NHS Phased Return to Work Plan: Template and Rights

This guide is for NHS staff coming back from sickness absence, or about to, and for anyone helping them. It covers where a phased return comes from, what a fit note can and cannot do, how pay works, how to propose a plan, and a copyable template. It is general information, not medical or HR advice. FrontlinePay is independent. Your occupational health service, trust policy and union rep decide the specifics.

What a phased return is

ACAS describes a phased return as a gradual return after absence, such as working reduced hours, doing different duties or taking on a lighter workload. It may suit someone recovering from long-term illness, a serious injury or a bereavement. The employer and the worker agree it together. A fit note may suggest a timeframe, but both should still talk it through. The length depends on the person and is agreed between both sides. Both should check regularly how it is going, and the employer should be flexible, which could mean extending the period or changing the duties or work pattern.

The elements you can phase are hours (fewer hours or shifts a week), duties (leaving out certain tasks), pattern (for example no nights or on-calls to start), place (some home working where the job allows) and support (extra supervision or check-ins). Most plans combine more than one.

Where a phased return comes from in the NHS

There is no statute that gives an employee a right to a phased return. In the NHS the starting points are in the Terms and Conditions of Service Handbook (England edition, Amendment 63 for Section 14):

• ✓ Section 14, paragraph 14.14. During the rehabilitation period, employers should allow employees to return to work on reduced hours or, where possible, encourage home working, without loss of pay. This needs to be consistent with statutory sick pay rules.
• ✓ Annex 26, paragraph 10. Employers should consider early interventions as early as practically possible, and at the latest within one month of an employee going sick. Phased return is one of them, described as enabling staff to work towards fulfilling all their duties within a defined and appropriate time through interim flexible working arrangements, whilst receiving their normal pay.
• ✓ Annex 26, paragraph 9. Reviews while someone is off sick should take occupational health advice on, among other things, the prospects of a return to the previous employment with or without adjustments and a phased return with or without a need for adjustments.
• ✓ Annex 26, paragraph 11. Before terminating a contract on grounds of incapacity, all other options should meaningfully be considered, including rehabilitation, phased return, a return to work with or without adjustments, and redeployment.

Wales, Scotland and Northern Ireland have their own editions of Section 14, so paragraph numbers differ. Annex 26 is the sickness absence annex in the England edition we read. Whatever the national text, your trust writes its own sickness absence policy, and that is what a manager will follow. Ask for it.

The fit note and what it can and cannot do

A fit note from a doctor, nurse, physiotherapist or other healthcare professional can say you are not fit for work or that you may be fit for work with support. GOV.UK says that under 'may be fit' the professional can tick one or more suggestions:

• • Phased return: gradually building up duties or hours
• • Amended duties: changing tasks to take account of the condition
• • Altered hours: changing when or how long you work
• • Workplace adaptations: changing the workplace, including home working

GOV.UK also notes that since 27 January 2022 a fit note is needed after 7 days of sickness to claim benefits or statutory sick pay. For what changed in statutory sick pay in April 2026, see our SSP changes guide.

Pay and sick pay during a phased return

Pay is the question that causes most disputes. Three sources apply, and they do not say exactly the same thing.

The Handbook wording is 'should', not 'must', and it sits inside your sick pay scale. Under England paragraph 14.2 your contractual sick pay follows a scale based on reckonable service, and paragraph 14.7 works out what is left from paid sickness in the 12 months before your first day of sickness. Paragraph 14.13 gives employers discretion to extend sick pay beyond the scale where a return in the short term is expected and an extension would materially support it. Together that means a trust can often support a phased return on normal pay, but you should confirm how yours treats the unworked hours, and whether the time counts against your sick pay. Ask in writing.

If your sick pay is running low, work out where you stand with the sick pay runway calculator and read what happens when NHS sick pay runs out. For how the scale works see NHS sick pay policy explained.

How to ask for a phased return

Free phased return plan template

Enter the hours you are proposing and the table builds itself, then fill in the details and copy the plan. Anything you leave blank shows as a square bracket for you to complete. The plan is not saved or sent anywhere.

PHASED RETURN TO WORK PLAN

Employee: [your name]
Job title and department: [job title, band and ward or team]
Trust: [trust name]
Line manager: [manager's name]
Date this plan was agreed: [date]
Plan based on: [for example the date of your fit note, the date of the occupational health advice, or the date of your meeting]

1. HOURS
[Add contracted hours, hours in week 1 and weeks to full hours above to build the table, or write the hours for each week here.]

2. DUTIES AND LIMITS
Duties: [what you will do, and anything you will not do yet, for example no lone working, no lifting, no on-call, no nights, supernumerary status]
Adjustments: [equipment, location, breaks, home working, extra time between tasks, anything from occupational health or the fit note]

3. PAY
Pay during the phased return: [what you and your manager agree, checked against the trust's sickness absence policy, including how any unworked hours are treated: normal pay, sick pay or statutory sick pay]

4. ANNUAL LEAVE AND BANK HOLIDAYS
[how annual leave and bank holidays will work during the phased return, as agreed with the manager and HR]

5. SUPPORT AND REVIEW
Check-ins: [for example a short weekly meeting with my manager on [day], and a review meeting on [date]]
We will review the plan at each check-in. If the plan is not working, either of us can ask to slow it down, hold the hours where they are, change the duties or extend the period. Any change will be agreed and written down. Occupational health can be asked for advice at any review.

6. IF THINGS CHANGE
If my health changes or I am unable to carry on, I will tell [manager or named contact] as soon as I can, and we will agree what happens to the hours and to my pay.

Agreed:
Employee: ______________________  Date: ____________
Manager: _______________________  Date: ____________

This plan is general and does not replace the trust's sickness absence policy or advice from occupational health, HR or my trade union representative.

An illustration of the table, not a recommendation

To show how the table works, here is one made-up proposal for someone on 37.5 contracted hours, starting at 15 hours in week 1 and reaching full hours in week 6, built by the same function as the template. Nothing in the sources we checked recommends a starting point or a length. Yours should come from occupational health advice, your fit note and what you can manage.

Reviewing it, and what to do if it is not working

ACAS says both sides should check regularly how a phased return is going, and that the employer should be flexible. Put that into practice:

• ✓ Book a short check-in each week at the start, and a longer review at the point the hours step up
• ✓ Keep a simple note of what you worked, what you found hard and any symptoms or fatigue you want to raise
• ✓ If a step is too much, ask to hold the hours where they are rather than waiting until you are off again
• ✓ Ask for occupational health advice if the plan stalls, and ask whether any reasonable adjustment would help
• ✓ Get every change agreed in writing, including what it means for pay

If a phased return is repeatedly not working, the next steps depend on your trust's policy. Annex 26 says that before a contract is ended on capability grounds the employer should meaningfully consider the alternatives, including phased return, adjustments and redeployment, and paragraph 14.18 of Section 14 sets out when an employer can end employment before sick pay runs out. Read NHS ill-health dismissal and your pension and the NHS capability procedure so you know what that process looks like, and speak to your union rep early.

Disability and reasonable adjustments

ACAS says that if you are disabled, your employer must make reasonable adjustments to support you during the return. A phased return can itself be a reasonable adjustment. Whether your condition is a disability under the Equality Act is a legal question and you do not have to settle it before you ask. Our guides on disability and reasonable adjustments at work and occupational health referrals explain how to raise it. If your absences are being counted against review points, see the Bradford Factor and trigger point calculator and the Sickness Absence Meeting Pack.

Related guides

This page is general information about phased returns for NHS staff, correct to the best of our knowledge as of 19 October 2026. It is not medical, HR or legal advice and should not replace your trust's sickness absence policy, occupational health advice, or advice from your trade union representative. FrontlinePay is an independent site and is not affiliated with ACAS, NHS England, any NHS trust or any trade union.