Absence makes the heart grow harder

Workplace absence may have cost the UK economy 12.2bn in 2004, according to annual figures from the CBI, but the suggestion that 1.7bn of this comes from staff pulling ‘sickies’ put employers and workers at loggerheads last month.

While the survey by the CBI and insurance firm Axa stresses that most absence is caused by genuine illness – and welcomes the fact that absence levels have returned to about the same level as 2002 after a surge in 2003 – it also argues that absenteeism remains ‘an issue’ for many employers.

Among the 500 or so companies polled, employers believe 23 million working days are not genuine. Absenteeism is a bigger problem in larger organisations, and is one area where there is little difference between private and public sectors.

Four out of five organisations monitor the different illnesses that cause their staff to be absent, but employers report a prevalence of unauthorised extensions to weekends, ‘duvet days’, and peaks during sporting events.

A total of 74% of the employers questioned say there is “definitely or possibly” a link between absence and Mondays or Fridays, with 65% saying there is a link to holidays and 40% to special events.

While genuine illness is the most significant cause of absence for manual and non-manual workers, particularly for manual workers, paid sickness absence is commonly seen as an “entitlement”. As such, it is thought to be the second most significant cause of absence.

For non-manual workers, home and family responsibilities are seen as the second most significant cause.

CBI director of HR policy, Susan Anderson, says: “We cannot bury our heads in the sand and pretend it is not happening. We need to create a culture that is sympathetic when people are ill but where we are not afraid to say if there is a problem.”

Line managers, she adds, are generally “utterly abysmal” at managing absence and, for a policy to be really effective, it needs to be clearly led by senior management or, if not them, then by HR.

“Most staff only take time off when they were genuinely ill, but we all know abuse does go on,” Anderson says.

“Employers and employees share a common interest in creating a culture where those that are genuinely ill are able to take time off and recover, but where abuse is not tolerated,” she explains.

Underlying causes

But Anderson’s view provokes an impassioned response from TUC deputy general secretary, Frances O’Grady.

Rather than simply shaking a stick at workers who are unwell and focusing on the disciplinary issues surrounding absence, employers need to be spending much more time and effort examining the underlying causes of absence, and absenteeism, O’Grady says.

As other speakers at the CBI conference to launch the absence survey in May pointed out, in many organisations, the vast majority of the absence management policy is devoted to disciplinary issues and procedures.

O’Grady highlights research published by the TUC in January, which stressed that, contrary to myth, the UK is not a nation of malingerers or shirkers. British workers are less likely to take short-term time off sick than in any other European country apart from Denmark.

“Three-quarters of people go into work when really they should be back home in bed. There is a need for a reasoned fact-based debate with a proper perspective,” says O’Grady. “There is also a proven link between working long hours and ill-health.”

According to the TUC, unpaid overtime benefited businesses to the tune of 23bn – nearly double the 12.2bn cost put on all workplace absence by the CBI.

“The fakers are outnumbered by those that go into work when they should not do so. Britain has the second lowest short-term sickness rate, and the fourth lowest long-term absence rate,” O’Grady says.

Long hours, job dissatisfaction, too great a workload, lack of control, and a general disrespect of workers are all factors in this debate, which is rigidly focused on the need to discipline those off work when they should not be.

“Stress is too often perceived as a figment of workers’ imagination. There is a bit of macho fear of mental health issues. If you have a heart attack, you are a hero, but if you have a nervous breakdown, you are a wimp,” she adds.

What was needed was a climate of trust, not the one of mutual suspicion that existed in many workplaces, she argues.

Yet, among the OH, HR and business professionals who attended the conference, Mark Doyle, managing director of IT business Trinity Expert Systems, a Coventry-based firm that employs 150 people, speaks for many.

He says it is not long-term sickness that is the problem. “When someone is off long-term, people are really good about it. The thing that really hurts businesses and customer relations is short-term illness – someone calling in on the Monday morning,” Doyle says.

Rather than a ‘them and us’ situation, employees want ‘sickies’ to be dealt with, because they have to pick up the pieces when a colleague regularly calls in sick at short notice.

“It tends to be the peer group that complains, and they look to you as the manager and want to know what you are doing about it,” Doyle adds.
Commitment from the top.

Where this leaves OH professionals, however, is unclear. Absenteeism is a notoriously hard area to tackle. But the CBI survey is adamant that getting absence management right takes commitment from the top.

Where senior managers have primary responsibility for managing absence, 2.3 fewer days are lost than when line managers alone have primary responsibility. Absence is also lower when HR has primary responsibility. Yet in 72% of organisations polled, line managers had the primary responsibility.

Sharing responsibility generally does not produce the same benefits as when senior managers have primary responsibility. OH still has a long way to go – it is responsible for absence management in only 19% of organisations.

More worrying, absence rates per employee where OH professionals have responsibility appear to be higher, at 8.2, than when senior managers (6.9) or HR managers and line managers (7.1 each) take responsibility.

OH and fitness to work

Better news for OH is the finding that employers feel OH professionals are best placed to assess fitness for work, better placed even than GPs.
This finding is certainly echoed in the experience of Geny Foster, OH nurse with consultancy Medigold Health.

She complains that organisations have to wait 40 to 60 days for a GP’s report. “Often we find the GP does not even know what the person is doing,” Foster says.

The number of organisations using OH to assess fitness to work has also gone up, from 82% in 2003 to 87% in 2004.

But there remains a significant gap in OH take-up between large and small companies, with all those surveyed which have more than 5,000 employees using OH, compared with just 57% of those that have fewer than 50 employees.

Most organisations – 87% – say they are “taking action” to cut absence. But, worryingly, absence is higher, at 7.4 days, in those firms that are doing something about it than those that are not (4.5 days).

As the CBI/Axa survey concludes: “Clearly, employers with high absence levels are seeking to address it – but to little effect.”

The average time before an employer invokes its absence policy is 10 days, with a review normally triggered sometime before that, often five days. There is wide variation in this in the private sector, between five and 14 days. The average number of spells of absence that trigger the use of a policy is three.

Return-to-work interviews are the most common absence policy, and are used by almost all the employers polled. Giving absence statistics to supervisors and disciplinary procedures are also very prevalent, says the CBI.

The top four most effective interventions for non-manual workers are:

  • Return-to-work interviews
  • Flexible-working patterns
  • Formal notification procedures
  • OH provision.

The best interventions in order of effectiveness for manual workers are:

  • return-to-work interviews
  • formal notification procedures
  • paying occupational sick pay from day one
  • disciplinary procedures
  • OH provision.

When it comes to rehabilitation, 60% of employers have formal arrangements in place to rehabilitate employees, although such programmes are more prevalent in larger organisations.

Public sector organisations are more likely to offer rehabilitation policies, yet also generally have much more long-term absence.

On stress, the CBI/Axa survey found that two-thirds of employers have a stress management policy, with just under half having a formal policy.
The survey also noted a blind spot among many employers when it comes to linking health and productivity.

The vast majority of the organisations polled (95%) have not examined this relationship. But of those that have, 17 out of 25 identified a strong link.

Those organisations also have relatively low absence levels – just four days per employee. But the survey is quick to caution that 25 is a very small sample.

Go to www.cbi.org.uk

‘Workstyle maxims’ cut absence and stress at Rolls-Royce

Aerospace engine manufacturer Rolls-Royce has succeeded in cutting absence and workplace stress since introducing a new absence management policy.

With about 35,400 employees around the world, it reported 191,000 days lost to absence in 1994. After a decade, chief medical officer Dr Ian Lawson says it has dropped to 118,925.

The company has also seen a 5% reduction in absence attributed to workplace stress. Key initiatives have included:

  • The introduction of a stress assessment questionnaire
  • A training package for employees on how to cope with pressure
  • Increased screening, surveillance, rehabilitation, health promotion and education by the OH service.

An important part of this, says Lawson, has been the creation of ‘workstyle maxims’, designed to change the culture of the organisation. These are:

  • Be aware of a long-hours culture
  • Learn switch-off techniques
  • Learn to space holidays so you don’t have extended periods at work
  • Take regular lunch and workstation breaks
  • Use more personal communication methods
  • Practise ‘mindfulness’ about other people.

Lawson says: “OH is giving the workforce permission to behave properly.”

Royal Mail reruns sickness incentive scheme

Royal Mail’s controversial sickness incentive scheme, which rewards employees who do not take time off sick, was just one part of a much wider absence management project, according to Jon Allen, head of employee relations.

The scheme, which ran for six months in 2004, will operate again this summer, although this time round only workers who have not taken a day off sick for a full year will be eligible to win a car, rather than after six months as before.

But there will be more smaller prizes, such as holiday or other vouchers, for those who achieve six months.

“If the incentive scheme did nothing else, it really raised the profile of the problem. The key was that it was part of a bigger package, which was about getting back control,” says Allen.

This included training for 13,000 managers, more use of online tools and more OH support.

On top of this, there was more regular, and structured, contact with staff on long-term sick leave, and earlier referrals to OH.

In six months, sickness absence among the organisation’s 190,000 employees had fallen by 1% to 5.7%, and attendance levels had shot up, Allen says. Last year, before the scheme was introduced, absence had been running at more than 6.4%, and more than 10% in some parts of the organisation.

Few short-term absence cases were referred to the OH service and, after six months off, about half never returned, rising to 95% of those who had been off for a year. A total of 40% were off with musculoskeletal disorders, and the same percentage with stress or psychological issues.

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