Ill-conceived | Telling GPs to sign fewer sick notes would be bad for staff and worse for HR

Telling GPs to sign fewer sick notes would be bad for staff and worse for HR

Doctors could be told to sign fewer employees off sick as the Government attempts to slash the amount of working time lost to illness.

But any benefits of having fewer absences could be negated by the time and effort required from HR to implement and manage workplace adjustments for these workers, an employment expert has warned.

The Telegraph reported this week that the Department for Work and Pensions (DWP) wants to tackle the rising number of people off work with long-term sickness in the wake of the pandemic.

The national newspaper reported that one of the key areas of consideration was to evaluate how GPs sign people off sick, which could form part of next month’s budget.

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“Doctors would be encouraged to focus on recommending ways people with long-term illnesses can continue to work with support rather than using sick notes to authorise them to drop out of the labour market entirely”, the publication said.

The Department for Work and Pensions (DWP) said it was “considering a range of factors to address inactivity” but refused to comment on speculation.

“The mental health benefits of work are well established. We want to do all we can to encourage as many people as possible to stay in work with the relevant support in place to help them do so, including signposting them to that support at the earliest possible opportunity”, a government spokesperson said.

‘UK has a problem with long-term sickness’...

In October 2022, the number of those inactive because they were long-term sick hit a record high of nearly 2.5 million, according to the Office for National Statistics (ONS). Additional figures showed that an estimated 149.3 million working days were lost because of sickness or injury in the UK in 2021, equivalent to 4.6 days per worker, costing the UK economy an estimated £20.6 billion.

Jonathan Boys, labour market economist for the CIPD, the professional body for HR and people development, described the figures as “a worrying continuation of the trend towards increased inactivity due to long term sickness” which required “urgent attention from employers and Government to address problems early on, to ensure people get the support they need and don’t fall out of the labour market entirely.”

Boys explained: “The UK clearly has a problem with long-term sickness and employers and policymakers need to take this more seriously. Significantly improving workers' access to occupational health services and advice and support for employers on occupational health issues affecting staff could have a big impact over time. The provision of timely access to occupational health services to workers in their 20s and 30s who suffer from back pain or other musculoskeletal problems would mean that steps can be taken to reduce the likelihood of these conditions becoming chronic, affecting people’s health and their ability to work.”

… but encouraging GPs to authorise fewer sick notes isn’t really the best solution.

Ushering employees back to work when they would otherwise be signed off sick could ultimately be a counterproductive move for a couple of key reasons. Firstly decisions such as these pose a real risk of exacerbating ‘Presenteeism’ - the trend of employees showing up to work but not being as productive due to mental or physical health problems that prevent them from doing their job.

Research from the Health & Safety Executive (HSE) in 2022 found that around 35 workdays in the UK are lost per worker every year to presenteeism.

How would fewer sick notes (and more under-productive workers) impact HR?

The second thing to consider is how HR departments would face additional work to accommodate the necessary adjustments for the employees who ordinarily might’ve been signed off sick.

Lesley Rennie, principal employment solicitor at WorkNest, explained some of the key points HR leaders should consider:

“Employers have a duty of care to safeguard the health, safety and welfare of their employees so businesses will need to carry out suitable risk assessments where an employee who would previously have been signed off is to remain at work.

“Depending upon the circumstances, businesses may need to take specific health and safety advice and take into account any potential impact upon their Employers’ Liability Insurance.

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“Careful consideration will need to be given to the support recommended by a GP and employers will need to have strong grounds for any decision not to put such support in place otherwise, they run the risk of constructive dismissal claims, prejudicing the fairness of any eventual dismissal based on the employee’s fitness and failing in their duty to make reasonable adjustments where the health condition amounts to a disability under the Equality Act 2010.

“The current Fit Note system already provides the opportunity for GPs to state that the employee may be fit for work with adjustments and to go onto provide advice on what those adjustments should look like. This is aimed at encouraging discussion between the employer and the employee to facilitate a return to work but businesses often find that little practical guidance is given. If there is a move away from certifying employees as unfit to promoting continued working with adjustments, businesses will need clear guidance from individual GPs on what adjustments are needed in a particular case.

“Given the demands on GPs’ time and the lack of any input from the employer as to the nature of the employee’s role and the workplace itself, it’s possible that employers may need to seek guidance from an Occupational Health provider to fully understand the condition and the limitations on the employee’s ability to perform their role, where previously this may not have been sought at all or would have been obtained at a later stage.

“Inevitably, increased management time will be required to implement, support and review the adjustments put in place and line managers may need additional training to take a more proactive role in supporting employees to remain working when they would otherwise have been off sick.”

So, what’s the solution?

One of the most direct ways HR teams can save themselves time and energy is by investing more effort into staff health & wellbeing, thereby reducing the risk of anyone having to be signed off sick (or continue to work through sickness and subsequently face a productivity slump).

Four in five (80%) employers have even increased their health and wellbeing support or employee benefits to adapt to the changing circumstances of their staff, according to new research1 conducted during January 2023 for GRiD, the industry body for the group risk protection sector.

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The research found that over the past 12 months, employees felt that their health and wellbeing had deteriorated mentally, physically, financially, and socially, with financial wellbeing being the area most impacted:

  • 40% of employees felt that their financial health had deteriorated.

  • 29% felt that their mental health had deteriorated.

  • 28% felt that their physical health had deteriorated.

  • 24% felt that their social health had deteriorated.

However, over the same period, employers themselves felt their responsibility had most increased for supporting the mental and social health of employees:

  • 51% of employers felt increased responsibility for their employees’ mental wellbeing.

  • 51% felt increased responsibility for employees’ social wellbeing.

  • 49% felt increased responsibility for employees’ financial wellbeing.

  • 47% felt increased responsibility for employees’ physical wellbeing.

As a result of this increased sense of duty, during the past 12 months, many employers have increased the provision of the health and wellbeing support or employee benefits, that they offer their staff.

In total, 80% of businesses have increased their support for health and wellbeing or employee benefits over the past 12 months. GRiD is pleased to see meaningful changes, including a quarter (27%) increasing their investment in new employee benefits to provide extra support, support being made available for more of the workforce (27%), and also extending support to family members (22%).

However, while GRiD believes that employers are right to adapt to changing circumstances, the industry body feels more could be done.

Twenty-four percent of employers have responded positively to employee requests for changes in health and wellbeing support, however three quarters (76%) have not. With financial wellbeing the area of most concern for employees, it would be good for employers to provide support here.

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Similarly, 20% of employers reported that they have increased access to funds to pay for support directly, but unlike offering employee benefits, such as private medical insurance, or group risk benefits (employer-sponsored life assurance, income protection and critical illness), funding support directly on a case-by-case basis can be expensive. It’s also difficult to budget for, as no employer can predict how many staff will need support in any given year or for how long that support will be required.

Katharine Moxham, spokesperson for GRiD, said: “A crystal ball would be hugely beneficial to help plan ahead for employees’ needs but in the absence of any ability to see into the future, employee benefits must be all encompassing to support all areas of health and wellbeing. This time last year, interest rates were still quite low and the full impact of the current cost of living crisis was not known and so it’s understandable that employers were not as focused on supporting financial wellbeing as they might be now.

“It’s important that employers do not try to second guess what employees need but listen to their current concerns. Many employee benefits, such as group risk products, are all inclusive in terms of the wellbeing support they offer. This means that no matter what happens within a business, or what external factors employees face, support is available across all pillars of health and wellbeing to ensure all staff have access to the comprehensive support they both need and deserve.”

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