Sickness absence and how it is managed in the workplace was the hot topic at Reward’s recent round table, in association with Canada Life. Our participants identified five key learnings…

health insurance

Sickness absence is not just about HR, it’s about line managers – and employees themselves

While sickness absence policy and any key performance indicators are likely to be driven by the HR department, ultimately it is down to line managers to record and identify potential long-term problems when it comes to staff sickness.

The culture of the organisation – and even the sector in which it operates – can be a significant factor in how effectively sickness absence is monitored. Putting trigger levels and other mechanisms in place is not routine practice in all companies and industries. Even where these exist, making sure that the measures are realistic and effective may not be achieved.

Companies need to make it easy for line managers to handle sickness absence, and to spot if employees are struggling health-wise before it becomes a major problem. After all, line managers should know their staff better than any centralised HR function – but they have a broader day-job to do as well. Employers don’t always make it easy for line managers to understand, implement and adhere to sickness absence policies, so making sure they are equipped with the tools they need is essential. This could include checking they understand and advocate benefits products such as income protection and private medical insurance as well as providing training on HR policies.

While line managers have a key role to play in supporting staff health and recording absence, employees themselves also have responsibilities. The extent to which staff are prepared to engage with workplace wellbeing – including being monitored – will vary.

“Younger staff are growing up with the idea of the quantified self, wearable technology and the metrics of wellbeing. They come into the workforce with an expectation that this will be tracked in a place of work” Steve Hackett, Aon Employee Benefits


Early intervention is essential, but hard to achieve

Mental health issues are an increasing focus in the workplace, with Canada Life stating that 25% of its income and activities are now mental health-related.

Critical illness can be clear from the start, but spotting potential long-term sickness, in mental health and other areas such as musculoskeletal, can be a challenge. Line managers not trained in spotting the warning signs or without backup such as occupational health to call on, may struggle. And while there may be triggers in place to highlight potential long-term issues, these are not always effectively configured, or understood within organisations.

Benefits ‘silos’, where there is no interaction between different types of health products, can exacerbate problems, making it difficult for employees, their managers and HR departments to direct staff to the right starting point.

For insurance-related benefits such as income protection, early intervention is essential in providing support and in reducing the risk of long-term claims. However, getting the balance right between what it is effective for an employer to deliver and what the income protection provider ideally requires is a challenge in practice. Even information sent to an occupational health provider is only as good as that submitted by the line manager.

“We’ve still not nailed early intervention – and the siloing of benefits doesn’t help.” Dan Crook, Canada Life


What gets measured gets managed, but effective benchmarking is hard to do

While setting triggers and benchmarks, and using data to shape sickness policy are all laudable aims, even the basics of absence recording are not always being done effectively. Even fewer organisations get as far as having a dashboard that brings all of the metrics together.

Some sectors are better at providing broader support than others – for example, the City Mental Health Alliance has carried out good work in the financial services sector.

Benchmarking also requires input from all of the workforce in order for organisations to respond to the findings – and sometimes those findings may reveal information that HR doesn’t want to share.

“You need a macro picture of health – it means nothing at an individual level. In our [social worker] industry, there are so many variables and so much is dependent on local regions.” Daryl Maitland, health and wellbeing lead, Cafcass.


“Data quality is variable and from different sources. Benchmarking is only as good as the data from managers.” Jo Berriman, Mercer


Take the time to understand the benefits you offer – and make sure your staff understand them too

With such a plethora of health products now on offer in the workplace, from health cash plans through to group income protection policies, it can be difficult for employers and staff to understand just what is on offer and how to interact with the services to get the most from them.

For example, group income protection can work as a rehabilitation service to help avoid long-term sickness claims in the first instance, or reduce the amount of time that an individual is absent from work. But in order to achieve that, employers need to understand that the service is a part of their product – not pay per referral – and can be made available right from the first day of sickness.

Other tools, such as the Best Doctors diagnosis service, may be available within products but not understood or used to best effect.

Early intervention can also help to identify the difference between a work-related problem and a medical one. This can be a sensitive area for line managers to report on: while sickness absence reporting will always begin with a line manager, and is about having a process in place for them to know who to call. “What does that line manager say?” asked a participant. “Are they going to say that someone is taking advantage?”

In order to encourage earlier reporting, income protection providers need to be able to overcome concerns from employers about how using rehab services might affect their premiums – and also that the service provider is able to understand work-related issues.

Medicalisation of work issues is a major consideration, particularly when it comes to mental health in the workplace. Identifying what needs to be addressed medically, versus what is an organisational issue, is a big factor for employers and income protection providers alike.

There are some generic factors that could be covered in a check-list for managers – for example understanding if an employee has been through a disciplinary recently, or has been experiencing problems at home, can give valuable insight.

“Day one reporting of mental health issues is a pipe dream – but you do need to involve all the relevant parties and put some timelines around it.” Steve Hackett, Aon Employee Benefits


Collaborate, communicate and co-ordinate

There are many stakeholders involved in sickness absence – employees, line managers, HR departments, occupational health, GPs, insurance product providers and other health benefit providers.

Making sure all of those parties communicate effectively is one of the biggest challenges faced as a part of healthcare management in the workplace.

GPs are a critical part of the absence process and will often be an early decision maker on whether sickness becomes longer term.

There has been widespread criticism of the ineffectiveness of the fit note process, but there are also secondary problems with the GP’s role in relation to workplace healthcare. The GP’s first responsibility is to the individual – and they will typically have a reactive, rather than proactive, role in general wellbeing.

As such, there is an opportunity for the employer to become involved with proactive healthcare, whether that’s introducing resistance training, such as mindfulness activities, or in providing insured products.

However, the most important role that the employer can provide is in identifying clear, shared processes, mapping out clear gatekeepers for particular interventions, and charting how the different stakeholders are involved.

“You can often tell when the report comes back from a GP that they’ve just relayed what the patient has told them, or are very non-committal. But they are under time pressure too – they’re likely to say “you’re telling me you’re stressed, but really I’m going to recommend that you go back to work.” Natalie Spencer, EEF