Cutting sickness absence is a priority in the public sector, but it does not have to cost a fortune, says Sally Hamillton

Public sector employees take more days off sick than their private sector counterparts, if numerous surveys on sickness absence are to be believed. For example, according to the Chartered Institute of Personnel and Development’s (CIPD) Absence management survey, published in July, the public sector has an estimated average of 9.8 days absence per employee per year. This compares with an average of 7.2 days in the private sector.

Whether these numbers are simply due to better recording of absence in the public sector or there is genuinely a significant gap is a matter of constant and feverish debate.

But whatever the reality, employers in all sectors are under pressure to deal with the expensive problem of sickness absence. This typically involves tackling two main types of absence. Not only do employers need to help genuinely ill employees get well again and return to work as quickly as possible, they also need to clamp down on bogus sick days.

Health and wellbeing benefits obviously have a role to play in terms of helping staff to fund and obtain treatment once they have gone off sick, as well as in boosting their overall fitness to reduce the chances of them becoming ill in the first place.

However, limited budgets in the public sector pose a significant challenge for employers as they need to find perks that will not exceed tight cost controls or raise eyebrows about how the money is spent.

James Kenrick, head of corporate healthcare at Hewitt Associates, says: “The sector needs to provide affordable benefits. Private medical insurance (PMI), although offered to some employees in the sector, is not cheap and is usually out of the equation, although there are alternatives such as healthcare cash plans.”

He believes public sector employers should take a proactive approach to tackling sickness absence, rather than simply reacting when issues arise. “The key is having an absence management process with early intervention, backed up by methods of improving staff motivation and morale. Having a health portal in place, for example, offering tips and advice on health and healthy living, and an employee assistance programme (EAP) that offers advice on issues such as tax, debt and childcare concerns are low-cost benefits that can help prevent stress taking hold,” he says.

Low-cost initiatives
However, perks such as health portals and EAPs need to be advertised and promoted widely, as well as refreshed regularly, if they are to work efficiently and provide the best value for employers, adds Kenrick.

Other low-cost initiatives which can be used to boost staff wellbeing include the provision of healthy meals in an on-site canteen, and inviting voluntary services into the workplace to provide advice and therapies such as aromatherapy.

“For the price of a pedometer, employers could also set up a scheme to improve fitness. We are running one for our staff linked to the idea of covering the same distance as if you were scaling Everest. Employers can do this and reward those who succeed by offering something like discounted gym membership or free healthy lunches for a week. They can negotiate with local suppliers for discounts or they could have a scheme whereby those who cycle in every day for three months can have an extra day off. This might be a cost in terms of lost productivity but not in upfront spend,” says Kenrick.

Peter Barnard, registrar at the Grimsby Institute of Further and Higher Education, believes the constraints placed on public sector employers mean they require a more imaginative approach to finding funds for absence management. “For example, local authorities are incredibly nervous about spending public money in any way that might be criticised. We are fortunate in that we do not only depend on public money but also offer some of our services on a commercial basis, so that gives us more freedom. Our print unit charges a commercial rate for private work, for example,” he explains.

Some grants are also available from local primary care trusts, which can be used to promote better employee health. “Our local primary care trust offers grants for various awareness programmes such as [as one recently] on obesity. We got them in to raise awareness [on this issue] among employees,” Barnard explains.

The institute has significantly improved its absence rate by offering a number of initiatives, including some low-cost benefits. During the 2007/08 academic year, for example, it awarded 483 employees who had not taken any time off sick with £10 vouchers to spend on the services offered within the institute such as hairdressing and cookery lessons. “In 2001 we lost 10,000 days a year with a workforce of 1,000. Last academic year we lost 3,806 days with 1,450 staff,” says Barnard.

The institute’s average absence rate per employee for the academic year 2007/08 was just 2.6 days.

Offering morale-boosting incentives to reward staff who do not take time off can have a direct impact on improving attendance, particularly when it comes to discouraging staff who are not ill from taking time off unnecessarily.

For example, one option is to offer to fund training for staff with good attendance records. “We offer free training, including the chance to study for degrees, to staff members. But staff need to have good work attendance records to be accepted. Last year we had 80 applications, 57 of which were from staff who had recorded no absences in the previous 12 months,” explains Barnard.

Royal Mail took a similar approach in a bid to reduce high absence levels (see box below). Dr Steve Boorman, chief medical adviser at Royal Mail, says: “The public sector is all about service and to improve that [employers] need to look at attendance management. The first step is to understand the scale and cost of absence and collect data. Then you need to focus on management capability. Line managers need training so they know when to refer sick employees to occupational health and how to conduct return-to-work interviews.”

Keep staff happy
Keeping staff happy at work is also key. “Royal Mail can be a tough place to work so we have given line managers budgets to quickly sort out physical problems that can improve conditions and morale. This can be something as simple as fixing a toilet door. We have also developed our occupational health service so we now work in partnership with services, whereas before we outsourced this,” says Boorman.

Not all public sector organisations have the luxury of being able to offer incentives to bring the absence problem under control, but they can still attack it successfully as long as there is widespread buy-in. For example, senior managers at the midwifery unit of the Northern Devon Healthcare NHS Trust decided to tackle high levels of absence, which ranged from 4.9% to 6.7% in 2007, as the issue was raising fears about the impact on service delivery and its ongoing funding.

Working with the Trust’s HR team and employment specialist PES, they launched a pilot scheme whereby absence reporting was improved, along with the training of line managers and HR. The new process was clearly communicated to employees which resulted in absence rates in the unit falling to between 2.5% and 3.5%.

Reducing absence levels, therefore, does not need to cost a lot as there are a number of approaches employers can take to address the problem, even on a tight budget.

Case Study: Royal Mail

Five years ago, Royal Mail was losing money and often offering a poor service to customers, not least because staff absence rates were typically high at around 7% a year and costing an estimated £1 million a day. In a bid to tackle the problem, it introduced a range of incentives and health and wellbeing initiatives that helped cut absence rates to 4.5% after three years, bringing 3,600 employees back to work each day and saving the group nearly £228 million, according to an analysis by the London School of Economics in May 2008.

The initiatives included introducing health screening and fast access to occupational health services, such as physiotherapy, and other support schemes such as an employee assistance programme (EAP). This was backed up with the introduction of health clinics at 90 sites and the launch of fitness centres in larger operations, including a £350,000 gym at the Mount Pleasant sorting office in London where staff are helped to get fit and back to work. Dr Steve Boorman, chief medical adviser at Royal Mail, believes the in-house fitness centre is particularly valuable. “People can lose contact with the workplace when they are on long-term sick leave.

“Coming in and seeing their mates can be part of the recovery process, as can seeing other sick employees making progress.” High-profile prize draws in 2004/05 to win cars and holidays as rewards for good attendance also helped reduce absence dramatically, although these had a limited shelf life. “Like any communication exercise it started to decay after while and made less of an impact, which is why we now focus on wellbeing programmes,” adds Boorman.

To read the full Health and Wellbeing supplement, Click here