UK 
United States
Kay Needle, early intervention and rehabilitation expert at Generali UK Employee Benefits, interviews Helen Appleby, Vocational Rehabilitation Services Manager at Form Health. They discuss whether new ways of working mean that the definitions of absence and presenteeism – and the way they are measured and managed – needs a rethink.
Employee absence in the UK is at its highest level for over a decade, according to latest data. Presenteeism is also up. Research carried out in the first quarter of 2023, found that 37% of employers reported some level of presenteeism in the past 12 months, compared to only 21% in the previous year. It found that more firms are reporting that employees are working when ill, and they are working beyond their contracted hours. This was evident in firms of all sizes and across all business sectors.
So, the question is, has the workplace and its policies, practices and measurement systems for absence caught up?
The same goes for presenteeism, according to a mini straw poll of audience attendees at the start of our recent webinar* on this topic where the majority (45%) said they didn’t measure presenteeism. Only 18% said they did, while 36% didn’t know.
New ways of working have brought huge benefits to many. So, we’re not going to debate the merits or otherwise of workplace versus home / hybrid.
But we do think it’s time to discuss whether new ways of working mean that the definition of absence and presenteeism need a rethink.
In some ways, illness and injury are now more manageable by those individuals who can flex their working day around how they feel. But does this mean that more people are working when they should perhaps be having time off? Does it mean that more people are pushing through minor problems until they become much bigger problems? We discuss this – and more – here.
Kay: We’ve noticed as a Group Income Protection insurer (that includes the provision of early intervention and rehabilitation support) that referrals to us from HR have become much more complex. For example, it’s often no longer the case that people are just referred due to, say, a musculoskeletal condition. Now, they might be referred for a musculoskeletal condition, plus they’re providing care for their elderly mother and struggling with low mood. We refer regularly to Form Health, for your Vocational Rehabilitation expertise. Are you seeing this in your wider experience too?
Helen: Yes, supporting individuals to remain in work and return to work has, in some cases, become more complex now than it was previously. The impact of the pandemic and the cost of living crisis has, for example, limited some people’s access to childcare and increased caring responsibilities. These additional life stressors can tip the balance between someone coping at work and not.
Vocational Rehabilitation comes into play here because we aim to look at the person as a whole – the physical, psychological and social – and we focus on how the employee is coping with the demands of their normal work role, both at that time and how they might do in the future. We also consider what support and guidance can be given to enable them to remain at work, or return to work.
The impact of the pandemic has also altered the way we live and work, and while home working has supported those employees with symptoms of ill health that are able to work, it has also meant that in some cases, employees who should take sickness absence to fully overcome illness, aren’t doing so. In such cases, the reason for absence becomes more complex.
Feeling like you’re not contributing fully to your job can increase feelings of anxiety and worry for some people. So I’d suggest keeping an eye on home workers who are taking these short, unplanned absences, or whose working patterns change. Some indicators that someone might be continuing to work at home while struggling can include regularly exceeding their working hours, working outside of working hours and at weekends. This type of working pattern can place someone at increased risk of absence relating to burnout.
Kay: Our spot poll of webinar attendees asked what triggered HR or Occupational Health (OH) to become involved in absence management. The majority (67%) said ‘line manager flags’. This came way head of other responses, such as: ‘Automatic triggers from a system’ (33%); and ‘Different triggers for different conditions’ (28%). So, with line managers representing such a key figure in absence management, how can they be encouraged to identify and flag issues earlier? How can we encourage them to understand this isn’t being disloyal to their team, it’s actually helping them?
Helen: It’s my understanding that the Bradford Factor has traditionally represented one of the main ways of measuring and monitoring short, frequent, unplanned absences that are more disruptive to organisations than longer absences.
I think these tools do need updating. But, in the meantime, it would be good to see more focus on the management of absences; how employees can be supported to cope fully at work, and what line managers and HR can do to help, to reduce the risk of absences recurring and the reason for absence becoming more complex.
There are also certain conditions, particularly those of a chronic or relapsing nature, that will require short, unplanned absence, and there are also occasions when someone is using a graduated return to work programme that will likely see them taking absences inbetween working days, so it’d be good to see systems being updated to accommodate such instances. This, as opposed to the traditional, very black and white, view of someone always being fully absent or not.
Kay: Yes, it’s still important for people to take time off sick if needed. But we need to redefine work ability – or work readiness. An increasing number of people are in work with a health condition that is ‘work limiting’ (around 3.7 million people, a figure that has increased by 1.4 million over the past decade). They might never be feeling 100% but they can still work – and indeed want to work, not only for financial reasons, but also for wellbeing reasons. Of course, there’s the big push from government currently for employers to better support people with long-term conditions, to get work and to stay in work. So, how can Vocational Rehabilitation support in such instances?
Helen: Vocational Rehabilitation probably isn’t needed in most cases where people with long-term conditions might just need flexibility from their employer to take time off for appointments. Work can give us all a reason to rise in the morning and that’s no different for anyone with a long-term condition; work can help them manage their day to day challenges – especially in a psychological sense, in that it can bring satisfaction and self-esteem – as opposed to adding to their existing challenges.
Vocational Rehabilitation helps people who can’t perform optimally all the time, to feel better in control of what they can and can’t do, to enable them to remain in or return to work. And part of the Vocational Rehabilitation process is to help HR and line managers feel as comfortable as possible to initiate and develop conversations with their employees regarding work barriers, what support is needed, and what they can provide.
As part of a Vocational Rehabilitation assessment, we look at a person’s Activities of Daily Living. This can include things like feeding yourself, looking after the children, walking the dog. We look at everything an individual needs to live and work. And, from that, we can determine how ready they are to cope with the full demands of their role. This helps us to work on coping strategies with the individual, as well as helping them identify when they might need to step away from work temporarily.
When employees don’t have access to Vocational Rehabilitation, or Occupational Health, it’s important for the line manager to check in with their employees, particularly those at home, and enquire about those basic needs.
Also, it can be helpful if employers lead by example, like taking time off when needed. And when they suspect their employee is struggling, that they try to minimise any apprehension related to taking necessary sickness absence, by explaining to them about: sick pay; access to wellbeing benefits; how they can keep in touch during absence; and what support can be provided by the line manager or HR to enable the return to work process.
*To access a free recording of the full 40-min webinar, please email [email protected].
Disclaimer:
All information contained herein represents the views and opinions of the author as of the date of writing and is provided for general information only. Nothing herein constitutes or is intended to constitute financial or other form of advice and no individual should rely upon the information provided in making a specific investment decision without first seeking independent professional advice.
