How to support employees with chronic illnesses

The most prevalent chronic conditions in the workplace are those related to chronic pain, particularly musculoskeletal issues. This includes lower back pain, neck pain, and general joint or muscle pain—conditions that can affect anywhere from 25% to 40% of employees aged 16 to retirement age¹.

Cancer, while less common, affects around 1.5% to 2% of employees. However, its impact is profound—not only for the individuals but also for their organisations. Worryingly, we’re seeing a rise in younger working-age populations being diagnosed with cancers like breast and colorectal cancer, possibly linked to lifestyle changes such as diet trends and reduced physical activity.

Mental health conditions are another significant category of chronic illness in the workplace. These range from stress, anxiety, and depression to more severe conditions like PTSD. Together, mental health and chronic pain form the majority of long-term health challenges employers need to address when considering chronic disease management.

I had a nearly 20-year career as a civil engineer, working on major projects like high-rise buildings and commercial developments. After having two children, I already knew it would be difficult to balance the long hours demanded by the industry while raising a family. I had just accepted a board position with a construction company when I received my breast cancer diagnosis. I had to turn down the role and focus entirely on my treatment.

At the end of my treatment, I couldn’t imagine returning to my previous career. Instead, I began working with the Nuffield Group on a programme to rehabilitate breast cancer patients. That programme, originally called Bosom Buddies, eventually evolved into Boutros Bear².

One of the most challenging aspects of recovery is the pressure people feel to return to work too quickly, often to reassure themselves or others that they’re “back to normal.” This can lead to burnout or setbacks. A graded return to work is far better, allowing people to rebuild gradually. My experience ultimately shifted my career into healthcare, where I now focus on supporting others facing similar challenges.

For any chronic illness, a structured rehabilitation programme, like ours at Boutros Bear, can be incredibly effective. These programmes combine weekly health coaching with tailored support based on an individual’s medical history and specific needs.

For example, if someone has limited mobility or pain issues, a health coach who is also a physiotherapist can address physical barriers—be it tightness in the hips, shoulder pain, or a lack of previous engagement with physical activity. The goal is to help people get moving and gradually rebuild their physical strength.

Health coaching also focuses on setting clear goals and behavioural intentions. It’s about asking questions like, “What do you want your life to look like if your condition is under control?” or “What have you given up because of your illness, and what could you regain?”

Week by week, small changes are introduced—whether through exercise, physiotherapy, or dietary adjustments like adopting a Mediterranean or anti-inflammatory diet. These cumulative changes lead to improved long-term outcomes, helping individuals move further away from the limitations of their condition and closer to a healthier, more fulfilling life.

Disclosure is incredibly important, but it can also be challenging. Many employees hesitate to talk to their employer about a chronic condition due to fears of discrimination or negative consequences. A 2017 Pfizer report, The Ripple Effect of Cancer³, highlighted that individuals with cancer, for example, often face pay cuts, being overlooked for promotions, or being pushed to lower positions—despite this being illegal.

We also hear from organisations claiming to have no employees with chronic conditions. Statistically, that’s highly unlikely – if not impossible. It suggests employees are afraid to come forward, which is understandable but creates a hidden problem.

The key is fostering a workplace environment where employees feel safe to disclose health challenges without fear of judgment or repercussions. This allows employers to make reasonable adjustments, like flexible work arrangements or graded returns after surgery or treatment.

From an employer’s perspective, encouraging openness brings real benefits. When employees feel supported, they’re more likely to stay loyal, remain engaged, and achieve better outcomes—creating a win-win situation for everyone involved.

Employers need to go beyond the light-touch support offered by cash plans or Employee Assistance Programmes (EAPs). While these can be helpful for immediate needs—like accessing a private GP, a counselling session during a crisis, or a few physio sessions—they aren’t sufficient for employees living with chronic conditions.

Supporting these employees requires a comprehensive rehabilitation programme. At Boutros Bear, for example, we take a holistic approach that includes:

• Physiotherapy and Movement: Helping individuals regain physical function and address pain through tailored exercises.
• Educational Content: Empowering employees with knowledge about chronic conditions, such as the neuroscience of pain, the role of diet, and overcoming fear of movement.
• Dietary and Nutritional Guidance: Allowing employees to gain a profound understanding of the role of their diet on their physical and mental wellbeing and supporting them to implement positive changes.
• Mental Health Support: Offering therapies like CBT and Acceptance and Commitment Therapy to address the psychological impact of chronic illness.

This deeper, more structured approach is more costly than traditional benefits but delivers a strong return on investment. By providing employees with the tools and support they need, employers can bring them back into the workplace, keep them engaged, and foster a healthier, more productive workforce.

When supporting a colleague with a cancer diagnosis, the first meeting is critical in building trust and understanding how to move forward together. The decision on whether to continue working, reduce hours, or take time off entirely should be left to the individual. They’ll often be guided by their oncology team and their personal preferences.

Cancer journeys are deeply personal, and there’s no one-size-fits-all approach. For some, work provides a sense of purpose and normalcy during treatment, and they may prefer to stay engaged in a reduced capacity. For others, focusing entirely on recovery is the priority, and this should be fully respected and facilitated.

For colleagues returning to work post-treatment, the experience can be particularly challenging. Physical changes—such as hair loss or bloating from treatment—can make facing an office environment daunting. Staying connected during their time away can ease this transition. Regular check-ins or visits allow colleagues to see gradual changes, making the return feel less abrupt and more supported.

When reintegrating, a graded return to work is vital. This could involve starting with informal catch-ups or light tasks to help them re-familiarise with their role and rebuild confidence at their own pace.

It’s equally important to respect their privacy. Avoid asking deeply personal questions about their diagnosis, such as the stage or type of cancer. Let them decide how much they want to share. While curiosity is natural, overly invasive questions can be distressing. Focus on creating a supportive environment where they feel safe to share or withhold information as they choose.

Ultimately, the key is sensitivity, patience, and understanding—ensuring they feel in control and supported throughout their journey.

The short answer is: there’s a significant gap. Most organisations rely on point-to-point solutions like EAPs or cash plans. While these can be helpful for immediate needs—like a few physiotherapy sessions or a crisis counselling call—they aren’t designed to provide the comprehensive, long-term support that employees with chronic conditions require.

For example, a few physio sessions won’t help establish the daily exercise and maintenance plans necessary for lasting behavioural change. Similarly, these solutions rarely address the dietary or preventative health strategies that can reduce the risk of recurrence for conditions like cancer or chronic pain.

What’s missing is a truly holistic approach—one that integrates dietary advice, exercise programmes, mental health support, and health coaching. These elements are deeply interconnected, and addressing them together yields far better outcomes. Unfortunately, this type of comprehensive care isn’t something we’re seeing in most organisational strategies today.

Programmes like ours at Boutros Bear are designed specifically to fill this gap. While they are priced differently than cash plans or EAPs, they offer real, measurable results by focusing on long-term health outcomes and sustained behavioural change. Employers who invest in these kinds of solutions will see stronger returns in terms of employee health, engagement, and productivity.

At Boutros Bear, we provide comprehensive programmes to help individuals manage chronic and long-term conditions, with benefits for both employees and employers.

Our journey with organisations often begins with educational webinars, covering topics like mental health and chronic disease management. These sessions address a growing need, as highlighted by the UK government’s Get Britain Working Again⁴ paper, which notes that chronic diseases contribute significantly to economic inactivity and affect 25–35% of the working population.

For employees engaging with our programme, the process is tailored and holistic. It typically unfolds over 12 weeks (or longer, if needed):

1. Initial Assessment: A health coach (an allied healthcare professional, often a physiotherapist) captures the individual’s medical history and current challenges. Together, they set achievable goals, focusing on what the individual wants to regain in their life.
2. Physical Well-Being: Movement and exercise plans are introduced, supported by pre-recorded exercises and access to an online community. Improvements often start showing by weeks 4–5.
3. Dietary Support: Around mid-programme, participants meet with a dietitian to explore personalised meal plans and make dietary changes aligned with their goals, whether it’s weight loss, gain, or general nutritional improvement.
4. Mental Health: Stress, anxiety, and depression levels are monitored through surveys. If needed, participants can access 6–8 sessions with a CBT therapist to address specific challenges.
5. Self-Management: By the end of the programme, participants are equipped with tools, educational content, and strategies to better manage their conditions independently.

For employers, we also provide training materials for line managers to help them understand how to support affected employees, make reasonable adjustments, and navigate the legal and moral frameworks.

Boutros Bear’s approach bridges the gap between point-to-point solutions like EAPs and the deeper, more integrated support needed to address chronic conditions effectively. The result? Healthier, more resilient employees and stronger organisational outcomes.