The Fit Note - Use it to reduce Sickness Absence
The new fit note was introduced on April 6th and doctors now have to advise what their patient can do if they are capable of some work. Employees will no longer have to wait to be signed back by their GP. This gives employers an opportunity to help their employees back to work faster and reduce sickness absence. The NHS bill for sickness absence is estimated at £3 billion plus a year 1-4. Shortening the average length of absence by even a small amount – which this measure has the potential to do, will save many millions.
How does the new Fit Note work?
Under the new scheme doctors certifying the fitness for work for their patients who have been off sick for 7 days or more will have to advise what a person can do if they are capable of some work. The employers will still receive the Med 3 form but it will provide new information. It is this that provides the opportunity to fundamentally change the expectation of what happens next.
The real problem with absenteeism:
Previously employers have been told by GP’s if their staff were fit or unfit. They and their employees have been reluctant to challenge that advice even though there may have been scope for a return in some capacity. Generally efforts have focused attention on employees who appear to stand out due to either excessive repeated short term absence, or to illness that is overwhelmingly serious. The visible twin peaks on the absence iceberg. But like all icebergs the body of the problem is in the short term absence that sits below the waterline.
Current interventions fix only the peaks not the bulk of the iceberg.
Absence management is effective for so long it is consistently applied. And Occupational Health Services can be effective when case managing those employees who are long term absent or seriously ill.
Can anything be done about the bulk of the iceberg? Ask yourself if all these people who are off ill in the UK ran their own businesses, would they stay in bed and stay closed for the entire length of the absence? You know the answer I propose is clearly NO.
Would there be days when they were too ill to work –probably. But critically would they also be capable of working in some capacity during or towards the end of the absence? I put forward that the answer is yes.
The urgent challenge:
Few managers have asked their employees to talk to their GP’s about letting them back to work on part hours or part role or even temporary alternative duties. Most managers find planning and implementing temporary alterations to work a time consuming activity. For many it’s easier to accept an all or nothing approach.
In the new arrangements, whilst the certifying doctor may still advise that a person is not fit, they will also advise on many occasions:
a phased return to work,
amended duties,
altered hours,
workplace adaptations.
The Opportunity:
Intervene early. Change the expectation of what can happen. Make a plan to use every opportunity to get an employee back early into useful work. You may choose to start with cases that hit a three or four week trigger and implement an early return programme. This can use a risk management approach to preparing the way back to work, involving Line Management, HR professionals, Occupational Health, as well as Health and Safety and importantly Staff representation.
There is an urgent need to make savings and this is an opportunity to increase efficiency through better utilisation of the current resources.
You should be able to create an expectation that the employee is expected to try to “keep our shop open” and that they will receive every support from their employer when they do.
The Author:
Dr Noel McElearney is a Consultant Occupational Physician with more that 20 years experience. He holds Fellowships from the Faculties of Occupational Medicine in London and Dublin and a Master’s from the University of London. He has worked for British Airways, The Wellcome Foundation, Marks and Spencer and Scottish and Newcastle before joining Atos Healthcare. Atos Healthcare is the UK’s leading Occupational Health Service provider.
Sources
1. Health and Wellbeing of NHS Staff –A Benefit Evaluation Model Report prepared for the Department of Health as part of the NHS Workforce Health and Wellbeing Review by The Work Foundation, Aston Business School and RAND Europe, June 2009
2. NHS Health and Well Being, The Boorman Review November 2009.
3. NHS staff earnings July-September 2009, The NHS Information Centre January 2010.
4. Sickness Absence Rates in the NHS; October – December 2009, The NHS Information Centre, April 2010