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In sickness and occupational health: Absence management


Occupational healthWe all want a healthy and happy workforce, so how can occupational health work with HR to help manage employee absence? Louise Druce investigates.

It seems the credit crunch is being blamed for everything these days, including days off work. Absence management company FirstCare, which monitors the likes of Coca Cola and the NHS, claims the number of people ringing in sick with flu-like symptoms and stomach complaints has been steadily growing, reaching record levels at the end of September.

The news will do nothing to ease the headache that sickness absence already causes UK firms. The Chartered Institute of Personnel and Development (CIPD) estimates it costs employers, on average, an unlucky £666 per employee per year – that’s eight working days or 3.5% of working time – with absences of over eight days accounting for 40% of this.

So how can occupational health (OH) services help? It’s a good question, as Professor Michael O’Donnell, chief medical officer at the UK’s leading disability insurer, Unum, believes there is often a gap in understanding as to what OH can actually do – and not all OH providers are good at explaining what their services should be.

More worryingly, in some cases, it has been used as more of a weapon, with managers threatening to send people to occupational health services if their absence doesn’t improve, reminiscent of the days when you were sent to the school nurse – and likely to instill as much apprehension!

Putting a face to a name

Occupational health practitioners come in many guises, including physicians, hygienists and psychologists. The CIPD has put together a comprehensive list of what occupational health involves but what is important, says O’Donnell, is that it should be looked at in a wider setting than medical issues and being used to assess whether someone is fit for work or not. Instead, he believes, occupational health should be seen as something that can facilitate people to work. “It starts by asking people what they would find difficult if they returned to work and how can we help,” he adds.

“It would be much better if the contract was written in such a way that HR people would pick up the phone to occupational health to find out the best way to get things done.”

Professor Michael O’Donnell, Unum

A major hurdle, however, is making occupational health services more human. “There isn’t sufficient dialogue between HR and occupational health. One of the issues is they see each other as competitors in some sense, which is unfortunate because they shouldn’t be,” says O’Donnell.

“A lot of occupational health contracts are relatively faceless to the employer. For example, HR will write a letter to the occupational health provider, having obtained consent from the employee, and an examination or GP report is arranged. It’s all very formal and stiff. It’s also unbelievably slow. A lot of the time, it would be much better if the contract was written in such a way that HR people would pick up the phone to the provider and talk things through to find out the best way to get things done. It’s also about occupational health selling themselves as a consultant rather than a contractor.”

Of course, there are situations where occupational health professionals are best placed to deal with long-term absenteeism and some employees might feel more comfortable talking in confidence to someone other than their manager about their illness.

But O’Donnell argues that occupational health professionals should also be educators to empower managers to deal with situations themselves, where possible. “Companies should use occupational health as a knowledge resource or if they are inexperienced or uncomfortable with absence or attendance issues. But as time goes by, you would expect managers to gain more confidence in dealing with issues themselves. You don’t always need an expert,” he continues.

For instance, if an employee has a broken leg but is keen to return to their desk-based role, it may be a case of managers finding a way to help with transport and mobility. In other cases, firms may be able to offer alternatives such as flexible working to help gradually reintroduce employees back into the workplace, if they have been off sick for a few months or need to take time off to care for an elderly relative.

One of the biggest problems is that some managers are uncomfortable talking to employees about how long they will need off work for fear of being seen to pressure them into returning and possibly finding themselves on the wrong side of employment law.

Train to gain

Last year, energy firm Centrica introduced a half-day occupational health programme, with HR’s help, to deliver training for line managers to deal with just this issue – how to have the return to work conversation. “A manager needs to know the things they shouldn’t ask, why they shouldn’t ask and why they don’t need to know,” says Centrica’s group head of occupational health Martyn Davidson.

The aim of the course was to make managers aware of how to position questions to avoid falling into these irrelevant traps and get the outcome they want. For example, rather than taking a more aggressive line with sick employees and asking, ‘what’s the matter with you and when are you coming back?’, managers should realise they don’t always need to know the exact symptoms of the illness and instead ask, ‘how can I help you get back to work?’

“It’s not complicated,” Davidson concedes, “but unless you take people through the process, they learn by trial and error and that’s where it goes wrong.” Even seasoned managers who had been faced with this situation before gained something from the course, he adds.

He also advocates incorporating occupational health into the company’s long-term business plan to keep managers engaged, rather than its services being called upon on an ad-hoc basis.

Power to the people

“Unless you take people through the process, they learn by trial and error and that’s where it goes wrong.”

Martyn Davidson, Centrica

Like O’Donnell, Davidson believes the human face of occupational health is important. “We would love it if HR used us as a resource first, rather than waiting until the problem has become embedded and formalised to some extent,” he says. “I think we can improve things by trying to make sure our face is known so they think about us and when they phone they know who we are.” This can also help employees feel more at ease when talking about their issues.

The company piloted a project that did away with the requirement for a GP certificate on the eighth day of an employee’s absence, requiring instead that the employee engage with occupational health to ensure they had all the help they needed. “The nice thing was there was a concern that people would abuse it and take longer off work but, in fact, that didn’t happen – behaviour and absence didn’t change very much,” says Davidson.

“We managed to improve the degree of communication between the absentee and the manager because it was a straight forward negotiation process in terms of how to get the absentee back to work and accommodating any problems based on what the doctor has advised.”

By dealing with sickness on a personal level, rather than treating it as a process to be dealt with, Davidson believes it sends a positive message out to the rest of the company that could improve overall absence issues. “It says we care about you, not because we have a statutory obligation, but because we want to look after your health in the workplace,” he says. “If you are off for any reason, we can get you back into work as soon as possible because we value you as part of the business.”

Managing sickness absence


  • Create a climate of trust by agreeing beforehand your methods, frequency and reasons for keeping in contact with absent employees.

  • Consider training for managers on a sensitive approach to help them get the most out of contact.

  • Keep a note of contacts made.

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

  • Welcome your employee back after their absence.

  • Carry out return to work interviews.

  • Give your employees the opportunity to discuss, in private, concerns about their health or other matters that are affecting their performance or attendance.

  • Remember that medication can have side effects on things like physical stamina, mood, machinery operation and safety critical tasks.

  • Don’t

  • Wait until someone is on long-term sick leave before taking action.

  • Delay making contact or pass responsibility to others unless you have sound reasons.

  • Make assumptions about your employee’s situation.

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

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

  • Source: Health and Safety Executive

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