I wonder how to manage employee absence from an elective procedure or prescribed medication?

Absence management is something most employers will need to navigate at some stage. While policies are often designed to address straightforward sickness absence, more nuanced situations can arise in which the reason for absence is less clear-cut. One such scenario that is becoming increasingly common is where an employee is absent due to side effects following an elective decision. This might include cosmetic surgery or the use of weight loss medication.

This issue is not purely theoretical. UK data shows that 148.9 million working days were lost to sickness absence in 2024 alone, averaging 4.4 days per worker.

These situations can create uncertainty for employers, particularly when the absence stems from an employee's choice. This article will explore whether the absence should be treated as sickness, whether sick pay applies, and how to ensure a fair and consistent approach.

Avoiding a fault-based approach

In some cases, elective procedures such as cosmetic surgery are planned in advance, and employers may reasonably require employees to take annual leave for the procedure itself. This is particularly relevant where the employee is otherwise fit for work but chooses to undergo treatment.

However, where an employee experiences unexpected complications or side effects following the procedure or treatment, the absence is more likely to fall within the scope of sickness absence.

It can be tempting to approach these situations by focusing on the fact that the employee made a voluntary decision. However, in practice, employers cannot withhold sickness absence on the basis that the underlying cause was elective. Once an employee is unwell, the key consideration is typically their fitness for work rather than how the illness arose. Adopting a fault-based approach can create unnecessary risk, particularly if it leads to inconsistent decision-making or a departure from established policies.

Understanding the role of company policies

Clear, consistent and well-communicated policies can provide valuable guidance in these situations. They can set expectations for notification requirements and the provision of medical evidence, helping ensure absences are managed consistently across the organisation.

Many employers choose to distinguish between planned and unplanned absence. For example, a policy may require employees to take annual leave for elective procedures where the timing is within their control, while treating any subsequent medical complications as sickness absence.

Employers may also wish to clarify their approach to sick pay. While eligibility for Statutory Sick Pay (SSP) depends on whether the employee is genuinely incapable of work, employers have greater flexibility with contractual sick pay. For example, a policy may provide that employees recovering from purely elective or cosmetic procedures are not entitled to enhanced company sick pay, even where they may still qualify for SSP.

Ultimately, having a clear and consistent approach not only supports fairness but also strengthens an employer’s position should decisions later be challenged.

Weight loss medication and additional considerations

Absence linked to weight loss medication can present additional complexities, particularly as the use of medications such as GLP-1 receptor agonists (often prescribed for weight management) becomes more widespread.

In some cases, these medications may be prescribed by a medical professional, even where they are privately funded, and may be linked to underlying health conditions such as obesity or type 2 diabetes. This means that what may initially appear to be an elective choice could, in reality, form part of a broader course of medical treatment.

Employers may also see absence arising from the side effects associated with these medications. Common side effects can include nausea, vomiting, diarrhoea, abdominal discomfort, fatigue, dizziness, and, in some cases, more significant gastrointestinal issues. Depending on the severity, these symptoms may affect an employee’s ability to work, particularly in roles that require concentration, physical activity, or regular, uninterrupted attendance.

As a result, employers should be cautious about making assumptions based solely on the perceived “elective” nature of the treatment. Consideration should be given to the underlying reason for the medication, as well as the impact of any side effects on the employee’s fitness for work. In some circumstances, there may also be wider considerations, including whether the employee’s condition could amount to a disability.

Taking a careful, evidence-based approach (supported by appropriate medical input where necessary) can help ensure that these situations are managed fairly and that potential legal risks are appropriately mitigated.

Managing absence in practice

When managing absence arising from side effects, a balanced and consistent approach is usually most effective.

Employers should:

• Follow their usual sickness absence procedures.
• Maintain appropriate contact with the employee.
• Obtaining medical evidence where necessary.

The focus should remain on the employee’s current ability to work rather than the circumstances that led to the absence. Where absence becomes more frequent or prolonged, employers can address this in line with their standard absence management processes.

Maintaining a supportive tone throughout is also important. While the initial decision may have been elective, the impact on the employee may be genuine and significant.

Summary

Situations where absence arises from an employee’s elective choices can feel complex, but in practice, they are best approached through the same principles that underpin effective absence management more broadly. By focusing on the employee’s fitness for work, consistently applying policies, and avoiding assumptions about personal responsibility, employers can respond in a way that is both fair and legally robust.

Ultimately, a clear, balanced, and pragmatic approach will enable organisations to manage these scenarios confidently while maintaining trust and consistency across the workforce.

Get in Touch

If you need support navigating complex absence issues or want to review your policies, our Employment team can help. Contact us on 023 8071 7717 or employment@warnergoodman.co.uk.