Return to work after cancer - early intervention

Early intervention practices are very important - the earlier you notice an employee is experiencing potential signs of ill health or injury, the sooner you can take steps to help them. Early intervention programme is considered to be more effective in fostering an improved health and safety culture, as it promotes a workplace that is supportive and committed to the health and wellbeing of employees.

If cancer is diagnosed, exposure to carcinogens and other substances that could make the condition worse or affect the outcome of treatment must be controlled. If controls are not sufficient or changes to the work process can't reduce exposure enough, then consider moving the employee to a different area or changing their duties.

Help and support

Early intervention in the return-to-work process will ensure the best outcome for both employee and employer. It is important to identify potential problems before they occur, or at an early stage.

Problems may include over-estimation of readiness to return to work, lack of understanding of the impact of fatigue by both individual and employer.

Other pre-existing conditions such as asthma or conditions associated with cancer and its treatment e.g. lymphoedema, numbness and/or tingling in extremities, reduced dexterity, decreased strength or range of movement, balance problems, pain, fatigue and so on should also be considered.

Immediate medical advice

If an employee with cancer develops any symptoms, they should be put in touch with an occupational physician or nurse. If the employer doesn’t provide these facilitates, they should advise the employee to consult their GP. It’s important that the employee can provide information about their work and the substances they’ve worked with or been exposed to in current or previous jobs.

Further help may be available from:

  • Fit for Work in Scotland - if employee has been absent for four weeks or more, the employer may be eligible for a free work-focused assessment to help them back to work.
  • Fit for work in England and Wales - all employers across England and Wales can refer employees who have been off work for four weeks or more for a free Fit for Work assessment.
  • ACAS - provides a helpline for employers and employees who are involved in an employment dispute or are seeking information on employment rights and rules. The helpline provides clear, confidential, independent and impartial advice to assist the caller in resolving issues in the workplace.
  • Employees can also get advice from Macmillan Cancer Support.

Review of risk management

If any problems are detected in the workplace, it is advisable to review your management protection programme, or to develop one if necessary. Such a programme may cover:

  • risk assessment
  • control measures
  • monitoring exposure
  • health surveillance
  • education and training of employees.

Consider whether specific risks identified are likely to make the individual’s health worse.

It is essential that any risk assessment and management process undertaken in the case of return to work after cancer is repeated at regular intervals, or specifically when there are changes in the individual’s health.

Recommendations for managers

It is important that any problems are dealt with as soon as possible.

Good practice recommends that you:

  • maintain regular communication with the employee so you can recognise any problems and discuss any changes required at work
  • provide support to individuals who are undergoing treatment, attending appointments, etc.
  • seek help e.g. from health and safety, occupational health and/or human resources departments
  • provide flexible work options, including varying start or finish times or working at home (if possible)
  • provide on-going support to the individual
  • manage the individual’s workload with them to reduce physical and psychological demands
  • understand the psychological impact that the cessation of treatment or the anniversary of diagnosis may have on your employee, and provide support.

Recommendations for those who are returning to work or receiving treatment

For those returning to work or working through cancer it is recommended that you maintain contact with your line manager. This includes:

  • keeping them informed about appointments and treatment
  • raising any problems or difficulties quickly
  • letting them know if any workplace changes or adjustments are not working.

Your line manager can often help you source further information or further help.

The content for this toolkit was produced as part of the IOSH-funded research undertaken by the Institute of Occupational Medicine, Loughborough Uional Medicine, Loughborough University and Affinity Health at work.