Managing Sickness Absence - a holistic approach

SAVE ITEM
case-study

11 / 06 / 2012

Summary

The organisation

Key outcomes

Key aims

Key stages of set-up

How it works

Sustainability

Next steps

Contact for further information

Summary

Following review of the Occupational Health Service, the HR Advisory Service, the Attendance Management Policy and the role of the line manager in reducing sickness absence, the trust has reduced absence by over 1 per cent in a 12 month period.

The organisation

St Helens and Knowsley Teaching Hospitals NHS Trust is an acute hospital trust employing around 7,000 staff, which includes 2,500 doctors in training under the single lead employer contract for the Mersey Deanery. HR and the new Health Work & Well-being Service (Occupational Health) are located on the Whiston Hospital site.

Key outcomes

Health, Work & Well-being function that meets the Safe Effective Quality Occupational Health Service (SEQOHS) standards.
  • Reduction in total days lost for both long and short-term absence.
  • Change in focus from tackling sickness with supporting long-term health and wellbeing.
  • Quicker decision making on long-term ill health cases.
  • More joined up approach across the organisation.
  • Key aims

    To reduce the sickness absence rate to 4 per cent with 2.5 per cent being long term absence, and 1.5 per cent short term absence.
  • To improve staff survey results.
  • Increase productivity.
  • Deliver a 1 per cent cost improvement through £1 million agency saving.
  • Key stages of set-up

    There was an initial timeframe of four months from September 2010. During this period, HR undertook a comprehensive review of absence management which resulted in a new absence policy and a redesign of management reports – the former involved comprehensive consultation including staff side. Within this, Human Resources Business Partners (HRBPs) and managers were consulted regarding their roles, and as result, absence triggers were simplified. There was also an audit of staff trigger levels and management actions around sickness absence, with a consultation directly with managers.

    The Occupational Health Service was seen as a key tool in tackling absence rates and the department underwent a total service redesign creating The Health, Work and Well-being (HWWB) Department. An investment business case was developed for non-core services e.g. a physiotherapy Employee Assistance Programme (EAP) and psychological interventions.

    In addition, the trust has invested in the Robertson Cooper Motivation, Morale & Leadership Styles surveys to identify areas where leadership styles might be having a negative impact on staff well-being. A number of departments have commenced the programme in 2011/12, including the Consultant Workforce as part of aligning the well-being agenda with the Talent Management & Leadership Development Strategy.

    How it works

    The new Attendance Management policy was approved by the trust executive in March 2011. The policy was launched with awareness workshops for managers and a new staff leaflet distributed. At this point, the policy excluded the Medical & Dental
    Workforce until further engagement had taken place about how the policy would work in practice for both trust consultants/SAS Grades and the Single Lead Employer workforce.

    The policy was extended to cover the medical workforce in December 2011 with implementation in early 2012. A new Health, Work and Well-being Department was launched in January 2011 which included investment in a wide range of extended
    services to meet SEQOHS, 24/7 Employee Assistance Programme counselling, psychology, fast track physiotherapy, holistic therapies and rapid access triage through a nurse led service.

    An Employee Assistance Programme pilot was undertaken with PPC as the provider, offering phone line and website support for staff and their families. New absence reporting structures were introduced for managers, including performance management, to ensure that managers were aware when an employee triggered the policy and needed to be staged. An automatic letter is generated if a member of staff takes more than two instances of sickness absence leave in a 12 month period. There are no exceptions to the new system, unless granted by the deputy director of HR.

    In addition, the trust is piloting on-line management referral using COHORT. This speeds up referral and reports back to managers. In July 2011, the HWWB service implemented the one way ESR/COHORT interface, with the two-way being developed for piloting by 2012.

    Sustainability

    HRBPs attend a care group and corporate divisional meeting on a monthly basis and work in an integrated way with the HWWB team. HRBPs hold monthly meetings with managers and attend staff meetings. The director of HR and deputy meet quarterly with department heads to review absence.

    The deputy director of HR attends a monthly meeting with the consultant in Occupational Health and head of health, work and well-being to review all long term absence cases of four months or more to ensure all appropriate steps are being taken to support either an early return to work, or a decision on ill health termination if appropriate, well before sick pay expires. This approach ensures ongoing dialogue between HR, HWWB, the employee and their line manager.

    The HR council has sickness absence, and well-being as standing items for performance reporting. Further to this, the board receives quarterly absence reports.

    Next steps

    Continuing high level oversight of case management.

    Recently a report from ESR was produced identifying long term sickness absences over the last five years to identify cases where individuals have had more than one instance of long-term absence and individuals will be contacted for a discussion with HWWB as to why they appear to being having long periods of absence year on year and what can be offered to support an improvement in their well-being. The Attendance Management policy now has a stage (warning) with regards underlying medical conditions; this has levels rather than stages and aligns with a capability policy which would enable staff with an underlying medical problem to be terminated due to being unable to attain a satisfactory levels of attendance due to their incapacity, without being in breach of the Equality Act 2010.

    Contact for further information

    Claire Scrafton

    Deputy Director of HR

    Email: Claire.Scrafton@sthk.nhs.uk

    Karen Brayley

    Head of Health, Work & Well-being

    Email: Karen.brayley@sthk.nhs.uk

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