Occupational rehabilitation in the food manufacturing industry

Image courtesy of Greencore Group

Information and case studies

Occupational rehabilitation - sometimes referred to as managing sickness absence and return to work (or managing attendance) - has become an essential part of running an efficient business. Long-term sickness absence (often defined as 4 weeks or more):

• can have devastating effects on the performance of a business and the health and well-being of employees;
• although only accounting for 5% of absence cases, accounts for around 30% of all absence days; 
• costs UK business around £4 billion each year (the CBI estimates all absence costs £13bn/year (2005)).

But this need not be the case

Considerable benefits can be delivered from working in partnership with employees and Trade Union representatives when managing sickness absence and return to work. In particular, organisations that have implemented effective management programmes have:

• reaped huge rewards in terms of having a healthy workforce;
• reduced costs;
• improved competitiveness;
• improved workplace relationships; and
• held on to valued staff.

One manufacturing company reduced musculoskeletal disorders by 90% and through that improved employee wellbeing as well as saving £0.5 million in the first year of the programme alone.

The key issues in managing sickness absence and return to work are:

• Sickness absence is not just a matter of ill-health. It is affected by a combination of the health condition, personal and work/organisational factors. The last two factors get more important the longer the absence.
• Early intervention is key. The sooner action is taken, the better the chances are of an employee making a full and speedy return to work.
• Work in a well-managed workplace is a treatment for people recovering from sickness absence and an early return to work improves both mental and physical recovery.
• Simple adjustments can enable workers to return to work safely before their symptoms completely disappear. Workers can normally return before they are 100% fit.

For companies without an existing rehabilitation scheme, putting one in place is not difficult. The essential elements are to ensure:

• there is an actively managed approach with a consistently applied policy, which is regularly monitored for its effectiveness;
• employees are offered sound medical advice as soon as possible following an injury or illness which is keeping them from work, and that this advice continues during rehabilitation;
•  return to work plans are agreed between the employer and employee, and that these identify the appropriate measures to be taken to assist speedy recovery, such as provision of physiotherapy or other specialist help; and
• these plans also identify steps to be taken to assist the employee back to work as soon as possible, for example by providing modified duties or limited hours and the work environment is suitably adapted if required.

Companies with existing rehabilitation schemes should consider ‘upgrading’ their scheme to a higher level. For example a ‘passive’ scheme (e.g. responding to a doctor’s note stating ‘Fit for light duties’ etc) could be upgraded to an ‘active’ scheme where there is ongoing medical assessment from Day 1 and treatment such as physiotherapy is provided. 

Active schemes are more common in larger companies with Occupational Health Departments but can also be put in place in smaller organisations. More advanced schemes may pay for additional medical treatment such as MRI scans in order to facilitate earlier diagnoses and a speedier return to work. An active rehabilitation policy helps to demonstrate the positive role occupational health can provide, and helps build trust in the system among employees. 

Rehabilitation should be:

• an integral part of a Board led approach to improving performance, by having a management process that aims to ensure a healthy workforce through - 
  • reducing work-related risks to health;
  • managing individual cases of ill health;
  • introducing evidence-led organisational interventions to support a better physical and psychological working environment; and
  • promoting healthy lifestyles.
• provided whether the injury/illness is work-related or not
• offered for absences arising from many causes, e.g. musculoskeletal injuries (e.g. bad backs), fractures, stress/depression, heart problems, post-operative recovery, dermatitis, asthma etc.
• provided for people off work and those back at work
• considered an increasingly important issue with an ageing work population.

Some insurance companies with Occupational Health Advisers offer rehabilitation packages as part of their Employer’s Liability Insurance. These can reduce the costs of injuries and accidents by helping employees return to work sooner.  This can reduce insurance premiums, compensation payments and hidden costs such as loss of production, retraining, overtime and recruiting additional staff.

The following case studies have been provided by major food companies and an insurance company. The summary table is helpful in targeting a particular case study of interest. The layout and detail of the case studies vary, however they all show good practice and some also indicate how things could have been done better. But all the case studies clearly demonstrate the benefits of having a good Rehabilitation programme in place.

• Case studies
• Case studies summary table

Further guidance: www.hse.gov.uk/sicknessabsence/index.htm

Acknowledgements:  The Food Manufacture H&S Forum (Occupational Health Sub-Committee) which prepared the above guidance, is grateful for the assistance of these organisations in the preparation of the case studies:

• Zurich (Medical Management Centre)
• Uniq
• Allied Bakeries
• United Biscuits