Long-term sickness absence: how fit notes will make a difference

Work. It pays the bills, gives structure to a day, a sense of self-worth and can be therapeutic, yet long-term sickness is on the rise, according to the latest figures from manufacturer’s body the EEF and insurer Unum.

Their 2009 Sickness Absence survey, published last week, found that 36% of the 697 organisations questioned reported a rise in the number of employees who were off for more than a month between 2007 and 2008.

About one-third of people taking long-term absences were waiting for surgery, medical investigations or tests after being diagnosed with back problems (34%), cancer (26%) or stress (25%).

Yet the trend is not limited to manufacturing. “The catering and hospitality industry has noticed an increase in long-term sickness, much of which can be related to stress,” said Nick Crighton, employee relations director, HR, at catering giant Compass Group.

Information quality

Sayeed Khan, chief medical adviser at the EEF, was not surprised that long-term sickness is rising. Khan, who is also an occupational physician, said both he and colleagues regularly see people from all walks of life who are waiting for tests and have been given bad information about how long they need to be off work for.

“There is no reason [to suppose that] what we found in manufacturing isn’t the same elsewhere,” he told Personnel Today. “This is a systems failure, with long-term sickness absence relevant throughout all sectors.

“Is the NHS fit for the working age population? The answer is no. A target waiting time of 18 weeks just to be seen? Come on, people lose their jobs before that time. The other element is people saying: ‘I have been told to stay off for three months.’ That decision is not made on the latest evidence-based guidelines. There’s a lot of unnecessary waiting.”

Fit for work?

The situation looks set to worsen, given the recession. Ben Wilmott, senior public policy adviser at the Chartered Institute of Personnel and Development, warned that people are more likely to go to work, even if they are ill, for fear of the detrimental effect sickness absence could have on their job security.

“From the last recession, we saw an impact in work intensity,” he said. “The difficulty with that is if people are coming in when they are not well, those sorts of problems can then escalate and become long-term sick problems.”

But change is afoot. Next month, the Department for Work and Pensions and the Department of Health will launch a ‘fit note’ consultation, which will seek comments from HR, occupational health (OH), doctors and other stakeholders, on how the scheme – to replace sicknotes and get people back into work quicker – should work. GPs will be urged to point out what a person can do, rather than what they cannot.

Industry has largely welcomed the move. But experts also cautioned there would be issues to iron out. “The challenge will be education and guidance, for GPs who issue the note and for employers in understanding what their role is, as the fit note will ultimately shift more responsibility to employers,” said Neil Carberry, head of pensions and employment policy at the CBI.

He added the note had to be “meaningful enough to employers to enable them to take actions to help keep their employees in work”.

Training for GPs

Susan Cartwright, director of the Centre for Organisational Health and Wellbeing – a recently launched centre for workplace health at Lancaster University – agreed. “The average doctor does not get a lot of training in occupational health and the requirements of jobs and job-holders.”

“A lot of the success of the proposed fit note system will depend on the way it is positioned – as helpfully aiding the return to work rather than something punitive,” she added.

Judith Smith, HR director at the Drivers and Vehicles Licensing Agency (DVLA), which recently launched a film and booklet to outline the types of adjustments that can be made for returning employees, said her organisation understood the concerns GPs had. “We have presented at local GP training events and are about to distribute the film to local GPs, together with the contact details of our HR and OH department, with an invitation to contact us to discuss any issues or concerns,” she said.

Line managers coached

Another HR director who is ahead of the game is Tesco’s Therese Procter. “If a member of staff is waiting for physiotherapy through the NHS, we try our hardest to find them a temporary role that matches their reduced capability,” she said.

“We coach our line managers to better understand individual capability. Most people can manage some type of work if they are waiting for treatment or recovering from treatments. They do not need to be 100% fit to engage in well-designed return-to-work programmes developed with their input and the input of personnel and occupational health teams, when necessary.”

An advocate of fit notes, Procter said there was plenty HR could do to gear up for their introduction, such as “leading the review of current processes and policies related to absence, return to work, flexible working, and supporting training with key stakeholders to ensure they encourage people to stay at work and return to work as soon as is practicable” to ensure that we are ready for fit notes,” she said.

Comments are closed.