How to address preventable causes of employee absence

Some employee absence will always be beyond an employer’s control, but most short-term absence can be managed with the right strategy.

If you read nothing else, read this…

  • Absence related to musculoskeletal and mental health issues is usually preventable.
  • Line managers are key in preventing absence as long as they are educated about how to do so.
  • Workstation assessments and health screening can help to identify employees’ health risks.

Sick days cost UK business nearly £29 billion a year, according to research published by PricewaterhouseCoopers (PWC) in July 2013, which is why employers are increasingly keen to implement whatever cost-effective measures they can to help prevent employee absence.

Employee Benefits Healthcare Research 2013, published in May, shows that the top causes of sickness absence are minor ailments, musculoskeletal conditions and mental health issues, both personal and work-related.

Kirsty Jagielko, head of product management at Cigna Healthcare Benefits, says: “It has not really changed in the last few years: the big ones are still mental health and musculoskeletal conditions. They are certainly very complex and can often be inter-related.

“Sometimes it’s quite hard to determine what the actual cause is because a musculoskeletal issue can lead to mental health issues, and equally a mental health condition can present musculoskeletal symptoms. With any condition, early intervention is key, as is quick access to support.”

Chronic conditions that might temporarily affect an employee’s health, such as Type 2 diabetes, and certain heart conditions may also be preventable. For example, employees with no hereditary heart conditions could aim to minimise their cholesterol.

Mike Blake, compliance director at PMI Health Group, says: “As an employer, the trick is not to make employees feel as if these conditions are things that should keep them off work and to try to educate and help them manage these things.”

Employers that want to prevent employee health conditions from developing or worsening should consider implementing a support programme that helps to identify staff health risks and health ‘numbers’, the data collected via health screening, such as body mass index, heart rate, blood pressure and cholesterol levels, and provides guidance on how to manage these risks.

Line manager involvement

Line managers are often the first point of contact for staff with health issues, which is why they have a pivotal role to play in helping their organisation to prevent or contain sickness absence. Cigna’s Jagielko says: “The whole move to day-one reporting to a faceless person is not the way to deal with health issues. Employees need to have that line manager contact.

“Line managers need to be in touch with employees from day one and need to be conducting return-to-work interviews on an employee’s return. They are the best people to assess what is going on.”

But for line managers to be able to take this approach to tackling absence management, organisations need to create a culture that encourages open dialogue between employer and employee.

Matthew Bergmann Smith, chief executive officer at Absence Manager, says: “The manager’s engagement with absence is critical because that is who employees work for.

“We advocate a very clear [absence management] process that has a well-defined role for managers, and makes sure they follow required actions through.”

A competent line manager will ensure they understand the healthcare benefits available from their employer, whether preventative or otherwise, and will strive to build experience in dealing with employee absence. Cultivating a strong team environment that supports all team members is another key tactic.

Employers can support their line managers by providing information and education that enables them to have conversations with absent employees. Jagielko adds: “Line managers do need support to have confidence to have that conversation.”

Staying in touch with an absent employee is essential to manage their swift return to work. This should involve managers ascertaining whether an employee’s health condition is self-limiting. In other words, will the condition resolve itself within a certain period?

PMI’s Blake says: “If it’s self-limiting, that doesn’t necessarily mean it’s short-term or no longer than 10 days. The important thing for an employer to do is look at that aspect: identify the point at which something could be long-term, ideally before it reaches that point. They should keep an eye on that and be in contact with the absent employee as much as possible.”

Preventative measures

Simple measures that employers can put in place to help prevent employee absence include workplace assessments, which are particularly useful in the case of musculoskeletal issues.

Jagielko says: “Employers can provide ergonomic advice on how best employees should sit at a workstation and tips and tools around different keyboard shortcuts instead of hanging on to a mouse.

“These are all simple things that can be delivered either through an occupational health service, or just through employers accessing available insights from the Health and Safety Executive.”

Healthcare providers can also help. Cigna, for example, offers a service that places a team of occupational health advisers into an organisation, carries out at-desk assessments, explains tips and tools and recommends supportive workplace equipment.

But an employer’s first step is to create a strategy that ensures any staff health risks and issues are identified as early as possible. This will enable it to identify and provide appropriate support, within its budget, to help minimise sickness absence.

Daniel Toms, senior client account manager at Jelf Employee Benefits, says: “Every employer will need a slightly different mix of jigsaw pieces [to create their health strategy], such as occupational health provisions, absence management triggers, and possibly an employee assistance programme, which will help support employees to try to address issues before they become a long-term problem.”

Read more on How employers can promote heart health in the workplace at:


Browne Jacobson

Case study: Browne Jacobson takes proactive approach to employee wellbeing

Browne Jacobson takes a preventative approach to health and wellbeing in a bid to minimise its employee sickness absence levels.

The law firm’s 700-plus employees have access to a range of initiatives that have a dual aim of preventing long-term absence and optimising employees’ workplace health.

The employer’s sport and social club, for example, has been running subsidised lunchtime pilates classes for nearly six months, and were so popular that a waiting list had to be introduced. Netball and running clubs are also on offer.

Helen Whitt, HR advisor at Browne Jacobson, says: “It’s not just about people being poorly and absent, it’s about [them] being fit and healthy at work.”

Wellbeing room

Browne Jacobson’s new office design in Nottingham boasts a wellbeing room in which employees can use for any reason, be it for time out from the workplace, prayers, mothers expressing milk, or for staff with back problems to carry out exercises.

Healthcare benefits, provided by Aviva UK Health include a group income protection scheme, which features an early intervention service that advises staff of available support, such as counselling or pain relief.

The employer also offers an employee assistance programme (EAP), which gives staff a channel through which to receive advice, be it personal, work or financial, and a fully-funded private medical insurance (PMI), which it offers through its flexible benefits scheme. Staff can choose to fund cover for their partners or dependents.

Through the PMI scheme, employees also have access to Back-Up, a service that supports employees with back problems to help minimise long-term absence.

Lauren Murphy, HR advisor at Browne Jacobson, says:  “If we become aware of someone having back problems at work, or just difficulty, we can forward them through the PMI scheme to Back-Up and that provides them with access to a physiotherapist within one week. So they’ll get an assessment and treatment pretty quickly.”

Whitt adds: “It’s preventative rather than reactive, and [employees] understand how to access the treatment themselves.

Major causes of employee absence
Sayeed Khan

Viewpoint: Sayeed Khan: Tackling preventable causes of absence

Driving down employee absence aids business growth, and manufacturers should not underestimate the relationship between increased production and reduced absence. Employees’ personal choices and work facilities have a huge impact on absence, and employers are increasingly recognising the importance of tackling preventable absence.

Employers can identify preventable causes of absence by distinguishing between work-related causes, such as occupational dermatitis, which they really must prevent, and work-exacerbated causes, such as stress at work and poor workstation design that make an existing health problem in an employee worse.

Regular, frequent dialogue between line managers and staff enable these issues to be addressed at an early stage before sickness absence occurs. Employers should not forget that they can analyse lots of data and identify common causes of absence by scanning the bar code on the bottom of a Fit Note, which will upload all the information on the certificate into Excel.

Employees’ lifestyles are important in preventing absence and employers can help by offering healthy alternatives in vending machines, healthy catering options and aligning work activities with national health promotion days.

Simple schemes, such as ‘free fruit Fridays’, have proved successful. Bikes-for-work schemes take time to sort out, but they are also effective.

Our sickness absence and rehabilitation surveys show that mental health is the third most common cause of long-term sickness absence after musculoskeletal disorders, and waiting for treatment and recovery.

Employees might be stressed by personal circumstances and work could exacerbate this, so employers should adopt an organisation-wide approach of integrating stress awareness into management policies. 

Stress prevention can be aided by the Health and Safety Executive’s (HSE) stress management standard and the HSE line manager competency indicator tool, as well as our work organisation questionnaire.

Employers are aware that reducing staff absence leads to increased productivity but, because they do not see immediate results, they risk a cultural downward spiral of not monitoring it closely.

A healthy and happy workforce is an engaged workforce that is more willing to go the extra mile.

Sayeed Khan is chief medical adviser at manufacturers’ organisation EEF

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