Managing teams while managing a chronic illness

Josie Kirk, Deputy Nurse Manager at the Blue Cross, shares her perspective as both a manager and as someone with a chronic illness, offering practical advice on providing effective, tailored support at work.

She highlights the importance of reasonable adjustments, open communication, and ongoing reviews to create inclusive, productive teams.

The Spoon Theory

Consider fatigue, often a symptom of various chronic illnesses. Have you ever heard of the Spoon Theory?​ (1)​. Imagine you have ten spoons of energy per day. You spend three spoons getting showered and dressed, two spoons travelling to work, four spoons whilst at work, two spoons travelling home, and three spoons making and eating dinner. You can’t continue long-term without adjusting to better manage the situation.  

Why supporting colleagues matters

It can be daunting for managers to find out an employee has one or several chronic health conditions or disabilities. However, supporting team members with chronic illnesses and disabilities can bring benefits too. When employers provide support, team members feel valued, motivated, productive and more loyal to the workplace. Dedicated employees and a supportive workplace improve team employee retention and enable vital practical experience and skills to flourish within the wider team.   
 
Managers have responsibilities to support employees under the Equality Act 2010​ (2)​, but how does this affect day-to-day management?  
 
A chronic illness or disability is any condition likely to significantly impact a person’s day-to-day life for over 12 months. Everybody with a chronic illness will be affected differently, even with the same condition, and personal experiences will change during illness. These changes may include symptoms, treatments, or flare-ups of conditions, so reasonable adjustments might need to be reviewed.  

Waiting for a diagnosis is the hardest part. 

Adjustments should be made when managers know or could be expected to know that someone is living with a disability. This is applicable to all team members, employees, contractors, locums, volunteers and job applicants. It’s worth remembering that many individuals will have a chronic illness or disability at some point in their lifetime.  
 
Waiting for a diagnosis is the hardest part for individuals, managers and wider teams. NHS patient diagnosis and treatment plans typically take longer to process than veterinary pathways. Until someone has a diagnosis, understands their illness and adopts treatment options, they may find chronic illness difficult to manage or explain to others. Workplaces generally understand diagnoses, but not unknown conditions.  

What do reasonable adjustments look like? 

Employers should provide reasonable adjustments for team members in the workplace, which will vary depending on the individual and workplace. The aims are for adaptations to help an employee remain productive within the workplace and remove or reduce the disadvantages of disability ​(3)​.  
 
Adjustments should be based on practicality, affordability and overall impact for each practice. For  example, adding a lift in one practice may be affordable and practical, but may not be suitable in another location.  
 
Reasonable adjustments are considered in sections depending on the individual situation.

They may include:

• Physical adjustments - kneeling pads, toilet access, wellbeing spaces, shelf height placement, placing less frequently used items being either lower or higher to minimise the need for repetitive bending or stretching.
• Changes to working arrangements - adapted training, mentors, changes to communication, breaks, support for appointments, task rotation, meeting agendas in advance to prepare for discussions and options to contribute later.
• Adjustment to role/duties - hybrid roles, working from home, flexible working, phased returns, restricted duties, alternative roles, adapted working hours and travelling times​ (4)​. 
• Prioritising budgets - based on necessity and impact of adjustments. Those having the most impact, which are easy to implement, should be a higher priority. The government Access to Work scheme may help with assessments and costs​ (5)
• Individuals are responsible for following medical advice -medications, physiotherapy exercises and self-help, for example pacing, meditation and mindfulness, to manage their fitness for work.  

Reviewing and adapting support

Regular reviews of reasonable adjustments are essential. These should help individuals, whilst mitigating impact on businesses and teams.  If this is not the case, then do seek further advice.  
 
Open communication is key when working together with employees. Open dialogue on both sides is essential to finding supportive solutions.  
 
Reasonable adjustments should be specifically tailored to each individual.

Here are a few things you can do to ensure clear communication is maintained when working towards effective reasonable adjustments: 

• Actively listen to how chronic illness affects employees.
• Acknowledge and explore options.
• Learn about specific illnesses, as this helps to improve understanding of situations. Charities often provide advice for specific conditions ​(6).​
• Follow your workplace policies and guidance and seek support from human resources departments or the Advisory, Conciliation & Arbitration Service (ACAS)​ (7)​. Further advice can be provided by medical care teams or occupational health referrals. 
• Discuss and trial adjustments.
• Maintain an open dialogue to review progress and record any pertinent points from conversations. This helps to track support provided and impact future reviews.  
• Consider completing individual risk assessments. 

Key takeaways

• Keep an open mind, actively listen and work together to find solutions that have a positive impact on everyone. 
• Prioritise your budgets and adjustments based on impact and ease of implementation.  
• Trial reasonable adjustments and seek support from your human resources department, occupational health referrals, or ACAS.

References 

1. Spoon theory explained - Royal College of Occupational Therapists 
2. Equality Act 2010: Guidance from gov.uk
3. What  are reasonable adjustments? ACAS
4. Let's talk adjustments - Royal College of Veterinary Surgeons (RCVS) 
5. Reasonable adjustments: a legal duty - RCVS 
6. Access to work scheme - Gov.uk 

Charities and support organisations 

Sane - mental health support and resources

Mind - mental health information and advocacy

British Dyslexia Association - support and advice for dyslexia

Fibromyalgia Action UK - resources for people with fibromyalgia

Versus Arthritis - support and research for arthritis conditions

Crohn’s & Colitis UK - help for people living with inflammatory bowel disease 

British Veterinary Chronic Illness Support - support network for veterinary professionals with chronic illness 

Back to top