Scottish Executive (2004) Workability Model. Physica

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Healthy Working lives and Attendance Management

• Dr Ewan B Macdonald
• Director, Salus
• Deputy Director of HR NHSL
• Head of Healthy Working Lives Research Group ,
  Univ of Glasgow

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National Strategy
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The policy context

• Improving Health in Scotland The Challenge
  (2003)
• Healthy Working Lives a Plan for Action (2004)
• Smart Successful Scotland
• DWP Pathways to Work (2002)
• Route to Economic Inclusion 5 year strategy

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Haste and time pressure at work in the
EU(LähdeMerllié and Paoli, European Foundation,
Dublin 2001)
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Health problems related to work, EU 15(Paoli
1997)

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Workplace Absence

• Nationally absence costs are estimated at 567
  per annum per employee ( CIPD )
• Each employee loses an average of 9 working days
  per year
• Effects in Lanarkshire?
• NL has an estimated 116.9k people working within
  its boundaries est cost 66 million
• SL has an estimated 110k people working within
  its boundaries est cost 63 million

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THE HEALTHY WORKING LIVES STRATEGY

• A healthy working life is one that continuously
  provides working age people with the opportunity
  ability support and encouragement to work in ways
  and in an environment which allows them to
  sustain and improve their health and well
  being.It means that individuals are empowered and
  enabled to do as much as possible, for as long as
  possible, or as long as they want,in both their
  working and non working lives

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Healthy Working Lives

• Inter agency working to ensure that all services
  are focussed on improving the functional capacity
  of their clients physical, mental, social,
  spiritual
• Scottish Executive (2004)

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Workability Model
Physical capacity
Work environment
skills
Work organisation
Mental capacity
Professional competence
workability
Knowledge
Social capacity
The workplace
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If we treated our professional footballers the
same way as we treated our workers there would
be no football played on a Saturday
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More than the Sum of the Parts
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Joining Up Delivery
Local Authorities
SaHW
NHS Boards
SHAW
SBC
Scottish Centre for Healthy Working Lives
Voluntary Sector
Unions
SAD
DWP
Occ. Health Providers
NHS Health Scotland
HSE
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Essentials of Healthy Working Lives

• Everyone at some time or another needs
• Health improvement
• Health protection
• Rehabilitation
• Life long learning
• Employability services
• Within the NHS this should be planned and
  systematic

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Local Multi-Disciplinary Teams
Health Safety
Occupational Health
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Why focus on sickness absence?

• Care
• Cost
• Control

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Why focus on sickness absence?

• Quality measure of human resource
• Improve the business and its efficiency
• - more profit with less cost
• Good managers have low group absence
• - are leaders
• - are motivators
• - own efficiency of their groups
• Efficient companies have low absence

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Absence
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Duration of Absence

• Age

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Absence indicators
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Absence indicators
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Absence indicators
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Absence indicators
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Absence indicators
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Sickness absence severity rate ratios for women
and men in certain occupations
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Changes in sickness absence diagnosis over 18
yearsMen in Great Britain decrease in days and
spells per capita in 1971/72 as per cent of
1953/54
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Control of sickness absence

• Short term absence
• - may reflect motivation
• - domestic problem
• - test match/football
• - rarely serious illness
• Long term absence gt 1 month
• - usually serious illness

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• The young have frequent short absences
• Women will have more absence
• Older employees
• - fewer episodes
• - longer duration

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• 10 of the population are absence repeaters
• 70 of these improve over 2 years
• You must monitor all the people, all the time.

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Analysis of sickness absence

• Percentage of time lost (severity)
• crude measure
• ? 1 person for 100 days, ? 100 people for 1 day
• Number of spells of absence (frequency)
• New spells in period/Average population in
  period
• Prevalence
• Point prevalence absent on 1 day
• Period prevalence absent throughout period

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Control of Absence

• Establish process
• Information systems
• Establish norms
• Determine special action levels

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• Record all absence for all employees
• Keep individual records of attendance
• Establish management information systems

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Control of sickness absence

• Recruitment
• best predictor is previous record
• work
• school (truancy)
• Training
• Stress importance of attendance
• Prompt reporting of absence
• Employer policy
• Tight supervision in first year

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Management responsibility

• Diagnosis
• Who? With what? Why?
• Occupational Illness, injury or stress
• Medical unrelated to work
• Social
• Behavioural

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• Treatment and Prevention
• Prevention Inception
• Have a policy on absence
• Train the managers
• Obtain skilled occupational advice
• Health promotion

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• Record all absences for each employee, preferable
  by the manager
• Record diagnosis
• Establish computerised record system
• Provide regular management reports
• To each manager
• To senior management

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Control of Absence

• Recurrent Short Term Absence
• Apprentice/New Start
• 1st Absence
• Manager interview
• How are you, we missed you.

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• 2nd Absence
• How are you, we really missed you.
• Cautioned, discussed with personnel
• 3rd Absence
• As above
• Formal Warning
• Personnel/Offer medical support

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• Mature Employee
• As before
• Action level based on circumstances

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Recurrent short term absence

• Employee category action levels
• Interview, discuss with personnel, medical
• New recruit
• Young males
• Young females

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Long term sickness absence

• Employee ill
• Weekly telephones manager
• Monthly manager must visit
• Discussion with personnel/medical
• Medical report requested Liaison with treatment
  agency
• Returns to work medical assessment
• Own job Alternative Work - Retirement

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Control of Sickness Absence

• All Absence
• Employee must personally report to manager by
  telephone on day of absence
• no say no pay
• On Return
• Manager must personally see employee, preferably
  in office

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New Employee

• Absences in 6 month periods
• Interview
• Discuss with Personnel
• Discuss with medical
• Consider dismissal

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Role of Occupational Health

• To protect, maintain and enhance the physical,
  mental and social well being of the worker
• Advisory not disciplinary
• Advises employee and manager
• Close liaison with personnel to support managers
• Policy development
• Analysis of morbidity
• Preventative strategies
• Selection, prevention, training, care

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Essentials of Healthy Working Lives

• Everyone at some time or another needs
• Health improvement
• Health protection
• Rehabilitation
• Life long learning
• Employability services
• Whether they get it at the right time or not
  depends more on CHAOS theory

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HWL and Attendance Management

• Respect for each individual
• Close management supervision
• Rapid rehabilitation, fast tracking
• Good Psychosocial environment
• Facilitate return to work, avoid absence
• Temporary alternative work
• Be prepared to challenge the GP certificate
• Ultimately if fails, IHR or Dismissal