Absence management: how health benefits providers help

Employers can do a great deal to ensure their employees remain fit, healthy and able to work. Director of Jelf Employee Benefits Chris Ford looks at how benefits providers can help.

A sickness absence policy should encompass the three Ps – preventive, proactive and provision. The most helpful absence policies are those implemented for all staff from day one of joining. The element that ismost important from day one is “preventive”.

There are a lot of tools available to employers to help with prevention, including health-awareness days, “bring-an-apple-to-work” days, employee assistance programmes (EAPs) and developing an absence policy. External health benefits providers, including insurance companies and occupational health service providers, will help with some of these, while others can be instigated by the employer.

Employers themselves can do a lot to help. For instance, specialist training is readily available to help line managers identify signs of stress-related absence, one of the most common reasons for absence. As with many absences, early diagnosis and intervention is key to prevent a short-term absence from becoming long term. When triggers of stress are identified, it is possible to put a solution in place. If left unresolved, the situation can get worse and affect more staff.

Communication is key

The point to emphasise here is communication. When staff feel that their employer cares if they are present or not, it can mean the difference between bouncing out of bed to go to work, or not. So the key is to let staff know that you do care and to tell them how.

Key points

  • Absence management starts on day one of attendance.
  • Companies need to look after their staff and tell them how they are being looked after.
  • Find out why staff are absent and understand what support is available.
  • Have a centrally managed process to manage absence and use all support available.
  • Assist staff back to work, including after their first day of return.
  • Look after staff who are still at work while colleagues are on sickness absence leave.
  • Ensure the sickness absence policy is communicated.

One of the aspects of a successful sickness absence policy that many employers ignore is being proactive. Employers that are proactive from day one of an absence put themselves in the best position for quicker returns to work. When staff have to talk to their line manager on their first day of absence, the manager has an opportunity to find out the reason for the absence and measures can be put in place.

Another reason it is important to record the first day of absence is that it is then possible to schedule measures at other key dates. For instance, after 28 days there might be an automatic referral to the company’s OH service, irrespective of the reason for the absence. There could be a review of all absences every three months, a chance to look at how they are all being managed and what stage each absence is at. If absence is not recorded, this management is not possible.

One of the most common reasons for sickness absence is musculoskeletal injuries. If the company can identify this as the reason, it has an opportunity to help. For instance, it may have access to fast-track physiotherapy and the employee can be made aware that this is available. Recent research by Jelf Employee Benefits found that the timing of medical assessment of staff varied widely between different companies, but 30% of companies either did not offer, or did not know if they offered, a medical assessment of staff. If it is available, it needs to be offered.

When staff are on sickness absence leave they do not stop being the employer’s concern. A number of areas of care can still be provided, and it is imperative that managers know what is available and what to expect. All resources can be brought into play, including access to EAPs, cognitive behavioural therapy (CBT), private medical insurance (PMI) or income protection (IP).

The longer a member of staff remains absent, the less likely they are to return to work. At some stage it is important to find out when an employee may come back to work, and the question needs to be asked. This might be handled by the company or by an external provider. Even if the absence is going to be long term, there is still much that can be done to manage the individual, from including them on the distribution of company news bulletins to inviting them to company events. This improves engagement and makes their return to work much easier. It is also positive for present employees to see that absent staff are managed.

The key here is early intervention. Make an assessment of the reason for absence. Understand what support is available, including from insurers; OH, IP and PMI are all able to help with prevention as well as physical and emotional treatment. The sooner the employee’s absence is managed, the more likely they are to return to work quickly.

Central absence policy and policing

For an absence policy to be effective, it must apply to everyone and it must be policed – this is where many companies do not do themselves justice. It is important for every company to have a policy, whatever their size. For some companies it may not seem important if one person is off for a short time as the rest of the staff will often rally. But a long-term absence can put pressure on departments already working to capacity.

On the flip side, some companies will automatically bring in cover for absent staff, such as a fire crew that can only operate with a given number of staff. In such situations, absences are not immediately felt by remaining employees.

In both situations, without a policy, the staff and the company are left in the dark. Line managers should take ownership of the first stage of absence management. They are best placed to find out when a member of staff is absent and the reason. It is also imperative that they know what support is available so that they can instigate the next step, which is often referring them to a central department, usually HR. HR needs to know about all the support that is available and how best to use it. OH, PMI and IP can be underused, but can be helpful in both prevention and cure.

OH teams can achieve results by identifying a pattern of absence and developing processes for better working conditions. For example, this can be particularly effective in companies with a high degree of manual labour with a lot of musculoskeletal absences, where OH teams have helped develop manuals on improving posture when carrying out activities to prevent injury.

The providers of IP will also have services available to help prevent absence, and it is prudent to explore these. It is also important to note that the most effective absence policies apply to everyone consistently. Some companies will choose to offer IP to just a few members of staff, usually determined by seniority or length of service. Research conducted in 2013 by Jelf Employee Benefits found that just 25% of employers offer IP to all staff. IP comes at a cost, but this needs to be compared with the benefits of preventing and reducing absence.

It is not always the best solution for the line manager to decide what support is offered. When different line managers have differing levels of expertise and knowledge, there is little hope of consistency. Line managers benefit from training – such as how to identify stress triggers, what questions to ask when an employee is absent and how to encourage engagement of absent employees – but when absences are managed centrally, such as by a central HR department, employees are more likely to be managed consistently.

Return-to-work interviews

The most effective absence management policies actively manage the return to work. This starts with an interview, which should not be simply a tick-box exercise. The line manager is well placed to carry out a return-to-work interview, and as with the rest of absence management, management information needs to be handled centrally in case more action is required, so that it can be handled consistently.

The first thing a company should find out is whether or not an employee is fully recovered. However, it may well be that ongoing management is required. If a number of employees are off with similar diagnoses, there may be preventive measures that can be put in place to reduce further absences. This could mean removing triggers for stress, improving the ergonomics of an office, improving preventive health screening or increasing education of health and fitness. After a return to work from a trauma, ongoing counselling may be of benefit.

Employers should find out more about the absence, even at the stage of return. The collective management information will be valuable and ongoing measures can be implemented for continuous improvement.

This stage of the process is also important for staff who are still at work. Present staff can be affected by others’ absence. For example, if a colleague has been affected by a serious illness, others may want to rally and get involved in events related to a particular charity to show their support. This also shows why it is important to communicate with all staff regarding absences. Sensitive health information cannot be relayed, but support from staff can be encouraged.

Specialist rehabilitation

Companies with a lot of support available often fail to use it. Often this is because they do not understand the benefits on offer. Many IP policies have EAPs, grief counselling or trauma counselling included, for example. Many OH providers will offer a raft of guides on particular causes of absence – for example, dealing with cancer in the workplace or correct posture for manual tasks. Many PMI schemes will include free information on health, wellbeing and preventive care.

Another inhibitor to using these services is that employers see them as traditional insurances that should not be used for fear that premiums will increase. However, it is in the interests of company-funded health and protection insurers to do what they can to keep staff well and facilitate return to work, and this can actually decrease costs.

It is important for health insurance and OH providers and the company to regularly review absences so that they can review their management. In research by Jelf, less than 30% of absence stakeholders discussed ongoing absence on a regular weekly or monthly basis. Management needs to be constantly reviewed to ensure it is effective.

Employers may look at the cost of absence as just the £680 that the CIPD quotes as the average cost of absence per employee per year. But this figure only takes into account the direct cost. There is also the cost of the effect on the rest of the staff, clients and the company. In real terms the cost is much higher, and it makes good business sense to manage this.

Why now?

Welfare reform is having a big impact on employers, all of which have more responsibility for their employees’ welfare than ever before. The costs and implications of unmanaged absence can skyrocket, and can be far-reaching and devastating for the employee, the employer and other staff.

The companies that have the most successful absence policies are those that do not shy away from the issue, use their insurances, start managing early and have a central policy.

About Chris Ford

Chris Ford is director of corporate and individual protection at Jelf Employee Benefits.
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