The HR and medical communities agree that the way forward in tackling the
sicknote crisis is to improve people strategies and to give occupational health
the responsibility for assessing fitness for work
Saudagar Singh, HR director, Npower
The rising trend in sick notes is simply a reflection of the steadily
increasing burden at home and work. Doctors are merely reflecting the
increasing pressures faced by their patients through mounting demands for
higher standards of living, the emphasis on the self over others and a more
serious, complex, faster-paced world. All of which are taking their toll.
The near ‘Utopia’ presented several decades ago of a future society in which
we would be challenged by the amount of spare time available to us, has not
only failed to materialise, but seems further from our grasp than ever.
The 24 hours seven-days-a-week, commercially-led consumer society, and the
inexpensive availability of technologies such as laptops and mobiles, have
ensured that many employees cannot easily ‘switch off’. The divide between home
and work has become progressively more blurred. And some employers regard those
that do not conform to the rising demands as uncommitted or unqualified for
promotion or a pay rise.
There is no question that for many staff who take time off, there is a
genuine medical condition. However, there will also be some who simply do not
enjoy the experience of going to work. Rather than pinning the blame on the
doctor issuing the sick note, employers should take a hard look at themselves.
We all understand that prevention is better than cure, and at Npower we have
taken various measures to proactively adopt a prevention culture. We now have
three dedicated Npower nurses to manage health issues proactively, and a counselling
hotline for problems, which are not necessarily work-related. These have all
contributed towards ensuring that Npower’s overall sickness level is below the
Surely it is in the interest of the organisation to understand, on an individual
basis, the issues of concern for employees, and to address them, or at least
explain if they cannot.
In the same way that organisations have a choice in the way employees are
managed, the working environment and the culture created, employees have a
choice in how much they choose to give above the minimum.
There is ample empirical data to demonstrate the strong correlation between
motivated staff and superior financial performance. Investment is needed into
resources to identify and address underlying issues.
Understanding what motivates individual workers and managing them
effectively, brings bottom line improvements. It could be as simple as
introducing a more relaxed dress code or renovating offices, implementing and
acting upon regular staff surveys, or even positively implementing personal
We have recognised the importance of ensuring that all levels of management
are appropriately equipped with the knowledge and skills to engage staff
constructively through our comprehensive management and leadership programmes.
The result is an inspired and professional management and leadership
population that is better able to motivate their employees. And as a by-product
of this, there has also been a reduction in sicknotes.
Dr Chaand Nagpaul, a GP in Harrow, north-west London and member of the
British Medical Association’s GPs’ committee
The survey by Personnel Today and
Doctor confirms that the status quo is highly unsatisfactory for employers, GPs
and patients. We need a system that is fair for all three.
Patients must feel able to be absent when they are genuinely
unfit to work, and employers must feel confident that employees are truly ill.
For GPs, the issuing of sick-notes uses up appointments. This
is a purely administrative task which denies access to GPs for other patients.
Certifying sickness puts GPs in an invidious position. We are
the patient’s advocate, and this compromises our ability to challenge them
about the legitimacy of an illness, because it threatens the doctor-patient
With many illnesses, especially stress-related ones, GPs are
unable to verify the condition. There are no investigations or clinical markers
– we can’t send them for a blood test to prove what they are saying. GPs have
to trust what patients tell them. Thus the GP is superfluous, since all we do
is write on a certificate what the patient tells us.
GP appointments are eight minutes long, and it simply isn’t
possible to adequately address the occupational aspects of an illness. GPs
don’t have the time, and it’s not their job. Neither is eight minutes enough to
sensitively challenge a patient about an illness.
GPs are hamstrung by the NHS’ nationwide paucity of
occupational health (OH) services. We are often powerless to deal with
sicknesses that are stress-related, because there aren’t enough counselling and
stress management services. GPs are often resigned to giving sicknotes by
default, rather than trying to solve patient problems. There’s also a lack of
OH facilities and employer support.
GPs should not be the first port of call for sicknotes.
Patients often don’t want to be off work, they want solutions. They need OH
All employers should have access to OH services, and the
Government should fund this. The reduction of DSS sickness certification claims
would more than pay for it.
This would end the sicknote culture, and create a culture of
solutions and getting people back to work. GPs will not be redundant as there
will always be patients who are sick because of a medical history, and
employers will need independent information from medical records.