Absence management refers to sickness-related or unauthorised absence from work.
Absence rates tend to be highest in larger organisations and are consistently higher in the public sector than the private sector.
Despite this, the CIPD survey shows that fewer than half of employers monitor the cost of absence and only half have set a target for reducing absence. The main focus of this article is sickness absence.
The main causes of absence are:
- minor illness
- anxiety and depression
- back pain
- musculoskeletal disorders
- home and/or family problems
The most effective measures to tackle short term absence include return-to-work interviews, trigger mechanisms, disciplinary measures and training line managers. For longer term absence the most effective approaches are providing an occupational health service and rehabilitation programmes.
The UK government has launched a range of initatives to reduce the numbers of people on incapacity benefit and promote the health benefits of being in employment. These include:
- the Welfare Reform Act 2007
- Pathways to Work pilots
- Health Work and Well-being strategy
- A new national director of health and work
There is also a range of employment law that employers need to be aware of when developing absence management interventions, covering issues ranging from discipline and grievance to the need to make reasonable adjustments for disabled staff.
The scale of the problem is shown in two annual surveys by the CIPD and by the CBI with health insurer AXA. The 2007 CBI/AXA survey puts the cost of absence to employers at over £13bn a year while the annual cost per employee is £659 according to the CIPD’s 2007 absence survey.
Absence rates tend to be highest in larger organisations and are consistently higher in the public sector than the private sector with evidence that the gap is increasing. The police and probation service have the highest absence rates in the public sector while sectors with higher than average rates in the private sector include transport, construction, textile manufacturing, printing and paper production, retailing and call centres. Manual working has higher rates than and non-manual.
The widely accepted costs of absence have been challenged by research done at Swansea University which claims the CBI and CIPD surveys do not take into account differences between industries and the costs incurred in reducing absence. The Health and Safety Executive has also claimed that the absence figures exaggerate the gap between the public and private sectors because many private sector organisations are small and do not record absence accurately.
The main causes of absence are: minor illness; stress, anxiety and depression; back pain and musculoskeletal disorders; and home/family problems. Among manual employees the most significant cause of absence (after minor illness) is back pain, while among non-manual workers it is stress-related ill health.
In line with changes to the UK economy and the shift towards services industries and away from manufacturing, the prevalence of mental ill health and musculoskeletal injuries has increased among absent employees while exposure to occupational hazards has decreased. A significant proportion of absence is not related to the workplace such as injuries not related to work and absence due to acute medical conditions. Employers also believe much sickness absence is not due to genuine ill health.
Employers are tackling absence levels to cut employee costs and to improve employee engagement and productivity levels. Those implementing absence management initiatives are putting increasing emphasis on demonstrating a return on investment.
The first step is to have an absence policy. Personnel Today has a policy guide on sickness absence and the Health & Safety Executive provides guidance about what policies should contain. I<A target=_blank type=disc &SL &searchwords="''survey of 600 companies by the Engineering Employers Federationn May 2006, 39% saw a reduction of short term absence after investing in an occupational health service and 28% saw a reduction in long term absence.
One of the key factors in cutting sickness absence is gaining senior level commitment and this is encouraging some HR and occupational health teams, including external providers of occupational health services, to develop cost benefit models to demonstrate return on investment for absence management services.
The UK government has launched a range of initiatives to reduce the numbers of people on incapacity benefit by trying to reduce the numbers who fall into long term sick leave and by helping incapacitated people return to work. The Pathways to Work pilots to support individuals returning to work, and is attempting to improve access to occupational health advice for small and medium sized enterprises through Workplace Health Connect and NHS Plus, an NHS-based occupational health service. In October 2005 the government published the cross-departmental Health Work and Well-being strategy to extend workplace health services to more employees and in September 2006, appointed Professor Dame Carol Black as Director of Work and Health to develop good practice in occupational health provision.
One of Dame Carol’s priorities is to improve communication between HR managers and primary care, in particular encouraging GPs to provide information to employers’ on patients’ capacity for work. Efforts to improve communication through reform sickness certification (which is required to process statutory sick pay) have so far failed to a solution. A report is due shortly on the alternatives to the current system.
The Association of British Insurers and some leading insurers have called on the Treasury to incentivise investment on occupational health services by changing the rules so that occupational health is no longer taxed as a benefit in kind which attracts National Insurance liability, but so far without success.
There are three main methods of measuring absence measurement: the lost time rate; the frequency rate and the Bradford factor.
Lost time rate is the person-hours lost to absence divided by the total amount of person-hours available. For example if one member of a 10-person team was absenty for a whole 35-hour week, the lost time rate would be:
Frequency rate is the number of absent spells (regardless of how long for) among all employees, divided by the number of employees in total, expressed as a percentage. For example if there are 15 absence spells in a month where a company averaged 100 employees, then the frequency rate would be:
15 absent spells x 100
Finally, the Bradford Factor measures the effect of persistent short-term absenteeism by an individual. The Bradford factor calculation is as follows:
Bradford Factor = S2D
where S is the number of occasions of absence in the period and D is the total number of days’ absence in the period. The period used is usually 52 weeks.
One single absence of 20 days is 20 points ((1 x 1) x (1 x 20)
Four absences of three days each is 192 points ((4 x 4) x (4 x 3))
Ten spells of absence of one day each is 1000 points ((10 x 10) x (10 x 1))
Employment law covers a wide range of issues that relate to absence management including sick pay, the duty of care, personal injury, dismissal, discipline and grievance, parental rights, maternity, disability, health and safety and data protection. The legal basis for absence policies and discipline are contained in the
- Employment Act 2002 and the
- (Dispute Resolution) Regulations 2004 (which are currently under review).
Among the many other regulations that affect sickness absence some important ones are:
- Disability Discrimination Act 1995
- Employment Rights Act 1996
- Employment Rights Dispute Resolution Act 1998
- Employment Relations Act 1999
The ACAS code of practice on grievance and disciplinary issues gives general guidelines on absence problems.
Absence Management Video
In these clips Pinsent Masons partners Ed Goodwyn and Kirsty Ayre emphasise the importance of the return to work interview in the context of managing short term absence and highlight the informal stage of the absence management procedure
There are a wide range of tools and methodologies available to reduce absence rates including:
- The use of private medical insurance or private health care to achieve faster return to work times than the NHS
- First day absence schemes which require employees to contact the employer on the first day of absence, and answer questions on the reasons for absence over the telephone
- Sickness Absence Management Systems, usually automated, which monitor absence and enable reports on trends as well as capture data which sheds light on the location of absence hot spots, for example
- Vocational rehabilitation services involving functional assessment and case management to return individuals to work, sometimes initially on restricted duties
- Employee Assistance Programmes (EAPs) – counseling services for employees experiencing work or non-work related stress
- Preventive measures including health promotion and ‘wellbeing’ initiatives, sometimes based on the ‘bio-psychosocial model’
CIPD, HSE and ACAS Absence Management Tool Kit for line managers
BUPA absence management tool
Voice activated telephone based absence recording and reporting service from AXA OH Services in association with BT and ECKOH – Sickness Absence Management (SAM)
EEF Managing Sickness Absence – A toolkit for changing work culture and improving business performance
Sickness Absence Recording Tool (SART) project carried out by the Institute of Occupational Medicine (IOM) for the UK Health and Safety Executive (HSE).
HSE Management Standards for work-related stress
Unum Workmatters absence tools
Guidance on absence management
ACAS advisory booklet on managing attendance and employee turnover
CIPD absence measurement and mangement factsheet
CIPD factsheet on stress at work
Health and Safety Executive guidance for employers on absence management
Health and Safety Executive example of what a good policy might contain
Employers Forum on Disability
HM Revenue and customs Employer Helpbook ‘What to do if your employee is sick’
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Absence Case studies
Barts and the London NHS Trust
British Polythene Industries
Glasgow County Council
Port of London Authority
Royal Mail Group
Useful organisations for ansence management
Association of British Insurers
Association of Occupational Health Nurse Practitioners
Backcare : the national organisation for healthy backs
British Medical Association (BMA)
British Occupational Health Research Foundation
Commercial Occupational Health Providers Association
Department of Health
Department for Work and Pensions
Disability Rights Commission
Employee Assistance Professionals Association
Engineering Employers Federation
Faculty of Occupational Medicine
Institute of Employment Studies
Institution of Occupational Safety and Health
Office for Disability Issues
RADAR (The Royal Association for Disability and Rehabilitation)
RCN Society of Occupational Health Nursing
Royal Institute of Public Health
Royal Society for the Prevention of Accidents (RoSPA)
Scottish Executive Health
The Scottish Paliament Health Committee
Society of Occupational Medicine
The Work Foundation
Trades Union Congress
Vocational Rehabilitation Association
Welsh Assembley Occupational Health Strategy
Work Life Research Centre