Operational managers should be able to review the overall patterns of their areas of responsibility in comparison with others and sliced by occupational group, work team or by day of the week. Individual patterns of attendance/absence must be accessible to line managers.

If such data is not available, managers should keep their own records, but must ensure that these are (a) comprehensive: they must cover all employees in the team, to avoid claims of victimisation; and (b) must be accurate.

‘Better information would help the Service manage sickness absence more effectively.
The information provided by Areas is not wholly accurate and, as a consequence, the reliability of overall data on sickness absence in the National Probation Service is undermined. Only 37 per cent of Chief Officers consider the national data to be ‘very accurate’, 54 per cent had ‘some doubts’ and 10 per cent thought data were only indicative. Internal Audit has also raised concerns about the reliability of sickness absence data.’
Source:  National Audit Office Report: Absence Management in the Probation Service, April 2006.

See ‘Cost’.

The Work Foundation suggests that designing jobs to make work interesting, build a sense of commitment and enhance employee engagement will achieve more than any other action to reduce absence.

Where work is fundamentally difficult to change then enhancing teamwork and involvement through ‘total quality’-type continuous improvement schemes can begin to encourage employees to feel greater interest in their work and hence to reduce absence. (See Project Plan)

Involving staff in working through the HSE Standard on stress avoidance, and/or reviewing the jobs in terms of musculo-skeletal strain can deliver the direct benefit of reducing causes of absence and the indirect benefit of true two-way communication to find constructive solutions.

UK-wide comparative data:

The Auditor General for Western Australia reports that the number of work days lost per year per full time equivalent in public services there = 6.6 (‘Absent Friends’, May 2001), and suggests a target of four days per head.

The Bradford Index Formula is:

S x S x D = (INDEX)

Where

S is the Number of occasions (Spells) of absence and

D is the Total number of Days absent.

For example:

Five absences of one or two days (2 +1+2 +2 +1) gives S = 5, and D = 8

Thus (5 x 5 x 8) = 200

A single long absence of six weeks (30 days) scores

1 x 1 x 30 = 30

But if that person had another absence of three days, the new calculation would show:

2 x 2 x 33 = 132

Note: the Index can be used at the level of hours worked/absent if that is more appropriate - see www.acas.co.uk/absence.

What the manager can do, is to review ‘capability’, in terms of demonstrated consistent attendance at work.

‘Capability’ is best set out in a procedure that is distinct from discipline, but with parallel stages and identical rights of hearings, representation and appeal.

The principle underlying a review of a person’s capability, on any grounds, should be that realistic and measurable standards have been set and the employees know what these are.

The consistency obligation in relation to attendance therefore suggests that the organisation’s policies should define threshold or trigger points for the review of any individual case.

Threshold levels should be defined within corporate policy documents which are readily accessible to staff.

Some organisations use simple triggers of a number of weeks’ absence, but these then miss the frequent short absences that cause considerable disruption and account for the bulk of time lost.

Use of the Bradford Index to define the ‘trigger’ points ensures that the disruptive effective of frequent short absences (which form the majority) is addressed within the overall attendance-management system.

Chartered Institute of Personnel and Development UK-national research shows that 60 per cent of time lost comes through absences of up to eight days.

www.CIPD.co.uk/surveys

Line manager
HR representative
Occupational health professional
A health and safety staff member may be involved if the case warrants it.

The volume of time lost by a relatively small proportion of staff is such that effective support and good management of those cases can have a significant impact on the overall performance of the organisation.

The purpose of a case conference is to review the known facts of the case to bring forward a return-to-work, by such means as:

• ensuring regular contact/visits are maintained;
• analysing the underlying cause of the absence and considering initiatives which might help the individual to return to work;
• making contact with the individual’s GP via a qualified health professional, such as an occupational health nurse, based on specific authorisation from the individual concerned;
• reviewing the individual’s Bradford Index score/patterns and history of absence; and
• agreeing on next steps, who will do what and when the situation will be reviewed.

Short-term phased return to work with some reduction in intensity may help. (see Rehabilitation)
Eventually, if the absence continues, and all other constructive options have failed, the discussion may turn to the potential termination of employment. This might be through retirement on the grounds of ill health if the condition is such that the individual is permanently unfit to work. (see Ill health)

Notes should be kept of the outcomes of all such case conferences, but remember that these will be discloseable to the individual (the ‘Data-subject’) under the Data Protection Act, or in the event of any legal challenge.
Given that any case which eventually moves into formal process through Capability or Disciplinary Procedure will have previously been discussed in case conferences, the case notes covering the earlier discussions are likely to form a key component of the paper trail which may be scrutinised in the course of subsequent proceedings

In order to qualify for payment, an employee must either complete the self-certification process (for absences of up to seven calendar days) or submit a medical certificate for absence of eight days or more.

Some organisations’ policies include the right for the employer to withdraw self-certification in the event that an individual has more absences than a defined level.

In communications about attendance it is best to convert ‘standard’ percentages or ‘days lost’ figures into meaningful briefings which staff can relate to.

In South Wales Fire and Rescue, in January 2006, there were 79 shifts lost through absence, but in January 2007, the figure was 43.

Gwent Police Force has undertaken a comprehensive revision of all policies and practices relating to attendance, with the result that the number of days lost per officer in 2005/2006 was better than in 2003/2004 by 5.22 days…with a strength of 1,510 officers, this is the equivalent of an additional 30 police officers working in Gwent throughout the year.

If the change is fundamental, going to the root of the employment, then caution is advised and specific legal advice should be sought.

There should be defined protocols to ensure that friendly and supporting contact is maintained by the Team Leader, Line Manager and senior managers concerned, at different times in a long absence, to check on their progress, chat about what is current at work, and check what could be done to help them back to work.  It is also important that this approach is adopted consistently across the board.

Thus the employer can define entitlements and obligations which are contractual in documents other than the main Statement.
However, if an original Statement contains, for example, a table setting out certain sickness benefits appropriate to various levels of service and if the employer seeks to revise that, then the employer must ensure that everyone who holds the original document is informed of the change. (See Consultation)

If such descriptions of benefits are contained in, for example, a handbook of national agreements or in internal sources (including intranet), then the main Statement should make specific reference to those and the employer must ensure that every employee is able to access the information.

The same is true of contractual obligations, where it is unusual for all the detail to be set out in the main Statement. An employer should not rely on hard-to-find regulations and should ensure that the attention of every employee is drawn to any change in obligations, such as the protocols to be followed in the event of absence. Subject to the above, failure to conform to properly defined and communicated procedures can be viewed as a possible breach of contract and can be dealt with through disciplinary procedures.

While many contractual policy matters in public services have been defined within national agreements, increasingly there is scope for local developments.

Like other workplace quality initiatives, it is a progressive programme and organisations are reassessed every three years.
Work to achieve the standard is consistent with the Business Excellence Model, which is being used to drive quality and organisational development in many organisations. Integrating action to improve the health of employees into business development and business practice has significant benefits both for the workforce and the organisation as a whole.

For more information, and a Corporate Health Standard pack, please see:
http://new.wales.gov.uk/topics/health/improvement/health-at-work/corporate-standard/?lang=en

Managers who are likely to be involved in decision-making in relation to appeals should not become involved in covert discussions about options at earlier stages as this compromises independence. Conversely, if a manager has been involved in the early stages of a case, then a suitable substitute senior colleague should take their place at the appeal.
It is likely that all such involvement will be discovered and made use of in any formal proceedings. It may be prudent to ensure any such exchanges use totally anonymous labels, such as ‘Case B’, which are not indexed and cannot be linked to an individual through any system. Discussion can then be about general principles rather than specific individuals. Advice obtained from the organisation’s solicitor, and internal discussion of that advice is protected and is not liable to be disclosed.

Data concerning an individual’s record of attendance which originates, say, from the payroll office, may reasonably be used by management elsewhere in the organisation to support discussions about that person’s capability in the job, or the effect of job-specific risks, as these are all part of the same concern, namely the administration and management of that person’s employment.
As the pattern of attendance at work is generated from within the organisation by its own machinery, and is not reliant upon any kind of declaration from the person concerned, then it is reasonable for line managers to have access to and to make use of  attendance records as long as the data is accurate.

Absence records that contain personal medical information relating to an employee are regarded as sensitive data within the Data Protection Act 1998 and are covered by specific obligation to ensure that data provided is ‘adequate, relevant and not excessive to the purpose.’ (see ‘Medical Confidentiality’)
Authoritative guidance on all aspects of the Data Protection Act 1998 is freely available on the website of the Information Commissioner’s Office, at:
http://www.ico.gov.uk/

The Disability Discrimination Act 1995 requires that any person with a disability has a constructive discussion with their employer to explore the need for ‘reasonable adjustments’ to their work, and for the employer to undertake such adjustments as are ‘reasonably practicable’. It is the organisation’s obligation (and not the employee’s) to ensure that any such agreement is made known to any manager who has any overlap of responsibilities.
If those adjustments include a reduction in contracted hours to allow for late arrival/early leaving, or a reduction in the number of days worked per week, then these will be defined in a formal agreement whose parameters are known to all parties.
Once those adjustments are agreed and implemented, then that employee is under the same obligations for consistent performance as any other employee, within the framework agreed, and the employee is not ‘exempt’ from appropriately applied capability criteria.

Before moving any case which involves frequent short absences into any formal procedure, it is worth asking the employee whether or not there is any single underlying cause, even if the reasons given are varied, as there is a possibility that an underlying cause could constitute disability.
A careful note should be kept of any such conversation, and that should be included in the case papers.

An employee who develops a disability in the course of their employment and who might become unable to carry out the specific job for which they were employed, has rights which the employer must respect, in relation to constructive attempts to make reasonable adjustments. In a key landmark case, a road sweeper who became unfit for that work won her case against the Council because they had, unreasonably in the view of the Employment Appeal Tribunal, and ultimately upheld in the House of Lords, insisted that she could only be appointed to a higher paid clerical post if she won the internal selection process.
The learning point from this case is that the employer is obliged to explore possibilities for retraining to enable redeployment of any employee who becomes disabled, and that the employer’s obligations to that disabled person take precedence over normal internal procedures about competitive selection.
(Archibald vs. Fife County Council, 2004)

Disciplinary procedures may be relevant if, for example, the individual fails to ring in, so that the absence is ‘unauthorised’, or if she/he refuses to participate in return-to-work discussions, or unreasonably refuses to co-operate with constructive invitations to attend occupational health reviews.

Disciplinary procedures aim to be constructive. The process is designed to draw attention to a particular issue and clarify the expected standards.

A frequently-asked-question relates to the circumstance where an employee submits a medical certificate, often for stress, just before a scheduled disciplinary hearing, and may even cite the imminent hearing as the cause of the stress.

Public Service employers are especially expected to act reasonably, and therefore the reaction to this certificate should be to postpone the hearing to a new date. Employers should inform the employee that the hearing will go ahead in their absence if they are still too unwell to attend, inviting them to send their representative and/or to provide written submissions in response to the issues that will be explored. Continued or long-term postponement might exacerbate the stress and would not be consistent with the obligations of duty-of-care.

Dismissal related to long-term absence (rather than frequent short absences) should be considered in the context of the prognosis for the future. Emplyers should consider how long it will be before this person can be helped back to work. There should be constructive mutual engagement in exploring possibilities for retraining, redeployment, etc., which should begin as early as possible, not merely on the expiry of sick pay.
If it is clear, even at an early stage, that no return to work is likely, then many employers will initiate discussions leading to termination even before the sick pay period has run out, but it is prudent to take specific legal advice in such cases.

Note that a condition that persists for 12 months and is medically deemed to then be ‘ongoing’ is a disability, and the employer is obliged to take action in relation to reasonable adjustments to help the person back to work, even if that is in a different role, which might include a higher grade or part time work.

It is the breach of this duty that has caused the prosecution of several major UK public sector bodies for various failures to protect their staff from obvious hazards in the work – where ‘obvious’ means they have been consistently identified as the cause of absence, and no action has been taken to reduce the risks or to protect the employee.

See ‘Risk’

Some organisations (eg Gwent Police) publicise these flexibilities under the label ‘Alternatives to Reporting Sick.’

Care should be exercised here, as it is perfectly feasible for a GP to have banned the person from coming to work, but to be encouraging them to lead an otherwise apparently normal life.

Psychological and stress-related illnesses frequently involve attempts to resume normality as part of the recovery process, and it is likely that staff suffering from these will be seen by their colleagues out and about.

In such cases, it is prudent for the Manager, in the course of one of the routine contacts with the absent colleague, to seek permission to let other colleagues know that they may see him/her out and about.

However, there are instances where sick pay is subjected to outright abuse, for example if the employee engages in paid employment elsewhere.

The requirement to demonstrate prudent management of public funds dictates that all such cases are investigated thoroughly and dealt with appropriately, but they are rarely ‘open and shut’. It is always wise to involve HR, and to ensure that the organisation’s policies explicitly forbid the undertaking of other paid employment while in receipt of sick pay

Dismissal should never be a routine matter, the employer, and everyone working in a managerial capacity, is obliged to act reasonably, and to follow the internal procedures. Many employment tribunal cases are based on the failure of someone acting on behalf of the employer to follow proper procedure, therefore even when faced with what might appear to be an ‘open and shut’ set of circumstances, diligent adherence to due process is essential.

A manager undertaking an unplanned visit to an absent employee’s home, with constructive intent and in accordance with the organisation’s sickness procedures, can also be assured that they are operating within the law.

Ill health retirement (IHR) cannot be ‘negotiated’, it is a matter of medical judgement, against the strict criteria that the individual is ‘permanently incapable’ of carrying out their job or work that is similar to it, and that decision will be taken in accordance with well-defined procedures.

The complexity arises in an individual case if the decision-making on the pension is slow or is delayed and in the meantime the individual passes key trigger points where their employment should be terminated through capability, ie they have been unable to perform their work consistently.

It is good practice to carry out case conferences from a much earlier point so that this situation should be avoided. The application for the award of ill health retirement should be submitted as soon as it is clear that this is a ‘permanent incapacity’ case and should not only be considered at the point where sick pay runs out.

In many organisations, dismissal  is automatic at the expiry of sick pay, even if there is a request for IHR pending.

On the other hand, the benefit of such a scheme is only likely to affect a proportion of staff who are in a state of health where they are able to make the choice between staying at home or going to work, and if that pattern is not a significant issue, then the cost of introducing a scheme is unlikely to be worthwhile.

(Reverse Incentive: non-payment for first three days of absence is an idea which has been trialled, but subsequently abandoned as it served to ensure that all absence was of at least four days duration.)

Performance reviews
Appraisal
Application for promotion
Probation reviews

Many public service organisations operate salary scales with annual increments which are ‘subject to’ satisfactory performance.
Use of the Bradford Index would enable consistent attendance to be included amongst the factors which determine whether or not the incremental progression should be awarded.

While it is perfectly possible, and indeed is recognised as being entirely appropriate to take action against people who have poor attendance records, the law provides safeguards to ensure that managers always behave reasonably.

The key to being “reasonable” is consistency: this is why large organisations must have carefully defined procedures in place, and all action that is taken must follow the procedure.

Many absences will be covered by a genuine ‘Sick Note’ – a Medical Certificate issued by a GP. The BMA has made it clear that it is not their members’ function to act as ‘watchdogs’ on employers’ sick pay schemes, and this is why the employer’s position in reviewing any case must be about reviewing attendance.
If the GP has said that the individual was unable to work on that date, then it is not possible for a manager to challenge the truth of that statement. Although, in long-term absence cases it is often worthwhile to contact the GP, through occupational health services, to explore the possibilities of a phased return with light duties.

What the manager can challenge, and should challenge, is the overall level of attendance displayed by that individual.

This classic performance management challenge is best addressed by standard performance management systems. Ensure there is a clear and up to date policy which is well-communicated. Ensure the data is robust and useful. Then measure the individual manager’s implementation, for example how many absences per month  properly documented or the ratio of cases completed properly. It is usual to find that work groups where the manager’s compliance is token, sporadic  or even completely missing will have high absence levels. Thus it is reasonable to use attendance rates in the areas of responsibility as a measure of managerial effectiveness. Simple comparisons for example‘Your area is the worst in the organisation' are probably going to be too crude whereas year-on-year improvements with external like-for-like benchmark  comparisons are more likely to indicate the individual manager’s performance.

There are various aspects of sickness absence management that lend themselves to exploration for possible future collaborative work between public service organisations in Wales:

• Spreading of experience: what works best?
• Setting the standards: 28% of the people working in Wales work in Public Services. If they can all be committed to good practice, this will help to shape the culture of the country.
• Shared Services.

1. Professional occupational health staff are in scarce supply, and their skills are not organisation-specific. Some authorities have well-managed, focussed in-house services which may well be capable of covering their neighbours.
2. Data collection and management can absorb considerable resource, and yet other organisations have already developed and installed effective systems.

The Platinum level of the Corporate Health Standard calls for corporate social responsibility which might be demonstrated through initiatives which have an impact on the health of the wider population. Collaboration in good practice on absence management might contribute toward this.

The existence of a Medical Certificate should not mean that Disciplinary or Capability procedures are put on hold: see Dismissal.

The informed expert opinion of an Occupational Health Medical Officer should be sought where it is believed, through the case conference system, for example, that an early return to work might be feasible through phasing or light duties, even if the GP has signed a standard Medical Certificate, but note that OH opinions are most useful when specific questions are asked in the referral letter.

Information freely provided on self certification forms and via medical certificates about the reason for an absence, can build up to form a record which is similarly sensitive, and the employing organisation must take reasonable steps to ensure that anyone who has access to that information or who is involved in processing its administration treat it with appropriate sensitivity.
Under the Data Protection Act 1998, there is an obligation to ensure that data provided is ‘adequate, relevant and not excessive to the purpose’. Thus it is good practice to include a statement on the self certification form, and in the relevant policy documents. The statement should explain that information provided as the reason for absence will be collated over time and may be used to inform future reviews of attendance or case conferences by line managers / team leaders, etc., even though focus on attendance means that the detailed medical reasons are often not part of such considerations.

The Information Commissioner’s Office (ICO) provides helpful, authoritative guidance on these matters at:
http://www.ico.gov.uk/Home/for_organisations/topic_specific_guides/employment.aspx
 
But the key point is contained in that Employment Practices Code, 2.3.4:

“Managers can be provided with information about those who work for them in so far as this is necessary for them to carry out their managerial roles.”

The manager must know what the causes of absence are, so that they can fulfil their duty of care to the returning employee such as taking steps to avoid recurrence,  remove the causes of absence, or contribute to the rehabilitation work.
Any procedure which ensures that the manager normally remains in ignorance of the causes of individual absence due to issues of confidentiality is likely to carry larger inherent risks relating to the failure of duty of dare (see www.unison.org.uk/acrobat/12879.pdf ).

Doctors are not allowed to provide employers with reports about the health of one of their patients without the specific permission of the individual concerned, but the Access to Medical Reports Act,1988, which defines those rights is designed to enable the proper delivery of such reports ‘for the purpose of employment’.

To conform to those requirements, the employee (/patient) has to give their written consent, which is generally provided via a pro-forma which also sets out the intended ‘purpose and scope’ of the information. If that scope can be designed to be for the benefit of the patient for example to inform decision making about rehabilitation to work, this is more likely to have a positive response than anything apparently punitive. The  1988 Act also gives the person concerned the right to see the report before it is sent to the employer and to have the opportunity to request that amendments are made to correct errors.

The employing organisation has an obligation to ensure the reliability of any of its employees who have access to such sensitive personal data.

This report goes on to argue that the key is to make work ‘interesting’, and it is clear that there is a strong correlation between the level of autonomy in a job and high attendance.
Motivation can be sustained through regular communication which includes appreciation of those with good records.

Note also: “Happiness & well-being” Cardiff University School of Psychology
http://www.cardiff.ac.uk/psych/cpdr/index.html

In Wales, the Chief Medical Officer reports that “musculoskeletal disorders (MSDs) are the most commonly reported occupational health illness in Great Britain, and in Wales, £90million is spent each year on incapacity benefits to individuals suffering with back pain, with costs of health care at around £150million per year.”
(Corporate Health Standard)
Posture, especially at keyboards is an important factor and all workstations should be set up in accordance with the Display Screen Regulations.
It is good practice for staff to ensure they break up physically-monotonous tasks with different forms of movement: stretching, moving about, etc and the employer should promote a healthy, active lifestyle, in accordance with the Corporate Health Standard.

This definition makes it clear that the profession sees its role, reasonably, as a constructive contributor to health promotion. It is not an arm of management to be used to assist in the disciplining of wayward staff.

Thus “being sent to see occupational health” is most unlikely to have any outcome other than helpful, constructive advice about the promotion of well-being, or advice to managers about steps they might take to enhance ‘the protection of workers from risks’.

This should be taken into account in reviewing the design of organisational procedures. If a manager has cause for concern about the level of consistency of attendance of an individual, then this is best handled by line management as a matter of capability.

Professional occupational health staff can make informed contributions to:

• pre-employment screening against defined specifications
• advice on the elimination of health hazards in jobs
• analysis of patterns in the causes of absence
• development of preventative intervention strategies (eg supporting smoking cessation; conducting immunisation programmes, advice on healthy lifestyles, etc.)
• participation in case conferences, obtaining input from GP
• supporting early rehabilitation return to work plans

Gwent Police:
Continuing close co-operation between Line Management, Human Resources / Personnel Managers / Officers and employee representatives i.e. Police Federation, Unison, Superintendent Association, is vital to this process. Occupational Health professionals are often well placed to promote a positive approach to dealing with sickness absence, both at an organisational and at an individual level.   {Attendance Management Manual}

The performance review of every team leader, line manager, senior manager and director, should include monitoring of comparative rates of absence, utilisation of return-to-work discussions, numbers of long-term absences, numbers of reviews conducted, warnings issued and dismissals.
“S.M.A.R.T.” targets should be set for the year ahead.

The National Audit Office report that across the Probation Service in England in a typical year:

1322  individual records warranted review
918    reviews were conducted
96      written warnings were issued
25      staff were dismissed

This report also observes that, unlike the Prison Service, the ‘threshold’ points in the Probation Service trigger a review, where judgement is applied to the circumstances of the individual case rather than triggering an automatic warning.

However, it is not unreasonable for those policies to contain a clause: ‘subject to the demands of the service’, which can be extended to define minimum overall attendance levels, so that, for example if a staff member is absent through sickness and then has difficulty in delivering their contribution to the service because of previous commitments to other time off, then the demands of the job should have higher priority than the other commitments.

At the time when permission is given for the employee to undertake the other commitment, it is good practice to ensure that any stipulations of  ‘subject to’, or expectations of the minimum attendance level inclusive of all reasons for absence, are spelt out in the formal letter which gives the initial permission.

This would then ensure that one individual was not entering into several external commitments, any one of which would on its own be entirely justified, but the combination might mean that the person was away from work more then they were present.

Many organisations rely on already-busy managers remembering to fill in some form when they receive a telephone call to notify them of an absence.
In designing or reviewing this system, it is good practice to find ways of ensuring it is a ‘closed’ system. That way failures to complete any stage will be obvious, for example through linking to electronic mail log-in screens or other flexitime record systems; cross referencing with requests for temporary staff cover or linking to self-certification reporting.

Good practice is to require absent employees to ring in every day they are absent until such time as they obtain a medical certificate.

Cardiff City Council, which employs c.18,000 people, have set up their employee record database to ensure that every person has an identified ‘chief’, ie the team leader, line manager etc, who will be the recipient of e-mails associated with the notification of absence, completion of return-to-work processes etc, and who are e-briefed on any policy/application revisions.

Thus it is perfectly proper for an organisation to include a statement about levels of attendance/absence as a mater of routine in all references. It is a relevant and potentially significant fact, but it must be verified for accuracy before disclosure to a third party. This approach does not breach any medical confidentiality rules as long as the author does not go into detail about private personal information.

Any organisation is entitled to seek information as a matter of routine on job application forms, asking the applicant for information about the number of absences in the last two years, for example.

The application form can then state that the information given will be checked with the previous employer(s), and standard wording in Reference-request letters should seek that confirmation.

As this information does not breach medical confidentiality, it should NOT be included in the confidential equal opportunities / diversity data-collection part of the application. But, should be in the main application that is then open to discussion at interview on the same basis as, say, attendance on optional training courses, or personal hobbies and interests.

It is good practice to include verified facts about attendance / absence patterns (eg Bradford Index scores) as part of the decision-making materials in all internal promotion applications.

Many public-service organisations operate a rule where anyone who has been absent for a defined period for example 6 weeks cannot return to work until such time as they have been cleared by occupational health.
This can lead to a bizarre situation where the individual’s GP has signed them off as being fit to return to work, but the internal rule then generates a delay, for example through waiting times for an appointment in occupational health. Such delay is unlikely to be justified unless the work has some very special health sensitivity.

Again, the proper operation of case conferences in relation to any long-term absence should identify the individual cases where a return should be conditional upon a visit to OH. In those cases, a letter stating this requirement could be sent to the individual with a copy to the GP, with some indication of the special sensitivity that justifies it.

It is questionable whether an absolute rule applied to all long-term absences that insists that the return is delayed until the individual has seen OH is justified. Good practice is for OH involvement to build up before a return date is generated, and hence the constructive involvement of OH should take place in advance of rather than after the GP has confirmed that the person is fit to return.

Reduced itensity options will depend on the nature of the work involved, but might include: occasional visits to the workplace / part-time work / revised duties / revised shift patterns. The scope should be discussed during case conferences and must be developed with medical input from occupational health and through them, the GP.
Such a plan should only be used as a constructive idea to help the employee to return to work.

The impact of the operation of a reduced-intensity plan on pay  may be neutral or beneficial to the individual, but the organisation will not be able to claim any kind of statutory sick pay rebate for a person who is working, even if that is in a reduced capacity.
If the phasing takes place while the person is still in receipt of full pay, then it is unlikely that there can be any adjustment to take account of part time work. After all, the organisation is already paying out 100% for no contribution at all, so any contribution is to the benefit of the organisation.

• that a return-to-work discussion has taken place;
• the person conducting the discussion had the individual’s Bradford Index, and / or attendance record in front of him/her before the interview begins;
• the individual employee knows that failure to complete the process could result in their sickness ‘account’ remaining open, showing them as continuing to be absent when they are actually present; and. 
• appropriate notes were kept. As a minimum these must record the fact that the discussion has taken place, but should ideally record any relevant facts reviewed in the discussion (but not medically-sensitive information.)

In practice, staff will return to work on any day of the week, and will appear at times that may not be convenient for the busy line manager to take the time to look up the necessary background data (attendance patterns) or to prepare for a discussion, especially if the data is not immediately available.

Good practice is to require the absent employee to ring-in on each day of absence until a medical certificate is received. Therefore the line manager should have an expectation of the timing of every return to work, either from the telephone contact or from information on the medical certificate, and it should be possible to prepare.
If it has not been possible to prepare, then it is prudent to fix the time for the discussion later that day, or the next day, to enable the discussion to be meaningful rather than to rush it through as a piece of bureaucracy.

(See also: Self-Certification and Stress-related absence)

The purpose of the review is to consider the person’s record of attendance and ensure that they understand that as they have hit this trigger point, their record is a cause for concern. It should explore any work-related issues causing the absences and consider the next steps.

Such reviews should be conducted in all a cases where the trigger is hit, even if ‘everybody knows’ that the case is completely genuine. The issue is not to question past absence, it is to encourage future attendance. E ven in these ‘sympathy’ cases, no-one knows what the future holds, and failure to conduct a review when it is triggered will mean there is no basis for any future action. The case may also be cited in the defence of someone else who then claims ‘victimisation’.
The outcome of the review will vary according to the judgement of the line manager concerned in considering the facts associated with the particular case. It should always include sympathetic considerations of the personal circumstances of the individual concerned and seek ways ands means of mitigating the cause of absence.

Some of the high-profile and very high-cost cases brought against public sector organisations (see www.unison.org.uk/acrobat/12879.pdf ) might have been avoided if such review mechanisms had been properly carried out. (Ref: Risk)

Clearly, the more serious trigger-points are always preceded by the first levels, which is why the outcome of all reviews should be confirmed by letter a copy of which should be lodged with HR. That letter should re-state what the next trigger point is (copy from the capability procedure.}

It is good practice to ensure that any manager who will be involved in conducting a review is competent to do so, with training or HR support where required. HR should adopt a suitably flexible approach to communication: a fair and constructive review which has achieved an improvement in the morale of the employee can be jeopardised through inappropriately managerial wording in standard letters from HR.

The organisation must ensure that all such obligations are specified and are understood, eg through induction or via occasional internal communications.
If this device is to have any deterrent effect, all of these calls should be to the line manager, but where that is not possible, then an authorised point of contact is preferable to leaving messages here, there or anywhere, with friends.

On the advice of the BMA, GP surgeries are unlikely to issue medical certificates for periods of less than eight days, and if they are requested to do so, they are likely to levy a fee. The certificate then issued is not much more than a receipt for the payment.

The emphasis in the management of attendance should be placed on line managers and not on the medical profession, whose priority is caring for the sick: see capability and occupational health.

It is essential that data based on the completion of all self-certified absence is used to build up comprehensive and accurate recording.

Chartered Institute of Personnel and Development UK-national research shows that 60 per cent of time lost comes through absences of up to eight days.
www.CIPD.co.uk/surveys
 
On each occasion of self-certified absence, the employee considers the question:
‘Do I want to accept the consequences of not going to work today?’
Of course one of those consequences may be that the employee will feel better, but a small increase in the numbers of staff taking the decision to go to work will increase the attendance levels.

Many organisations use a suitable senior management group to oversee attendance management  such as the ‘Performance Board’ of Newport City Council, and 'Absence Management Group’, of Cardiff City Council. These groups can examine the action plans developed in those areas with poorest attendance rates, ‘home-in on hot-spots’,  and ensure that there is genuine commitment to the development of the healthy workplace.
In order to nurture ownership amongst line managers, it is good practice to take the matter beyond HR, and very important for the whole spread of performance to be regularly scrutinised at the most senior level.

Non-smokers increasingly object to practices such as allowing extended or frequent breaks for smokers.

Organisational commitment to the WAG  Corporate Health Standard will ensure that there is a focus on development of the ‘healthy workforce’.

The journey toward becoming a non-smoker is a different one for each person, but either through the duty of care to the employee, or through concern for the non-smoking team-member colleagues, or through concern for the proper management of public funds, line managers should press the idea of smoking-cessation on any of their team who smoke. Explicit, constructive, reference should be made to it in the course of any return-to-work discussions, maybe with supportive information about sources of help.

Many aspects of ‘lifestyle’ choices can have an effect on attendance, and individuals have the freedom to choose how much alcohol they consume / how much exercise they do or do not take or whether they are concerned about their weight. But, if those choices have an impact on attendance levels and ultimately on the individual’s ability to fulfil their contractual obligations and long-term earning power, then they must be of concern to the caring employer. There is an obvious mutual benefit to the employee and the employer from promoting well-being and many organisations offer screening programmes for staff for example to reduce the risk of coronary heart disease.

This correlation adds to the Work Foundation case that the root causes of sickness absence are to do with issues of fundamental work design (“make it interesting”), and suggests that analysis of the reasons why people leave will also inform analysis of the causes of absence.

It is therefore good practice to operate routine systems that will capture employees reasons for leaving, eg through completion of ‘Exit Questionnaires’. Employers should back these up with regular in depth interviews conducted by independent people (eg HR) to assess whether there are particular issues that might be overcome with positive effects on both absence and turnover.
The perception that management fail to deal effectively with persistent abuse, or fail to show appreciation to the regular attenders, may contribute to high turnover and would create a ‘spiral of decline’ in that the best people will be those who leave, while those with poor attendance records stay.

Therefore, any organisation wishing to reduce absence levels will be well-advised to focus some attention onto stress-avoidance.
Refer to:

http://www.hse.gov.uk/stress/why.htm

http://www.cipd.co.uk/subjects/health/stress/stress.htm

The HSE has produced a Management Standard, adherence to which will (a) have a positive impact in removing the causes of stress, and (b) create the basis for a defence against litigation.
However, the adoption of this standard should not merely be ‘another policy’ to join the fine collection already on the shelf / intranet. While obviously it is necessary to create a formal statement of policy, the most important aspect is the integration of that policy into everyday practice. For example it should underpin standard questions in return-to-work discussions or in exit interviews, and help to design-in greater interest into otherwise mundane jobs.

Stress increases as an inverse factor of the level of autonomy in the work. That is the jobs with least autonomy have highest stress although jobs with high autonomy are more likely to generate exhaustion. Low autonomy jobs also show the highest levels of absence.

While it is unlikely to provide ‘quick-wins’, increasing employee involvement through delegation of greater autonomy or by engagement in some form of continuous improvement scheme is likely to contribute to sustained long-term improvement.

http://www.hse.gov.uk/stress/standards/standards.htm
See also: ‘Violence’

(there is …. ) “ no substitute for a laser-like focus on the factors that shape the underlying determinants of health and health inequalities.”
The Work Foundation “Healthy Work, Productive Workplaces”  Dec 2005

Many organisations (including Gwent Police, North Wales Fire & Rescue) operate colleague support networks. Volunteers from amongst the staff undergo training and are then available to listen to colleagues to enable them to work through any issue in a completely confidential and non-hierarchical setting. This system may also extend to critical incident support, to offer debriefing for anyone who wishes to speak about such experiences.

• Reduction in frequency of odd days self-certified 
  (specify from > to )
• Reduction in average length of absences over 4 weeks (specify)
• Increase in use of reduced-intensity rehabilitation programmes
• Increase in use of case conferences
• Reduction in numbers of long-term absences
• Increase in the numbers of warnings issued
• Increase in the numbers dismissed through capability

Targets are best used where the figures are SMART
(Specific, Measurable, Agreed, Realistic, Time-defined)

Technology enables many desk-based functions to be carried out at home, but these developments are creating a whole new range of challenges to managers.

While dealing with the e-mail inbox from the marital bed at midnight may be a cause for concern in relation to healthy lifestyles, and is probably a sign of excess workload, dealing with some work at home is perfectly normal.  The flexibility this creates to enable some staff to juggle home and work demands can help to reduce absence (see family friendly).

Continuing to engage in remote work-activity when absent under a medical certificate will generally be unhelpful to the recovery of the sick person and confusing to the staff who are working on the basis that this person is not there. Even during short absences the inability to dis-engage from work might hinder recovery and prolong absence. Decisions made when feeling ill or under medication are not likely to be the best.

The sense of ‘losing touch’ which often arises in long absences is best overcome by personal contact, and it is good practice on receipt of a medical certificate to re-direct the employee’s work e-mail to someone else to ensure continuity of communication and avoid the creation of a backlog while it is re-directed.

This principle should be clearly stated so that staff will be aware that in the event of their absence their whole e-mail account will be liable to being read by others in the organisation.

While professional staff can be trained in techniques to restore calm by reasserting their control over the situation, sustained incidence of aggression, which can include aggression over the telephone as well as face-to-face situations, is likely to make genuine symptoms of ill-health more common. For example sleeplessness isoften caused by the individual ‘replaying’ a hostile event in their mind, stomach upsets are a common reaction and so, if the exposure continues, it is likely that the symptoms will recur without any specific trigger. {see Stress-related absence}

Analysis of absence levels by occupational group are likely to show that those with roles involving heavy emotional demands in the delivery of services to the public are usually amongst the highest.
It is also striking that the most serious cases where public bodies have been prosecuted for failure in their duty of care often involve occupations where there is recurring hostility of one form or another - refer to risk. The employing authority cannot simply take it for granted that anyone doing those jobs will be subject to abuse, and must take steps to design out, or at least to mitigate the consequences of, any risk of aggression.

The HSE Management Standard on workplace stress is useful in this regard, especially if it can be implemented through a process of staff engagement.

The Information Commissioner’s Office (ICO) provides guidance on the use of ‘Violent Warning Markers’ in an organisation’s record system. See http://www.ico.gov.uk/

Refer to: http://www.acas.org.uk/index.aspx?articleid=335

Many public service organisations designed and agreed their procedures before the recent changes and today, in comparison with the ACAS models, they are over-elaborate and difficult to use.
The more complex a procedure is, the greater the risk of non-compliance with some internal detail, causing the possibility that any action taken may be overturned, even if the case actually warrants it.

If busy line managers perceive that they will become bogged down with lengthy bureaucracy, they are unlikely to trigger action through a procedure. There is a risk that inappropriate action outside the processes may be taken, leading to valid claims of bullying.

It is good practice to REVIEW disciplinary and capability procedures against the ACAS model, and  ensure that they are streamlined to remove the traditional public-sector complexity. As these are important contractual documents, any such revision should be based on genuine consultation, and consultation with the key user group, line managers, is essential.

Large public-sector organisations are especially obliged to be seen to act reasonably in their handling of internal disciplinary / capability issues, and the steady accumulation of a paper trail relating to the handling of cases through the early stages is now expected in the event of appeal against dismissal. This does not suggest that managers should not take action where it is due in accordance with procedures, it does suggest that those actions should have constructive intent and should be carefully documented.

Warning letters themselves should be clear and specific, recording the fact that a hearing took place on a particular date, that representation was provided by an appropriate internal trade union officer (or that this was offered and declined) and what the outcome was. The letters should indicate the consequences of subsequent failure and include agreed review dates and dates when the warning will no longer have validity for further action.
Copies of all warnings issued to staff should be held in a central HR file.