Juggling work and cancer is a challenge for anyone – but a blood cancer diagnosis can complicate things even further. While some blood cancers will require urgent treatment, others will require a longer-term approach – potentially affecting employees for the full length of their careers. So it’s really important that we recognise the impact that a blood cancer diagnosis can have on a working individual – and know what we can do to support them.
1. Some blood cancers require immediate treatment…
If your employee has been diagnosed with an acute or high-grade (fast-growing) form of blood cancer, they’ll need to take time off work to receive treatment. The length of time they’ll need to spend in hospital, and recover at home, will depend on the type (and strength) of treatment they receive – for example, recovery from a stem cell transplant could be anything from four to 12 months; sometimes longer.
Legally, employers are obliged to pay statutory sick pay (SSP) to anyone off work for four or more days in a row, including weekends and holidays. If your employee is too ill to work for an extended period, you’ll need to pay SSP for up to 28 weeks.
Your employee may also be entitled to company sick pay (also called ‘contractual’ or ‘occupational’ sick pay) on top of SSP, depending on their contract. Often, an employer will pay company sick pay as well as SSP, at least for an initial period, as a goodwill gesture – even if the contract doesn’t require them to. If you do choose to do this, you should have a set of guidelines in place that outline under what circumstances and for how long you’ll do this, to make sure all employees in a similar situation are treated fairly.
Ill-health insurance can provide financial support for an employee who is unable to work for a longer period of time, or for someone who has been advised to stop work completely. However, providing this benefit can be expensive for the employer and some policies will list exclusions which mean they’re not suitable for everyone, so it’s worth doing your research before taking out a policy.
Many blood cancers and cancer treatments can leave people immune-compromised (which means it’s harder for their body to fight infections). If your employee has a significantly long recovery period, but has reached a point where they’re no longer immune-compromised, you may also want to offer them the opportunity to come into work (in a non-working capacity) for a few hours on an occasional basis. This way, they can keep in touch with colleagues and project teams, making their eventual return to work much easier.
Macmillan has more information to help employers supporting someone receiving cancer treatment.
2. … while others are life-long conditions
Blood cancer doesn’t always require high doses of chemotherapy – depending on the diagnosis, some people can manage their symptoms with daily tablets, continuing to work as normal.
In fact, some people won’t require any treatment at all. If your employee has been diagnosed with a chronic (slow-developing) blood cancer, they may be placed on something called ‘watch and wait’ – which means they’ll be monitored with regular check-ups and blood tests.
Many people on watch and wait will continue to work during this monitoring period and as they start treatment, so it’s important to be aware of your responsibilities during this time. In England, Scotland and Wales, employees with cancer are protected from discrimination at work under the Equality Act 2010. For the purposes of the Act, anyone with blood cancer is considered to meet the definition of disability from the day they are diagnosed. This is true even if they appear well and are not yet receiving treatment.
As an employer, you’re therefore legally obliged to make reasonable adjustments to make sure any workers with blood cancer (including contract workers, trainees, apprentices and business partners) aren’t seriously disadvantaged when doing their jobs. Examples of a reasonable adjustment include allowing time off for check-ups or treatment, offering flexible working hours or offering the option to work from home to help employees cope with fatigue (a common symptom of chronic blood cancers).
If your employee is on ‘watch and wait’, you may wish to download this fact sheet from Bloodwise for employers, for more information.
3. Some blood cancers are life-long
It’s also important to be aware that some forms of blood cancer (like acute lymphoblastic leukaemia, for instance) can quite quickly become life-threatening if someone doesn’t respond to treatment, while others (myeloma, for example), although very treatable, cannot currently be cured.
Depending on their condition and individual outlook, some people can live with blood cancer for the rest of their lives and will wish to continue working following their diagnosis. In this situation, you should make any reasonable adjustments required to help them continue with their work, as mentioned in the section above. You’re also legally obliged not to treat any employee less favourably because of a blood cancer diagnosis, or a reason arising from their diagnosis (such as the need to work reduced hours), unless such treatment is justified.
Although it’s difficult to think about, it’s also important to consider the steps you’ll need to take should your employee unfortunately die from their illness. Macmillan has lots of information about the practical steps you’ll need to take should this happen – for example, telling colleagues and stakeholders, and appointing someone to be a point of contact between your organisation and the individual’s family.
You’ll also need to have plans in place to support the rest of the organisation. Cruse Bereavement Care is a charity that supports people when someone dies; it offers face-to-face, telephone, email and website support, and can be a good point of reference for your employees. The Bloodwise Support Line (0808 2080 888) is also there for anyone affected by a blood cancer diagnosis. Lines are open Monday–Friday, 10am–4pm.
4. It’s important not to make assumptions
No two blood cancer diagnoses – or individuals – are the same, so it’s important not to make assumptions about your employee’s circumstances, capabilities or any adjustments you may need to make in the workplace.
For example, some individuals may choose to tell colleagues themselves about their diagnosis, while others may prefer for another colleague to share the news on their behalf. Some people – particularly those without many symptoms, who manage their condition with regular check-ups or daily tablets – may choose to keep their diagnosis private. This is entirely their right and any request to keep things confidential needs to be respected.
If your employee does choose to share their diagnosis with others, it’s important to understand exactly what information they would like to be shared, how they would like it communicated and with whom. Where possible, any decisions like this should be made in partnership with your employee – and, where relevant, on the advice of their specialist doctor (haematology consultant).
For guidance to help you make reasonable adjustments for employees with blood cancer, go to gov.uk. Visit our information and support pages to find out more about specific blood cancers.
5. Remember: things can change
It’s important to make sure that any arrangements for your employees remain appropriate if things change. For example, if your employee continues to work following their diagnosis, you may want to schedule quarterly review sessions, or more informal chats following you’re their check-ups, so you can make further arrangements if their symptoms develop.
Equally, if your employee has received treatment for an acute blood cancer and is recovering, it’s important to help them prepare for their eventual return to work. If you don’t have access to advice from your employee’s healthcare team, you may want to seek advice from an occupational health professional, who will specialise in workplace health issues like a phased-return to work. You’ll also need to think about anything else that might affect your employee’s return to work, including your own assessment of their needs and those of the rest of the team.
Although it’s important to get a return-to-work plan right, it’s also good to be aware that too many emails or appointments could overburden your employee – particularly if they’re still recovering from treatment. Where possible, follow their lead and make it clear that you’re happy to discuss next steps when they’re ready.
The NHS offers occupational health services that are available to all UK businesses.
6. Emotional support is just as crucial
Practical support is key – but a blood cancer diagnosis can have a serious emotional and psychological impact on people, too. Being told that you have blood cancer can be very upsetting and will almost certainly bring many different emotions.
Even for people on watch and wait, who aren’t receiving treatment, continuing life ‘as normal’ can be a daily struggle, with many experiencing high levels of anxiety between their check-ups. As an employer, it’s important to be aware of this and to recognise that everyone will cope with a blood cancer diagnosis in their own way.
Employee assistance programmes and counseling sessions can be really valuable to anyone finding it difficult to process a blood cancer diagnosis, so it’s crucial that you make employees aware of any support that is available to them through your organisation.
Read blogs from the Bloodwise Community to learn more about the emotional impact of life with blood cancer.
Macmillan offers workplace training, guidance and resources to help organisations manage cancer in the workplace. Visit macmillan.org.uk/atwork to find out more.