Transcript Slide 1

Sickness Absence Management
David Grech MD MIM
Medicare
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 knowledgedependent. 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 absence
Manual
Non-Manual
Minor illness
Minor illness
Back pain
Recurring medical conditions
Recurring 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 !
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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 work
2. 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
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Recording & measurement
Keeping in contact
Making absence short term
Long term absence
– Return to work plan
– Workplace adjustments
– Stress management
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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
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'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.
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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 100
No of employees
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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:
SxSxD
S = number of spells of absence in 52 weeks taken by an individual
D = number of days of absence in 52 weeks taken by that individual
Introducing an IT programme
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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:
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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 adjustments
Health 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
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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 workrelated 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:
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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
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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