Absence essentials: phased returns to work

In the latest of our series on practical absence management, we focus on phased and graduated returns to work after long-term absence.

Learning points

A phased return to work after long-term sickness absence forms a central part of many rehabilitation plans, and employers see it as one of the most effective elements of their return-to-work policies.
Phased returns should be time-limited, although they also need to be flexible and adapt to the different pace of individuals' recoveries.
Phased returns should be seen as part of a wider package of workplace adjustments for those returning after a long absence.
Phased returns should balance the needs of the individual with those of the employer, and line managers need to be persuaded, perhaps through additional staff resources and support, that employees can return and contribute before they are 100% able to carry out normal duties.
Occupational health and other specialist support can help to draw up plans for a phased return, and in monitoring changes in capability as the return progresses.
Employers should consider income and job security arrangements when planning a phased return.

A phased or gradual return to work after long-term sickness absence forms a central part of many return-to-work plans.

The manufacturers' organisation, the EEF, describes phased returns as a "cornerstone of rehabilitation". A graduated return is the most obvious way of dealing with the fact that people are rarely sick one day and fit for work the next, and that employees often feel more tired than usual when starting back to work after a long absence.

A phased return can be particularly useful in dealing with the growing proportion of long-term absence cases that are related to stress and mild-to-moderate mental ill health. Such cases require particularly sensitive handling - plunging an employee straight back into a situation that contributed to the original stress absence could easily cause an immediate relapse and thus further sick leave.

Widespread use

Employers widely use phased returns as part of rehabilitation, according to several research studies, including a Department for Work and Pensions (DWP) study of employers taking part in the government's current job retention pilots¹. Employers taking part in these pilots, and using phased returns as part of rehabilitation, report that employees return to work for as little as an hour a day and gradually increase to full hours over several weeks.

Phased returns are designed to be a period during which people can become accustomed to the working environment, build confidence or morale, and become re-acquainted with the business and any changes that might have taken place in their absence. Some large employers with formal rehabilitation plans offer phased returns to every employee returning from long-term sickness absence.

Many phased returns take place as part of a wider rehabilitation programme, typically involving a combination of a graduated return to full hours, and modified duties and tasks, supported by regular reviews of progress involving managers, personnel and other specialists, including occupational health support. Just over 70% of employers in a 2004 IRS survey of small manufacturing organisations² will make changes to previous hours to allow a phased return as part of their rehabilitation plans. Almost 90% will modify tasks - so-called "light" or "restricted" duties - as part of rehabilitation.

Successes and barriers

Most phased returns are successful - employees return earlier and are back to full capacity quicker, according to the DWP research. Offering a phased return is also a good way of letting employees know that the organisation values their contribution and wants them back. Phased returns are considered the most effective element of rehabilitation by the largest proportion of employers in the 2004 IRS survey - 35.8% view it as the single most effective element and 80% rank it in the top three.

However, the DWP report does point to a number of barriers to effective phased returns, notably that they are generally easier to arrange for managerial staff, who tend to have more flexibility and variety in their work and, therefore, have the scope to adjust their hours and tasks.

Health and safety concerns mean that reduced duties can be difficult to arrange for operational roles that demand high levels of physical fitness. The DWP research also found that some line managers put up barriers to graduated return by stating they will only welcome team members back if they are able to work to full capacity immediately.

Aims and time limits

The HSE argues³ that the aims of all adjustments to help people back to work after sickness absence, including phased returns, should be:

to return the employee to the job, with any modifications if needed, or to an alternative job if no adjustments are possible;
to retain valuable skills; and
to remove the barriers to return to work.

To provide an opportunity for employees to be gradually reintroduced to the workplace at an earlier stage in a reduced capacity;
to provide an opportunity to assess capability without the pressures of a return to work on full duties; and
to provide cost-effective assistance to university departments that may be employing temporary staff to cover the long-term absence.

Requiring at least some annual leave to be used to ensure full pay;
requiring employees to build up a flexitime debt which is then worked off once the employee is back to full hours;
full paid leave for the contractual hours not worked if an end date for the phased return is agreed; and
special leave if none of the above options are appropriate.

This article was written by Sarah Silcox, a freelance writer and trainer on employee health issues.

¹Job retention and rehabilitation pilot: employers' management of long-term sickness absence, DWP research report no.227, 2004.

²"Managing long-term absence and rehabilitation: part 2", IRS Employment Review 796.

³Managing sickness absence and return to work, HSE,www.hse.gov.uk/sicknessabsence.

⁴Fit for work: the complete guide to managing sickness absence and rehabilitation, EEF, 2004, www.eef.org.uk.

⁵Best practice in rehabilitating employees following absence due to work-related stress, HSE research report no.138, www.hse.gov.uk.

Document extract. Phased returns and rehabilitation: Oxford Brookes University

In cases where an employee is not able to return to work to full duties after sickness absence, but a full recovery is expected within the period of entitlement to sick pay, the OH adviser, line manager and HR manager should consider arranging a rehabilitation programme in consultation with the employee.

Principles of a phased return:

Phased-return rehabilitation programmes should normally last for a pre-defined period within the employee's entitlement to sick pay, but may be extended in exceptional cases by the director of human resources.The programme must be agreed by the employee and line manager, in consultation with the link HR manager and occupational health adviser.The employee will receive full pay for the duration of the rehabilitation programme.The programme will be reviewed regularly by the line manager and occupational health adviser, and adjustments made if necessary.When the period of rehabilitation ends, the employee will be expected to return to work in their normal employment capacity. Where this is not possible, the line manager, link HR manager and occupational health adviser will jointly investigate alternatives, including permanent redeployment, early retirement on grounds of ill health, dismissal on grounds of medical incapability and negotiated resignation.

Source: "Managing absence from work due to ill health, appendix 1", Oxford Brookes University.

Box 1: Tips for a successful phased return

Case studies of flexible return-to-work options, including phased and graduated returns, suggest the following success criteria:

the plan should be designed to allow a gradual increase of tasks and hours as appropriate to each case;
sufficient resources and support need to be available to ensure that the reduced tasks and hours actually occur;
there should be monitoring throughout the return to work to ensure that the tasks and hours remain appropriate to the employee's changing capabilities and health status;
the plan should be flexible and adjusted if necessary;
the return should occur over a sufficient time period for the employee to recover (this period may not be obvious at the start of the phased return); and
other options, such as homeworking, should be considered where appropriate.

Source: "Best practice in rehabilitating employees following absence due to work-related stress", HSE research report no.138.

Box 2: Income security during phased returns

The following examples show how employers organise pay and reward during phased returns to work:

Crown Prosecution Service: employees working part time on medical grounds are paid for the hours actually worked, and the balance between this and their contractual hours is paid at the sick-pay rate;
Leeds University: payment during a phased return may be at full salary, part salary pro rata to the hours actually worked, or full salary with the use of annual leave, depending on individual circumstances;
Nuneaton and Bedworth Borough Council: during a phased return, which usually lasts for one calendar month, employees receive normal pay for full contractual hours. However, if the phased return extends beyond a month, the employee must use annual leave or time off in lieu to make up the time when they are not working;
Oxford Brookes University: employees on phased returns receive full pay for the duration of the programme; and
University of Salford: in cases of phased return for an agreed period, remuneration is not less than the amount that the employee would receive as occupational sick pay.