I am the head of a small consultancy business with 12 employees, and have recently had some very upsetting news about one of the members of staff. Over the past few months one of our longest-serving and most reliable employees has had a series of hospital appointments, around which she continued to work normally and very effectively.

However, after the latest appointment she did not return to work the next day, and telephoned me with a bombshell: she has been diagnosed with breast cancer. Although I understand that the disease was caught before it became too advanced, she does requires surgery, sooner rather than later. I can only imagine what she must be going through and my heart goes out to her.

I have told her to stay at home for as long as she needs to, and have signed her off on sick leave. But there is no telling when, or if, she will be able to return to work after surgery, as she may require further treatment. The future is uncertain, not only for her, but for the business. She is a vital member of staff and has several clients that rely on her.

She was happy for me to inform our colleagues, which I have done. But I don’t know how much we should be telling her clients and how we can avoid a great deal of disruption to the service they receive. Hiring a replacement would seem inappropriate while there is a chance she may return, but we are already overstretched and there is a limit to how far everyone can “muck in” to fill the gap.

Furthermore, we do not have medical insurance and I am unsure about how we can give her a measure of financial reassurance in the long term without writing a blank cheque.

How can I be a caring employer while at the same time doing what is best for the business?

Tracey Huckfield

Head of HR, Macmillan Cancer Support

She says: It’s quite normal that people affected by cancer worry about telling their employer, but your wish to be supportive will be invaluable to her. So, first, develop your understanding of what she’s going through as cancer doesn’t affect everyone equally. At www.macmillan.org.uk there’s lots of information, including a guide for employers, Working Through Cancer.

Next, invite her for an informal chat. Explain your wish to help and understand her cancer and its effects. Explore her feelings about work: she may want some “normality” by returning part-time, so agree a manageable plan and review it weekly. Ask her permission to contact her GP, who could better explain things and advise you. Agree on a plan to deal with clients. Some may wish to give their own support, yet may need an alternative contact during her absence.

If she’s unable to work, it isn’t going to be possible to predict how long she’ll be absent. Keep in touch with her. Let her know she’s valued and missed. Ask her how much contact she’d like while she’s away. Does she want to hear from colleagues?

As her condition’s been caught early, there’s every chance she’ll be able to return to work. People who have cancer are covered under the Disability Discrimination Act (DDA) so you should do what you reasonably can to help her return. Perhaps reorganise her duties temporarily or take on a temp for routine tasks.

Also, your employee is entitled to statutory sick pay and any company sick pay you offer. Once this expires, as she is a valued member of staff, you could consider offering her an extended sick pay period – dependent, of course, on the business’s ability to pay and whether you wish to set a precedent.

Do mention the Macmillan website and helpline to her (08000 895 500). With these she can get all the advice she may need on emotional, financial and practical issues, be it benefits or a grant, support groups or online chat.

Other tips from Macmillan’s Working Through Cancer guide include assigning a mentor or buddy among work colleagues; providing an employee assistance programme (EAP) and allowing flexible or home-working on an employee’s return to work. To download the full guide, visit www.macmillan.org.uk/get_support

Stuart Whitaker

Senior lecturer in occupational health, University of Cumbria

He says: This manager faces a difficult challenge. While sharing the shock of the employee’s diagnosis and wanting to care for her on a personal level, they have a competing responsibility to manage the productivity of the business. They have to do this within financial, business and legal constraints, taking account of any extra burden that may be placed on other employees. All of this can seem overwhelming.

They would be well advised to seek advice from HR and occupational health (OH) specialists, and charities such as Macmillan or Cancerbackup. The first thing to recognise is that many people do come through this situation, and most return to work in a relatively short time. However, the precise course of events cannot be predicted and so the manager needs to make plans with the employee based on the best information available at the time.

The manager, with the employee’s consent, can refer her for an OH assessment. The purpose of this is twofold: to gain an independent view on the likely impact of her condition and how it will affect her ability to work; and to find out what types of reasonable adjustments might be beneficial, what type of rehabilitation plan might be put into place, and what additional support or services might be provided over and above those provided by the NHS to help her function in the workplace.

Reasonable questions to ask of the OH specialist might include an estimation of the likely length of absence, whether on return to work the employee should resume their normal duties, whether redeployment to another job might be appropriate on a permanent or temporary basis, whether there is likely to be any implications for the health and safety of the employee in carrying out their normal duties, and what reasonable adjustments might be required to meet the requirements of the DDA.

In some cases, particularly where there is a rehabilitation plan in place, more than one assessment may be required to support the employee in coming back to work. A discussion early on may reassure her about the prospects of her return, and then additional support at the point of return may be most beneficial. Safe, sustainable and successful return to work is based on a partnership approach where both the employee and their manager receive the optimal level of support they need at this difficult time.

Catherine Kilfedder

Health advisor, BT Group

She says: One in three of us will experience cancer at some point in our lives. It sounds as if your employee’s cancer has been caught early and she has a good chance of recovery. Unfortunately, there is still stigma and fear attached to the word cancer, which is why people often do not want to talk about it, especially to their employer or colleagues.

Understandably, you want to support your employee and get her back to work if possible. The DDA makes it unlawful to dismiss people living with cancer on the basis of their diagnosis, and employers are expected to make reasonable adjustments. This could mean offering flexible hours and homeworking, adjusting performance targets and allowing a phased return to work.

Encourage the employee to meet you to discuss her situation. This will allow her to air any concerns and help you to gauge what support she needs.

This conversation should be handled sensitively and she should not feel under pressure to make any decisions immediately. If your company has access to an EAP, provide her with the details.

While undergoing treatment she may wish to keep working, which may only be possible with some degree of flexibility. As her line manager, you will need to work through the options, ensuring the impact on her, the team and the business is considered.

If she decides to continue working and you are concerned that her treatment may affect her ability to do her job, check with her that her specialist has approved her working. If she is unable to continue working, keep in touch with her while she is off. Keeping her in touch with events at the company will make the transition back to work easier. Staying in touch with colleagues may also be important to her. She is the best judge of what level of contact she wants and how much information she wants people to know.

It is important that you also have the support you need to deal with what is undoubtedly a distressing situation. You may have access to management advice through your EAP, but there are also a number of sources of support and information out there.

If you have any queries or problems, please send them to troubleshooter@peoplemanagement.co.uk