NICE issues draft guidance on absence management

The report is aimed at primary care services and occupational health professionals. It seeks to reduce the number of working days lost in the UK because of sickness absence. The number currently stands at 175 million days a year, costing£12bn annually.

The report points out that once someone has been off work for more than six months they have an 80 per cent chance of being off work for five years. Worklessness associated with working age ill-health costs more than£100bn a year.

The Trades Union Congress has urged unions to use public sector disability equality duties to negotiate changes to sickness absence procedures. Disability equality duties require public bodies to seek to eliminate disability discrimination and actively promote disability equality.

Proposed changes

One TUC proposal is that sickness absence associated with disability should be counted separately from ordinary sickness absence. Another is that employers should introduce a disability leave policy.

The proposed disability leave's purpose is to allow an unpressured period outside the sickness absence procedure for consideration of adjustments. This would permit management to undertake a proper assessment of a disabled person's needs, procure any necessary equipment or training, or identify a suitable alternative post. Effectively, it would be paid special leave. It is suggested that a maximum period of disability leave should be set on an annual basis.

Health service implications

So what does this mean for health service managers? In terms of long-term sickness absence management, the first step is to undertake an early assessment of the employee. Ideally, this would be undertaken between two and six weeks into any absence, but in any event before 12 weeks. At that stage, with the assistance of occupational health advice, an assessment should be made of the person's functional capacity and the need for any work modifications.

The second proposal is that a case worker should be assigned to plan and co-ordinate any occupational or rehabilitation interventions.

The main causes of absence are acute medical conditions, back pain, musculo-skeletal injuries, stress and mental health problems.

Return to work

The third stage would be agreeing with the employee a set of interventions, particularly for those with musculo-skeletal problems, so that a return to work programme can be agreed. This might include a staged return to work or a return to partial duties.

The next steps would then be the delivery of interventions by trained practitioners, and in the case of employees with back problems, a multi- disciplinary "back school" programme with follow-up sessions as necessary.

It is recommended that employers and health professionals work together to tackle sickness absence.

To read more, go to www.nice.org.uk

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