Health and wellbeing: Engaging sick employees with return to work objective

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  • When dealing with staff suffering from conditions that can potentially led to long-term illness, early intervention, which ideally makes use of occupational health services, is crucial.
  • A good relationship between employee and line manager is key, with the focus on what can be done ‘with’ not ‘to’ the employee.
  • Benefits, such as employee assistance programmes, private medical insurance and group income protection, are often underused.
  • A seamless path should be established between the elements of the absence management programme.

Case study: Line managers key to Royal Mail staff support package

At Royal Mail, line manager involvement is central to engaging staff in their early recovery and return to work.

The firm’s chief medical adviser, Dr Steve Boorman, says: “We did a lot of work on how to manage attendance, and one issue we identified was there was a risk of little contact between manager and employee until the individual was signed fit to return.”

Now Royal Mail ensures contact is made between manager and staff as soon as they go off sick. For those with musculoskeletal or mental health problems, the onus is then on the line manager to secure early intervention and support from occupational health.

Boorman, who headed up the NHS health and wellbeing: the Boorman review, published in November 2009, says a significant predictor of future absence was the degree of empathy and constructiveness managers showed in return-to-work interviews.

Royal Mail has now developed interactive support tools and training materials to support managers in how to conduct return-to-work interviews.

Its attendance management strategy is supported by its benefits. Its 365-days-a-year, 24/7 employee assistance programme has been extended to provide legal, debt and financial advice, as well as information on work modification and health advice.

A co-ordinated approach is needed by the employer to engage the long-term sick with the goal of getting them back to work as soon as possible, says Peta Hodge

In these tough times, reducing the number of working days lost to sickness, particularly musculoskeletal and mental health issues, is a growing priority for many employers. The cost associated with this is well known: The Confederation of British Industry/Pfizer Absence and workplace health survey 2010, published in June, found 180 million days were lost to sickness in 2009, costing the UK economy £16.8 billion.

Engaging employees who are off work due to long-term illness – not only with the idea of recovery, but specifically with getting back to work – is therefore crucial. Eugene Farrell, business manager at Axa PPP Healthcare, says: “With long-term absences, the disconnect with the workplace can be quite profound. Coming back into the workplace can be very daunting; probably worse than starting a new job.”

It is therefore essential to talk to the employee about their return to work from day one of their absence. Jenny Hawker, a principal in Mercer’s global health management division, says: “It is about keeping the individual’s mind focused on the fact they are going to return to work. If the individual feels that is what everyone is aiming for, it encourages them to keep engaged with the process.”

For most organisations, the strength of the relationship between employee and line manager is key. Helen Dickinson, head of people at Simplyhealth, says: “It is the line manager that takes on the bulk of the responsibility for managing an absence. So if there is a close working relationship, if there is regular contact that keeps the employee informed of what is happening in the workplace while they are away, and if they know they are being missed, that makes a huge difference.”

Industry guidance published

This view was reinforced by the industry guidance Manager support for return to work following long-term sickness absence published last month by the British Occupational Health Research Foundation, the Chartered Institute of Personnel and Development, Healthy Working Lives and the Health and Safety Executive (see box).

To fully engage an employee, their return to work needs to be a collaborative process. Hawker says: “Employers will get a quite different outcome if the manager and HR do it ‘to’ a person rather than ‘with’ a person. They need to make sure the individual feels part of the process and decision-making.”

From a practical point of view, the early involvement of any occupational health service is also recommended, says Dickinson. “It gives the individual a different medical perspective, from someone who is trained and understands the workplace and the work the individual does. So it can be a very practical and focused discussion.”

Jon Green, principal of Buck Consultants’ healthcare practice, adds: “The best way to manage absence and to engage employees better is through early intervention. And that early intervention needs to use all manner of tools, probably the most important of which is the line manager retaining a regular dialogue, and the appropriate use of occupational health.”

Once all that is in place, an employer can move on to looking at how the individual can be supported in his or her rehabilitation. That is where benefits such as employee assistance programmes (EAPs), private medical insurance (PMI) and group income protection can play a big part. Employers should look at the benefits they have in place and make sure they are maximising their potential to engage staff in their own recovery. “Employers should know about these benefits and should make the employee aware of them so they can use them,” says Hawker.

Face-to-face counselling sessions

There is a danger that benefits such as EAPs can be put in place but are then just left on the shelf and underused by employees who are unsure about the help they offer. But an EAP should be the first line of support for all stress-related illnesses and a good programme will provide a number of face-toface counselling sessions, which can be an important tool in getting the employee to engage in his or her own recovery.

The manager supporting the individual’s return to work may also get support from the EAP. Axa’s Farrell says: “The EAP can have a dialogue with the manager to discuss the nature of the condition and how the line manager might want to approach being with that individual and supporting them.”

Surprisingly, perhaps, group income protection schemes, which traditionally kick in to reimburse the employer if the employee is off work for several months, are being used increasingly as early intervention tools. Green adds: “We have got a couple of clients that will contact their income protection providers as early as after one or two weeks’ absence. For some conditions, where early intervention is key, such as psychological and musculoskeletal problems, better and more progressive insurers will invest at that stage.”

This investment might take the form of help with developing graduated return-towork plans, funding for workplace adjustments, funding of specialist counselling such as cognitive behavioural therapy (CBT) or other telephone or face-to-face support. “The service has started to move beyond the traditional insurance model,” says Green.

Fast access to treatments

PMI can also be useful in engaging staff in their own recovery and early return to work, giving them fast access to treatments such as physiotherapy, chiropracty and osteopathy. “It helps people feel they are taking control of getting back quickly,” says Dickinson.

PMI and EAPs may also include a health information line or wellbeing portal, possibly giving staff information about their conditions. PMI can also provide access to a psychiatric nurse to oversee the management of stress-related conditions, ideally linking with the EAP to ensure support is offered once any counselling sessions are exhausted.

Green says employers should be looking to establish a seamless path for the employee through the absence management programme, including occupational health services, EAP, PMI, and income protection.

Nothing is more likely to make staff disengage with the process than a stop-start approach, with them being offered a little support here and there, but with gaps in between. Employees need to feel they are on a well-planned journey, with a full return to work as their destination.

What †line managers should be doing

  • Stay in touch regularly with the individual while they are off sick.
  • Reassure them their job is safe.
  • Prevent them from rushing back to work before they are ready.
  • Provide a phased return to work.
  • Help them adjust to the workplace at a gradual pace.
  • Ask the employee’s permission to keep their team informed about their condition.
  • Encourage colleagues to support the individual’s rehabilitation.
  • Hold regular meetings to discuss the individual’s condition and the possible impact on their work.

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Source: Manager support for return to work following long-term sickness absence, by the British Occupational Health Research Foundation, the Chartered Institute of Personnel and Development, Healthy Working Lives, and the Health and Safety Executive.

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