If you don’t want employees to become stuck on reasonable adjustments, it’s vital proactively manage the return-to-work situation, the adjustment to duties, and the employee’s expectations, writes Dr Bernard Yew.
As any occupational health professional will know, reasonable adjustments have a vital role to play when it comes to supporting people with health conditions to remain in work.
However, once someone no longer needs the adjustment, it can all too easily become embedded – perceived as permanent change in terms and conditions rather than a temporary adjustment – if the situation isn’t proactively managed.
Return to work
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For example, perhaps someone with back pain was temporarily taken off heavy duties. They’ve now recovered, but the adjustment was in place for so long that they no longer see this as part of their role.
Or maybe someone who no longer needs to work from home is refusing to come back into the office, long after the specific medical need for this has passed.
Home-working can often be one of the most difficult adjustments for an employer to remove, as non-medical barriers can also come into play.
For example, individuals may be tempted to rebuild their life around their new-found flexibility. They might end up changing their childcare arrangements, selling their car, or moving further away from the workplace.
Critical to managing expectations in this scenario is clearly communicating from the outset why the adjustment is being put in place and why it will be removed once no longer medically required.
For example, spelling out very clearly from the outset that this will happen after completion of their treatment or once the adjustment is no longer medically required.
That way employees are less likely to create other, non-medical barriers to having the adjustment removed further down the line.
Prevent adjustments becoming a change in contract
Managers should be encouraged to check in with employees every few weeks to ask how they’re coping and discuss any change in situation, such as an external medical review, which could be a trigger to discuss the existing adjustments.”
Another reason employees can become stuck on ‘temporary’ adjustments is employment law. Any temporary adjustment left in place for more than a year can reasonably be considered a change in contract by the employee.
Therefore, employers who don’t regularly review adjustments can find that less challenging departments become inundated with people on adjustments. Or they may end up with so many people unable to do core duties that the adjustments cease to be ‘reasonable’.
It is therefore essential that any adjustments are regularly reviewed to meet both the individuals and business needs.
Managers should be encouraged to check in with employees every few weeks to ask how they’re coping and discuss any change in situation, such as an external medical review, which could be a trigger to discuss the existing adjustments.
If someone’s condition has worsened, stronger adjustments might needed. If their condition has improved, the manager should be prepared to discuss reducing or even removing adjustments.
Consider all barriers to removing adjustments
All kinds of barriers can arise to make someone resistant to having their adjustments removed. They might perceive their commute as being too much or say it will impact on their caring duties or cost too much to start getting the train again. However, if there isn’t a medical reason for the adjustment the employee may be in breach of contract.
Employees who appear recovered, but insist they still aren’t medically fit to have their adjustments removed, might need to be referred into occupational health to establish whether or not there are any underlying medical issues.
Biopsychosocial models can also be used to consider not just the physical, but also the social and psychological barriers at play.
For example, if someone believes that their colleagues will be hostile to having them back after so long or catastrophising that going back to what they were doing will make them sick again, the individual can be helped to process and overcome these concerns.
If there are new barriers to returning, such as depression after cancer treatment or fear of certain movements following an operation, the individual can also be helped to overcome these.
Ease the employee off reasonable adjustments
Forcing the issue and trying to abruptly remove a recovered employee’s adjustments can provoke the employee into quitting.
Although this could be said to resolve the situation, the whole point of reasonable adjustments is to support people to stay in work and retain valued talent. It’s therefore important to talk to them about any non-medical barriers to return.
If they can’t face a two-hour commute every morning, for example, a compromise could be found by allowing them to start work an hour earlier every morning to more than halve their travel time. If they don’t want to do heavy duties in the morning, because their medication hasn’t kicked in, they could have these scheduled for later in the day.
If they’re worried about getting sick again, a risk assessment could be carried out before their return to identify and address any potential problems.
If there are social barriers, such as resistance to giving up homeworking due to wanting to meet their children from school, the organisation might have to look at these non-medical barriers. For example, by giving the employees a little more flexibility or time to put new childcare arrangements in place.
Promote the benefits of returning to full duties
The longer an employee continues to work with restrictions, the less likely they are to return to a normalised way of working. As we saw during the pandemic, people who were isolated at home due to one health issue could easily develop a secondary health issue because of becoming more inactive or socially isolated at home.
It is important for occupational health and employers to help employees understand that the sooner they can get back to normality the better for their all-round health.”
Similarly, if someone on lighter duties due to a short-term issue isn’t returned to full duties once recovered, they could eventually become so deconditioned they can’t return to full duties even if they wanted.
If they are taken away from client-facing work, due to acute anxiety, but not reintroduced to this as soon as they can cope again, they could lose the confidence to ever do this again in future.
It is therefore important for occupational health and employers to help employees understand that the sooner they can get back to normality the better for their all-round health.
If employees are resistant to returning to the physical office, it can also help to communicate the physical benefits of becoming more active during the day and the mental health benefits of becoming less isolated.
They will also get to experience more personal growth from bouncing ideas off others and seeing how other people think and handle things differently.
The more you can help employees to understand why removing restrictions that are no longer medically required is also in their interests, the more motivated they will be to support this.
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