Employer perspectives on support to employees with health-related needs

Background

Employers play a key role in supporting employees with health‑related needs (EwHN). While flexible and hybrid work may facilitate support, reduced everyday visibility can complicate employers’ ability to identify needs and act early. This study explores how employers navigate support for EwHN and the challenges that arise in flexible work contexts.

Methods

Semi‑structured interviews were conducted with 23 employer representatives (line managers and HR) from diverse organizations, mainly public‑sector office workplaces (=17) with hybrid or remote work. Data were analysed using thematic analysis informed by Psychological Contract Theory.

Results

Four themes were identified, relating to uncertainty in identifying and acting on unspoken or ambiguous needs, intensified by limited visibility in flexible work; relational trust as a precondition for support, shaping information sharing, and fairness concerns; tensions between empathy, performance demands, and responsibility for both individual and team; and support as an ongoing, negotiated process requiring shared understanding of work capacity.

Conclusions

Employers navigate complex and shifting tensions when supporting EwHN, particularly in flexible and hybrid settings where limited insight into employees’ situations may delay or misdirect support and increase firmer, control‑oriented responses. Effective support does not require detailed medical information but relies on sufficient insight to enable appropriate work adjustments. Focusing on employees’ abilities and remaining work capacity, rather than diagnoses, promotes psychological safety and more sustainable support processes.

Key messages

• In flexible and hybrid work, limited visibility creates uncertainty that can delay or misdirect employer support for employees with health-related needs.

• Support to employees with health-related needs does not require medical details; focusing on remaining work capacity fosters trust, psychological safety, and sustainable work adjustments.