How to support employees affected by cancer

We’ve all been touched by cancer in our lives – in fact, more than 700,000 people of working age are living with a cancer diagnosis. And in these times, it can be difficult to know what to say and do.

According to international research by Macmillan, 6 in 10 people with cancer now return to work. This trend means that colleagues, managers and employers are also increasingly likely to face cancer in the workplace. However, people who have finished treatment tell Macmillan they have difficulties returning to normal life, including work. For many people, this is a new experience, and they’re not sure how to handle it.

The role of employers when supporting people with cancer

Employers play a pivotal role in supporting people with cancer and their carers, but as an employer or line manager, you may not always feel confident about how best to support an employee who is affected. To start with, cancer is covered by the Equality Act 2010 and understanding best practice will help you to meet your obligations under this legislation, as well as give you some direction if you’re unsure.

As an employer you also need to meet the needs of other individuals in the workplace, and your organisation as a whole. For employees, a supportive approach from employers can reduce anxiety and provide the skills and confidence to deal with cancer at work. Macmillan provide this useful guide that offers businesses support in managing the impact of cancer.

In the rest of this article, we’ll provide a summary of some of the steps you can take to support an employee who has been diagnosed with cancer.

When the employee receives the diagnosis

As soon as you become aware that an employee or their loved one has been diagnosed with cancer, encourage them to have a confidential discussion with their line manager, HR manager or occupational health manager (as appropriate within your organisation).

Let your employee take the lead by telling you what has happened. When it’s time for you to move the conversation on, here are some points you could ask about:

• How they’re feeling, emotionally and physically.
• Whether they wish colleagues to be informed, and what information should be shared.
• What sort of time off they might need for medical appointments and during treatment (they may not know at this point – it’s often a case of seeing how things go).

You can also offer information about:

• The options for time off.
• Organisational policies on flexible working, work adjustment and return-to-work after sick leave.
• Their rights under the Equality Act 2010, which covers people with a cancer diagnosis, and other relevant laws such as carers’ legislation.
• Any services your organisation offers to help them (for example, an employee assistance programme that provides counselling). If your organisation has access to a welfare officer or occupational health expert, it could be helpful to involve them at an early stage if the employee wants their help.

Make sure you close the meeting with an assurance that your employee’s work is valued and that your door is always open if they need your assistance. Agree how you will keep the lines of communication open, and set a date for the next meeting so you can keep on top of the situation.

Telling colleagues

It’s important that communication with colleagues, clients and customers is not haphazard or left to chance. Agree a communication plan with your employee early on, including what you will, and will not mention to others. They may not wish to tell others they are affected by cancer, and this must be your employee’s decision. However, colleagues may be more understanding about absences, changes in work arrangements and new assignments if they know what is happening.

If your employee agrees that others should know, ask them:

• If they want to break the news themselves.
• If someone else should do it, and whether they want to be present.
• How the news should be communicated, for example one-to-one, or in a meeting.
• How much information should be shared and what should remain confidential.

When sharing information, concentrate on the impact your employee’s illness may have on people and projects at work. Avoid personal details. Use positive language but be honest about what to expect. Don’t dramatise and inform your team about how to best approach and talk with their colleague. You can also invite staff to speak to you or another manager if they’re having practical problems with the situation, or if they are feeling distressed. If you think it’s appropriate, you can point them towards services like Macmillan, which can provide more support.

As a manager, you may be one of your employee’s most important sources of support. You don’t need to be a medical expert, but a basic understanding of cancer and its treatment can help you fulfil that role. This knowledge will allow you to plan for and recognise issues that may emerge at work. Click here to find out more about different types of cancers and the different treatments.

You and your colleagues may also have strong feelings – this is only natural. Don’t hesitate to ask for support in dealing with emotions of your own. Within the limits of confidentiality, it may help to talk to another manager in your workplace.

Options for time off

If your employee hears that they or a loved one has a cancer diagnosis, they may need some time off to be with their family before coming back in to work.

Agreeing some time off work will be one of your employee’s most pressing needs. They should try to give you advance notice so you can arrange cover, but sometimes the unexpected occurs and this may not be possible. People who are having tests, receiving treatment and recovering from cancer will need to attend medical appointments. They may need to stay in hospital, for example if they’re having surgery. They may also benefit from receiving complementary therapies.

Your organisation should have clear policies about sickness leave – this is an essential part of the contract of employment. Your sickness leave policy should include information on how time off for medical appointments will be dealt with. Employers are obliged to pay Statutory Sick Pay (SSP) to qualifying employees who are off sick for four or more days in a row, including weekends and holidays. It is not payable for the first three days in any period of entitlement but thereafter is payable for up to 28 weeks at a weekly-rate subject to current limits. Of course, your employee may be entitled to occupational or company sick pay on top of SSP under their contract of employment. Your organisation may decide to pay over and above these statutory or contractual obligations.

Sometimes cancer puts people on an emotional rollercoaster. Distress can hit them out of the blue. If this happens to your employee, it might help to offer them a private space for a while. You may suggest they go home for the rest of the day. Ask if they would like you to call a relative or friend to come and travel with them.

Keeping in touch

People often feel ‘out of touch’ with work during their absence. It’s important to maintain appropriate contact with your employee during periods of sick leave. It will remind them that they’re valued, however handle communication carefully because there is a risk that your employee might feel you are pressuring them to return too soon.

You should discuss your organisation’s sickness absence policy with your employee. It’s helpful to clarify responsibilities on both sides. If possible, discuss arrangements with your employee prior to their absence.

• Ask them if they want to receive newsletters and key emails.
• Do they want to hear from colleagues? If so, do they prefer phone or email?
• How frequently do they want to hear from the team?
• Ask them to let you know a good time to speak.
• Be aware that the pattern of cancer treatment may make it difficult for your employee to be in contact at certain times, and this may only become apparent after treatment is well underway.
• On the other hand, once you have agreed to call at a certain time on a certain day, keep to that arrangement as your employee may have deliberately made the effort to be ‘up and about’.
• Sometimes your employee may not want any contact. Explore their reasons and reassure them you just want to be supportive. It may simply be a reflection of how they’re feeling at that point in time. You can revisit their decision at a later date when they may find the prospect of contact from work less daunting.

Returning to work

When to return

The simplest and easiest way you can help staff members with cancer is to plan their return-to-work carefully with them. Reasonable adjustments such as flexible working arrangements and a phased return-to-work can ease the transition back to work when people are still dealing with the physical and emotional effects of cancer and its treatment. The health of your employees is vital to the health of your business and a successful return to-work after cancer is in everyone’s interests.

If your employee has been away from work having treatment, it can be difficult to know when they are ready to return. Macmillan’s research into working and cancer found most employees surveyed received little, or no worthwhile medical advice about returning to work at the right time. Many people are largely left to make this decision alone, based on when they feel it’s the right time to return.

Flexible options for returning

 Return-to-work planning should be taken with a constructive approach, where both you and your employee discuss and agree the best way forward. Cancer can be unpredictable so plans should be flexible, allowing for changes along the way.

The possibility of flexible working and a gradual, phased return-to-work are potentially helpful ways of easing someone back into the workplace. It’s important to involve the employee with cancer in a genuine dialogue and a joint decision-making process about their return-to-work.

It’s a good idea to schedule a meeting with your employee at least a couple of weeks before they start their first day back on the job. This gives them a chance to ease back into work, hear important updates and raise any concerns about what to expect. It also allows you to find out how they’re feeling and iron out any potential problems before they occur. It will help you plan any reasonable adjustments you might need to make in the workplace or to the employee’s working day (see below).

On their first week back

For a successful return-to-work, you can try these specific steps:

• Welcome them back. Be there on their first day, or failing that, make sure you phone in. Make sure the rest of the team are expecting them, adding to the welcome.
• Meet at the start of the day to discuss their work plan and handover arrangements. This is another opportunity to check for concerns they may have.
• Arrange a smooth handover. Make sure they don’t come back to a mountain of work and emails. Spread the work out so everything doesn’t land on them at once. This may be the right time to start thinking about any adjustments to the individual’s role or workplace. Your employee will be reassured if they know that it may be possible to make adjustments to help them deal with specific challenges.
• Make them feel part of the team again. Treat all your employees equally to ensure everyone knows arrangements are fair and to avoid resentment.
• Carry out regular reviews. Agree a regular review process with your employee.
• This way, you can monitor their progress, ensure their workload is manageable and make any necessary adjustments to help them succeed.
• Make sure they are taking breaks and that they’re not over-working.
• Consider a health and safety assessment, especially if there has been a change in duties or working arrangements. If they are working from home, you should assess this environment for health and safety too.
• Signpost sources of information and further support.
• You can suggest talking to an occupational health or HR professional if this is possible in your organisation. If your employee benefits plan includes access to a confidential counselling service, you can let them know this is available.

Supporting Carers

Most of the points above can also apply to carers. In addition, carers may have additional difficulties re-entering the workforce. This may be due to loss of skills and confidence, but in circumstances where a carer is bereaved, they’re also likely to suffer emotionally. This is a very personal situation but may be a further barrier to returning to work, and a carer may require help in overcoming these issues. Alternatively, some people may just want to work through problems themselves.

Health and safety considerations and occupational health

Many employees choose to share their cancer diagnosis with their employer. As a manager, you have no legal right to know the diagnosis or the clinical details of an employee’s condition. In fact, employees have a right of confidentiality under the Human Rights Act 1998. However, civil law and medical ethics recognise that managers may legitimately seek information relating directly to operational matters.

Occupational health advisers can assist managers in undertaking an appropriate and specific risk assessment for individual employees with a chronic health problem, such as cancer.

You can ask an occupational health professional for advice on questions relating to the:

• Likely duration of absence.
• Likely degree of disability on return-to-work.
• Likely duration of any such disability.
• Adaptations needed in the workplace to overcome the functional effects of disability.
• Impact of disability on performance and/or attendance.
• Impact of disability on health and safety.
• Consideration of alternative employment within your organisation.

If you do seek occupational health advice about an employee’s condition (with their permission), you should frame your requests for information around questions that are relevant to running your organisation. To some degree it will be a matter of trial and error. It will help if everyone is prepared to take it gradually, and possibly encounter some setbacks.

On the positive side, people who return to their jobs after cancer treatment often find their work takes on an increased importance in their lives. Work provides a sense of self-worth and allows an individual to focus on their abilities, not just their illness. A job can restore normality, routine, stability and social contact. Of course, for many people it’s also crucial to regain the income, particularly if they have been on unpaid leave or reduced pay.