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Caring for employees with a terminal condition

Written by: Mark Stevens
Published on: 27 Feb 2024


Image © Diane Munro/ / Adobe Stock

​It’s a sad fact of life that an employer may find that an employee has received a terminal diagnosis. While it’s naturally going to be hard for the employee, any employer with an ounce of feeling will want to support the employee sensitively and compassionately.

Of course, each situation will be unique, but there are a number of key legal issues that employers need to consider.

Equality Act 2010 rights

A terminal illness is likely to fall under the definition of a disability, and the Equality Act 2010 is likely to apply. This means that an employee with terminal illness has the right not to be treated less favourably at work.

Less favourable in this context means:

  • Direct discrimination – essentially doing something because of the condition, such as terminating the employee's employment
  • Indirect discrimination – a policy or practice that has a more detrimental effect on people with the condition
  • Discrimination arising from disability – doing something, not because of the condition, but because of something caused by the condition, such as taking into account their sickness absence when deciding on bonus entitlement
  • A failure to make reasonable adjustments – failing to make reasonable changes to the workplace or the role to lessen the impact of the condition
  • Harassment – unwanted conduct relating to the condition
  • Victimisation – doing something because the individual has complained about discrimination.

The Equality Act 2010 specifically requires employers make reasonable adjustments for employees with a disability. Employers should therefore explore and consider reasonable adjustments to accommodate employees' needs at work – which may change over time. Employers only have to make these adjustments if they are reasonable in a specific situation; there is no set rule regarding what a reasonable adjustment is.

Reasonable adjustments could include allowing the employee to work from home or another location; flexible working arrangements, such as changes to start or finish times, introducing more breaks during the day, or condensed working hours; changing the duties of an employee's role; adjusting an employee's workstation, including providing new equipment; and time off work for treatment. If in any doubt, guidance should be sought from occupational health, and the employee's doctor, as to what adjustments might be appropriate.


An employee may be entitled to take sick leave and could qualify for statutory sick pay if they are too ill to work. They may also be entitled to contractual occupational sick pay if it is provided by the employer.

And where employees pay into a workplace pension scheme, or have done so in the past, they may be able to take their pension early by applying for ill-health retirement or medical retirement. In some circumstances, employees with a terminal diagnosis or less than a year to live may be able to take all of their accrued pension in one lump sum – employees should review their pension provider's rules and take specific advice in relation to their options.

At the same time, employees should also review the terms of any private medical insurance, group income protection or death-in-service cover that they may have access to through their employer.

Supporting and managing employees with a terminal diagnosis

In addition to legal requirements, employers should foster a compassionate culture that supports people, including those with a terminal diagnosis. Employers might seek to develop support for employees with a terminal illness, such as a policy, guidance, line manager training or awareness-raising.

In terms of managing absence, being flexible and compassionate when managing absence is key to creating an environment where employees feel able to tell their employer about how they are feeling while supporting employees' emotional well-being.

As to steps that employers could take, they should think about removing employees with terminal illness from standard sickness reporting procedures – perhaps as a reasonable adjustment; enhancing the organisation's established financial arrangements for sick pay for employees with a terminal diagnosis; allowing paid time off work for employees to attend medical appointments; and adjusting reporting lines in relation to who and how employees should notify if they are unable to attend work.

It makes sense that these arrangements should be discussed and agreed with the relevant employee.

Providing leave

Apart from statutory and/or contractual sick pay, employers should also consider compassionate leave for people where needed, for example where an employee is struggling to manage the wider well-being impacts of their diagnosis and needs some time and space from work.

They could also think about offering flexible working or temporary adjustments to working hours, for example agreeing a reduction in hours. However, employers and employees should be mindful of any financial implications of doing this, as this could have an impact on reward and benefits, such as death-in-service benefits. Again, the specific options should be carefully discussed.

Keeping in touch

Having sensitive and supportive ‘keeping in touch conversations’ are another key element of managing employees working with a terminal illness. Employers should have sensitive conversations with the employee about how best to keep in touch during their absence, and how frequently. Some employees may want to keep up to date with news about work while others may prefer minimal contact. Any keeping-in-touch conversations should be approached with empathy and without the employee feeling any pressure to return to work before they are ready.

Employers should plan a return to work before the employee returns so that the individual knows what to expect and has the opportunity to think about any issues they would like to raise, such as potential adjustments. Managers should keep in mind that someone returning to work with a terminal illness is likely to be dealing with the emotional as well as the physical effects of their symptoms and diagnosis.

Supporting managers

Lastly, employers need to recognise that a line manager will often be the first point of contact if someone needs to discuss their diagnosis and health needs. Employers need to also ensure that they too feel supported and are also sufficiently comfortable and competent to have empathetic conversations; they need to understand how to respond to an employee who shares health information about a terminal illness and what actions to take as well as the specific support available.

HR professionals must ensure that managers develop a basic knowledge of the illness that the employee has been diagnosed with, so that they can have a broad understanding of the condition’s likely impact and what adjustments may help.


Dealing with a terminal illness, whether as the sufferer or an employer, is never going to be easy. However, with a little forethought it’s possible to make the process more bearable for all involved while demonstrating to the wider workforce that the employer cares about staff.