For years now, occupational health (OH) practitioners have striven to raise their profile with employers, position themselves more centrally on the business agenda, and become part and parcel of the senior-level decision-making process. However, with swine flu and absence expected to dominate the headlines and business agenda this winter, whether what is still a relatively small (and often over-stretched) profession will still relish being thrust quite so centre-stage is a moot point.
Nevertheless, the good news is that, even without swine flu, it is quite clear that the provision of OH is finally being recognised by employers as one of the most important weapons in their armoury when it comes to tackling both short- and long-term absence. While small firms still remain something of a wasteland when it comes to offering access to OH, those that do rate its intervention and expertise highly, according to the Chartered Institute of Personnel and Development’s (CIPD) annual absence survey.
The poll of more than 640 HR professionals concluded that OH support was one of the most effective ways of managing short-term absence. Perhaps even more importantly (given its disproportionate cost to the economy and employers) public, private and not-for-profit employers also rated it as the most effective approach for managing long-term absence.
Private vs public
The survey, as it has done in previous years, highlighted the continuing gap between absence levels within the private and public sectors. While private sector absence had been falling year-on-year (see box below), public sector absence remained “stubbornly high”, the CIPD pointed out, with the gap now costing the taxpayer about £700m a year.
Intriguingly, this was despite the fact that public sector managers were more likely to have been given training in absence management – normally a key factor in successfully reducing absence generally – than their private sector counterparts. They were also more likely to use key performance indicators and trigger systems and provide access to OH.
Managers and the NHS
While CIPD adviser Ben Willmott concedes demographic factors such as the sector’s ageing workforce and the often “challenging” physical and stressful nature of many public sector jobs can play their part, the attitudes of line and senior managers remain a crucial issue. Managers in public sector organisations, the survey argues for example, tend to be less likely to use disciplinary procedures to manage unacceptable absence.
“There is no easy answer in terms of how OH practitioners can influence line manager behaviour. But what is important is that the messages around the role of the line manager in supporting employee health and wellbeing are heard at senior levels,” Willmott says.
Others, such as Dudley Lusted, head of corporate healthcare development at AXA PPP Healthcare, argue that the continuing discrepancy between the two puts another factor into sharp relief – the NHS.
Lusted argues that the principal causes of long-term absence (ie, psychological and mental health issues and musculoskeletal problems) are exactly the two areas the NHS has traditionally struggled with most, both in terms of meeting demand for treatment and, just as importantly, the speed of intervention. Yet the public sector depends much more on the NHS for its treatment of employees, with just 7% of employers providing fast-track private healthcare cover to some or all of their employees, against 70% of private sector organisations.
“I can’t understand why so many employers continue to pay people not to work when the tools to deal effectively with their problems are so well established,” Lusted says. “It’s no accident that employers that use them have lower rates of sickness absence than those that do not.”
CIPD absence survey 2009: key findings
- The average level of employee absence has fallen to 7.4 days per employee per year from eight days in last year’s survey. It is highest in the public sector (9.7 days), compared with 6.5 days in manufacturing and production, and 6.4 in private sector services.
- The average cost of absence per employee per year is £692, up slightly from last year’s figure of £666, and is highest in the public sector (averaging £784 per employee, compared with £906 last year). Absence costs the UK economy £17.3bn overall.
- Minor illnesses are the main cause of short-term absence for both manual and non-manual workers, followed by (for manual workers) musculoskeletal conditions, back pain and stress, with stress being the second biggest cause of short-term absence for non-manual workers.
- Acute medical conditions, musculoskeletal conditions and stress are among the top four causes of long-term absence among manual staff, with stress being the number one cause of long-term absence among non-manual staff.
- The most commonly used approach to managing short-term absence is return-to-work interviews (83% of organisations), followed by trigger systems to review attendance (74%), and the provision of sickness absence information to line managers (73%) and the use of disciplinary procedures (73%).
- Return-to-work interviews are the most commonly used approach to managing long-term absence, (74% of organisations), followed by risk assessments following return to work (61%), employee absence information for line managers (60%) and use of OH services(60%).
- The involvement of OH professionals is rated the most effective approach for managing long-term absence by all the main employer sectors.
- Almost four in 10 employers say the recession has increased their organisation’s focus on reducing absence levels and costs, with one in five seeing an increase in mental health problems such as anxiety and depression in the past 12 months.