Supporting staff affected by cancer: guidance for employees and line managers

In England, Scotland and Wales, cancer is treated as a disability under the Equality Act 2010 from the point of diagnosis. This means employees who have, or have had, cancer are protected from disability discrimination. Employers must consider reasonable adjustments where workplace arrangements place the employee at a substantial disadvantage because of cancer or its effects.

You do not have to tell your manager or colleagues that you have cancer. However, sharing information with your manager, HR Partner or through an Occupational Health referral can help LSE understand what support or adjustments may be helpful. You can decide what information you feel comfortable sharing and with whom, if anyone, this can be shared.

• Speak to your line manager, HR Partner or the Staff Disability and Mental Health Adviser if work is becoming difficult because of treatment, symptoms, fatigue, appointments or recovery.
• Ask for adjustments as early as possible, where you feel able to do so. Adjustments can be temporary or long-term, informal or formally recorded, depending on what is needed. You may find it helpful to use the Workplace Adjustments Planner to support discussions with your manager.
• Keep your manager updated if your needs change. You do not need to share medical details, but discussing the impact on your work and the support and /or adjustments that would help can enable the School to provide appropriate support.

Your response can make a significant difference to the employee’s experience at work. Start with an open, supportive conversation. Listen, avoid assumptions, and ask what would help. Focus on the impact on work rather than asking for unnecessary medical detail.

• Respect confidentiality. Do not share information about the employee’s diagnosis or treatment with colleagues unless the employee has agreed what can be shared and with whom.
• Agree how and when you will keep in touch, particularly during any periods of treatment or sickness absence.
  
• Review adjustments regularly, as support needs may change during treatment, recovery or return to work.
• Be mindful that cancer awareness campaigns, fundraising activity or awareness months may be difficult for some staff affected by cancer. For example, Breast Cancer Awareness Month takes place in October and may be a sensitive period for some people. Consider how communications or workplace activities may affect staff and avoid assumptions about whether someone will want to engage with, or discuss, these campaigns.
• Review useful information and tools, such as:
  • Staff Disability Toolkit
  • Sickness Absence Toolkit
  • Occupational Health Referrals
  • Return to Work Discussions: Guidance for Managers
  • Workplace Adjustments Planner

Seek advice from your HR Partner, Staff Disability and Mental Health Adviser or through an Occupational Health referral where support needs are complex, changing or unclear. 

There is no fixed list of reasonable adjustments, and a number of adjustments may be combined depending upon the circumstances. Adjustments should be discussed collaboratively and tailored to the individual’s role, treatment, symptoms and recovery. Examples may include:

• flexible start and finish times
• temporary reduced hours or workload
• hybrid or home working where appropriate
• time off for medical treatment or appointments
• additional breaks and/or access to a quiet space
• temporary changes to duties, deadlines or priorities
• a workstation review or DSE assessment where symptoms, treatment side effects or recovery affect posture, comfort, mobility, fatigue or the use of equipment
• a phased return to work following absence or treatment.

The Workplace Adjustments Planner can be a helpful optional tool to support discussions, identify barriers, agree possible adjustments and review them over time. Expert medical advice, including advice from a health professional or through an Occupational Health referral, can also help identify appropriate adjustments.

Returning to work following cancer treatment can be a gradual process. Fatigue, pain, immune system changes, cognitive or physical changes, emotional impact and follow-up appointments may continue after treatment has ended. A return-to-work plan should be realistic, flexible and reviewed regularly.

• Consider a phased return (see below), which can include temporary adjustments or reduced duties where appropriate.
• Agree review points so the plan can be adjusted if the employee’s energy levels or treatment schedule changes.
• Occupational Health may be able to advise on suitable adjustments and return-to-work planning.

Following cancer treatment, employees may be physically and emotionally ready to return to work but may not yet have the stamina, concentration or energy levels to resume their normal duties immediately. A phased return can help employees transition back to work gradually and sustainably.

A phased return is a temporary arrangement that enables an employee to build back up to their normal working pattern over an agreed period. This may involve:

• reduced working hours or days
• a gradual increase in workload and responsibilities
• temporary adjustments to duties
• additional rest breaks during the working day
• greater flexibility around start and finish times
• hybrid or remote working arrangements where appropriate.

As recovery from cancer can be unpredictable, managers should avoid making assumptions about what an employee can or cannot do. It is important to have open conversations with the employee about their needs and to review arrangements regularly.

Where available, advice from Occupational Health, a fit note or the employee’s healthcare team[KD1]  should be considered when developing a phased return plan.

A phased return should be tailored to the individual's circumstances and reflect factors such as:

• the type of cancer and treatment received
• side effects such as fatigue, pain, cognitive difficulties, sometimes described as “brain fog”, or reduced stamina
• ongoing treatment appointments
• the nature of the employee’s role and responsibilities
• the employee’s own preferences and confidence about returning.

Where appropriate, consider and agree the following areas based on the medical advice received:

• the duration of the phased return
• working hours and duties during each stage
• review dates
• any temporary adjustments required
• what support will be available if difficulties arise.

Employees recovering from cancer may need longer adjustment periods than initially anticipated, so plans should remain flexible and responsive to changing needs.

• HR Partner: advice on sickness absence, manager support, formal processes and policy questions.
• Occupational Health: advice on health-related work impacts, adjustments and return-to-work planning.
• Staff Disability and Mental Health Adviser: advice on disability-related workplace support and possible adjustments.
• Staff Counselling Service and Employee Assistance Programme: confidential emotional and therapeutic support.

Access to Work is a government scheme that can provide practical and financial support for disabled people and people with health conditions. It may fund support such as specialist equipment, support workers, travel-related support and mental health support. Access to Work does not replace the employer’s duty to make reasonable adjustments, and the application process can take time, so it should usually be considered alongside local workplace adjustments rather than as the only route for support.

The Access to Work webpages and the Access to Work Toolkit provide further information about the scheme and how to apply. 

The organisations below provide general cancer information and/or support for specific cancer types. They are external organisations, so staff should check directly with the organisation for the most up-to-date information.

General cancer support and information

• Business Disability Forum: Briefing – Employment adjustments for people with cancer: LSE staff can access all Business Disability Forum resources by registering with the Business Disability Forum with their LSE email address.
• Macmillan Cancer Support: guidance on work and cancer, employment rights, reasonable adjustments, money and practical support.
• Maggie’s: practical, emotional and benefits advice for people affected by cancer and their families.
• Cancer Research UK: information on cancer types, symptoms, diagnosis, treatment, research and coping with cancer.
• NHS cancer information: information about cancer symptoms, treatment and sources of support.
• Cancer Care Map: a searchable directory of local and national cancer support services across the UK.
• Shine Cancer Support: support for adults in their 20s, 30s and 40s affected by cancer.

Cancer-type-specific support

• Breast Cancer Now: information and support for people affected by breast cancer, including guidance on work and returning to work.
• Blood Cancer UK: support for people affected by blood cancers, including leukaemia, lymphoma, myeloma, MDS and MPN.
• Leukaemia Care: information and support for people affected by leukaemia, MDS and MPNs.
• Bowel Cancer UK: information, a peer support line, online community and nurse-led support for people affected by bowel cancer.
• The Brain Tumour Charity: information and support for people affected by brain tumours.
• Roy Castle Lung Cancer Foundation: specialist information and practical and emotional support for people affected by lung cancer.
• Target Ovarian Cancer: specialist information, nurse-led support and online community support for people affected by ovarian cancer.
• Prostate Cancer UK: specialist nurse support, one-to-one support, wellbeing resources and local support information for people affected by prostate cancer.
• Pancreatic Cancer UK: specialist nurse support, information resources and peer community support for people affected by pancreatic cancer.
• Melanoma Focus: information, guidance and support for people affected by melanoma, including a helpline and patient resources.

Do I have to tell my manager I have cancer?
No. You do not have to share your diagnosis. However, your manager or HR may need some information about the impact on work in order to explore support or adjustments.

What if my needs change during treatment?
Adjustments should be reviewed regularly and adapted. Treatment and recovery can fluctuate, so flexibility and regular check-ins are important.

What information will be kept confidential?
Information about your diagnosis, treatment or health should only be shared where there is a clear work-related need and, wherever possible, with your agreement. You can discuss with your manager what you are comfortable sharing, who can be told and how information should be communicated.

Will I receive sick pay if I need time off for treatment or recovery?
If you need time away from work for treatment, recovery or appointments, speak to your manager or HR Partner about sickness absence arrangements and any relevant pay provisions. The Sickness Absence Toolkit provides further information, and your HR Partner can advise on the appropriate process based on your circumstances.

I am worried about an Occupational Health referral. What does it involve?
Occupational Health is intended to provide independent advice about how your health may affect work and what support or adjustments may help. A referral should be discussed with you in advance, including the reasons for the referral and the questions being asked.

What support is available when I return to work?
Support may include a phased return, temporary or longer-term adjustments, regular check-ins, workload discussions, Occupational Health advice and access to internal or external support services. Plans should be reviewed regularly, as recovery and treatment effects can change over time.

What should a manager do first?
Respond with care, listen, ask what support would help, agree confidentiality and seek HR or Occupational Health advice where needed.

When should Occupational Health be considered?
Occupational Health may be helpful where advice is needed on work capacity, adjustments, return-to-work planning or the impact of symptoms and treatment on work. Employees and managers are advised to consult with their HR Partner for advice on the referral process.

How should I record information confidentially?
Keep records factual, limited to what is necessary and stored securely in line with LSE processes. Avoid recording unnecessary medical detail. It may be helpful to note agreed adjustments, review dates, communication preferences and any advice received from HR or Occupational Health.

Where can I get support as a manager?
Managers are not expected to manage complex health-related situations alone. You can seek advice from your HR Partner, Occupational Health, the Staff Disability and Mental Health Adviser, or relevant internal support services, particularly where needs are changing, sensitive or unclear.

Where else can I signpost an employee for advice or support?
Depending on the situation, you may signpost to the HR Partner, Occupational Health, Staff Counselling Service, Employee Assistance Programme, Staff Disability and Mental Health Adviser, and relevant external cancer support organisations listed in this guidance.