Time off for cosmetic surgery: your rights

You might be well enough to sit at a desk after surgery but not to lift a care-home resident, unload a van or stand through a kitchen shift. Your fitness for your job matters. An employer cannot reject Statutory Sick Pay simply because you chose the operation, but there is no separate right to cosmetic-surgery leave.

What you can do today

Check company sick pay before booking leave. It may cover your usual wages. If you only get SSP, holiday can pay more, but uses leave you may need later. Do not surrender holiday because your manager says cosmetic surgery never qualifies for sick pay.

Your union rep can help challenge a refusal. UNISON organises care and NHS staff; Usdaw represents shopworkers; GMB and Unite cover logistics and hospitality. For free advice, contact Acas or Citizens Advice.

1. Save the policy. Find the sickness reporting deadline, company sick pay clause and holiday booking rules. Keep a copy outside your work account.
2. Ask about your actual duties. Tell your clinician if you lift people, drive, handle food or stand all day. Get advice on recovery and restrictions. Self-certify the first 7 calendar days; get a fit note for longer sickness. A private surgeon can provide one, as can a GP or an appropriately qualified nurse, pharmacist, physiotherapist or occupational therapist.
3. Write to the person who approves leave. Request time for the procedure. Explain the expected sickness absence, or request holiday if that is your choice. Get the reply in writing and follow the reporting rules when absence starts.

The law in brief

Acas says there is no general legal right to time off for medical appointments. For a purely cosmetic procedure, arrange annual leave, unpaid leave or a shift swap unless your contract gives you something better. Do not assume that telling your manager the date amounts to approval.

Recovery is separate. SSP has no blanket elective-surgery exclusion. If you are incapable of work and meet the eligibility rules, it can apply. That does not guarantee company sick pay or immunity from absence management.

There are exceptions to the general appointment rule. Pregnant employees have a right to reasonable paid time off for antenatal care. Disability-related treatment can require reasonable adjustments, and gender-reassignment absence has specific protection in Great Britain. We explain those below.

Sick pay after surgery: what you get

Since 6 April 2026, SSP has no minimum earnings threshold and no three unpaid waiting days. These changes are in force under the Employment Rights Act 2025.

You must be treated as an employee for SSP purposes, have done some work for the employer and be ill for at least one full working day. Report sickness by the employer’s deadline, or within 7 days if none is set. Late notification can cost you SSP. Provide a fit note after 7 consecutive calendar days, including non-working days.

The rate is the lower of £123.25 a week or 80% of average weekly earnings, normally calculated over 8 weeks, with rules for recent starters. SSP covers full sick days you would normally work, called qualifying days. Linked absences can use the same 28-week maximum. Payment is through payroll, subject to tax and National Insurance where applicable.

GOV.UK gives the eligibility and evidence rules. A private clinic’s fit note can count; your operation need not be on the NHS.

A shopworker with steady earnings of 10 hours a week at £12.71 earns £127.10. Their SSP is 80%, or £101.68 a week. These examples assume complete qualifying weeks and otherwise satisfied eligibility conditions.

Using holiday instead of sick leave

Employees and workers generally have at least 5.6 weeks’ paid holiday, or 28 days for a five-day working week. Part-time entitlement reflects the working pattern. Check your balance and holiday pay before choosing this route.

Under the default GB rules in regulation 15 of the Working Time Regulations 1998, request leave with at least twice-length notice. Ten days needs at least 20 days’ notice. An employer refusing the dates must give notice at least as long as the leave requested. A relevant agreement can vary these defaults. Wait for approval.

Employers can normally require holiday on particular dates with twice-length notice. They cannot force you to use it while off sick. Acas makes that distinction explicit. If you request holiday during sickness and they approve it, sick leave can pause while you receive holiday pay, then resume if you remain unfit.

If you become sick during booked holiday, report it and ask to have those days treated as sick leave, preserving the holiday. Holiday still builds up during sickness. Carry-over has limits and differs for regular-hours and irregular-hours or part-year workers. Check your position if recovery crosses the holiday-year end.

What to tell your employer

Tell your employer when you expect to be unfit and for how long. Follow the reporting policy even if they know about the operation. Focus on your duties and recovery restrictions, not your whole medical history.

A fit note does not rule out further questions about recovery or lighter duties. Acas says an employer needs permission to obtain a doctor’s report under the Access to Medical Reports Act 1988. You can refuse, but they may then decide on the evidence available. If you agree and want to see the report before it is sent, say so.

Report gossip, intrusive questioning or bullying under the grievance policy, with dates and witnesses. Not every cruel remark is automatically unlawful discrimination. Ask an adviser about comments concerning sex, disability or gender reassignment. Our bullying guide explains how to keep evidence.

When surgery is medically advised or reconstructive

A procedure described as cosmetic might be medically advised, such as rhinoplasty to improve breathing or reconstruction after an accident or mastectomy. Acas says usual sickness absence and pay rules apply where the operation is medically required. Medical advice alone does not create a blanket statutory right to paid appointment time.

In Great Britain, time for disability-related treatment can be a reasonable adjustment under the Equality Act 2010. Cancer counts as a disability from diagnosis. Penalising related absence can be discrimination, although the employer may have a lawful justification. Employer knowledge matters. Ask in writing for treatment leave, changed absence triggers or a phased return. See our reasonable adjustments guide.

Gender-affirming surgery is different

Do not accept a policy that labels gender-reassignment treatment “cosmetic” and refuses normal sickness arrangements. In Great Britain, Equality Act section 16 prohibits treating that absence less favourably than sickness or injury absence. It also covers unreasonable less favourable treatment compared with other absence. Discrimination protection has no minimum service requirement.

Acas warns against assuming this surgery is elective or cosmetic. The protection does not promise full wages regardless of the sick pay scheme. Keep any refusal and get union or law centre advice. Our trans rights at work guide covers the wider protections.

Agency, zero-hours and self-employed

“You’re only agency” and “you don’t earn enough” are not complete answers to an SSP request. GOV.UK treats some groups of workers as employees for SSP. Agency workers who are employed earners can qualify, with payment normally handled by the agency or employer responsible for their wages.

The engagement still matters. SSP may end when an assignment ends if your contract does not continue between assignments. Casual and zero-hours staff also have rules about how long eligibility continues. Ask for a written explanation rather than assuming a 28-week guarantee.

If you have two jobs, SSP may apply to each. Recovery might prevent care-home lifting but not separate desk work. Tell each employer accurately what you can do; get advice if earnings are combined for National Insurance purposes.

Workers retain statutory holiday rights even without SSP. Genuinely self-employed people get neither from clients. Check your employment status and agency rights before accepting a refusal. Universal Credit or New Style Employment and Support Allowance may help if you qualify. See working while claiming Universal Credit.

Can they discipline or sack you?

Sick pay entitlement is not a guarantee against dismissal. Employers can manage absence and, in some circumstances, dismiss for capability after a fair process. They must comply with discrimination law and consider relevant reasonable adjustments. A blanket refusal to consider disability-related or gender-reassignment absence needs challenging.

As at 1 October 2026, ordinary unfair dismissal protection in Great Britain generally needs two years’ service. Discrimination claims do not, and some automatically unfair dismissal claims have separate rules. Being off sick does not itself make dismissal automatically unfair. Get advice before resigning. See discipline while off sick, dismissal because of illness and unfair dismissal claims.

If shifts disappear or you receive a warning, save old and new rotas, the policy, medical evidence and messages. Contact your union, Acas or a law centre promptly.

If sick pay is refused or runs out

1. Ask payroll for the reason. Request the calculation, qualifying days and written reason. Keep payslips and sickness notifications. Separate SSP from company sick pay.
2. Use the SSP dispute route. GOV.UK directs you to discuss it with your employer, then contact the HMRC enquiry line if unresolved. Use that page’s contact link. Your union or Citizens Advice can help.
3. Get SSP1 and check benefits. If you do not qualify, SSP1 is due within 7 days of your first sick day. If SSP is expected to end before your sickness, it is due on or before the beginning of the 23rd week. If it ends unexpectedly while you remain sick, it is due within 7 days of ending. GOV.UK confirms these deadlines. Check Universal Credit or New Style ESA eligibility.
4. Protect any separate claim. An SSP dispute is not the same as a discrimination or dismissal claim. Do not let payroll discussions run down your tribunal deadline.

Scotland and Northern Ireland

The core SSP, GB holiday and Equality Act rules described here apply in Scotland as well as England and Wales. The Scottish tribunal breach-of-contract deadline exception is noted above.

Northern Ireland has separate legislation. The Labour Relations Agency confirms day-one SSP from 6 April 2026, at 80% of average weekly earnings capped at the flat rate. The Equality Act and Acas deadlines above are GB rules. Ask the Labour Relations Agency about leave and deadlines, and the Equality Commission for Northern Ireland about discrimination. See nidirect and our Northern Ireland guide.

What changed and what is next

1. 6 April 2026In force: SSP from day one, with no earnings floor

   The three waiting days and minimum earnings threshold were removed. The current weekly payment is the lower of £123.25 or 80% of average weekly earnings.

2. 1 October 2026In force: longer GB tribunal time limits

   Most claims concerning events from this date have six months less a day. Earlier events generally retain the previous limit. Scottish tribunal breach-of-contract claims change on 9 November 2026.

3. 1 January 2027Scheduled: shorter unfair dismissal qualifying period

   The government’s timetable schedules a reduction to six months’ service for dismissals from this date, and removal of the compensatory award cap. These are not the rules in force on 1 October 2026.

Questions people ask

How do you get time off for plastic or cosmetic surgery?

Ask in writing about time for the procedure. If you have no contractual or specific legal entitlement, arrange holiday, unpaid leave or a shift swap. Report sickness if recovery makes you unfit.

Will you get sick pay while recovering?

SSP can apply if you meet the qualifying conditions. Company sick pay depends on the policy. A purely cosmetic operation does not, by itself, disqualify you from SSP.

Do you have to name the procedure?

Focus on fitness for your job and provide the required sickness evidence. Your employer may need further information, but needs permission to obtain a doctor’s report under the Access to Medical Reports Act 1988.

Can your boss force holiday for recovery?

Not while you are off sick. It is your choice to request holiday then. The general power to direct holiday dates does not override that.

Can agency and zero-hours staff get SSP?

Some qualify. SSP status differs from employee status for other rights. There is no earnings floor, but the engagement and other conditions matter. Ask for written reasons if refused.

Sources

1. Time off for medical appointments, Acas.
2. Sick leave, Acas.
3. Statutory sick pay changes 2026, Acas. Source of the 1.3 million estimate in the reality check.
4. Statutory Sick Pay: what you will get, GOV.UK. Rate, earnings calculation and dispute route.
5. Statutory Sick Pay: eligibility, GOV.UK. Evidence and SSP1 deadlines.
6. How different employment types affect SSP, GOV.UK.
7. National Living Wage increases to £12.71 per hour, GOV.UK. Worked-example and reality-check wage rate; replacement percentages and shortfalls are our calculations.
8. Holiday entitlement, GOV.UK.
9. Working Time Regulations 1998, regulation 15, legislation.gov.uk.
10. Sick pay and holiday pay, Acas.
11. Employment Rights Act 1996, section 55, legislation.gov.uk. Antenatal care.
12. Equality Act 2010, legislation.gov.uk. Disability provisions and section 16 on gender-reassignment absence.
13. Gender reassignment discrimination, Acas.
14. Employment tribunal time limits, Acas, updated 1 October 2026.
15. Employment Rights Act 2025 and Commencement No. 3 Regulations 2026, legislation.gov.uk.
16. Employment Rights Act implementation timetable, Department for Business and Trade.
17. Statutory Sick Pay changes 2026, Labour Relations Agency, and Sick pay rights, nidirect.