during this initial period.

If the absence extends beyond seven consecutive days — and this includes weekends and non-working days, not just days they were scheduled to work — they'll need a fit note. Fit notes can be issued by a GP, nurse practitioner, occupational therapist, pharmacist, or physiotherapist. The range of professionals who can issue them has expanded in recent years.

HR dashboard illustration for sick leave and payroll management

One point that catches employers out: you cannot withhold Statutory Sick Pay if the fit note arrives late. The employee's entitlement to SSP is based on when they were actually sick, not when they provided the paperwork.

Statutory Sick Pay explained

Every UK employer has a legal obligation to pay Statutory Sick Pay to eligible employees. Understanding the rules is non-negotiable if you're running a business with staff.

Current rules (2025/26 tax year)

Under the rules that apply until April 2026, SSP is paid at £118.75 per week. There are three waiting days at the start of any period of sickness — meaning the employee receives no SSP for the first three qualifying days they're off. To be eligible, the employee must earn at least £125 per week on average, which is the Lower Earnings Limit.

SSP is payable for up to 28 weeks in a single period of sickness. After that, the employee moves onto other benefits. You pay SSP through your normal payroll on the employee's usual payday, deducting tax and National Insurance as you would with regular pay.

What changes from April 2026

The Employment Rights Bill introduces the most significant reforms to SSP in decades, and they take effect from April 2026. These changes will affect every employer in the UK, and small businesses need to prepare now.

Waiting days are abolished. SSP becomes payable from the first day of sickness. The three-day waiting period that currently applies disappears entirely. This means every qualifying absence, even a single day, triggers an SSP obligation.

The Lower Earnings Limit is removed. Currently, employees who earn below £125 per week aren't entitled to SSP. From April 2026, all employees become eligible regardless of what they earn. This is a major change for businesses that employ low-paid or part-time staff.

A new calculation method applies. Instead of the flat weekly rate, SSP will be calculated as the lower of either 80% of the employee's average weekly earnings or the flat rate (currently £118.75 per week). For lower-paid workers, this means they'll receive 80% of their average earnings rather than the full flat rate.

What this means for small businesses

The removal of waiting days is the change that will hit hardest. Under current rules, short absences of one to three days cost you nothing in SSP. From April 2026, every single day of sickness absence carries a pay obligation. If you have staff who occasionally take individual sick days, your SSP costs will increase.

The removal of the earnings threshold also means you'll be paying SSP to workers who were previously below the Lower Earnings Limit. If you employ part-time staff on low hours, budget for this additional cost.

You should update your payroll system before April 2026 to ensure it handles the new calculation method correctly. If you're running payroll manually or on outdated software, now is the time to switch to a system that will apply the new rules automatically.

Fit notes — what employers need to know

Fit notes are the formal medical evidence that supports a sickness absence beyond seven days. Understanding how they work — and what you can and can't do with them — is essential for managing absence properly.

A fit note will state one of two things: either the employee is "not fit for work," or they "may be fit for work" with certain adjustments. If the note says "may be fit for work," it will include recommendations such as amended duties, altered hours, a phased return, or workplace adaptations.

Your obligations as an employer

When a fit note includes recommendations for adjustments, you should genuinely consider them. You're not legally required to implement every suggestion, but you need to show you've given it proper thought. If you can't accommodate the adjustments, the employee remains off sick and continues to receive SSP.

If the employee has a disability under the Equality Act 2010 — which includes long-term conditions that substantially affect their ability to carry out normal daily activities — you have a legal duty to make reasonable adjustments. Failing to do so could result in a discrimination claim, regardless of what the fit note says.

You cannot challenge a fit note directly. If you believe the employee is fit to work despite what the note says, your option is to seek an independent occupational health assessment. You cannot override the fit note, refuse to accept it, or insist the employee returns to work against the medical advice it contains.

Managing long-term sickness absence

Long-term sickness is generally defined as an absence lasting four weeks or more, though there's no strict legal definition. It requires a different approach from short-term absence and carries significantly higher risks if handled poorly.

Keep in regular contact

Maintaining contact with a long-term sick employee is both good practice and legally important. The contact should be supportive, not pressurising. Agree on a frequency and method — perhaps a fortnightly phone call or email — and stick to it. Going silent for months and then suddenly demanding a return date is a common mistake that damages trust and can weaken your position if things escalate.

Occupational health referrals

For absences that are becoming prolonged, an occupational health referral can provide valuable clarity. An occupational health professional can assess the employee's condition, estimate when they might return, recommend workplace adjustments, and advise on whether the condition constitutes a disability under the Equality Act.

You should get the employee's consent before making a referral, and share the questions you'd like the occupational health professional to address. The report will help you make informed decisions about how to manage the ongoing absence.

Return-to-work planning

When the employee is ready to come back, a return-to-work interview is good practice. It gives you a chance to discuss what happened, what support they might need, and whether any adjustments are required. For longer absences, a phased return — where the employee gradually increases their hours over a few weeks — often works well for both sides.

Document everything. The conversation, the agreed plan, any adjustments made. If the situation later becomes a dispute, having a clear record of what was discussed and agreed is invaluable.

The discrimination risk

Long-term sickness can easily overlap with disability. Under the Equality Act 2010, a disability is a physical or mental condition that has a substantial and long-term adverse effect on someone's ability to carry out normal day-to-day activities. "Long-term" means lasting or likely to last 12 months or more.

If an employee's condition meets this definition, you have specific legal duties including reasonable adjustments and protection against dismissal or detriment related to their disability. Dismissing a long-term sick employee without proper process and without considering reasonable adjustments is one of the highest-risk decisions an employer can make.

Tracking and recording sick leave

Accurate sick leave records aren't just helpful for managing absence — they're a legal requirement. From April 2026, the Fair Work Agency has expanded powers to inspect employer records, and having gaps in your documentation could lead to penalties.

What to record

For every sickness absence, you should record the dates of the absence, the reason given by the employee, whether a fit note was provided (and what it said), the return-to-work date, any adjustments discussed or implemented, and whether SSP was paid. These records need to be retained for at least six years, even after the employee has left your business.

Why patterns matter

Beyond individual records, tracking patterns across your workforce helps you identify potential issues early. An employee who's regularly off on Mondays or Fridays, or who has frequent short absences, may need a different conversation from someone who's off once with a genuine illness. But you can only spot these patterns if you're recording the data consistently.

Sage HR tracks sick leave from the moment it's reported, triggers SSP calculations based on the current rules, stores fit notes digitally, and generates absence reports that make patterns easy to identify. Having everything in one system means you're not scrambling to piece together records from emails, spreadsheets, and paper forms when you need them.

Common sick leave mistakes

Managing sick leave is an area where small businesses frequently make avoidable errors. Here are the ones that cause the most problems.

UK sick leave HR infographic

Not paying SSP to eligible employees. If an employee meets the qualifying conditions, you must pay SSP. It doesn't matter whether their contract is temporary, they're on probation, or you think they're not genuinely ill. The obligation exists and ignoring it exposes you to enforcement action.
Requiring fit notes too early. You cannot demand a fit note for the first seven days of sickness. Self-certification is the legal standard for the initial period, and insisting on medical evidence before that point creates unnecessary tension and has no legal backing.
Not making reasonable adjustments. When an employee's condition qualifies as a disability under the Equality Act, failing to consider and implement reasonable adjustments is discrimination. This applies whether the employee is currently off sick or has returned to work with ongoing health issues.
Inconsistent absence management. Treating different employees differently when they're off sick — being lenient with one and strict with another — creates a discrimination risk even if you didn't intend to discriminate. Apply your absence policy consistently across the board.
Not tracking patterns. Without consistent absence records, you can't identify concerning patterns, calculate SSP accurately, or demonstrate compliance if the Fair Work Agency requests your records. Track every absence, every time, no matter how short.
Ignoring the April 2026 changes. The removal of SSP waiting days and the earnings threshold will catch out employers who haven't updated their processes. Make sure your payroll system and your team are ready before the changes take effect.

Sick leave management isn't just about paying SSP and filing fit notes. It's about having clear policies, applying them consistently, keeping thorough records, and treating employees fairly — even when the absence is frustrating or inconvenient. The businesses that get this right have fewer disputes, lower legal risk, and healthier working relationships.

Frequently asked questions

Can I ask an employee why they're off sick?

Yes, you can ask the reason for their absence, and most absence policies require employees to provide a general reason. However, they don't have to disclose a specific medical diagnosis for short absences. For absences over seven days, the fit note will indicate the nature of the condition.

What if an employee is frequently off for short periods?

You're entitled to manage attendance and address patterns of frequent short-term absence. This should be done through a formal absence management process, applied consistently. Document the pattern, have a supportive conversation, and explore whether there's an underlying health issue that needs addressing before moving to any formal process.

Do I have to pay company sick pay on top of SSP?

There's no legal requirement to pay more than SSP unless your employment contract or company policy provides for enhanced sick pay. Many employers do offer contractual sick pay that's more generous than SSP, but this is a business decision, not a legal obligation.

Can I dismiss someone who's been off sick for a long time?

Potentially, but it must be handled with extreme care. You need to follow a fair process, consider occupational health advice, explore reasonable adjustments, and demonstrate that continued employment is no longer sustainable. If the employee's condition is a disability, dismissal carries a significant discrimination risk. Take legal advice before proceeding.

What happens to SSP after 28 weeks?

SSP stops after 28 weeks. At that point, you should provide the employee with an SSP1 form so they can claim Employment and Support Allowance or Universal Credit. Your obligation to pay SSP ends, but the employment relationship continues unless formally terminated through a proper process.

Will the April 2026 SSP changes apply to existing sickness absences?

The new rules apply to periods of sickness that begin on or after the date the changes take effect. If an employee is already off sick when the changes come in, the existing rules continue to apply to that period of absence. New absences from April 2026 onwards follow the new rules.

This article is for informational purposes only and does not constitute legal or HR advice. Employment law is subject to change, and the rules described here reflect the position at the time of writing. Always check the latest guidance from HMRC and Acas, or consult a qualified professional for advice specific to your business.