This isn’t the start you had in mind.
You’ve just brought someone into the business who felt like a great fit. Right skills, good attitude, someone you could see adding value quickly. Then, during those early conversations, they tell you they’re managing a long-term health condition that could affect their attendance.
What should feel straightforward suddenly isn’t.
You want to support them properly. At the same time, you need the business to keep moving. In a small business, those two things are closely connected, and when one shifts, the other feels it straight away.
That tension is completely normal. The key is how you handle it from the outset.
Don’t assume the worst
A long-term condition does not automatically mean problems.
Many people manage ongoing health issues while working effectively and consistently. When expectations are clear and communication is right, things often settle far better than you expect.
What makes this harder in smaller businesses is the lack of buffer. One person being off more frequently or needing more support can have a noticeable impact on:
- workload across the team
- customer delivery
- your own time and headspace
That’s why getting the approach right early on makes such a difference.
Know where you stand, without overcomplicating it
Some health conditions may fall under disability protections. That does not mean you need to become a legal expert overnight.
What it does mean is taking a more considered approach before making decisions, particularly where absence or performance is involved.
Where businesses tend to come unstuck is when they:
- react too quickly without understanding the situation fully
- treat sickness and performance as the same issue
- make decisions during probation without stepping back first
A bit of pause and perspective at this stage can save a lot of difficulty later.
Have the conversation early and properly
In most SMEs, there isn’t a dedicated HR team guiding these situations. It often lands with the business owner or a manager who already has a full workload.
That makes early conversations even more important.
This isn’t about lowering standards or overpromising support. It’s about being clear on both sides.
You need to understand:
- what the individual feels they may need
- what is likely to impact their role day to day
- what the business can realistically offer
And they need to understand:
- what the role requires
- what consistency looks like
- where the boundaries are
Avoiding the conversation does not make it easier. It usually creates more uncertainty and more pressure later.
Adjustments should be practical, not open-ended
Support does not need to be complicated.
For a new starter, it is often about putting a few sensible measures in place while they settle in, such as:
- some flexibility around start or finish times
- regular check-ins to keep communication open
- clear priorities during the early months
- reducing unnecessary pressure while they get up to speed
The important point is this: adjustments need to work for the business as well.
It is reasonable to think about:
- how this impacts the rest of the team
- whether the adjustments are short-term or ongoing
- what happens if things do not improve
Supporting someone does not mean committing to something the business cannot sustain.
Be careful around probation decisions
Probation periods are where this tends to feel most uncomfortable.
If someone is struggling and there is a health element involved, it is important to step back before making any decisions. Acting too quickly can create risk, especially if absence is linked to an underlying condition.
At the same time, probation exists for a reason. It is there to assess whether the role works in practice.
Getting this balance right comes down to:
- consistent, documented conversations
- being clear about expectations throughout
- taking advice before making final decisions
Handled properly, probation can still do its job without putting the business at unnecessary risk.
There are limits, and it’s okay to acknowledge them
This is the part many business owners find hardest.
Wanting to do the right thing does not mean the business has to absorb ongoing disruption indefinitely.
There are situations where, despite support and open conversations:
- attendance remains unpredictable
- the role cannot be carried out reliably
- the impact on the wider team becomes too great
When that happens, it is not about fault. It is about whether the role and the reality of the situation still fit together.
These situations can be handled fairly and respectfully, but they do need to be managed properly.
It’s not about choosing sides
This is not a choice between being supportive or protecting your business.
You need both.
When situations like this are handled early, openly and with the right structure, many work out well for everyone involved. And when they don’t, you are in a far stronger position to make a clear, fair decision because you have approached it properly from the start.
If you are dealing with something similar and want to sense-check your approach before it becomes more complicated, that is exactly where we can help.