Sickness Absence Management

David Grech MD MIMMedicare

Sickness absence – a financial problem

• Average absence levels in Malta have improved slightly (6.9d ’03 to 6.7d ’04)

• The average direct cost of absence in the UK in 2004 was £475 a year per employee – equivalent to £11.6 billion across the UK workforce.

• Sickness absence significantly affects productivity and performance, particularly in the shift dependent manufacturing sector as well as service-sector companies where customer satisfaction is people- and knowledge-dependent. This can result in direct and indirect absence costs equivalent to 12-23% of payroll depending on industry sector.

Sickness absence - An emotional problem

• Managers often feel powerless to intervene, either in the progress of short- and long-term absences, or their causes.– increasing perceived clinical readiness by doctors to over certify

sickness absence and diagnose emotive and hard-to-manage conditions such as stress

– desire to avoid being caught in the employer-liability litigation spiral.

 • While many companies are trying to tackle the

symptoms, they struggle to diagnose and treat the root cause. As a result, absence management remains in the “too difficult” tray. Worse still, many firms locally appear to be in a state of denial about the issue.

Causes of sickness absenceManual Non-ManualMinor illness Minor illnessBack pain Recurring medical conditionsRecurring medical conditions Back pain

Non genuine absence Stress Musculo-skeletal injuries Non genuine absence

Stress Musculo-skeletal injuries

Acute medical conditions Acute medical conditions

Drink or drug related absence Drink or drug related absence

Minor illness includes colds, flu, stomach upsets and headaches

Non-genuine illness is a significant collateral cause of absence, accounting for an estimated 15 per cent of total absence in the UK

Company size

• Larger companies report higher average absence levels for each employee (UK CIPD)

• Possibly, larger companies are more likely to employ temporary staff or offer overtime to cover for absent employees while smaller companies are more likely to share the absent person's workload across other employees or leave it until they return; this may itself predispose to lower staff morale, higher stress and lower productivity

• may partly explain why public sector absence levels tend to be higher than those in other main sectors

Long term absence

• Although long-term absence only represents <10% of incidences, it may account for up to 30-40% of all working time lost

• Research shows that beyond the sixth week of sickness absence, almost one in five workers will stay off sick and eventually leave work

Stress !

• Being taken increasingly seriously as a significant contributor to sickness absence and mental ill health among workers

• Causes of occupational stress:

1. workload / volume of work2. organisational change / restructuring; job insecurity 3. pressure to meet targets; manufacturing and production

sector is most likely to rate this as a factor.4. relationships at work and management style; lack of

support for employees from line managers

Sickness absence management • Recording & measurement• Keeping in contact• Making absence short term • Long term absence

– Return to work plan– Workplace adjustments– Stress management

• Professional advice• Absence policy• Involving line managers• Targets & benchmarking• Attendance incentives• Legal, DP & other issues

Absence recording• Are you able to identify which of your employees are really off work

sick and why they are off?• You need to know why your employees are off work so you can:

– identify employees whose return to work may be delayed or prevented unless you intervene;

– help employees whose frequent absences may disguise other problems;

– plan cover for an absent employee; – check for patterns of ill health that could highlight possible work

related causes, underlying domestic issues or the onset of disability;

– benchmark your performance against competitors to judge whether your own record is good or bad.

• Early action can increase the chances of your employee returning to work more quickly

How to measure time lost• 'Lost time' rate

– The most common measure of absence. – Total absence (hours or days) in the period x 100

Possible total (hours or days) in the period– can be calculated separately for individual departments of groups of employees to

reveal particular absence problems.

• Frequency rate– shows the average number of absences per employee, expressed as a percentage.

It does not give any indication of the length of each absence period, nor any indication of employees who take more than one spell of absence:

– No of spells of absence in the period x 100No of employees

• Bradford Factor– The Bradford Factor identifies persistent short-term absence for individuals, by

measuring the number of spells of absence, and is therefore a useful measure of the disruption caused by this type of absence.

– It is calculated using the formula:S x S x DS = number of spells of absence in 52 weeks taken by an individualD = number of days of absence in 52 weeks taken by that individual

Introducing an IT programme

• monitors employee absence,• records the reasons for the absence• calculates costs• most OHS providers supply this service as an outsource

Keeping in contact• Keeping in contact is a key factor in helping

employees return to work after a long-term absence • The company doctor visit is not a substitute for

keeping in touch !• Contact can be a sensitive topic as some employees

may feel pressed to come back to work too early • Without contact, those who are absent may feel out of

touch and undervalued • Make sure your conversation with the absent

employee is clearly focused on their well-being and their return to work. Try to focus as much on what the employee can do as well as things they may need help with.

Keeping in contact (2)• Minor illness: when employees notify you of a minor illness that is

likely to end within seven days, further contact is not really necessary. However a Return To Work (RTW) interview will be useful to get people up to speed and discuss any underlying issues if this happens often.

• Traumatic injury or sudden illness: extend your sympathies and use discretion until the longer prognosis is known.

• Planned treatment: employees may welcome hospital visits but try to check with relatives first.

• Stress: if you are notified that an employee is suffering from a stress-related illness make contact within a week. It is unlikely they will be ready to discuss returning at this stage. Use discretion until the longer-term prognosis is known.

Aim for short term staff absence

• starting everyday activities again including going to work helps people to feel better

• any remaining pain or discomfort can often be managed with the right adjustments at work

• the barriers to returning to work often arise from personal, work or family-related problems rather than the original health condition itself

• early intervention by employers, working in partnership with safety and trade union representatives, significantly increases the chances of people off sick returning earlier to work.

Return to work (RTW) planning for longer absence

• best time is 3-4 weeks into the absence• should be tailored for the individual and might include:

– the time period of the plan – a statement of alternative working patterns – information about changes to terms and conditions – what checks will be made to make sure it is put into practice – dates when plan will be reviewed

• appoint a coordinator to pull the plan together. • empower the individual to influence their return to work

as being important for their well being and confidence.

Return to work (RTW) planning (2)

• The plan may also be used to agree alternative working arrangements for employees who may need help during periods of ill health or to balance work and family responsibilities– allowing a gradual return-to-work, eg building up from

part-time to full-time over a period of weeks – changing work patterns or management style to

reduce pressure and give the employee more control – altering the employees working hours, eg allowing

flexi-working to accommodate family demands

Workplace adjustmentsHealth is not the whole story. Job satisfaction and a

well-managed working environment make common conditions such as joint pain or anxiety easier to cope with

• access to work scheme • new or modified equipment and tools, including IT• modified workstations, furniture,and movement patterns.• additional training for workers to do their job eg refresher courses.• modified instructions or reference manuals.• telephone conferences to reduce travel or if face-to-face meetings

cause anxiety.• buddies, mentors or supervision for workers while they regain

confidence back at work.• reallocating or alternative work

Pays and worksite risk assessments often have to be revised

Occupational stress management

• Stress audits / risk assessments are the most common measuring tools used

• Written stress policy ensures that workplace stress is managed consistently across the organisation

• Training to increase awareness of issues around work-related stress among managers and/or employees. Of course, some individuals will always suffer from stress !

Individuals ’ ability to cope with pressure varies considerably and obviously much stress is not related to work at all and is centred on people ’s home lives. This is why employers need to have in place support systems to help rehabilitate those who are unable to cope

Involving line managers

• Line managers need to be trained in:– the organisation's absence policies and procedures – their role in the absence management programme – legal and disciplinary aspects of absence – role of occupational health services – operation (where applicable) of trigger points – development of return-to-work interview skills – development of counselling skills.

Consulting an OHS provider

• Occupational health involvement is regarded by HR practitioners as the most effective method of managing long-term absence. Occupational health services should:

• monitor the health of employees • help identify health problems and fitness for work issues

at an early stage • formulate rehabiltiation programmes/return to work

strategies • work closely with line managers and HR professionals • promote employee wellbeing and healthy living.

Consulting an OHS provider (2)

• occupational health provider company– should provide a diverse range of occupational health

practitioners including physicians, hygienists, psychologists, ergonomic experts and occupational health nurses

• in-house occupational health department• occupational health professional or other health

professional such as a company nurse or doctor

Targets and Benchmarking

Sickness absence targets used by employers reviewed in the UK CIPD 2005 study

• mean target for employers is seven days per employee per year

• over 10% of employers aim for an annual percentage reduction in working time lost

• targets are most common in food, drink and tobacco employers and least common among construction employers

• clear connection between the size of an organisation and the likelihood of it having targets for reducing absence

Do’s of absence management

• Take time to know your employees and the things that affect their health

• Create a climate of trust • Consider training for you, your managers and employees on a

sensitive approach to keeping in contact. • Consult employees, human resource managers and TU

representatives, although be careful not to discuss an employee’s medical condition without their knowledge and consent.

• Be flexible, treat each case individually but on a fair and consistent basis.

• If the employee is able to travel suggest they come in to see colleagues at lunch time or coffee breaks.

• Welcome the employee back to work after absence. • Remember that medication can have side effects on things like

physical stamina, mood, driving, machinery operation and safety critical tasks.

Dont’s of absence management

• Wait until someone goes on long term absence to consider the best way for you to manage

• Put off making contact or pass responsibility to someone else unless there are sound reasons for doing so.

• Talk to people about the employee’s circumstances without that persons knowledge and consent.

• Put pressure on employees to discuss their return to work before they are ready.

• Say that colleagues or team mates are under pressure or that work is piling up.

• Forget that recovery times for the same condition can vary significantly from person to person.

Other absence issues

• Attendance incentives• Data protection• Disability discrimination• Absence and pregnancy

Effective absence management is about creating work environments where employees are less

likely to wake up and think 'I don't feel like going in to work today'

Thank you