Myths about sickness absence

Sickness absence is a headache for UK employers, with costs estimated at 11bn a year and around three-quarters of a million employees off work with long-term sickness.

This is a problem that OH professionals and employers are seeking to address, but now a disability insurer is claiming that some traditional beliefs about illness and sickness absence are unfounded.

According to Unum Provident’s chief medical officer, Dr Michael O’Donnell, the company’s research shows that the pre-existence of certain illnesses, behaviour and circumstances are far more predictive of future work absence than previously thought – and stress is one of the conditions it considers suspect.

“If a person has a history of frequent consultations with their doctor for anxiety, stress, depression, dizziness or breathlessness, their chances of taking long-term time off work for health reasons increases.

“In fact, a history of such problems may be a more important predictor of long-term incapacity than a history of actual definable diseases, such as heart problems. This should not be surprising, as many studies show that disabled people give better attendance at work than their non-disabled colleagues.”

The study found that a history of depression or subjective disorders – where there is no identifiable disease process to cause the health problem – appears to pre-date a significant proportion of sickness insurance claims for medically unexplained symptoms. A history of poor attendance at work is also highly predictive of future absence, according to UnumProvident.

But Lawrence Waterman, president elect of the Institution of Occupational Safety and Health, is unimpressed by this interpretation. “Employers are already finding it hard enough to recruit people with the talent they need; it’s going to be even more difficult if they start to exclude people presenting particular problems,” he said.

“What OH and employers need to do is help people make the best contribution they can at work despite their difficulties. If people find they have clear goals at work, co-operative colleagues and support from their line manager, it might well be a place they rush to, to escape problems causing them stress outside the workplace.”

“Nobody is perfect and employers are not employing people who are always 100 per cent mentally and physically fit. Our view is that employers must take people as they are, and that OH and health and safety professionals need to work together to improve both organisational practice and support for individuals.

He added: “Instead of focusing on having fitter employees, we should be focusing on having fitter employers. This view also stigmatises people with low-level mental illness, and I’m not happy about that.”

However, Ben Willmott, employee health adviser with the Chartered Institute of Personnel and Development (CIPD) takes the view that employers need to be cautious about taking on staff who have habitually been off sick.

“Most employers should be taking account of potential applicants’ sickness records. If someone has taken long periods of time off when working in a similar job, you need to look at the reason for that. Assessing whether someone has the capacity to do the job should be part of the recruitment process – that’s common sense,” he said. “Research has shown that previous sick records are a good indicator of future sick records.”

Willmott said jobs should be assessed for their “stress quotient” along with the other aspects of the work involved, and that this should become part of the interview process.

“It’s particularly relevant with certain jobs. For instance, candidates for teaching posts need to be sure they can stand up in front of a class of rowdy teenagers and assert themselves,” he said.

While Willmott concedes that employers need to tread carefully when dealing with applicants who have mild mental health disorders, to make sure they do not fall foul of disability discrimination legislation, he doesn’t think they should duck the issue of discussing why previous stress-related absences have occurred.

“Employers need to have a frank conversation about stress and related mental conditions. What caused the problem? Was it a one-off? Was it connected to work? Has it been resolved? If this is the case, then there is no reason that someone should not make a full contribution in their new job,” he said.

A closer relationship between HR and OH is essential to getting the balance right. Fifty per cent of employers surveyed by the CIPD reported that stress-related absence increased last year, while only 9 per cent said it had fallen.

The causes are workload, management style, relations at work, performance targets and organisational change – and where management issues and job design are the cause, collaboration between OH and HR is clearly vital.

“It’s important that employers are able to pin down and address specific causes of stress,” said Willmott.

“And good job design means that stress levels can be reduced. The HSE management guidelines highlight the fact that having a well-defined job role, which you are well-trained for, can help you cope with the demands of stress. That is a very helpful approach to this issue.”

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