Sickness absence

Do you have a policy for managing sickness absence?  Do you know how much sickness absence is costing your company?  A good policy can dramatically reduce the levels and the costs of sickness absence.

Long-term absence is bad for individual morale and self-esteem.  It can make it much harder for the employee to return to work, and can lead to long-term unemployment. In many cases sickness absence is the result of a lack of understanding of the nature of the illness.  Employees and employers may not realise that with just a few minor adjustments to the work, many individuals can return after days rather than months off sick, and continue to work while they recover from illness or injury.

Many employees can remain at work after a minor injury or period of illnes.  For example employees who have migraines may be able to take medication, rest in a quiet room for an hour or two then return to normal work.  Employees with epilepsy may just need half an hour of rest after a minor seizure before resuming normal duties. Employees with a minor cut or abrasion may return to work after simple first aid measures.  Even after fractures employees may be able to continue working; many continue working with a broken rib or a broken finger or toe, after a simple risk assessment and minor adjustments to their role.

Sickness certification can only be undertaken by the employee’s treating GP or specialist.  In almost all cases neither will have had any training in occupational health.  They will not understand the nature of work or the interaction between work and health, and as a result they often recommend far more time off work than is necessary.  Furthermore, GPs are expected to act as the patient advocate and as such the majority simply sign patients off sick if they are requested to do so, regarding any decision on whether the patient is fit for work as a matter for the patient to determine themselves.

Many GPs just give sick notes to patients on demand.  Some will attempt to discuss the issue but will still provide the sick note.  Only a relatively small percentage will only provide a sick note on clear objective grounds (McEwan, 1991, Hussey et al., 2004).

The Government has made efforts to improve the process of sick certification with the introduction of the ‘fit note’ which enables the treating clinician to advise their patient may be fit for some work. The Royal College of General Practitioners ran a series of training workshops for GPs after the fit note introduction.  Dr Tony Williams, Medical Director of Working Fit, was selected as one of the trainers for these workshops, running a number throughout the South East.

These workshops helped GPs understand how best to manage a consultation for a fit note. They also identified some of the challenges facing GPs when they try to explain that a patient is fit for work when the patient is worried about the risk of working or does not want to work.

We can advise on the pro-active approach required and provide expert confidential assessment and support in individual cases.

  • Hussey, S et al.  Sickness certification system in the United Kingdom: qualitative study of views of general practitioners in Scotland. BMJ 2004;328:88.
  • McEwan I.M.  Absenteeism and sickness absence.  Postgrad Med 1991;67:1067-71.