Managing workers affected by cancer in SMEs

Newsletter articles

1 Sep 2012

Employment Studies Issue 16

Sally Wilson, Research Fellow

Sally WilsonA recent study conducted by IES's work health and well-being researchers investigated experiences of managing cancer in the workplace among smaller employers. The work was commissioned by Macmillan Cancer Support (MCS) to establish whether its 'Working Through Cancer' (WTC) package of support, currently targeted at larger employers, is suitable for use by managers working in small and medium sizes enterprises (SMEs).

Experience and characteristics of SMEs

A recent survey to assess demand for this type of support showed that a significant proportion of SME managers had dealt with WTC issues in the workplace. Sixteen per cent of employers reported having experience of managing an employee affected by cancer directly, while 11% of employers reported managing someone who had cared for someone with cancer; 24% reported experience of managing one or both of these scenarios[1].

Interviews with employers and SME intermediaries identified a number of potential benefits that SMEs are able to offer when an employee is affected by cancer. In particular, the 'family mentality' often seen in smaller companies can provide a supportive environment for a member of staff dealing with a long-term illness. Many SME research participants who had managed a worker with cancer felt that they had handled the situation well and had been able to help the affected employee remain in work productively.

Getting the right balance between support and business needs

However, the study also revealed that SMEs can struggle with aspects of this scenario that benefit from having relevant experience and expertise to draw upon in-house. Also, in the absence of company policies to refer to, their approach to long-term health issues can be ad hoc. While most employers want to do the 'right thing' it can be very difficult to get the balance right between supporting an employee and making decisions that are in the interests of the business.

The cost of long-term absence can be difficult for some SMEs to absorb and it is not always viable to hold a job open for an unwell member of staff (or an employee who is a carer of someone with cancer). Further, the inconvenience of unpredictable absence can have a disproportionate effect upon staff in small organisations due to their size. And, although awareness is increasing that cancer is legally defined as a disability, smaller employers can find it hard to identify and implement suitable in-work adjustments to enable a member of staff with cancer to remain in work.

The study confirmed that many smaller businesses operate in relative isolation and have few points of reference when approaching scenarios with which they are unfamiliar. In contrast to large companies where staff can consult with a head office or other branches, contact between SME managers and the wider business world can be limited to day-to-day contact with a small number of clients and suppliers. As a result, there can be limited opportunity for managers within SMEs to update their skills or gain awareness of where to turn for help.

Need for support and advice

Employers who participated in the study tended to be unfamiliar with sources of support or advice that might facilitate management of these issues, such as Access to Work or the Department for Work and Pensions (DWP) Health for Work Adviceline (or its equivalents in Scotland and Wales). Those who reported accessing support cited Acas, the Federation of Small Businesses and the Health and Safety Executive as sources. Without reliable sources of information and support, SMEs potentially lose out on a view that is independent and balanced as well as informed.

The needs of carers were also considered; a number of employers had managed or comanaged a smaller business while undertaking caring responsibilities themselves. Further, many had frequently experienced difficulties keeping the business afloat when a senior member of staff with a role in running the business had been absent as a result of caring responsibilities. The responses of other key parties, such as franchisers, co-partners, and junior staff providing cover, had not always been supportive.


The study concluded that efforts to support SMEs to manage work and cancer issues need to acknowledge the practical considerations of 'keeping the business going' and employers' concerns regarding the financial viability of retaining staff who are not able to perform their usual duties.

A number of recommendations were made regarding the format and content of information that SMEs would prefer to receive. IES's recommendations are currently under review by MCS in advance of launching further WTC initiatives later this year.

Footnotes [back]

1. BDRC Business Opinion Omnibus Survey (October/December 2011)

For more information on this work, please contact Sally Wilson at IES.