Curing the sicknote epidemic

The British Medical Association’s (BMA) condemnation of employers over the UK’s sicknote epidemic (Personnel Today, 20 June) provoked a strong reaction from HR professionals.

An estimated 67,000 visits are made to GPs each year for the purpose of sickness certification, government figures show. Dr Peter Holden, chairman of the professional fees committee at the BMA, claimed that this level of sicknote certification was a “cop out” by complacent employers. Work-related stress, he said, was “almost always down to poor management”.

It is a very costly business. UK employers paid out a total of £13.2bn in 2005 for sickness absence – or £531 per employee – according to annual research from the CBI and insurer Axa.

Working closer

There is no consensual opinion on how to manage sickness absence. However, many of the employers who contacted Personnel Today following Holden’s comments said that, while they were keen to work more closely with GPs to tackle the problem, it was not always reciprocated.

Doreen Ellis, an occupational health practitioner at cosmetics firm Cosi, said she attempted to organise a company open day for local GPs and practice nurses to discuss the company’s sickness policy, but no-one turned up.

“If GPs don’t meet us half way at least, we stand no chance of reducing sickness absence within the deprived areas,” she said.

Chantal Walton, director of consultancy HR on Tap, agreed. “Give us a break – GPs and employers both have a responsibility together on this issue,” she said.

Eleanor Tansley, HR manager at Thistle Victoria, Westminster & Kensington Gardens hotel, accused Holden of being out of touch with employers.

“Dr Holden really has no idea what is actually going on in the real world,” she said.

Sicknote confetti

Accusations that GPs handed sicknotes out “like confetti” were also rife.

“GPs are contributing to the increase in sicknotes with the arbitrary way they issue them,” one respondent said. “I have heard many a story from staff who say they know first-hand that the GPs hand out sicknotes at the blink of an eye, with very few questions asked.”

Another respondent said: “I’m afraid the continuing culture of absenteeism is nourished by GPs who apparently ignore their years of expensive training to avoid having to make a professional judgement.”

Ellis said the number of sicknotes so easily handed out “merely reflect the doctor’s appointment schedule rather than a carefully considered prognosis on the part of the doctor”.

Absence management is clearly a contentious issue, for which, unsurprisingly, the government, employers and GPs are reluctant to take sole responsibility.

Dr Steven Quillam, a GP from Northumberland, said the situation had snowballed in the past few years.

“I have noticed a gradual increase in requests for reports from employers – via the employee, so that they can try to get it for free – or employment-related aspects of the patient’s health,” he said.

Quillam said GPs should be given more autonomy. “What’s wrong with accepting a date to return to work from a sicknote?” he asked. “This implicitly means the GP believes a patient is fit to return to work.”

But Dr Sayeed Khan, chief medical officer at the manufacturing and engineering organisation EEF, said GPs did not have the necessary training on issuing sicknotes or on work rehabilitation.

“GPs can’t provide a reasonably thought-out sicknote if they haven’t been trained,” he said.

Changing culture

Khan said employers needed be more adaptable. “We have to change the culture and look at what employees can do rather than what they can’t.”

The Department for Work and Pensions attempted to address the sicknote issue in a consultation report, A new deal for welfare: Empowering people to work, last month.

“The government is looking at increasing the range of occupational health support available to employees,” the report stated.

“We think there is already a strong business case for employers to do more, but further financial incentives are an issue that we need to consider in more detail across government,” it said.

One thing that everyone does agree on is that tackling the sicknote epidemic is going to take time.

Health and the workplace

The government believes absence can be cut by improving overall health in the workplace. This is one of the main remits of the national director for health and work, Dame Carol Black, who was appointed in April.

The newly created role was part of the Health, Work and Wellbeing Strategy, launched last year by the Department of Health, the Department for Work and Pensions and the Health and Safety Executive.

Health minister Lord Hunt said Black, a professor of rheumatology at the Royal Free and University College Medical School, “will play a significant role in ensuring delivery of the workplace health commitments outlined both in the strategy and in the Choosing Health White Paper”.

Doctors slam employers’ ‘cop out’ over sicknotes

For more on the absence management debate, see Unions undermine moves to cut down sickness absence

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