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Honesty is the best policy for small business bosses supporting employees with cancer

Research from AXA PPP healthcare suggests managers in smaller sized businesses need an honest, open approach to supporting employees who have, or who have had, cancer back to work. 

Returning to work after cancer can be a daunting prospect. As well as the physical effects of cancer and its treatment, such as fatigue, employees may experience psychological or emotional effects, even when they get the ‘all clear’. Workplace support and flexibility can help ease the transition but, for smaller sized firms, this may not be so easy to accommodate.

It’s perhaps not surprising, then, that new research from AXA PPP healthcare suggests that managers in smaller businesses might need some help when it comes to supporting employees with cancer – and especially in talking with these employees to establish what support is needed. The healthcare company polled 500 UK managers of someone who has or has had cancer, 82 of whom work in organisations employing 10 to 49 people, and found that over half (51%) of the managers in these smaller sized organisations admitted they have never discussed the employee’s cancer with them. In a similar vein, nearly half of these managers (48%) confessed they didn’t know how to talk about cancer – or indeed other illnesses – with employees. These are worrying findings as this lack of dialogue could be limiting managers’ ability to support employees back to work.

To address this, AXA PPP healthcare has prepared some tips to help managers to speak more openly with employees returning to work after cancer treatment.

  1. Talk to them while they’re away from work

If an employee diagnosed with cancer is, or is going to be, absent from work, agreeing with them as soon as practicable how and when you’ll be keeping in touch can help to manage their – and your – expectations. Likewise agreeing how they want to talk about their cancer. This should hold you in good stead and should help to ease their transition back to work in due course.

It is therefore encouraging that many managers in smaller sized businesses have been taking a proactive approach to this – of those who have discussed employees’ cancer with them, nearly three quarters (73%) said they’d asked the employee how they wanted to talk about it and discussed it with them.

Evelyn Wallace, cancer care operations manager at AXA PPP healthcare, comments: “Talking with an employee about their cancer can be hard. Line managers often want to show empathy but also have practicalities to consider – especially in smaller sized businesses where it might be harder to cover for workmates with medical conditions that necessitate having time off. But an open and honest conversation with the employee can enable bosses to gain a better understanding about the support they need and may, in turn, help to ease their return to work.”

  1. Respect their wishes for confidentiality

While an open conversation can pay off when it comes to talking with an employee about their cancer and the support they need, the same shouldn’t be assumed when it comes to talking about it with their colleagues – even in the close working environments that can prevail in small businesses. Respecting how much the employee wants their colleagues to know can help them keep control over what is a very personal matter. It’s therefore alarming that, of the respondents who have managed an employee back to work in an organisation employing 10 to 49 people, over half (52%) admitted they’d told the employee’s colleagues about their cancer without discussing it with them, as they thought their workmates should know about it.

  1. Don’t make assumptions about their abilities

Employees can feel pressured to quickly return to their previous hours and workloads after having a serious illness such as cancer. While this may be fine for some employees, it might leave others feeling physically and emotionally drained. An assumption that employees wouldn’t be ready to resume their responsibilities is perhaps why half of the small business managers we surveyed who’ve managed an employee back to work, unilaterally decided to reduce the employee’s responsibilities without their agreement. Similarly, 78% gave the employee a different role on their return to work, which seems to have been counterproductive as 64% of them said the employee didn’t like it.

Evelyn Wallace continues, “Every person is different and managers – despite good intentions – should never make assumptions about what the employee is able to do. Instead, it’s far better to ask them and then establish what adjustments can be made – for example to their place or hours of work or to their responsibilities. While a change of role might be appropriate, it must be agreed by the employee to avoid discriminating against them because of their cancer.”

  1. Be flexible

It can take time to recover from any serious illness and each person will want to handle things differently. Indeed, our research of 500 adults who have or have had cancer and returned to work revealed that 40% said they felt scared, anxious or nervous about the prospect of going back to work. It is important to remember that they may need time off work for appointments, treatment and recovery, so don’t expect an orderly or formulaic return to work.

Iain McMillan, director of SME, AXA PPP healthcare, comments: “Small business bosses often have the advantage of being able to put in place flexible arrangements to help employees return to – and stay at – work after they’ve been absent. Managers may also have a close working relationship with their employees, meaning they’re ideally placed to identify when an employee needs support and then establish what flexibility can be arranged. The key to putting in place such support is managers feeling able and comfortable in having an open and frank conversation with the employee.”

Download AXA PPP healthcare’s Manager guide to speaking about cancer here. You can also find information on the AXA PPP healthcare website: and join the conversation using #LetsSpeakCancer.