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Phased Return to Work Agreement

A completed agreement setting out a supported six-week return, temporary duties, pay, reasonable adjustments and documented reviews.

Jurisdiction: England and Wales - completed fictional worked example

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Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# PHASED RETURN TO WORK AGREEMENT

Date: 1 October 2031

Parties: Gareth Morgan and Larch & Vale Accountants Ltd

## 1. Purpose and parties

Gareth Morgan is employed by Larch & Vale Accountants Ltd of 9 Castle Street, Hereford HR1 2NW as a Senior Payroll Adviser and reports to partner Helen Brooks. Gareth was absent through illness from 2 July to 30 September 2031. He will begin this six-week return on 6 October 2031, and the company agrees the plan after considering the occupational health report dated 22 September and GP Fit Note dated 29 September.

## 2. Facts, scope and terms

For weeks 1 and 2, the Monday–Friday ranges are 6–10 October and 13–17 October 2031; Gareth will work Monday, Wednesday and Friday from 10:00 to 16:00, totalling 18 hours each week. For weeks 3 and 4, the ranges are 20–24 October and 27–31 October 2031; he will work Monday to Thursday from 09:30 to 16:30, totalling 28 hours each week. For weeks 5 and 6, the ranges are 3–7 November and 10–14 November 2031; he will work Monday to Friday from 09:00 to 17:30 with a one-hour unpaid break, totalling his contractual 37.5 hours each week.

## 3. Process and responsibilities

During weeks 1 and 2 Gareth will reconcile internal payroll files, attend no client meetings, supervise no staff and handle no same-day payroll deadline. Weeks 3 and 4 add supervised client email and one scheduled call each day; weeks 5 and 6 restore his normal caseload progressively. Performance targets are suspended for all 6 weeks and return at 50% for weeks 7 and 8, then to the contractual level from 1 December 2031. He may work from home on Wednesdays in weeks 1–4.

## 4. Evidence, records and safeguards

The company will pay Gareth his full contractual salary of £42,600 per year throughout the plan, and statutory sick pay is not being claimed for days on which he works. Annual leave and pension contributions accrue normally. Adjustments are a quiet desk near the window, screen breaks of 10 minutes every 90 minutes, written agendas, and permission to record agreed actions. Gareth will tell Helen promptly if an adjustment is ineffective, without having to disclose more medical detail than necessary.

## 5. Review, escalation and outcome

Helen and HR Manager Ruth Evans will meet Gareth at the end of weeks 2, 4 and 6, on 17 October, 31 October and 14 November 2031. Each review will record hours completed, symptoms or barriers voluntarily reported, duties managed, adjustment effectiveness and the next step. The plan may be extended in writing if occupational health or a GP recommends it; an extension is not a disciplinary sanction and will not reduce Gareth's contractual salary unless he separately agrees.

## 6. Reservations and practical protections

If Gareth cannot safely progress, he will tell Helen or Ruth and the next phase will pause while further medical advice is obtained. The company will consider alternative reasonable adjustments before any capability process, including under the Equality Act 2010 where the condition may amount to a disability. Gareth remains responsible for following safety instructions, recording working time accurately and taking breaks; the company remains responsible for supervision, confidentiality and a safe workload.

## 7. England and Wales law and completion

This agreement records a temporary supportive arrangement and does not vary Gareth's permanent contract except for the stated hours, duties and targets during the plan. It is governed by England and Wales law, was completed on 1 October 2031, and may be changed only by written agreement between Gareth Morgan, Helen Brooks and Ruth Evans. Each party keeps the signed copy and the occupational health and Fit Note references.

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