Role of the Occupational Health Department in Absence Management and Rehabilitation

Another of the NI Update lectures

 Dr Leslie Hawkins

 Absence management

Facts & figures: CIPD survey July 2005

• Analysis based on 1110 organisations & over 2.9m people
• Average cost is £588 per employee per year
• Most important cause is minor illness; 61% – 5 days
• Manual workers – back pain
• Non-manual workers – stress

Absence management policies

• 87% organisations have absence management policies
• Return to work interviews are regarded as the most effective method of managing short term absence
• Involving OH is seen as most effective tool for managing long term absence

What is rehabilitation?

• An approach whereby those who have a health condition, injury or disability are helped to access, maintain or return to employment – DW&P 2003
• Is a process that, for the client, should develop better life quality, vigour, knowledge, capacity for coping with disease and recognition of opportunities and limitations – K E Anderson in Practical Ethics in OH 2004
• Occupational rehabilitation is the process of assisting employees back into the workplace following injury or illness whether  it is work related or not – Hughes 2004

Why Rehabilitation?

• Financial
  • Reduces costs
  • Reduces claims
• Moral
  • Return someone to where they want to be, usually to where they were before the accident or illness
• Legal
  • Management of Health & Safety at work 1999 Reg 6 Health Surveillance
• HSC’s strategy 2010 & beyond – to work with stakeholders to strengthen the role of H & S to getting people back to work through much greater emphasis on rehabilitation

Government statistics

• 1995 – 27,000 people forced to give up work
• Each week – 3000 people move from SSP to Incapacity Benefit (IB)
• 90% on IB believe they will return to work
• 5:1 odds against returning to work

Research & Pilot studies

• Job retention & vocational rehabilitation: the development of a conceptual framework. (James & Cunningham 03: HSE 106)
• The Job Retention and Rehabilitation Pilot DW&P 02-04
• Developing a framework for vocational rehabilitation. A discussion paper DW&P May 04

Case study

• British Telecom v Pelling (May 2004)
• YET
• PersonnelToday 07.09.04
• BT boasts 8000 home-workers, 70% of their 90K workforce working flexibly

Principles of Rehabilitation

• Policy
• Commitment of stakeholders
• Eligibility criteria & support
• Budget & resources
• Commitment to confidentiality
• Accountability
• Dispute strategy
• Early contact
• Referral to OH
• Developing an agreed rehabilitation plan
• Support with therapeutic interventions
• Flexible return to work – recuperative duties
• Work adaptations or adjustments

Those involved

• Employee
• Line Manager
• OH
• Therapeutic services e.g. physiotherapists, ergonomists, counsellors

OH role

• Referral process
• Referral circumstances
• Serious &/or long term medical conditions
• Stress related problems
• MSDs
• Work related illness or injury
• Frequent periods of absence
•  
• Assessment of the individual
• Identifying health problem
• Obtaining further medical information
• Length of absence or likely return to work
• Residual disability
• ? DDA applies
• ? Restricted duties long or short term
• Ongoing treatment e.g. physiotherapy, medication
• Review of refer?
• Assessment of the workplace
• Risk assessment or “job analysis”
• Focus on capabilities and not disabilities
• Travel to and from work
• Access & egress in emergencies

Advising on “recuperative duties”

• Points to consider
• Reasons for length of absence
• Acute or chronic condition
• GP/specialist opinion
• Job analysis
• “Psychological” fitness
• Employee attitude
• Travel arrangements or home working
• Company policy or insurers conditions for payments

Tolley”s recommendations for reduced hours

• >16 hours per week and >4 hours per day
• Agreed gradual increase over 6-8 weeks
• Rehab treatment outside these working hours
• OH review progress

Prevention is always better than cure, however there will always be the need for rehabilitating the sick and injured employee

References & bibliography

• Chartered Institute of Personnel and Development (2004) Employee absence 2004: a survey of management policy and practice http://www.cipd.co.uk
• Chartered Institute of Personnel and Development (2004) Absence Management fact sheet http://www.cipd.co.uk
• Walters M (2005) One stop guide: Absence Management http://www.personneltoday.com
• HSE (2004) Managing absence and return to work: an employers and managers guide HSG249
• Waddell G, Burton A K (2004) Concepts of Rehabilitation for the management of common health problems, London: TSO
• Hughes V et al (2004) Tolleys Guide to Employee Rehabilitation, Lexis Nexis UK
• Better Routes to Redress http://www.brtf.gov.uk
• P James et al (2003) Job retention and vocational rehabilitation: The Development and evaluation of a conceptual framework, HSE Contract Research Report 106
• Department for Work and Pensions (2004) Building Capacity for Work: a UK Framework for Vocational Rehabilitation http://www.dwp.gov.uk
• Access to work, information for employers Ref No:DS4JP July 2004

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