Comment: Managerial training is the cure for sickness absence

It’s time managers learned how to handle sickness absence at work, says Graham Johnson, operations manager, Bupa Wellness.

Picture the scene – you have seen the employee referred to the occupational health (OH) clinician at the request of the employee’s line manager seeking advice about their fitness for work following a period of protracted absence. All questions have been answered and the employee and employer informed that, in the opinion of the OH clinician, they are ready to return to work.

Then, lo and behold, some months later, the employee returns with a note from the manager saying thanks for the previous report, but the employee returned to see their GP following the last appointment and was issued with another sick note, so please see the employee again and comment on their suitability for work!

Herein starts the merry-go-round of absence – management referral, seek opinion, do nothing, send back to OH – it makes me dizzy!

Manager role

One of the themes of the much publicised report on the health of Britain’s working-age population by Dame Carol Black, is the role of the employer in the management of sickness absence. The role of poor management has also been cited in the latest CBI/Axa annual absence survey, where poor ongoing management of sickness absence was cited as a reason for long-term absence in the public sector.

To further emphasise the importance of management engagement, the National Institute for Clinical Excellence (NICE) is developing, at the invitation of the Department of Health, ‘Guidance on the management of long-term sickness and incapacity’. As part of this work programme, NICE has referenced in the consultation documents the need for better training for line managers in handling and monitoring sickness and a move to linking managers’ performance to their management of sickness absence. About time.

In those circumstances where the OH clinician has stated that in their specialist opinion the employee is fit to return to their duties, with the employer’s support and, dare we say it, a consideration of a rehabilitation programme or even alternative duties, employers often respond: “But how?” I ask you, what is their problem? Do they not want the responsibility of people management? Well, let me tell them it goes with the territory, as does the kudos, the company car and all the other perks.

To use a football analogy, just because many of today’s top footballers are undoubtedly talented professionals armed with these skills, this does not automatically make them a people manager. So why promote your best guy on the tools to a line management role without any thought as to whether they have the ability to manage people?

Training

‘The role of OH in attendance management’ could be a dissertation for a management course. Instead, this should be mandatory training for all those with responsibility for people management. Better this than the often obligatory and no more important, some would argue, training course on what to do in the case of a fire in the workplace.

Let’s consider this on the basis of risk and probability and the number of fires in business premises as measured against the number of occasions when an employee reports sick and needs to be managed. This should leave us to consider where UK plc should target its priorities.

Incentivising employers to reward line managers for adopting the principles of sickness absence policies and for measured reductions in sickness absence would go some way to reducing the oft seen referrals to OH of: ‘Please see John, who has been absent for six months with back pain and advise why he has been absent for so long and when we can expect a return to work’.

Crystal balls and magic wands spring to mind, plus a question for the manager who has a trigger point in his absence policy of four weeks for the consideration of the intervention of OH: what have you been doing for the past 20 weeks?

Conflict of opinion

But what of those situations where managers are not confident to act on the advice of OH, and question what they should do when the employee returns with a Med 3 sick note following OH advice that they are fit to return to work?

When there is such a conflict of opinion, the manager should be instructed to read the findings of the Employment Appeal Tribunal (EAT) case of First Manchester Ltd v Kennedy (2005 UK EAT/0818/04) where on appeal, and when considered by another EAT, the court held that an OH report can be relied on by the employer, even if it is contradicted by other medical reports, unless it is clearly unreliable.

So what is it to be, Mr Manager? Do as you are expected and listen to the advice given by your OH teams? Or simply medicalise your operational problems, refer them to OH, and then blame us when you get the advice you deserve?

Roll on March 2009, when NICE is expected to publish its guidelines, and managers can receive the training they so need.

These are the personal opinions of Graham Johnson,operations manager, Bupa Wellness.