Much of the research into sickness absence tends to concentrate on staff opinions and causes of absence, particularly among healthcare professionals. Considering that around£1,750 per full-time employee is spent on sickness absence every year, it seems strange that there has been little research into the perspectives of line managers, who are at the forefront of managing absence.
Wolverhampton City PCT
Despite having a sickness absence policy and full support for managers from the occupational health and human resources departments, Wolverhampton City primary care trust experienced an increase in sickness absence rates from 2006 to 2007. It formed a research team to investigate, which chose to interview a selection of managers across the trust regarding:
policies and procedures;
causes of absence.
Discrepancies emerged around what constituted a sickness period, particularly regarding half-day absences, with some managers adopting a more lenient approach than others. Much of this seemed to depend on mangers' relationships with their staff.
Like many PCTs in England, Wolverhampton City uses the electronic staff recording system to monitor sickness. Despite the many advantages of the system, it does not give a definite picture of causes of sickness absence, as a high proportion of absences are recorded as "not known" or "other".
Policies and procedures
Managers were all receiving monthly information about their absence rates from HR, which they generally found to be helpful. However, not all managers were implementing the sickness absence policy in full. The team sought clarification as to whether the policy was used as guidance or strictly adhered to.
Overall, managers responded positively to working with directorate HR managers and HR advisers. The need to improve communication and information exchange between occupational health and managers was highlighted.
Causes of absence
Stress as a cause of absence was identified by all managers, with some departments losing up to 52 full-time equivalent days per employee each year. Common work-related stressors included staff shortages and resultant increases in workload, as well as harassment and bullying from patients. However, more than half of stress cases were recorded as both personal and work-related.
Using the findings
The following work is currently under way:
the results of the sickness absence review have been announced and will be used to make evidence-based changes to the sickness policy;
the electronic staff recording system is being examined, particularly the "not known" category;
absence management and occupational health reports will become a regular agenda item at management meetings;
free, confidential occupational health counselling services and additional medical staff sessions will be provided for all employees;
self-management leaflets and external stress management training days will be used to promote stress awareness among employees;
a health and well-being steering group is being created to promote and implement incentives for creating a healthy workplace. Work is being conducted with a view to providing free weight watching and smoking cessation sessions for staff.
A further, smaller review is to be held in a year to examine any changes in sickness absenteeism.
As a result of these changes, the PCT has reported a steady downward trend in absence rates since January 2008 and is likely to hit the target of 4.75 per cent. Furthermore, the 2007 staff opinion survey reported a decline in staff suffering from work-related stress, from 38 per cent in 2006 to 33 per cent. This is still higher than the national average of 31 per cent and remains a priority for the trust.
Director of workforce Steph Harris said: "We needed to go back to basics to ensure our managers were clear about their responsibilities in relation to the sickness policy and procedures and that they applied them consistently."
Tips on investigating absence
Staff involvement is pivotal to ensure polices and procedures are being applied fairly and consistently.
Ensure you have a collaborative research team. Wolverhampton City PCT's research team consisted of the director of workforce, head of human resources, consultant clinical psychologist, staff side chair, research and development lead, research assistant and occupational health manager.
Ensure the trust has a culture of supporting change and that change is measured and reviewed on a regular basis.