Specialfeature Sickness absence with EEF
time: 90% of companies agree that minor illnesses are the most common cause of short-term absence, while more serious conditions are major causes of long-term absence. However, there is a key point the survey raises that seems to contradict the common belief that stress is one of the most frequent causes of absence: at least for EEF members, the level of absence caused by stress is stable, if not slightly decreasing. The number of companies placing it in the top three of causes of sickness absence is half that of 2006. Khan believes this is not a chance finding. “We have five years worth of trends that attest stress has been less and less a cause of absence. EEF spent a lot of time and effort getting employers to accept that there is stress in the workplace, and giving them guidance on how to tackle it and manage it in a sensible way. This guidance is bearing fruits,” he says. Stress and other conditions like back pain are good examples of cases when early intervention by the employer can bring benefit both in terms of reduction of absence and employee wellbeing. According to Steve Pointer, head of health and safety policy at EEF, picking up an issue early on can make a big difference. He says: “It’s very important that line managers have some training in managing sickness absence. Identifying when a person has an issue with stress, depression or anxiety disorders and picking it up immediately before it becomes a big problem is very important, and occupational health services can help with that. It’s one of those cases when investing £200 or £300 in some basic treatment can actually save a lot more money in the long term.” Setting targets and implementing policies are key elements to a good management of sickness absence, and employers need to do more in this direction: policies have proven extremely beneficial, and training managers can help them detect unjustified absence during return-to-work interviews and identify steps that would help a worker going back to work sooner. In addition, the EEF survey found an increase in the number of companies, especially SMEs, that use occupational health services. Often these are provided by external bodies.
Private vs NHS In 2010, over two fifths of companies who EEF interviewed made use of private healthcare to speed up rehabilitation. Jill Davies, chief executive of Westfield Health, says: “We suspect that private provision may prove a rising trend as the UK comes out of recession and as health service reforms continue to create public uncertainty about the availability of NHS services. The government certainly has a role to play here. At present, treatments such as physiotherapy may be taxed as a benefit in kind,
particularly if it treats a condition not caused by work. This is a major disincentive to their provision. Changing this would have only a small impact on tax revenue, but would send an important signal to employers about the importance of their role in providing for rehabilitation.”
Fit for purpose The area where the fit note can really make a change is rehabilitation. For this to happen, however, a change in culture is necessary. Both GPs and employers need to modify their approach. General practitioners need to learn how to use the fit note to its full potential. At the same time, employers need to become more proactive and flexible in terms of the tasks they can have their workers perform. The purpose of the fit note is to allow people back at work earlier, and this can be achieved only through a collaboration between GP and employer. The first needs to specify the types of tasks an employee can and cannot perform; the latter has to figure out ways to modify the tasks and deploy a member of staff even when they can’t carry out their usual activities. Khan emplains: “Employers just need to be a bit more creative about what can be done to make people go back to work earlier. They can’t slow down a production line, of course, but they can put employees back to work on the line for a shorter time and then having them do a nonmanual job.” Pointer agrees. “If a GP says people can go back to work if they can sit down or work from home, employers should look for opportunities to do it rather than at reasons why they can’t,” he adds. The survey found that employers proactively engaging with their local GP tend to receive much better fit notes back. Promising as it is, the fact that fewer companies see GPs as a barrier to rehabilitation doesn’t mean that practitioners don’t need to make an extra effort. Many tend to write on fit notes things like “light duties”, which is a general and unclear recommendation. “Needs to seat” or “no lifting” are much more helpful. With funding from the Department of Work and Pensions, the Royal College of General Practitioners has trained 3,000 GPs. This has been very useful, but a lot more needs to be done: there are 45,000 GPs in the country. EEF hopes to reach at least one practitioner in each practice in the UK, to make sure information spreads. Pointer adds: “GPs need to understand they don’t need to know everything about a workplace to provide constructive and helpful information.” Several steps in the right direction have already been made, but only better communication and a change in culture can ensure we reap all the benefits the fit note can bring, while meeting Mr Bevan’s desire for an enhanced health system.
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