NHS sick leave: supporting staff well-being

With the average cost of absence running at£659 and the average level of absence climbing to 8.4 days per employee per year, it is in employers’ interests to support staff health and well-being proactively rather than simply manage absence.

Meanwhile, the government faces the challenge of cutting the number of people claiming incapacity benefit, which has jumped to nearly 2.7 million, compared with about 0.7 million in the late 1970s. The two problems are linked: to cut the number of incapacity benefit claimants, we need to prevent people going off sick in the first place, as well as help claimants back into the workplace.

Starting with the problem of employee absence, mental ill health is, behind musculoskeletal conditions, the second biggest cause of this, according to the joint Chartered Institute of Personnel and Development and Active Healthcare Partners research report New Directions in Absence Management.

This shows that the average spell of absence for a mental health condition is 21 days and the proportion of incapacity benefit claimants suffering a mental health condition has grown in the last decade to nearly 40 per cent today compared with 25 per cent in the mid-1990s.

The increase in obesity is also a major worry. Department of Health research reveals that if current trends continue, the proportion of men who are obese will have risen to 33 per cent by 2010 from 22 per cent in 2003. The number of obese women is set to rise from 23 per cent to 28 per cent. It is estimated that treatments for conditions linked to obesity, including heart disease, cancer, depression, back pain and skin problems swallow 9 per cent of the NHS budget.

Progressive practices

The starting point for promoting and supporting employee health and well-being has to be good people management and effective work organisation.

The institute’s research into staff attitudes shows progressive people management practices, such as flexible working, good quality line management, giving employees a voice, and training and development opportunities, are associated with lower levels of stress.

Many employers could improve how they manage long-term absence. About a third do not give staff access to occupational health services even though access to such services is consistently rated by institute members as the most effective approach to managing long-term absence.

Only four in 10 organisations have rehabilitation programmes to help employees with long-term health problems make successful phased returns to work - despite rehabilitation programmes being rated as the second most effective approach in managing long-term absence.

Organisations should also provide opportunities for flexible working wherever possible to help people balance the often competing pressures they are under from home and work which can contribute to stress levels and mental ill health. The institute would like to see the right to request flexible working extended to cover all employees rather than just parents and carers.

The business case is also bolstered by the potential risks associated with litigation and damage to the employer’s brand when they fail to meet their legal obligations.

The institute’s 2007 absence management survey reveals that the proportion of employers with staff well-being strategies increased to more than 40 per cent, up 25 per cent on the previous year. Among the most popular benefits are counselling services, employee assistance programmes, smoking cessation support, health screening, healthy eating options and subsidised gym membership. The market in employee well-being is set to expand further, with more than 40 per cent of respondent organisations planning to increase their well-being spend in 2008, compared with just 2 per cent intending to reduce investment in this area.

Another important issue is how GPs and employers can work together more effectively to help people who are off work sick make a phased return, starting in less demanding roles or with reduced hours.

The Labour Market Outlook survey shows 80 per cent of employers believe GPs and employers should work together more closely and that GPs are rated negatively by employers for the level of support they provide in helping people return to work.

The institute supports a number of related proposals, including:

• information on phased return to work;

• improved training for GPs on “fitness for work” issues;

• changes to GP contracts to add incentives for closer working with patients’ employers and provision of advice on phased return to work;

• employment advisers in GP surgeries.

The other key challenge for government is how to help a greater proportion of incapacity benefit claimants back into work.

Research into recruitment of the core jobless has found 18 per cent of employers exclude people with mental health conditions when recruiting to their organisation.

However, among employers who have hired from this group, nearly two thirds (61 per cent) rated their experience as positive, compared with 15 per cent who had a negative experience.

More organisations might have the confidence to recruit former incapacity benefit claimants if they were aware of the positive experiences of employers that have already hired such people.

Institute members support work placements and training grants as ways of helping people with a history of health problems back into work.

Work placements allow people who have been out of work for long periods to gradually build up their confidence as well as the skills to return to work. They also give employers the opportunity to assess the individuals in a low-pressure environment.

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