Better Backs 2007 Speakers notes: Managing sickness absence and return to work

Back to campaign pack

Slide 1

This presentation is part of the Better Backs Campaign.

There is further information in the Better Backs Campaign Pack:

Staying active and returning to work information sheet 6 gives the advice that staying active helps you manage your back pain and your life. This is evidence-based advice supported by health professionals.

Managing sickness absence and return to work information sheet gives practical advice to employers about how to help back pain sufferers remain at or return to work. This presentation complements that information.

Slide 2

I am going to talk about managing sickness absence and return to work. In particular I will cover:

Problem of back pain;
Good health at work;
Good practice in managing sickness absence and return to work;
Sources of help and advice.

Slide 3

Listed are the statistics on MSDs in the workplace. These come from the Self-reported work-related injuries (SWI) survey. Overall, back pain is a health problem common in the working age population. Back pain is a significant proportion of that – about 40% - and 437,000 new cases in 2005/06.

The estimate that 80% of us will suffer at one time or another is from research conducted by Professor Kim Burton at Huddersfield University.

Slide 4

The law does not require employers to rehabilitate their absent employees

BUT

Employers do have duties under the Health and Safety at Work Act 1974 to control risk to individuals who have returned to work with continuing poor health and under the Disability Discrimination Act (DDA) 1995 to put in place reasonable adjustments to enable disabled workers to continue working.

Slide 5

Delivering good health at work should be a core activity for all organisations. It should be a board level performance issue and not simply marked as a matter of routine compliance with health and safety and employment laws.

Good health at work is of course not only marked by lower levels of accidents and ill health but also reduced lost time due to all causes of ill health and injury. Importantly better organisational performance is realised through employees having increased energy and dynamism.

Slide 6

Sensible health and safety management and managing sickness absence and return to work are both sides of the same coin – ensuring good health at work.

Slide 7

Sickness absence is influenced by the health condition, personal and work/occupational factors

Personal and work/occupational factors become more important the longer the absence (including with injuries) and become the major obstacles to be overcome to ensure a return to work. They may be more important for short-term absence as well.

The implications of this model are that any approach to sickness absence needs to centre on identifying and then providing support to overcome obstacles to return to work. These may encompass some or all of the three factors listed above and the importance of these factors will vary from person to person. It is of note that for many of those on long term sickness absences the major barriers to return to work are no longer health but psychological and work/organisational centred.

Slide 8

Good management of sickness absence and return to work is accompanied by four tenets. These are:

Early intervention

Early and regular contact with an employee off sick is paramount although it may not be cost effective to do more than this until at least two weeks have passed as most people are likely to have recovered and returned with in this period.

Work is not harmful if properly managed

Too many see work as the problem and not as the goal or part of the solution. Overall work is good for physical and mental health and wellbeing. Work may cause or make worse ill-health but a well-managed organisation should be addressing any risks through control measures although these may need to be reviewed in the light of someone’s sickness absence.

A return to work can often happen before symptoms cease

It is unnecessary, unrealistic and unhelpful to wait until all symptoms cease and;

Work is a treatment in its own right

There is good evidence to show that work aids physical and mental recovery improving self-esteem, confidence and indeed physical healing.

Slide 9

HSE’s good practice guidance identifies six practical elements to manage sickness absence and return to work. These elements were arrived at following reviews of the evidence base and a wide consultation with practitioners, experts, representatives of industry, trade unions and professional groups. These elements are:

Recording sickness absence

The need for regular, at least weekly summations with ideally prompts for managers. Use the data to examine and monitor what it tells you at an organisational level about trends and the work environment.

Keeping in contact

This is a key factor and must be done regularly and early. Getting the tone right depends on the line manager knowing the individual but all employees must understand this applies to everyone and should expect it as the norm. If the employee refuses contact use alternative approaches but also refusal may contravene an employee’s contractual obligations. Managers may also need support in difficult situations.

Planning and undertaking workplace adjustments

The purpose is to remove obstacles to return to work especially personal and work/organisational barriers. Communication is key - ask the employee.

Making use of professional or other advice and treatment

This is not just occupational health professionals, though clearly they are important, but also the removal of organisational and work obstacles needs different advice, e.g. a harassment advisor for bullying and mediators for conflict situations. Occupational health advisors must be proactive and provide what the organisation needs.

Agreeing and reviewing a return to work plan

Again, communication with the employee is key – it should be empowering not parental. A plan needs to be discussed early and in place by about 20 days. It should be time bound not driven by symptoms and end in full time return to work with temporary adjustments and control measures that on review may need occasionally to be permanent, especially for some disabled staff

Coordinating the return to work process

Human Resources and Trade Union representatives can play an important role here. You may need professional case managers in complex cases.

Slide 10

Temporary modified work can be recommended to facilitate an early return to work for employees off sick with back pain.

Workplace adjustments may help the employee return to their existing job, or an alternative role.

Rethinking and redesigning processes, in consultation with employees, team-mates and their representatives, will often quickly repay the investment through improved efficiency, and can often improve motivation.

The DDA requires employers to make reasonable adjustments to enable a disabled employee to continue working. They must do all that is reasonable to modify the disabled employee’s job, including access to it and/or their working arrangements.

Slide 11

In designing workplace adjustments, consider the individual’s:

knowledge and experience of the job;
their skills, their learned ways of working;
their behaviour; interactions with others, problem solving;
their physical limitations; muscular strength, ranges of movement, energy/stamina.

If an employee is suffering from back or joint pain, you may need to consider adjustments to ergonomic factors such as working posture, use of muscle force for gripping and handling, the type of equipment used, the working environment, the pace of production and the spacing of rest breaks.

Slide 12

The task involves handling the paper from a pallet on the floor. Handling from floor level means bending over which puts additional strain on the lower back than would be applied if handling the same load at waist height.

Factors to consider for return to work:

Assess weights – consider reducing the unit weight of loads;
Assess movements required – can the task be improved to reduce risk from movements required? Can path or distance be reduced or improved?
Assess work height – can this be improved to help posture and prevent individual having awkward hand, arm and wrist postures? Is a platform helpful?
Assess rest breaks – could short, frequent rest breaks be built into the work pattern?

Make changes to reduce task demands – improves the job and promotes recovery.

Slide 13

Reduce the risk to the print worker by provision of a scissor table enabling the handling to be done at waist height. Indeed employers should not wait for a worker to go sick before acting to the reduce the risks this task presents.

Slide 14

The rack was identified as being heavy and having to be held in awkward postures

The steam from the cleaning process meant it had to be held at arm’s length to avoid injury.

Slide 15

These adaptations reduced the load not only for someone returning to work but for all the workforce – a more efficient way of completing the task.

Slide 16

Clear, well thought out and unambiguous policies will remain in managers filing cabinets unless at least three other factors occur. Namely:

A strong and continuing commitment from the very top of an organisation;
A strong and continuing commitment to skilling line managers to be confident in managing sickness absence and return to work;

A strong and continuing commitment to partnership between all parties, especially the line manager and employee - the two people that the Health and Safety Executive would view as central to a successful outcome. But this partnership also includes senior management, health and safety, occupational health and human resource professionals and trade union representatives.

Slide 17

Managing sickness absence and return to work: An employers’ and managers’ guide. HSG249. ISBN 0-7176-2882-5. Priced Guidance £9.95 from HSE Books.

Managing sickness absence and return to work in Small Businesses, INDG399. ISBN 0-7176-2914-7. A copy can be down loaded from HSE’s website. Single free copies are available from HSE books and in priced packs of 15 from HSE Books.

Off work sick and worried about your job? Steps you can take to help your return to work, INDG397. ISBN 0-7176-2915-5. A copy can be down loaded from HSE’s website. Single free copies are available from HSE books and in priced packs of 15 from HSE Books.

Working together to prevent sickness absence becoming job loss: Practical advice for safety and other trade union representatives, WEB02. This is available as a download from this CD or from HSE’s website.

Specific advice on the HSE website on managing sickness absence and return to work www.hse.gov.uk/sicknessabsence

Slide 18

In conclusion:

Managing sickness absence and return to work is integral to creating good health at work
Associated with high performing and well managed organisations

It’s not rocket science – simple practical steps can make all the difference