On the mend

Alternatives to how sicknotes are issued are being piloted.

News that pilots looking at alternatives to GPs writing sicknotes are finally to get under way this autumn will come not a moment too soon for most HR professionals.

It has become clear in a succession of reports that HR managers and directors are almost at the end of their tether over the lackadaisical attitude of some GPs to writing sicknotes.

While the vast majority of workers who call in sick are, we have to believe, genuinely ill, there is a suspicion, admitted as much by GPs, that hard-pressed family doctors are far too prepared to sign employees off work without enough investigation.

GPs, certainly, want shot of sicknotes, despite the fact they can bring in a sizeable portion of their income. At the British Medical Association’s annual conference in June, they voted unanimously for the current system to be scrapped.

As part of their new contract agreed with the Department of Health, GPs want to have made “substantial progress” towards giving up responsibility for sickness certification by April 2006.

The pilots, which are due to kick off in October and will run for 15 months, are the first stage in this process. As reported in Personnel Today (News, 27 July), the pilots will look at two models: using in-house occupational health (OH) departments and remote services.

The in-house model, which will run at Peugeot Citroen’s Ryton manufacturing plant in Coventry, and London Taxis International, also in Coventry, will see employees self-certify as normal for the first seven days and then, rather than going to their GP, make an appointment to see their OH department.

After this, a ‘fitness to work’ report will be drawn up, with the worker either coming back to work at on agreed date, or being passed on to the appropriate medical, treatment or rehabilitation services.

The other model, involving a number of smaller firms in Banbury, will involve giving organisations access either to a nurse-based call centre that will log absentees and offer basic medical advice, or an OH service where an adviser will visit the organisation in person.

The main reason for the pilots is to thrash out how such models might work on a larger scale and to ascertain what does and does not work. To that end, they are being evaluated as they progress by academics at the University of Warwick.

While the fine detail still needs to be worked out, what is clear is that, like it or not, the current system is changing. Subsequently, the approach of HR professionals to sickness certification will probably have to change radically too.

Issues of communication, resourcing, data management, training and education, absence management protocols, links with GPs and OH services will all have to be addressed.

At one level, all HR can really do at this stage is sit back and watch as the process unfolds, suggests Ben Willmott, employee relations adviser at the Chartered Institute of Personnel and Development (CIPD).

But getting your own absence management procedures and protocols ship-shape would certainly not be a bad idea, he adds. This should also mean ensuring line managers take some responsibility for the process as, once GPs are no longer the ‘gatekeepers’, it is likely they will need to get involved much more closely anyway.

“There will also probably need to be more co-ordination between GPs and employers on areas such rehabilitation and return-to-work programmes. Currently, it is not happening in enough cases. HR and GPs will be forced to talk more about what is going on,” Willmott predicts.

Anything that improves the current system would be welcomed by employers, argues Kate Groucutt, policy adviser on reward and employment at the Confed-eration of British Industry (CBI).

Its absence survey in June showed many larger employers felt OH professionals were better placed to assess fitness to work than GPs. The main challenge, she believes, is around capacity – are there enough OH professionals to go round? And if, as appears likely, that there are not, what other options are there?

Because of this, Willmott, Groucutt and Dudley Lusted, head of corporate healthcare development at private healthcare provider, AXA, which co-authored the CBI survey, all agree the remote model pilots may end up the ones employers prefer.

AXA’s own statistics point to the fact that when self-certification is increased from five to 10 days, the number of workers requiring sicknotes halves. Such a move could, at a stroke, cut the sicknote burden, whoever is doing it, argues Lusted.

And, asks Lusted, if GPs are no longer earning the fees from sickness certification (estimated at some 15 per cent of their income), what will happen to that cash? Will the Government be prepared to claw it back and invest it into OH services, particularly services for smaller employers?

Over the coming months, it appears there will be many hard questions for HR and others to answer.

Get involved

Organisations looking to find out more about the pilots should e-mail Peugeot’s group occupational health and safety adviser, Dr Barbara Kneale, at barbara.kneale@mpsa.com

Questions for HR

  • Take a hard look at existing absence management procedures – how will they be affected by new certification arrangements?

  • Look at how any new arrangements will be communicated to staff and managers – is extra training or education required?

  • Are there resourcing or data management issues that need to be addressed, particularly over employee confidentiality or the keeping or absence/sickness records?

  • Will links between GP services, existing OH services and your organisation need to be re-evaluated or strengthened?

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