Holiday Entitlement During Long-Term Sick Leave UK 2026

The foundational principle is that periods of sickness do not interrupt the accrual of statutory annual leave. This was established at the European Court of Justice in Stringer v HMRC joined with Schultz-Hoff v Deutsche Rentenversicherung [2009] IRLR 214. The Court held that the right to paid annual leave is a fundamental social right that cannot be made conditional on the worker being actively at work.

The UK implements Stringer through the Working Time Regulations 1998: Regulation 13 grants 4 weeks of EU-origin leave, Regulation 13A grants the additional 1.6 weeks of UK leave. Both accrue throughout periods of statutory sickness absence. The employer cannot lawfully require the worker to work to accrue holiday; the contract of employment continues throughout sick leave and the holiday clock continues to tick.

The Court of Appeal applied Stringer in the UK in NHS Leeds v Larner [2012] IRLR 825: a worker absent on sick leave for the entire leave year and who then resigned was held to be entitled to a payment in lieu of all accrued holiday for the year of absence. The case is regularly cited as the authority for the full-accrual rule.

Where a worker is unable to take their holiday because of sickness, the EU-origin 4 weeks must be allowed to carry over. The cap on the carry-over period is 18 months from the end of the leave year in which the holiday was accrued. This limit comes from the ECJ in KHS AG v Schulte [2012] IRLR 156 and was confirmed for the UK by the Court of Appeal in Larner.

The 18-month limit reflects the rest and recuperation purpose of annual leave: holiday that is taken many years after it was accrued no longer serves the rest function it was designed for. So a worker who accrued 4 weeks in the 2025 leave year (ending 31 December 2025) has until 30 June 2027 to take it. If they remain on sick leave throughout, the unused leave is lost at that point, unless the contract is terminated first (in which case it is paid out under Regulation 14).

The 1.6 weeks of UK additional leave is governed by Regulation 13A, which does not include the carry-over provision Stringer/Larner created for the EU 4-week slice. The 1.6 weeks can be carried over by written agreement between worker and employer, and many sickness policies do allow this in practice, but it is a contractual extension not a statutory right.

Pereda v Madrid Movilidad [2009] IRLR 959 established a related rule: a worker who falls sick during pre-booked annual leave can convert the sick days back to sick leave and reclaim the holiday days for later use. The employer must allow the worker to reschedule the affected holiday at a later date. The same applies to a worker who falls sick before a pre-booked holiday starts; they can postpone the holiday rather than lose it.

The practical mechanics: the worker must follow the employer's normal sickness notification procedure during the holiday (typically a call to the line manager on day 1 and a fit note from day 8). The days covered by the fit note are sick leave (paid at the sick leave rate, usually SSP or contractual sick pay) and the equivalent number of days are restored to the holiday balance for later use.

Employers can require evidence (a fit note) for sickness during pre-booked holiday, even though for ordinary 1 to 7 day sickness absences self-certification is the norm. The reason is that converting holiday to sick leave changes the pay rate, so the evidence bar can be slightly higher. ACAS guidance on holiday when off sick confirms this convention.

A worker on long-term sick leave can request to take annual leave during the sickness. The most common reason is income: Statutory Sick Pay is £118.75 per week in 2025/26, which is far below normal earnings for most workers. Converting two or three days of sick leave into holiday days brings in normal pay for those days and uses up some of the accrued leave balance.

The employee should make the request in writing, specifying the dates. The employer can refuse a specific date on operational grounds (the same rule as for any other holiday request) but cannot lawfully refuse the principle of taking holiday during sick leave. The fit note continues to apply for the days not designated as holiday. The payroll system processes the holiday days at the normal holiday pay rate (normal pay) and the sick days at the SSP or contractual sick pay rate.

There is no requirement that the worker be medically fit enough to take holiday in any meaningful sense to be entitled to the holiday pay; the right is to the payment, not to the activity of holiday-making. A worker recovering from major surgery can lawfully take holiday at home in bed and receive normal pay for those days while the rest of the sickness absence continues at SSP. This is a common income-smoothing strategy for long-term absentees and is fully lawful.

When the worker returns from long-term sickness, their accrued-but-unused holiday balance can be substantial. A worker absent for the full leave year has 28 days carried over (assuming full-time). A worker absent for the full year plus another 6 months has 28 days from the previous year (within 18 months of carry-over) plus 14 days accrued in the partial year of return, totalling 42 days available.

Most return-to-work plans front-load the carried-over leave to give the returning worker time to rebuild stamina before a full schedule resumes. A phased return on reduced hours can be combined with one or two days of leave per week to keep total income at the pre-sickness level while reducing total hours worked. Occupational health and HR typically structure this in writing as part of the return-to-work agreement.

The carry-over clock continues to tick during the return-to-work period. Leave accrued in 2025 must be taken by 30 June 2027. Leave accrued in 2026 must be taken by 30 June 2028. The employee should plan the take-up of carried-over leave around these deadlines, with priority to the oldest accrual to avoid losing any.