All of us at some stage in our lives will experience ill-health; this can have a significant effect on an individual and the business. How we are perceived and treated as an employee whilst in this vulnerable state can have a long-standing effect on how we feel about our employer. Below are some important factors to consider when dealing with sickness absence and returning to work.
The Importance of Work:
Employees get paid for coming to work and when they are off they are not fulfilling their contract of employment. Managers and employers need people at work to do the daily business of delivering services and goods to keep up profits. Without the correct kind and number of workers, a business will ultimately fail. So for employers, it is imperative that their workers work. Simplez! But there is another side to this argument, research has shown that work in itself is essential for good health and well-being for the individual worker too. Many studies have shown that:
- The longer people are off work the more likely it is that they will never return to work
- Other illnesses often occur whilst people are off sick due to isolation and lack of social interaction eg depression and anxiety
- After only 6 weeks’ absence from work due to sickness, a person’s ability to return to work falls away and 1 in 5 will never return to the original job
- Most people who permanently leave work are suffering from mild to moderate mental health issues or muscle, joint or back pain and not serious incurable health conditions.
I understand most of the issues with sickness absence or being away from work for long periods as I am an occupational health professional myself. But I surprised myself when I left my last company only to find that I was imagining all sorts of conspiracy theories about my colleagues when I didn’t hear from them for many months. I believe this happens when people are on prolonged sickness absence or who are absent from work for any reason. Considering the pressure that you’ve probably put on the remaining team members and the isolation from colleagues makes it remarkably easy to think the worst of people and it’s difficult to imagine that people would ever want you back. Managers should lead the way in ensuring that the absent employee is reassured about their support whilst ill and their value to the company.
The Manager’s Role in Managing Absence:
The manager has a number of duties when dealing with absence which can be summarised as:
- Managing the worker
- Undertaking the return to work interview
- Facilitating recovery by encouraging rehabilitation programmes
- Removing work related barriers to return to work
- Monitoring performance that is affected by health issues (sometimes called capability)
- Encouraging attendance
Keep in Contact
Some employees may fear they forced to return before they are ready, but without contact, your absent employees are likely to feel increasingly out of touch and undervalued. Managers often feel that asking absent employees for information about likely return dates or details about health will appear intrusive. You may feel equally uncomfortable about talking to an employee whose performance, combined with frequent short-term absence, is causing you concern. Listed below are some dos and don’ts to help you deal with these issues.
- Create a climate of trust by agreeing methods, frequency and reasons for keeping in contact
- Consider the timing and form of contacts and who should make them
- Be flexible, treat each case individually but on a fair and consistent basis
- If your employee is able to travel, suggest they come in to see colleagues at lunch time or coffee breaks
- Keep a note of contacts made
- Welcome your employee back to work after absence
- Carry out return to work interviews (see below for more details)
- Give your employees the opportunity to discuss their health or other concerns that are affecting their performance or attendance in private
- Remember that medication can have side effects on things like physical stamina, mood, driving, machinery operation and safety critical tasks
- Encourage your absent employees to talk to their own GP about what they may be able to do as they make progress or adjust to their condition. This will help you to judge whether a gradual return is the best way forward or whether other workplace adjustments are necessary
- Wait until someone has been off for weeks and weeks before trying to make contact
- Delay making contact or pass responsibility to someone else, unless it’s unavoidable
- Make assumptions or listen to gossip about your employee’s situation or their medical circumstances, find out directly from the employees themselves
- Talk to other people about your employee’s circumstances without that person’s knowledge and consent
- Forget that recovery times for the same condition can vary from person to person
What if My Absent Employee Refuses Contact?
Make sure all your employees understand their responsibility to keep you informed about why they are absent from work and when they are likely to return. Remind them of their responsibilities of when call in about the absence. Does everyone understand the provisions for sick pay and notifications to you as the employer? Some workers won’t notify you or the illness or keep in contact because of sensitive issues. They may feel embarrassed about describing their condition, or the illness linked to difficult work situations or working relationships. You can help by:
- Telling your employee who they can talk to in confidence, such as an occupational health service if you have one or HR but in all cases assure them of your reasons for asking the questions
- Enabling your employee to talk to someone of the same-sex or religion, or at a neutral place away from work and home if that is a barrier to communications
- Making the first contact in writing if there is a problem with normal communications and offering help with any problems at work
- Referring workers to Occupational Health early in the absence
Managers Managing Absence
Involve absent employees in planning their return to work by
- Ensuring reasonable adjustments for those who are disabled or not yet fully fit
- Control work risks to individual in the short-term
- Controlling work responsibilities and processes preventing poor health being made worse
- Regularly reviewing the work situation if required
When is a Managers help required:
- Become ill or injured and performance could be affected if health worsens
- Are already in poor health, stressed, whose condition may get worse unless the system of working is changed
- Already have their performance affected and beginning to take days off sick
- Are already on long-term absence and need help to return
- Become disabled due to accident, injury or disease
Key elements in managing the return to work process
- Keeping in contact with those off sick, agree on names and dates of when to have visits or discussions about the health situation
- Adjusting the work place to keep people at work or help those returning to work
- Making use of professional advice and treatment via Occupational Health professionals
- Agreeing and reviewing a return to work plan
- Providing funding for some treatments eg counselling, physiotherapy
- Coordinating the return to work process, this can either be done directly with the manager or a designated person in the team or HR
Managing Fit Notes from the GP
In order to receive statutory sick pay employees who are sick for more than seven days must give a fit note from the GP. For more information about fit, notes see How to Manage Absence in the Workplace.
One of the questions I get asked about fit notes is whether an employee can return to work when they bring in a fit note marked with ‘unfit’ from their GP. The answer to this is absolutely clear. A fit note is an advisory note to an employer and only used for statutory sick pay purposes. One of the biggest myths around sick notes or fit notes, as they’re now called, is that insurance companies will not let signed off workers on site. This is not true – if in doubt ask your insurer.
A good tip – if an employee is going to see their GP to talk about their health and fitness for work after illness, serious accident or long-term absence, why not discuss the work options available before the employee sees the GP. GP’s generally appreciate any help from the employer on what options are available in your particular workplace.
Occupational Health Referral
An occupational health service provides a private service (paid for by the employer or business) so that workers (and Managers) get expert advice from health professionals who know and understand their business. Many larger companies employee occupational health services to help managers deal with sickness absence in a fair and consistent manner. The steps below will help managers get the most from the occupational health service providers:
- Refer to occupational health immediately if a worker complains of any work related issues eg work-related stress or joints/muscle pains
- Refer those off sick after 3 weeks absence for long-term absence with no date of return in sight
- Explain clearly the reason for referral and ask employee to sign the referral form to show that they understand why they need to attend occupational health
- Managers should let workers know what questions the occupational health service is going to answer and why it’s important
- When the manager receives a report back from occupational health with recommendations, it is really important to consider the recommendations in the report seriously; if a manager is not happy with recommendations then it would be wise to have a case conference with the worker and occupational health to consider alternative solutions.
- It is well-known that management makes the final decisions about recommendations and dismissals etc. under employment law. Managers should not fall into the trap of believing that recommendations made by occupational health are set in stone. All parties should be willing to accept an element of negotiation around opportunities available and flexible working; in that way, there is usually a solution.
Return to Work Interview
Conducting a Return To Work Interview as part of Managing Absence
This is an important and highly effective tool for managing absence. It might be an informal chat to welcome an employee back to work, and to confirm their record of absence is correct. It could be a full discussion of any remaining health issues with the potential to affect work and adjustments needed. A return to work interview is a good opportunity to offer help to an employee you suspect affected negatively by pressures, whether domestic or work related. If they become distressed, stay focused, give them time to recover and reassure them that you are listening. The main thing is to listen well and be fair.
Watch this video: A Managers Guide to Return Work Interviews for more information:
Many companies have adopted the return to work interview as a strategy for controlling absence and ensuring the safety of the worker and others. They are useful for controlling short-term absence and ensuring that those returning to work are fit and able to do so.
Traditionally managers feel uncomfortable discussing health issues in detail, especially with members of the opposite sex or if the perceived health issue is embarrassing or likely to cause distress. Formal management training can help with ways of minimising any embarrassment or risk to either parties but a good way of dealing with people in the return to work interview scenario is to use the WARM approach.
WARM is an easy to remember phrase which encompasses all the main points you want to cover during the return to work interview.
Here are the four stages you need to cover using the acronym WARM:
- Welcome back, be friendly and open, non-hostile, focus on the individual and well-being
- Absence discussion, (look at attendance record, count up days absence this year etc)
- Responsibility for attendance at work (remind of need to attend in cases of short-term repeated absence, business needs, importance of work the individual does)
- Move on – update on what has happened in their absence, allocate work for the day/week ahead
If Employee is Distressed:
No matter how carefully you discuss health, disability or absence problems there may be times when your employee becomes distressed. If this occurs stay focused, give the employee time to recover and reassure them you are listening
- Find out if they need external support (do they have friends and family to talk to or is there a counselling service available?) if not, suggest returning to their GP for further help and support
- Arrange another meeting if necessary but recognise that there are limits to what you can deal with personally
- Special training may be needed to deal with tragic circumstances or severe illness
Other factors have an impact on how you deal with absence issues and return to work programs, here are some:
The Equality Act
If an employee becomes disabled then you are legally required to make reasonable adjustments to the workplace.
Becoming Disability Aware
If your employee is or becomes disabled, you are legally required under the Equality Act to make reasonable adjustments that will enable your employee to continue working. What is reasonable will depend on:
- The financial and other impacts of adjustments on your particular department and its activities;
- How effective adjustments are likely to be;
- The particular needs of your individual employee, not the nature of their disability alone; and
- The availability of financial or other help to you
The adjustments needed by an employee following illness or injury and those for a disabled person will often be similar. It is helpful to get into the habit of considering reasonable adjustments to help an employee return to work whether they are disabled in the legal sense.
How Do I Find Out About What Adjustments Are Needed?
Adjustments need not be difficult and solutions will often be found by working together with your employee and their trade union representatives. But sometimes, professional advice will be necessary and Occupational Health can help here. The key steps in planning adjustments are:
- Consider your employee’s needs and what they can do
- Assess the possible barriers to your employee’s return
- Consider the adjustments needed to overcome these barriers
- Review health and safety risk assessments in the light of the proposed adjustments
- Review how well the adjustments work
- Seek professional advice, where necessary, to help you and your employee make informed decisions
Making Reasonable Adjustments
Ill health or injury is sometimes caused by a specific event such as an accident. More often it is a combination of factors, such as increased workloads, lack of control over work or failure to take breaks. Pain and discomfort feel worse when there are other difficulties to deal with at the same time.
If an employee is suffering from back or joint pain, you may need to consider adjustments to ergonomic factors like working posture, the equipment used, the working environment, the pace of production and the spacing of rest breaks. Employees will readjust more easily and gain confidence to cope with lingering pain or depression brought about by events outside work if they feel supported at work, demands are reasonable and tasks are satisfying.
Examples of Adjustments to Working Arrangements
- Allow a phased return to normal working hours or workloads to build up strength and confidence
- Change your employee’s working hours to allow easier travel to work, or allow flexible working to ease work/life balance
- Provide help with transport to and from work
- Arrange home working (providing a safe working environment can be maintained).
- Allow your employee to be absent during working hours for rehabilitation assessment or treatment.
Examples of Adjustments to Premises
- Move tasks to more accessible areas and closer to washing and toilet facilities
- Make alterations to premises, eg providing a ramp for people who find steps difficult
Examples of Adjustments to the Job
- Provide new or modify existing equipment and tools
- Modify workstations, furniture, and movement patterns
- Provide more training
- Modify instructions or reference manuals
- Modify work patterns or management systems to cut pressures and give the employee more control.
- Arrange telephone conferences to cut travel
- Modify testing or assessment procedures
- Provide a buddy or mentor to your employee while they regain their confidence at work.
- Reallocate work within the employee’s team
- Provide alternative work
Under health and safety law you have to undertake a risk assessment of your activities to prevent people being harmed by your activities. If there has been a significant change in an employee’s capability due to illness, injury or disability making them more vulnerable to a particular activity or task a new risk assessment may be required.
Unfortunately, there will be occasions when there is no reasonable adjustment or control measure that will enable an employee to return to their original job, in these cases, it will be necessary to consider alternative employment.
Help and support
Today, there are about 300 mental health conditions alone; added to this are the thousands of other physical disorders. Managers cannot be expected to know about them all especially in relation to ability; Occupational Health is there to help and advise in health related matters and HR will advise on practice, policy and procedure.
If in doubt about any aspect of ill-health at work contact should be made with HR and Occupational Health to discuss the implications for you and how you can best help and support your employees. If you don’t have your own occupational health service then consider using one of the free National occupational health services helplines;
England and Wales:
- Fit for Work (bit.ly/2vBKFdH)
- 0800 032 6235
Welsh Language Line:
- Ffit I Weithio (bit.ly/2vBNbk7)
- 0800 032 6233
- Fit for Work Scotland (bit.ly/2vBzfGT)
- 0800 019 2211
Planning and Undertaking Workplace Adjustments
Return to work programmes can be advised by Occupational Health and the purpose of adjustments is to:
- Return your sick employee to their job with any adjustments needed, or to an alternative job if no adjustments are possible
- Retain valuable skills
- Remove barriers to return to work.
Keeping in contact with your absent employee will help you to plan any adjustments to their work that may be needed for their return. Some adjustments may also be necessary to enable employees with a health condition that could worsen over time to stay in post.
In many cases, a phased or gradual return to normal hours within a fixed timescale is a key way of getting your employees back to work. There is no single pattern that suits everyone. Discuss in advance with your employee what impact this will have on their pay.
Meeting Health And Safety Requirements
Health and safety law requires you to undertake risk assessments of your activities to prevent people being harmed. You need to review your risk assessment and possibly amend it:
- If there has been a significant change in your employee through illness, injury or disability, or effects of medication, that makes them vulnerable to additional risk; or
- If you are introducing adjustments that could affect the work and health of others.
You can do a great deal to make sure valuable employees are not lost through sickness. Management working together with Occupational Health and HR can put in place and monitor that best practice is followed to fulfil our legal and moral obligations to those who become ill or disabled during their time in your business.
Using the Bradford Index to Manager Absence click here
Access to work: What is Access to Work?
What is Occupational Health: Video on my YouTube channel