Getting back on the job

The new best practice guidelines from the Health &Safety Executive (HSE) focus on how employers and employees can work together to hasten a successful return to work – and provided they are followed, are likely to make a significant contribution to reducing days lost to long-term sickness absence.

Certainly the Government has long recognised not just the burden on the economy, but the social toll exacted by extended absence from work.
Jane Kennedy, minister for work, said at the launch of the guidelines: “For too many people, long-term sickness absence leads to the spectre of unnecessary job loss, continued ill health and social exclusion. A culture exists where long-term sickness absence is accepted as a fact of life. When employers try to do something about it, they and their managers often lack even the necessary skills and support to act. We need to change this culture.”

Keith Wiley, OH policy adviser at the HSE, says the guidelines are a natural development of the programme of work set out in Securing Health Together. “In Securing Health Together, we identified that a more holistic approach to dealing with occupational health was required if we were going to make a difference,” he says. “The guidelines are about looking at the barriers to people coming back to work and identifying what adjustments need to be made to get people back to work.”

Wiley believes the way forward is to encourage employees to talk about their work to GPs and for employers to get in touch with an employee’s GP to discuss the issues involved.

But OH adviser Cynthia Atwell points out that medical issues are only one factor in long-term absence cases, and particularly where an employee has underlying non-medical problems, such as domestic problems or unresolved conflict within the workplace, that are preventing their return to work, they are likely to need special help.

What the guidelines say
Employers may need to:

  • Work with trade union and employee representatives on help for ill, injured or disabled workers
  • Check and record sickness absence
  • Train managers to deal with sickness absence and disability
  • Involve absent employees in planning their return to work
  • Wage arrangements/conditions of work – do they help or hinder return?
  • Plan reasonable adjustments for disabled workers
  • Control any risks to employees from work activities
  • Manage work to prevent poor health being made worse by work
  • Once these are put into place, employers can follow the six steps to managing sickness absence and return to work:
  • Record sickness absence
  • Keep in contact
  • Plan and undertake the necessary workplace adjustments
  • Seek professional advice
  • Return-to-work plan
  • Co-ordinate return-to-work process.

Key issues
Employers need to know why employees are off work so they can:

  • Identify employees whose return to work may be delayed or prevented unless you intervene
  • Help employees whose frequent absences may disguise other problems
  • Plan cover for an absent employee
  • Check for patterns of ill health that could highlight possible work-related causes, underlying domestic issues or the onset of disability
  • Benchmark your performance against competitors to judge whether your own record is good or bad.

Early action can increase the chances of an employee returning more quickly.

Recording sickness absence
To successfully record sickness absence, and to consider what help employees need to return, it is necessary to collect information from employees. When writing a policy, talk to them about the type of information employers will need to collect, to make sure they are happy and understand the need for it.

Keeping in contact
Keeping in contact is a key factor in helping employees return to work after a long-term absence. Contact can be a sensitive topic, as some employees may feel pressed to come back to work too early, whereas without contact, those who are absent may feel out of touch and undervalued.

Planning and undertaking workplace adjustments
The purpose of adjustments is to:

  • return the sick employee to their job with any modifications needed, or to an alternative job if no adjustments are possible
  • retain valuable skills
  • remove the barriers to return to work.

If an employee is or becomes disabled, employers are legally required under the Disability Discrimination Act 1995 to make reasonable adjustments to enable the employee to continue working. Not all disabled employees will need permanent adjustments to keep working. But if an individual does need help, employers need to make sure they reasonably can to modify their job.

Adjustments need not be difficult. Employers will often find solutions working with your employee and their representatives. To resolve more complex issues, they may need to seek professional advice.

Stereotyping assumptions about the capabilities of disabled people should be avoided – these are not only unfounded, but now against the law.

Many disabilities have no impact on a person’s job. The best advice will come from the individuals themselves, their doctors, disability employment services and disability charities.

In many cases of illness, a phased or gradual return to normal working hours within a fixed timescale is a key element in getting sick employees back to work.

Seeking professional advice
An a small or medium-sized enterprise (SME) may not have routine access to occupational health services, but sources such as NHS Plus and disability employment services may be able to help.

Many insurers offer rehabilitation services as part of their employers liability insurance policies.

Payments, private medical and income protection insurance may be taxable to the employee. Services for work-related ill health and general welfare counselling are normally exempt from tax.

If an employer or employee needs assistance with reasonable adjustments, the employee can apply to the nearest Jobcentre Plus for help. A disability employment adviser (DEA) will consider whether Access to Work (AtW) can help and refer the employer and employee to an AtW Business Centre.

Sometimes people do not realise their behaviour causes distress, or unexpected circumstances can occur which may cause conflict. One way of tackling this is to use workplace mediators. But, when talking to employees, employers must ensure that everyone understands what is acceptable behaviour at work, which reduces the possibility of conflict at work.

Return-to-work plan
Employers should not prepare a return-to-work plan too soon, or put pressure on employees who are off work for valid reasons. However, leaving it too late may mean the employee loses confidence in being able to return. The best time is three to four weeks into the absence.

The plan should be tailored for the individual and might include:

  • the time period of the plan
  • a statement of alternative working patterns
  • information about changes to terms and conditions
  • what checks will be made to make sure it is put into practice
  • dates when plan will be reviewed.

A co-ordinator should be appointed to pull the plan together, and the individual given as much opportunity to influence their return to work as possible – this can boost their well being and confidence.

A plan may also be used to agree alternative working arrangements for employees who may need help during periods of ill health or to balance work and family responsibilities.

Before implementing the plan, employers should discuss the plan with the employee and other relevant people to make sure all are happy and that it meets the views of the employee, and any professional advisors provided to the employee by, for example, their GP, OH adviser, or disability adviser.

Co-ordinating the return to work process
If employers have to get help from a number of advisers, it may be useful to appoint a co-ordinator to ensure information is available on time, arrangements are smooth and everybody knows what to expect.

The co-ordinator must be familiar with the employee’s job and work environment, able to communicate and negotiate with staff at all levels, and be sensitive to the needs of the employee concerned. Personal information should not be shared without the individuals’ consent.

A more formal approach to co-ordination, known as case management, may be needed in complicated cases or when input is needed from a wide variety of sources. A case manager is typically someone who is professionally qualified in a relevant medical area and may be involved in treating the employee. Case managers can also mediate in cases where communications have broken down or help is needed to move things on.

Nominating one person to co-ordinate the process means all parties involved have one point of contact. This is especially important for the employee at home who may get frustrated if they feel they are being passed around departments.

Action points for employers

  • Keep in contact with sick employees. Involve employees in planning their return
  • Enable people to resume work on a part-time basis rather than stay
    away completely
  • Adjust or remove any aspects of the job that make return difficult, or offer an alternative job if necessary.

Action points for employees

  • Keep in touch with your employer and ask for news from work to help you feel part of it
  • Talk to your doctor about your job and about going back to work
  • Tell your employer about specific prob-lems that make your return difficult
  • Make an informal visit to your employer to discuss your return to work plan.

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