Shattering the debilitating impact long-term absence can have on business and its purse strings is a real challenge, and one that employers continue to struggle with. Annie Hayes asks the experts to share their secrets.

What is long-term absence?

Ben Willmott, employee relations adviser at the Chartered Institute of Personnel and Development (CIPD) says that the professional body generally agrees that long-term absence constitutes a continuous period of absence for four working weeks or one calendar month, but the definition is not always as clear cut. At energy powerhouse Centrica, the time-line is a little shorter.

Martyn Davidson, head of occupational health for the firm, says that a period of absence for 21 days or more falls into the realms of ‘long-term absence’ but adds there is “no general agreement” on when sickness falls into the category of long-term.

What we do know is that long-term absence is only a small portion of the wider absence statistic. According to the CIPD’s latest absence survey (2007), the majority of absence is short-term – up to seven days – accounting for 70 per cent of total absence. Just 17 per cent falls under the lesser talked about mid-term absence period of eight days to four weeks, and the rest is classed as long-term absence. Davidson says that at Centrica, the problem is fairly modest, with around 5 per cent of total absence constituting the long-term variety.

Long-term absence is therefore a minority problem but one that can have far-reaching consequences and can actually cause more headaches than the more prevalent short-term variety, partly through the nature of the conditions that tend to be long-term, which can be difficult, sensitive and tricky to deal with, such as stress and mental health conditions, as well as the problems associated with getting those who have been off sick for long periods of time back to work.

How can employers strive to reduce long-term absence? What policies can be put in place?

Davidson says the trick with long-term absence is to move it into the medium-term camp, but how can this be achieved?

John Sellars, managing director for absence management specialists Employ-Mend Limited, says the first thing to do is to ensure that the absence policy maps out a clear process to be followed.

Plans, he says, should involve early signposting of employees to relevant sources of support already provided by the employer including EAP/counselling services, physiotherapy and other treatment facilities for members of cash plans and private medical insurance, which can help to fast-track diagnosis and return to work.

Davidson agrees and adds that part of the problem with long-term absence is that a great deal of time is wasted waiting for diagnosis to occur: “It’s the way the NHS works. We pay for consultation or intervention that moves the process along.”

Dr Steve Boorman, director corporate responsibility, Royal Mail Group says that businesses also crucially need to measure the problem and understand its costs. Sadly, he says, investigation of this kind can show that long-term absence is simply the result of poorly managed short-term absence.

“The longer an individual is away from the workplace, the less the chance of return, so a first step is early assessment and contact with individuals who are sick. This shows the employer cares and is offering support.”

And early consideration of the next steps is also crucial, he adds: “Alternative hours and reduced physical or mental demands may enable individuals whose functional capacity is impaired to return to the workplace. There is good evidence that earlier return reduces long-term disability and risk of long-term sickness or retirement.”

In what way should long-term absence be managed differently to short-term?

Boorman says: “Long-term absence usually involves medical certification, and liaison with primary or secondary carers may be necessary to seek better understanding of the medical issues impact and likely prognosis. Long-term illness often results in reduced physical and mental fitness, which in turn may require a gradual return to work – building stamina as fitness improves towards a full return to work.”

Sellars says that in contrast to such serious medical conditions, short-term absence is often down to behaviour-related issues. “The success for short and longer term absences is a clear and systemic process combined with a proactive support process for managers.”

Stephen Walker, director of Motivation Matters, sheds further light on the distinction and says that while short-term absence needs to be understood all the time, long-term absence, due to a continuing condition, needs to be understood once and reviewed periodically.

“The key to managing long-term absence, based on the overall policies of the organisation, is to understand the condition and its progress. Then you have a notion of when the individual can return to full employment.”

How can HR work with occupational health services? What can they offer?

Willmott points to the findings of the CIPD’s 2007 absence surveys, which ranks access to Occupational Health (OH) as the most effective intervention for managing long-term absence.

Boorman adds that HR plays a key role here. “At its simplest, HR often acts as the gateway, by having the data on length of absence or recurrent episodes of absence. HR can provide the information to support a good occupational health referral, which needs to include information on past attendance, employment length, job description and any other relevant information such as past warnings regarding poor attendance or accident report.”

At a more specialised level, HR can mentor and coach managers about legal obligations and ensure business policy is clear and understood, says Boorman.

The approach at Royal Mail Group, Boorman comments, is to ensure line managers are well-supported locally by a comprehensive OH approach, focusing on case management with experts working with the HR team to ensure policies and approaches are innovative and effective.

Sellars is so convinced that OH is the only way forward that he goes as far as to say that OH should be “routinely” sought when dealing with longer term absence scenarios, especially those where consideration of disability discrimination is required.

What initiatives/strategies can be used to help staff back to work, following a long period of absence?

Boorman suggests that as a first step bosses should never give up on the individual. As Willmott remarks, good employers recognise that people will have a time during their life when they have to take time out of work for a significant health problem.

One of the key problems is the longer an employee is off the less likely it is they will return. Boorman says: “A key step is ensuring individual understanding of the benefits of returning to work – individuals may believe that the employer is pushing for early return simply for business reasons and not understand that early return has mutual benefit in promoting long-term recovery and reducing long-term absence.”

Fears, expectations and beliefs need care and understanding and careful management, he advises.

“Good interpersonal communication can help avoid situations in which an individual understands one outcome, the GP another and the manager yet another,” he remarks. “Agreed case management plans can be very helpful by documenting agreed return to work points and the work to be done. These can also include targets for progression or improvement and options for alternatives should these not be met.”

Long-term absence is clearly a key issue to get right and sometimes the simple methods are the best. As Davidson concludes: “There’s no magic bullet, the same old thing done more conscientiously and carefully can work wonders.”