Management Of Sickness Absence Research Articles

Management of Long Term Sickness Absence: A Systematic Realist Review

The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.

The Danish national return-to-work program – aims, content, and design of the process and effect evaluation

The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes - duration of sickness absence and RTW - and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation. The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013. The trial registrations are ISRCTN43004323, and ISRCTN51445682.

Work-related sickness absence as reported by UK general practitioners

Issues surrounding sickness absence are of interest due to growing awareness of the costs to employers and the UK economy, a greater understanding of the interaction between health and work, and increasing evidence that work is beneficial to physical and mental well-being. The Health & Occupation Reporting network in General Practice (THOR-GP) is a national source of information on work-related sickness absence. To assess the factors influencing work-related sickness absence in the UK. General practitioners (GPs) report cases of work-related ill-health via an online web form. Sickness absence information reported with each case was compared by demographic information, diagnosis/symptom and employment factors. Between 2006 and 2009, THOR-GP received 5683 case reports of work-related ill-health; 53% were musculoskeletal diagnoses and 31% were mental ill-health diagnoses. Over half (56%) of cases reported had associated sickness absence. Diagnosis had a highly significant influence on the occurrence of any associated sickness absence. Eighty-one per cent of mental ill-health cases were reported to result in sickness absence compared to 50% of musculoskeletal cases. Public sector employees incurred sickness absence more frequently than those from the private sector. Industries with the highest mental ill-health incidence rates had sickness absence episodes most frequently. Within employment groups, levels of sickness absence were inversely proportional to the level of self-employment. These data reported by GPs with vocational training in occupational medicine may help to inform policy decisions targeting work-related exposures and the management of sickness absence, thereby reducing the UK burden of work-related sickness absence.

The management of sickness absence in the NHS

Sickness absence continues to be an economic burden to the NHS. Managers are faced with employees' sickness episodes and may have some challenges in managing this issue. This article draws on sickness absence statistics to highlight the extent of the problem in the NHS in England. It focuses on some influencing factors and possible causes of sickness absence, and explores strategies that managers could adopt when managing sickness absence in their clinical environments. It concludes by highlighting the important role that managers play in the process of managing sickness rates.

Leadership effectiveness and recorded sickness absence among nursing staff: a cross-sectional pilot study

To investigate nurse managers' leadership behaviour in relation to the sickness absence records of nursing staff. Sickness absence is high in healthcare and interferes with nursing efficiency and quality. Nurse managers' leadership behaviour may be associated with nursing staff sickness absence. Six nurse managers completed the Leadership Effectiveness and Adaptability Description (LEAD) questionnaire, which assesses leadership behaviour in terms of leadership flexibility (i.e. the range of leadership styles) and effectiveness (i.e. using the leadership style that is appropriate for a given situation). LEAD scores were linked to the number of recorded days of sickness absence and both short (1-7 days) and long (>7 days) episodes of sickness absence in the nursing teams. Leadership flexibility of nurse managers was not associated with sickness absence among nurses. High leadership effectiveness was associated with fewer days and fewer short episodes of sickness absence. Leadership effectiveness was unrelated to the number of long episodes of sickness absence. Effective nurse managers had less short-term sickness absence in their nursing teams. If these tentative cross-sectional associations are confirmed in longitudinal studies including more departments, then training effective leadership may improve the management of short-term sickness absence.

Responding to change: the 1990s

Responding to change: the 1990s

Rigorous management of sickness absence provokes sickness presenteeism

Rigorous management of sickness absence provokes sickness presenteeism

Translating national policy changes into local HRM practices

PurposeThe purpose of this paper is to explore how a national policy on sickness absence management is translated by HR managers into local human resource management (HRM) practices by developing and applying an analytical framework with three dimensions: individual preferences, strategic reframing, and local grounding.Design/methodology/approachThe paper is based on policy documents and interviews with HR managers in Dutch law firms. The theoretical scope is the debate on HRM and institutional contexts.FindingsThe paper uncovers a variety of individual preferences among HR managers' interpretations of the national policy. However, in strategically reframing the policy, the organizations act upon it from a mainly “managerialist” perspective: they focus on reducing absence through increased control of employees, rather than reforming organizational practices that may adversely affect the health of workers. The local groundings reinforce unequal power relations between different categories of employees: HR managers/line managers; professionals/administrative personnel; men/women. The paper contributes to the understanding of how changes in institutional contexts are translated into organizations and the role of HR managers within this process.Research limitations/implicationsThe paper explores the translation process in a particular setting. It would be fruitful to broaden the scope to other institutional contexts and organizations and to include a diverse range of actors to develop additional knowledge of the interaction in the translation process.Originality/valueThe paper develops both empirical and theoretical conclusions on the translation, that is, the sense making of HRM in an uncertain environment of changing national institutions.

Under cover.

Law at Work, Health and Safety Law EMPLOYMENT AND health and safety law underpin good management practice, yet many nurses who manage staff have little training in these two key areas. They may have covered areas such as equality and diversity, basic health and safety, moving and handling, and recruitment and sickness absence management but not much else.

Wincanton reduces sickness absence by 10,000 days

PurposeThis paper aims to demonstrate how supply‐chain company Wincanton has reduced sickness absence, improved productivity and heightened morale.Design/methodology/approachDraws upon the experience of Wincanton's sickness absence management program, driven by the partnership between the HR department, Wincanton employees and absence‐management specialist active health partners (AHP).FindingsDescribes the significant variation in staff‐absence levels across different sites and types of work contract and the detrimental effects of such absence on Wincanton's performance. The company selected an absence‐management service led by nurses in order to provide effective, timely medical advice, encouraging staff to take responsibility for their health while at the same time facilitating a prompt return to work.Practical implicationsShows how taking an active approach to staff absence and aligning reporting systems to identify and share good practice have had a positive impact on staff morale, productivity and profitability.Originality/valueHighlights a significant reduction in average absence figures per employee and cost savings for the business.

Predicting job loss in those off sick

Evidence shows incapacity benefit claimants (those off sick >26 weeks) are at greatest risk of long-term job loss. To develop a screening tool to select those at risk of job loss, defined as failure to return to work among those off sick. The screening tool was for use in the Job Retention and Rehabilitation Pilot of the Department for Work and Pensions. A literature review identified risks for long-term incapacity and job loss as multifactorial. Potential predictors for return to work were then assembled into a set of questions and tested by a prospective study in general practice surgeries and a retrospective study of occupational health records of local authority employees referred for sickness absence management, using univariate and multivariate logistic regression analysis. Univariate logistic regression analysis of the retrospective study produced odds ratios with 95% confidence intervals for each question (where P <or= 0.05) and a C-index was then constructed for their predictive power. Five questions holding the greatest predictive power were subjected to multivariate analysis and in the final model had a high C-index of 0.90 (0.5 = no predictive power, 1.0 = perfect prediction). They formed the screening tool. The questions cover self-assessment of ability to return to work after current sick leave, of ability to do current job in 6 months' time, sick leave in past year, current age and whether awaiting a consultation or treatment. A screening tool identifying those most at risk of job loss has been produced.

Rates of sickness certification in European primary care: A systematic review

Background: General practitioners (GPs) are responsible for assessing a patient's capacity for work and issuing a sickness certificate, enabling a patient to receive statutory sick pay and take time away from the workplace. The management of sickness absence across Europe varies considerably, and there is a need for comparable rates of certification to facilitate appropriate health and economic planning. Objective: To systematically review the literature reporting rates of sickness certification in general practice settings. Methods: Electronic databases were searched from their inception to November 2007. Inclusion criteria were reporting a measure of sickness certification, conducted in European primary care. Results: 298 citations were identified from the literature search, of which 11 met the inclusion criteria. These studies demonstrated that the rates of sickness certification are not routinely recorded. The certified rates were subject to wide variation, ranging from 18 per 100 person years in Norway to 239 per 100 person years in Malta.Conclusion: There is large variability in sickness certification policy and hence sickness certification rates across Europe. A system that enables comparisons across countries would be beneficial in ensuring health and economic planning. To enable a baseline rate of certification to be established and compared across countries, standardized reporting of sickness certification is needed.

Sickness absence management: Encouraging attendance or ‘risk-taking’ presenteeism in employees with chronic illness?

Purpose. To investigate the organizational perspectives on the effectiveness of their attendance management policies for chronically ill employees.Methods. A mixed-method approach was employed involving questionnaire survey with employees and in-depth interviews with key stakeholders of the organizational policies.Results. Participants reported that attendance management polices and the point at which systems were triggered, posed problems for employees managing chronic illness. These systems presented risk to health: employees were more likely to turn up for work despite feeling unwell (presenteeism) to avoid a disciplinary situation but absence-related support was only provided once illness progressed to long-term sick leave. Attendance management polices also raised ethical concerns for ‘forced’ illness disclosure and immense pressures on line managers to manage attendance.Conclusions. Participants felt their current attendance management polices were unfavourable toward those managing a chronic illness. The policies heavily focused on attendance despite illness and on providing return to work support following long-term sick leave. Drawing on the results, the authors conclude that attendance management should promote job retention rather than merely prevent absence per se. They outline areas of improvement in the attendance management of employees with chronic illness.

Mondial UK reduces absence and increases productivity

PurposeDemonstrates how, through monitoring and management of staff sickness in 2005, Mondial UK successfully reduced sickness absence.Design/methodology/approachDraws upon the experience of Mondial's implementation of a sickness absence management programme, driven by the HR department but which brought together the business as a whole, from the executive board through to roadside technicians, to ensure its success.FindingsDescribes how staff absence levels within technical services and among shift workers in the operations centre were previously very high. The company focused on encouraging staff to take responsibility for their health and well being, empowering line managers better to address absenteeism and making changes to the profit‐related pay (PRP) scheme to target frequent short‐term absenteeism.Practical implicationsShows how a focus on staff health and well being as an integral part of a business can make a positive impact on its productivity and profitability.Originality/valueHighlights a year‐on‐year reduction in average absence figures per employee.

The problem and management of sickness absence in the NHS: considerations for nurse managers.

This paper examines the topic of sickness absence management in the context of the healthcare sector. National Health Service (NHS) employee absenteeism is an expensive and difficult problem. Nurse managers need to assess the extent and characteristics of absenteeism, be aware of their organization's sickness policies, evaluate the effectiveness of these policies and contribute to the development of related initiatives to ensure prudent management of sickness absence. A literature review has been undertaken, providing a broad conceptual context by which the problem of sickness absence in the NHS can be examined. The focus of this paper is to examine the accumulation of research based knowledge to provide a healthcare perspective on the problem of sickness absence management. Sickness absence management within the NHS is challenging but provides opportunities to improve the working lives of NHS employees. Sickness absence cannot be eradicated but it can be reduced by a selection of measures that reflect the uniqueness of the NHS. The many and diverse causes of sickness absence need acknowledgement, when devising strategies that can effectively provide solutions to the problems of sickness absence.

Management of sickness absence: a quality improvement study from Slovenia.

PROBLEM: A need to improve the communication system between general practitioners (GPs) and the national health insurance institute's (NHII) committee of experts for the referral and approval of sickness leave...

Absent without leave: a gender perspective on the management of staff sickness in social services

This article is concerned with the management of sickness absence and its implications for women staff. Changes in the management of sickness absence in a London local authority are outlined and considered in relation to the predominantly female staffing profile of the organization, and to women's work roles, health needs and stress factors, in the light of research on the Social Services workforce (Balloch et al., 1995, 1998). It is argued that the approach to managing sickness absence in the local authority has disproportionate effects on women and that it undermines other goals of the organization. It is suggested that the causes of absence have been ignored in favour of symptomatic action, that in the interests of an effective workforce links between absence and stress should be addressed and that gender roles should be considered explicitly in policy-making and workforce planning.

The management of occupational health by NHS Trusts in the north of England.

This paper reports the findings of an audit of the management of occupational health arrangements in 36 NHS Trusts in the Northern and Yorkshire region of England. A questionnaire was designed based on a national NHS occupational health standard to obtain data on eight categories of occupational health activity: health and safety; pre-employment assessments; Infection Control; health surveillance; sickness absence; ill-health retirement; health promotion and record storage. The management arrangements for occupational health were varied. Assessments of workplace hazards, prevention of HIV-positive workers from performing exposure-prone invasive procedures and the assessment of pregnant workers were identified as issues for further consideration. Provision of competent and effective occupational health services will assist in the management of sickness absence and in the protection and promotion of health of staff. It will also contribute to the health and safety of patients.

Recent changes in occupational medicine in The Netherlands.

In some respects, the Dutch seem to be forerunners in Europe. Occupational health care for all workers can be considered as a substantial progress. Nonetheless, The Netherlands has taken the lead in Europe regarding high work pressure, sickness absence and disability for work. The resulting focus on sickness absence management in many companies is associated with changes in the tasks and position of the occupational physician. Quality of occupational health care is not always as high as it should be, partly as a result of the commercial approach occupational health services have to adopt nowadays. However, the post-academic education programme, with special attention for training of skills, is increasingly adapted to occupational physicians working in a commercial environment. Moreover, a basis has been laid for a better infrastructure and occupational physicians show an increase in professional enthusiasm. Furthermore, co-operation between different professionals has become increasingly common, resulting in a more comprehensive support for companies. Efforts are being made for better co-operation with general practitioners and medical specialists. Finally, the priorities for future research have been clearly outlined by a programming study. Experts are in demand for studies regarding implementation and evaluation of interventions, especially cost-benefit analysis. Furthermore, work stress and musculoskeletal disorders remain on the research agenda.

Hereditary Spherocytosis

<h3>Objectives</h3> Studies identifying national occupational health (OH) research priorities have been conducted in several countries to establish where OH research should be focused and where funding should be targeted. However, the UK findings are now over 20 years old, and OH practice is continuously evolving. The aim of this study was to identify current research priorities for UK occupational physicians (OPs) and occupational health researchers (OHRs). <h3>Methods</h3> Current research priorities in OH were identified using a modified Delphi technique. This was conducted in two rounds to achieve consensus. Research priorities were rated, and then ranked using questionnaires developed from expert panel discussions, key research topics identified from the medical literature and participant feedback. Overall and intergroup comparisons were completed for the ranking scores. <h3>Results</h3> Consensus among OPs and OHRs was high with almost all (9/10) primary domains rated as ‘very important’ or ‘absolutely necessary’ by more than 54% of respondents. The research priority areas ranked highest were jointly <i>economic evaluation/cost effectiveness studies</i> and <i>disability management</i> followed by <i>occupational disease/injury/illness. Occupational health policy</i> was ranked lowest after <i>sickness absence management</i> and <i>health promotion</i>. The secondary domain analysis identified priority emphasis on mental health and psychosocial hazards within the workplace and the need to further develop evidence-based guidance for clinical OH practice. <h3>Conclusions</h3> We identified the current research priorities for UK OPs and OHRs. The findings will inform future national OH research strategy and support research that addresses important knowledge gaps within OH and other interdisciplinary specialties.