Cancer isn’t an easy thing to discuss. There is no shame in admitting that. However, with around 750,000 people of working age with some form of it in the UK – representing over a third of the 2 million people living with the condition – it is wise to think about your approach now before you, as an employer, have to deal with it. With people living longer and retiring later, the numbers of people in the workplace diagnosed are only going to increase. Cancer is just one – and certainly the most emotive – example of the serious illnesses that could impact on your employees, their attendance and productivity.
“The pressures put on an employee with cancer have a direct effect on their ability to manage or even recover,” says Elliott Hurst, director of health consulting at AXA PPP Healthcare, one of the biggest UK health insurance providers. The physical and emotional strain of a serious illness can be severe and, when you combine that with the potentially damaging financial impact, the result can be devastating. But that’s not to say a diagnosis automatically leads on to periods of absence.
“From an employer’s perspective, it is better to have your experienced and valued employees contributing to the workplace in some way, shape or form than not and with proper planning this can be achieved,” says Hurst. Therefore, an effective workplace policy should be in place to ensure you are best equipped to deal with cancer and other serious illnesses. As with all good policies, it is best to begin by amassing all the relevant information that’s available, including a full understanding of the law. As an employer, you are legally obliged to make workplace adjustments where appropriate, just as you would with any other disability. Access to Work is a specialist disability service delivered by Jobcentre Plus, which gives practical advice and support that may be able to help with the cost of making workplace adjustments.
“It is good to have a better understanding of the illness your employee is suffering from. Cancer, for example, is not a single disease with a single cause and a single type of treatment,” says Hurst. “Each cancer experience is different, but having a little knowledge can help you as an employer to better understand what the person is going through and how best to support them.”
A government white paper in 2011 suggested that employers need to do more about the health of their employees. Dr Gordon Wishart, a cancer surgeon and medical officer at HealthScreen UK has seen a major rise of employers offering cancer screening as part of their benefits packages. “Companies are engaging with us to explore early cancer detection for their employees, which in many ways is adding to the already existing employee benefits that are available through employers and in some cases that’s been completely sponsored by the company,” he says.
With most cancers, if you pick it up early it requires less treatment, which is a better outcome for employees and for the employers. “It means less time off work, and getting that employee back to their desk as soon as possible and back to being an efficient, productive member of the team,” says Dr Wishart. A screening by HealthScreen UK only costs around £100 and if it is paid for through a salary sacrifice, it becomes more tax efficient and an employee will only pay around £50-60, or about £5 per month.
Often a small business won’t think about the issue of cancer until it is raised by an employee, which can take managers and HR by surprise. Therefore they are often nervous and uncertain about what to say. Good quality conversations between employee and employer are essential to understand their requirements and plan for the best possible support.
“It is important for employers and managers have some kind of training or insight that allows them to understand how much a serious illness like cancer can really turn somebody’s life upside down,” says Dr Jill Miller, a research advisor at CIPD. “Have an awareness of the emotional and financial strain it puts on people and that how you respond and support employees has a huge impact on both their morale and on the rest of the workforce as they will see the organisation is a good place to work.”
There are a few things to bear in mind when having these conversations. “It is best for the manager, the employee and HR to get the expectations out at the beginning,” says Dr Miller. “It is important to talk about who the employee wants to know among the business and how they want other people to react. Do they want people to talk about it, or do they want them to act normal and talk to them as they always have done?”
Needs will differ from employee to employee and from cancer to cancer. Different cancers will have different paths and treatments will have different demands on people, so constant conversations with employees to get updates on their progress is essential to know what’s going on. “It’s important to think about what support and flexibility you can offer to help people stay in work,” advises Dr Miller.
Employers also need to understand that recovery is a process and that it takes time. Legally, they have a duty to make reasonable adjustments to support a return to work, which will depend on the circumstances, including practicality, cost and the extent to which an adjustment will be effective in alleviating any disability. Adjustments might include offering lighter duties or allowing extra breaks.
These days, many people are cured of cancer or are able to live with it for many years. Some people may have short or long-term side effects from the illness or its treatment. Therefore, they may continue to need support after their treatment ends. “Many people tell us that that work can help to restore a sense of ‘normality’ after a cancer diagnosis. Try to find out a little about the type of cancer your employee or the person they are caring for has and what the effects of treatment are likely to be,” recommends Hurst.
Work contributes to financial independence, provides a sense of purpose, creates structure in our lives and is a lifeline back to normality, wellbeing and recovery for those suffering. For Dr Miller, it is essential to make the transition back to work as easy as possible. “It is also important to think about employees caring for those with serious illnesses and how to respond to employees who are supporting a family member or close friend who has had a cancer diagnosis.”
There is comprehensive legislation in place to support a successful return to work. Together, the Equality Act 2010 and the Disability Discrimination Act 1995 provide protection from discrimination. Everyone with cancer is classed as disabled from the point of diagnosis for the rest of their life, and their employer or a prospective employer must not treat them less favourably for any reason relating to their cancer. All areas of employment are covered including recruitment, promotion, training, pay and benefits.
Coming back to work can be very difficult for a patient. A recent study by Macmillan, the cancer charity, showed that 57% of survivors who were in work when diagnosed had to give up their job or change roles due to their illness. This means the total loss in productivity of survivors unable to return to paid work in England was estimated, in 2008, to be as high as £5.3bn. You must be prepared for such a possibility because small businesses often rely on teams that, while few in number, are high in skills and experience, so the impact can be particularly devastating.
If an employee comes back to work, which is often the case, there are a number of steps that can be taking to make things easier. This includes implementing a standard, phased return to work plan. You should also provide regular catch-ups to check all is working well.
More than anything, a clear policy is key to coping with cancer in the workplace. But it’s important to remember that with the devastating effects of serious illness on employees, there are no quick fixes.
Ryan McChrystal
Surviving Breast Cancer Now! 
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