Policing sickness absence

The
police force’s OH departments face the immense challenge of maintaining the
physical and mental health of officers while battling huge sickness absence
rates, by Nic Paton

There
are not many employers who expect their staff to get injured in the course of
their work – but then Britain’s police forces are no ordinary employers.

With
more than 150,000 officers in 53 forces around the country, supplemented by
civilian and support staff, the police service is a huge employer. But whether
it is leaping walls to catch burglars, dealing with traumatised relatives or
being hit with bricks during riots, it has long been recognised that being a
police officer can, quite often, be very bad for your physical and mental
health.

According
to Home Office statistics, the number of days lost due to officers taking sick
leave in 2000-01 was just over 1.5 million. The average number of days lost for
each officer was 12.2, compared with the 2001 average of 10.2 days in the
public sector, and 7.2 in the private sector. Musculoskeletal diseases (MSDs)
were the most commonly cited reason for ill-health retirement, making up 55 per
cent of all cases.

Over
the years, this situation has often been compounded by a ‘macho’, long hours
culture, with many feeling unable to admit to illness – particularly
psychological illnesses – for fear of being seen as weak or unable to ‘cut it’.

But
things are changing, most noticeably with the launch of a Home Office strategy
for OH in October 2002 (see box above). Crucially, this has been backed by an
investment of more than £15m, with the result being an expansion of OH and,
just as importantly, raising the profile of OH and what it can do to tackle the
problem.

Merseyside
Police

“OH
used to be seen as a place where you ended up if you had been off sick for a
long time, or maybe somewhere you went if you wanted to be ill-health retired,”
explains Mary Perry, OH and welfare manager at Merseyside Police.

The
Government’s cash has allowed Merseyside Police to increase its OH staff,
something that was sorely needed, says Perry. Before, the force had just two OH
advisers for 6,000 officers and civilian staff – not an unusual ratio.

Since
January 2003, this has increased to five OH advisers – three full-time and two
part-time.

“For
us, a key element of the national strategy is its emphasis on early
intervention and prevention, but we felt we did not have enough staff to do
that,” Perry says.

While
in the past, OH was normally unable to react until someone had reported sick or
injured, the goal is now to get referrals before someone is absent from their
duties.

“We
are looking for trends and hotspots, and we are also working to educate
managers about OH and what we do,” Perry explains.

“We’re
trying to get the message across that it is about early intervention,
rehabilitation and retention.”

If
an officer is injured on duty, there is now an automatic referral to the
in-house physiotherapy service, which will be able to assess the injury and, if
appropriate, draw up a rehabilitation programme.

“We
look to provide a physiotherapy service as soon as we can. The idea is to have
a phased return to work linked to a risk assessment process. If possible, we
aim to rehabilitate people within the workplace,” says Perry.

Managers
are now more likely to have a better understanding of how OH works, and the OH
teams are less likely to be working in much less isolation. For instance,
absence is generally tracked and monitored by the personnel teams, but it makes
sense for the OH units to work more closely with HR to look at underlying
causes and possible solutions.

Physical
injuries are certainly a key area of Merseyside’s OH work but, increasingly,
mental and psychological injuries have become an issue. Reported absences
because of psychological illnesses, including stress, are rising. This is a
national trend, and in response to the problem, the OH unit now employs a team
of specialist mental health nurses to provide counselling and support at an
early stage.

“MSDs
and stress are the two key themes of the strategy, so we want to look at the
roles within the force that could potentially cause a cumulative stress
reaction,” says Perry.

Roles
such as family liaison officers and traffic investigating officers can, because
of the nature of the work, develop a stress reaction. Police officers and
support staff who perform these roles are now provided with a one-to-one
support session to identify the risk factors at an early stage.

Other
new initiatives included the launch, in January, of a revised stress policy and
the development of a mental health strategy.

“For
some staff, there is a concern that admitting to feeling stressed or anxious
may result in being removed from a role that they enjoy. It is therefore
important to educate staff that the support sessions are about taking
responsibility for looking after your mental health and accessing support
services at an early stage,” says Perry.

Metropolitan
Police

The
Metropolitan Police uses a mixture of proactive and reactive OH provision for
its 40,000 officers and civilian staff, says Gordon Davison, director of HR and
people development.

The
OH is a multi-disciplinary one. There is a senior occupational physician, who
is supported by a number of medical officers. There is also a practice manager,
who is supported by team managers. These are complemented by a team of
occupational health nurses and a network of welfare counsellors. The OH team
looks to assess any injuries picked up in the line of duty, as well as looking
for any psychological injuries that may need to be addressed.

Sickness
absence levels are currently averaging fewer than nine working days per officer
per year and, in the past year, have dropped by one day a year – a statistic
that Davison is proud of. 

After
physical injuries, stress is the second largest cause for this absence, and is
the largest single cause of long-term injury.

As
part of its stress management strategy, an audio-visual presentation has been
made available to the whole force, and can be accessed through individual
workstations.

This
will be followed by a stress audit carried out across the organisation by
managers. Some 10,000 officers and civilian staff will be surveyed, to help
identify where stress levels are at their highest, what types of jobs are prone
to stress and whether there are identifiable pockets of higher than average
stress.

“What
we want to develop is a risk assessment tool that will give managers guidance
and enable them to help their staff. We are trying to help people at an earlier
stage,” explains Davison. This, he suggests, will link in with the Health and
Safety Executive’s work in developing a blueprint for tackling stress in the
workplace.

On
top of all this, in 2002, the force began piloting a private psychotherapy
programme, with the aim of providing early intervention and rehabilitation. The
results so far are encouraging, says Davison, and the plan now is to run a
second pilot at the end of 2004.

Greater
Manchester Police

In
response to the strategy, Greater Manchester Police has introduced a mobile OH
unit and has created the post of temporary health promotion co-ordinator.

The
force’s main unit is based in Prestwich, which is in the city, so it is not
accessible to all staff. The mobile unit, therefore, can now visit at least one
site per division or branch for two days at a time on a regular basis.

Appointments
for health screenings can be arranged via a central administration team, and
time is set aside for ‘drop-ins’, where officers can get health information and
advice.

Among
its services are: physiotherapy clinics for injured officers, reviews of
officers and support staff who are on restricted duties, and help for managers
and support staff who are off sick.

As
well as undertaking regular health screenings, the unit offers voluntary health
screening for cholesterol tests, blood pressure, lung function and stress
analysis.

The
new money is welcome and will make a difference, agrees Sharon Samworth,
principal OH manager at South Yorkshire Police. “We have been fighting to
increase the numbers of OHAs in this department for a number of years,” she
admits.

The
service – two OHAs, with one extra position currently vacant, and a clinical
nurse, for 5,500 officers and civilian staff – works closely alongside the
force’s counselling and welfare services. Again, MSDs, stress and
rehabilitation are the key challenges.

A
central focus has been on backs, with the development of a monthly back care
clinic and, for the OH team, sorting out training on biomechanical assessment
software, which can help to put people on the road to rehabilitation. So far,
two pilot groups have been carried out to assess the impact of having a
biomechanical approach to back care, and the initial results look positive.

“We
had one officer who had a ligament injury, and we were able to improve his
symptoms so significantly that he has now been taken off the sick list and is
back on light duties,” enthuses Samworth.

Sickness
absence rates have also improved substantially in the past six months, partly
through the introduction of an attendance management policy. People’s
expectations about what happens after an injury have been raised, argues
Samworth.

“People
are seeking OH resources more readily and quickly because, as a result of the
attendance management policy, they do not want to go off sick,” she says,
adding that attitudes have been changing, particularly in the past three to
four years.

The
key has been to identify pockets of stress within the operation and to raise
basic stress awareness, says Samworth. She hopes to develop some joint working
initiatives in this area with the counselling service this year.

“We
will be providing stress awareness and educating managers to manage it locally,
and talking to employees too,” she explains. She is also looking at setting up
‘resource areas’, where staff can go, in privacy, to use software about stress
and get more information and advice.

“It
is fantastic that, for the first time, OH has been given this high a priority
by the Home Office, but a lot of people still do not know who we are or what we
do. The Government’s theoretical expectations don’t always meet the practical
reality of being able to deliver the OH service,” she says.

So
there is still some way to go. The Government may have given OH a greater
focus, and there may be increased awareness of its role and what it can do
among both senior and front-line and officers.

But
for many in the service, OH is still not a priority or, at the very least,
there is not enough understanding of what OH can offer, or what sorts of
constraints it is often working under.

“The
biggest problem is in the retention and recruitment of OH staff. The Government
needs to look at why this is happening, and it is not doing this at the moment.
A lot of OH departments are treated very badly. I know of some colleagues who
are put under enormous ethical and professional pressures from inappropriate
management,” says Samworth.

www.policereform.gov.uk
www.merseyside.police.uk
www.met.police.uk
www.gmp.police.uk

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