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Sunflowers

As an Occupational Health Nurse for over 30 years it’s interesting to reflect on how the management of sickness absence has changed over that time…or has it?  Traditionally HR and Managers have deferred to GP opinion on whether their employee can return to work and despite changes which have led to the establishment of the Fit for Work Service, this still appears to be the model many organisations follow.

I am always amazed at how some organisations are still following the path which only leads to the GP, rather than using the medical professionals who are qualified and competent in advising on fitness for work. This path is a dead end as all you will get is the employee’s opinion on what they feel they need, or a suggestion for ‘light duties’, What is actually needed is real actionable advice on treatment options to improve work capability which is what occupational health can provide. It is interesting to reflect on the fact that the expense of writing for meaningless GP reports can be more than paying to get employees diagnosed and treated in the first place.

There also appears to be a certain dissatisfaction around occupational health reports with some managers feeling that they are of limited value because they do not ‘get the employee back to work’ Yes, this may be the case, but the reason for this is that the power to ‘get employees back to work’ does not always rest with occupational health. It lies with the organisation’s willingness to consider helping the employee to access appropriate diagnostic procedures. If this approach is taken, a treatment and recovery plan can be commenced, rather than paying employees to wait at home for NHS appointments.

Each week in my clinics I hear the same stories about NHS waiting times and GPs advising employees not to go to work and I watch while employees become more and more remote from the world of work as the weeks and months pass by. Employers seem to become helpless in the face of these cases and feel that they have no option other than to watch and wait. Would this happen in any other area of their business? I think not.

There is a lot of research and good examples of how a happy healthy engaged workforce is good for business.  In January 2016 the CIPD produced its report ‘Growing the health and wellbeing agenda: From first steps to full potential’. This report provides us with a vision where employers are encouraged to create an active management system for workplace health and wellbeing. It recommends that employers use a holistic approach which is both proactive and preventative.

So, how can this vision be achieved?  I have recently been working with organisations to help them build a model of proactive management for sickness absence which includes using private medical services to treat employees who are at home waiting for NHS appointments. Typically the waiting times for an NHS MRI scan, Physiotherapy and a Consultant appointment are very lengthy and so hold up an effective diagnostic and treatment process which could bring employees back to work quickly.

Yes, many organisations have an Occupational Health service, but what can we really do to bring an employee back to work when the reason for a protracted absence is a lack of diagnosis. I am therefore encouraging employers to undertake an across the board look at how ill health is managed, so that a cohesive proactive strategic plan can be created to manage health and wellbeing in the workplace. Many organisations have a budget structure which supports sickness rather than health.

Some employers do invest in some proactive interventions, but they appear at times to be working against the organisation rather than with it. Do you have an EAP? Is it used? Do you receive meaningful statistics so you can evaluate its effectiveness? No? Then why not look at using this money for something which gives more value?   You may find that you are using all your budget on an EAP which is not used, when your absence statistics show that the most common reason for absence is back or knee pain.

Another area to consider is exploring whether a simple low cost cash plan could provide quick access to diagnostics such as imaging, so that early symptoms are diagnosed and treated without the employee slipping into the usual pattern of long term absence. However, the most exciting new possibility is the £500 tax exemption for treatment which was introduced with the Fit for Work Service in 2015. The medical treatment must be recommended to help your employee return to work after a period of absence due to ill health or injury and either a healthcare professional must assess them as not likely to be fit for work for at least 28 consecutive days, due to ill health or injury; or, they have been absent from work for at least 28 consecutive days due to ill health or injury.

The medical treatments must be recommended by a healthcare professional from Fit for Work or by a healthcare professional within your own occupational health service for the tax exemption to be applicable. Further information is available on page 15 of the DWP’s Fit for Work guidance document and on www.gov.uk. For some reason this incentive is largely unknown and does not appear to have been widely publicised, which I find bewildering.

Employers should therefore seriously consider the range of options now available to proactively manage absence at work.  Absence affects the bottom line and is a business risk and should be managed as such. The times are definitely changing, so, what are you waiting for?