But where working relationships have become strained, a successful return often depends on more than clinical recovery and practical adjustments. It also depends on rebuilding understanding between the people who will be working together again.

As a workplace mediator, executive coach and Senior Consultant at Affinity Health at Work, I’ve spent many years helping organisations navigate complex workplace relationships and I've come to see sustainable return to work through a different lens.

Seeing Return to Work Through a Different Lens

When supporting someone back to work after illness, we naturally focus on whether they are well enough to return, what adjustments they need, what work they can safely undertake and how best to support those first few weeks back. These are all essential considerations, but they don't always address the human side of returning to work - the conversations, relationships and confidence that often determine whether someone truly feels able to come back.

Does the employee trust their manager? Do they feel safe enough to talk honestly about the support they need? Does the manager feel confident having sensitive conversations? Has the team developed assumptions during the employee's absence? Is there a shared understanding of how the return will be supported and how everyone moves forward together?

Someone may be physically recovered and capable of performing their role, yet still feel anxious about seeing their manager, worried about how colleagues perceive their absence, or uncertain whether the working relationships they are returning to will be any different.

Successful return to work depends on honest conversations about what someone needs to succeed. Where trust has been damaged, those conversations become much harder. Employees may minimise their concerns because they don't want to appear difficult, while managers may avoid exploring sensitive issues because they fear saying the wrong thing. The result is that the conversations people most need to have are often the ones they avoid.

When Relationships Become Part of the Return-to-Work Challenge

The illness itself may not have been caused by workplace relationships. It could be work-related stress, depression, cancer, surgery, a musculoskeletal condition or another physical or mental health condition. However, relationships can have a profound influence on whether someone feels able to return and, importantly, whether that return is sustainable.

In my experience, relationship difficulties rarely begin with one dramatic event. More often, they develop gradually. A manager under pressure may become more directive without realising how their communication is being received. An employee experiencing ill health may become quieter, more defensive or less engaged. Conversations become shorter and more transactional. As communication reduces, both individuals begin filling the gaps with their own assumptions about the other's intentions.

By the time sickness absence occurs, both individuals may genuinely feel misunderstood. Sometimes the biggest barrier to a successful return isn't visible on a fit note or captured within a return-to-work plan. It sits beneath the surface in damaged trust, unresolved conversations and assumptions that have never been challenged.

What Mediation Can Teach Us

If damaged relationships, unresolved conversations and assumptions can make returning to work more difficult, how do we help people move forward?

Imagine an employee returning after an absence where working relationships have become strained. They may believe the only way they can return is if they have a different manager. The manager, meanwhile, may believe the best way forward is to draw a line under the past and move on. These are what mediators refer to as positions - the solutions each person believes will resolve the situation.

This is where mediation offers a different perspective. One of its greatest strengths is that it provides a structured way of helping people have the conversations they have often been avoiding. Rather than focusing on who is right or wrong, mediation encourages people to move beyond their positions and explore the interests and values that sit underneath them.

The employee may actually need to feel respected, listened to and psychologically safe. They may want reassurance that their concerns have been understood and that the circumstances surrounding their absence will not simply be repeated. The manager may need confidence that expectations are understood, communication has improved and the team can move forward positively.

One of the most rewarding moments in mediation is when people begin to recognise that, although their initial positions are different, they often have shared interests they hadn't previously recognised. Those shared interests often include a respectful working relationship, honest communication, clarity about expectations and the opportunity to move forward successfully.

That shift changes the conversation. Rather than trying to convince the other person they are right, people become more willing to understand one another's perspective and work together to find a way forward. Whilst formal mediation will not be appropriate for every return-to-work situation, its principles have much to offer.

Turning Better Conversations into Better Outcomes

The challenge, of course, is translating those principles into everyday return-to-work practice. One of the lessons from our research at Affinity Health at Work is that both employees and managers often need support to prepare for return-to-work conversations. Too often, they arrive with different assumptions, different expectations and very different levels of confidence. The conversation that follows can therefore reinforce misunderstanding rather than rebuild it.

These findings led us to develop our online IGLOO Return-to-Work Toolkits for both employees and managers. Rather than viewing return to work as something led solely by the manager, the toolkits guide both employee and manager through the journey together. Working through the same stages, using a shared language and reflecting on many of the same questions helps both parties prepare for more open, constructive conversations before they even sit down together.

Our evaluation of the toolkits found that managers felt more confident having return-to-work conversations, employees felt better prepared to discuss what they needed, and organisations used the learning to strengthen their wider return-to-work policies and practices. Interestingly, we also found that employees using the toolkit sometimes took slightly longer to return to work than those receiving usual support. However, they were more likely to remain in work once they had returned. This is an important reminder that success shouldn't simply be measured by how quickly someone returns to work, but by whether the return is sustainable. Sometimes investing a little more time in preparing people, rebuilding understanding and creating shared expectations can lead to better long-term outcomes.

Whether organisations use structured tools such as these or develop their own approach, the principle is the same: preparing both employee and manager leads to better conversations and greater shared understanding.

Putting this into Practice

Where working relationships have become strained, consider the following.

• Look beyond the practical arrangements. Agreeing adjustments is essential but also think about what conversations need to happen before someone returns.
• Prepare both managers and employees. Managers often need as much support and confidence as the employee returning to work. Helping both employee and manager prepare for conversations can create greater understanding and more realistic expectations from the outset.
• Measure success by sustainability, not speed of return. Success should be measured not only by how quickly someone returns, but by whether they remain well and in work.
• Create opportunities for honest conversations. Create space for people to share perspectives, challenge assumptions and develop a shared understanding before trying to solve the problem.
• Focus on rebuilding understanding. The aim isn't necessarily for everyone to agree. It's to create enough shared understanding that people can move forward together.

Clinical recovery matters. Practical adjustments matter. But where working relationships have become strained, sustainable return to work also depends on rebuilding understanding. Because people don't just return to work, they return to relationships.