A man working in a factory
Returning To Work
A man working in a factory

Going back to work (voluntary or paid) after illness can be challenging. Persisting symptoms such as shortness of breath, fatigue, poor concentration, and anxiety can all make return to work more difficult. The longer you are off sick, the harder it can be to go back to work.

Doing the right kind of work is good for your mental and physical health, even if you have a health condition.


I am confident about going back to work – what should I do?

If you have been off sick for seven days or less then you can self-certify your leave for this time. If you have been off work for more than seven days and feel fit enough to work then you need to obtain a fit note. If your employer agrees, a similar document can be provided by a physiotherapist, podiatrist or occupational therapist instead. This is called an Allied Health Professional (AHP) Health and Work Report. https://www.gov.uk/taking-sick-leave.


What if I am not sure about going back to work?

If you do not feel fit enough to return to work, the following steps may make a return to work feel more manageable.

  1. Talk to your GP or another health care professional, such as an occupational therapist.

    Your health care professional will discuss with you how your symptoms impact on your work, and how your work affects your symptoms. They may suggest that you can do parts of your job or return part time.

  2. Consider contacting ‘Fit for Work’

    Fit for work (fitforwork.org) is a government funded service that offers free expert and impartial work related health advice. Anyone looking for guidance about work related health issues can call the free telephone advice line 0800 0326235.

  3. Obtain a fit note or alternative evidence

    Your doctor or other health care professional will give you a fit note if your health affects your fitness to work. The fit note is your property and you should keep it. If your employer wants one for their records they can take a copy. The fit note provides advice from your health care professional to your employer. Your employer can decide whether or not to accept it.

  4. Understand ‘reasonable adjustments’

    The fit note may make suggestions about a graded return to work or workplace modifications (often known as ‘reasonable adjustments’). These are changes to the work environment that allow people to work safely and productively. You are classified as disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long term’ negative effect on your ability to do normal daily activities. Substantial means that everyday tasks take much longer than usual. Long term means 12 months or more, for example shortness of breath that develops following pneumonia.

    Reasonable adjustments include allowing employees who have who meet the definition and criteria outlined above regarding long term mental and/or physical impairment to make a phased return to work, including flexible hours or part-time working. Other examples of reasonable adjustments can range from making physical changes to the workplace like installing a ramp for a wheelchair user to smaller adjustments such as allowing someone with fatigue to have a longer rest at lunch time, shorter, more frequent breaks or start and finish work later so travel is easier.

    Graded returns to work should consider both the hours of work and the complexity of the work.  Typically, a graded return to work takes place over six weeks. For example, attending work two days a week for the first week, three days a week on the second and third week, four days a week on the fourth and fifth weeks and full time in week six. If you have had a serious illness and have persistent fatigue then this may be too fast.

  5. Identify any support that would be helpful at work to you

    You will know your capabilities and workplace better than anyone. Having thought about the work adjustments detailed above, it is a good idea for you to write down your suggestions so that you have a clear proposal to discuss with your boss, a return to work plan.

  6. Contact Occupational Health

    If your workplace has an occupational health department then you may be asked to see an occupational health advisor or another member of the occupational health team such as an occupational therapist before you return. Their aim is to keep you healthy and safe while in work and manage any risks to your health in the workplace. You can then discuss your proposed return to work plan with occupational health and they can liaise with your manager.

  7. Talk to your line manager

    Before you go back to work it is helpful to meet with your line manager. You can discuss your proposed return to work plan (step 5) with your line manager. In this meeting it is helpful to focus on how any difficulties you have can be managed by both you and your employer.

    For example, you can explain the nature of fatigue and say it would be very helpful if you do not need to go to lunchtime meetings, but have half an hour away from your desk to rest.

    We recommend that you take your written proposal in with you, so that you do not forget or miss anything. At the end of the meeting it can be helpful to summarise the agreed plan and write it down either you or your manager can do this. This helps everyone remember what was agreed.

    There is no obligation to discuss your symptoms in detail with your line manager, but you may want to consider taking in some information on symptoms experienced by people who are recovering from either Covid or a hospital stay. The purpose of this is simply to increase understanding of the conditions you and anyone like you experience. You could email this in advance of any meeting, if you felt this was appropriate for you.