Sickness absence in the 21st Century

1
Sickness absence in the 21st Century

• Police Federation July 2008
• Hugh Robertson
• Senior Health and Safety Officer
• TUC

2
Scale of the problem

• 165 million working days lost every year.
• 36 million have an occupational cause
• 2.2 million suffering from an illness they
  believed was caused or made worse by work
• Average worker takes 7 days off a year steady
  fall
• Sickness absence rates have fallen consistently
  over past 10 years
• European comparisons difficult but UK levels
  probably among lowest in Europe
• Public private split
• CBI puts cost for employers at 13 billion

3
Reasons for absence

• Record keeping very bad (reasons)
• 2/3 of days are short term minor illnesses.
• Remainder either recurring or serious long term
  illnesses
• Stress now single largest cause of long-term
• Relationship with lifestyle issues (smoking,
  diet, exercise, drugs and alcohol)

4
Sickness absence issues (1)

• More presenteeism than absenteeism
• No evidence of widespread abuse
• Different approach to long and short term (short
  term often cultural)
• Relationship between physical and psychological
  factors
• Either too ill to work or perfectly well

5
Sickness absence issues (2)

• Interventions limited by funding
• Little access to rehabilitation
• Little link with prevention
• 1/3 of absence caused by work
• Interventions often based on fear of compensation
  claims (so employers concentrate on work-related)

6
Traditional response

• Sanctions (pay, or promotion)
• Incentives
• Reduce sickness absence by concentrating on
  worker not the cause
• Where absence likely to be long term early
  retirement.

7
Positive response

• Focus on prevention
• Return to work policies
• Keeping in touch
• Access to occupational health services and early
  rehabilitation
• Adjustments to enable return to work
• Recuperative duties (rather than restrictive)
• Help to support and empower workers

8
Approaching Lifestyle issues

• There is a role for employers gyms, canteens,
  etc.
• Must not be done in a patronising manner
• Workforce involvement
• Must concentrate on the relationship with the
  workplace (worklife balance, stress, transport
  etc)
• Not a substitute for prevention Yoga for stress
  etc)
• No actual evidence workplace health promotion is
  effective

9
Evidence base for Sickness absence

• Simple focusing on attitudes does not work
• Incentives and sanctions can both backfire
• Rehab works in some cases but little info on for
  what and when
• Early access to physios does seem to help for
  MSDs
• CBT including group interventions can be
  effective
• Early interventions by managers does work
• Prevention is more effective than sickness
  absence
• Involving workforce/representatives has a
  considerable effect

10
Agenda for change

• Universal access to OH provision
• Employers need to have a policy framework for
  dealing with sickness absence
• Better training and support for GPs
• Changes to benefits system to encourage phased
  return to work and prevent transfer of
  responsibility to state
• Legal right to rehabilitation
• Work should be adapted to the worker, not the
  other way around