How to tend to the needs of the long-term sick

With economic inactivity due to long-term sickness hitting record levels, HR has a critical role in improving health, wellbeing, talent and business outcomes, writes Dan Cave

The chilly first months of each year are largely soundtracked by coughs, sniffles and noses being blown – but workplace sickness is no mere seasonal issue.

Last August, Office for National Statistics data showed economic inactivity as a result of long-term sickness hit a record high of 2.58 million people, a figure that has risen by 449,000 since the start of the Covid-19 pandemic.

This cohort has caught the government’s attention.

With skills shortages still a top concern, the government is rolling out plans to guide people who are on long-term sick leave, and those with mobility, mental health and chronic illnesses, into work.

Read more: Record numbers fall out of workforce due to long-term sickness

Though there has been much debate on the ethics of this focus, headlines have led on the government’s outside-the-box plans, which include encouraging employers to use running, gardening and singing clubs, as well as coaching and more traditional therapies, to reduce long-term absence.

Novel? Yes. But with many employees signed off with complex health issues – mental health is the top factor in long-term economic inactivity, followed by musculoskeletal issues. Two in five cases of long-term sickness cite five or more health conditions, and there are multiple indicators that the UK’s health is in decline – many employers are now facing up to their responsibilities of better engaging with this group.

To do so empathetically and productively, Gemma Dale, lecturer at Liverpool John Moores University, says that employers need to firstly understand how the design of work (culture, job, ergonomics) interacts with varied health conditions.

She says: “Long-term illness also must be approached differently to short-term illness, a rigid policy won’t necessarily work [to drive a successful return or hire] but a tailored, adaptable approach is key.”

Alongside this flexibility, HR business partner consultant Joanna Pilch says the pillars of good communication, signposting to support such as employee assistance programmes (EAPs), plus cultural elements such as promoting work/life balance and stress reduction are critical in good returns.

She says: “Employers should develop a range of diverse return-to-work strategies, such as phased returns, and also maintain open, transparent communication.”

For Bertrand Stern-Gillet, CEO at Health Assured, this communication must be underway before any return, or throughout a hiring process, and be frequent, consistent and caring to be effective.

He says: “You can ask: ‘How are you doing? Did you manage to walk today? Is your back easing up?’ It varies depending on the condition but this is fundamental [to a successful and quick return].”

Read more: How inclusive communication can revolutionise workplace culture

Stern-Gillet also warns against getting someone back full-time immediately and encourages employers, especially resource-stretched SMEs, to employ novel approaches to managing health.

He adds: “There might be laughs at things like running or singing clubs but these can truly help create a holistic approach to health without the need for huge amounts of HR time.”

Kayleigh Frost, clinical lead at Health Assured, says that lateral thinking can save time and money, and get an employee actively engaged in managing their health, which boosts the business. “HR might not need to turn to occupational health as there are so many tools that often get forgotten about,” she says.

Frost details that these include free resources, such as mental health management tasks from Mind, as well as managers working with returnees to create structures and accommodations that work for them, which have the added benefit of driving transparency and building better connection.

However, Rachel Suff, senior policy advisor at the CIPD, adds that employers shouldn’t just chase low-hanging fruit like mindfulness apps – where there are questions concerning their usefulness – and focus investment on evidenced interventions such as counselling support.

“Employers need to take a systematic approach to supporting health and wellbeing,” she adds, “investing in managers’ capability to discuss health issues with staff.”

Pilch agrees that developing managers to guide difficult conversations about health is a critical part of ensuring that return-to-work schemes are successful, especially as they need to empower individuals.

She says: “Addressing employer responsibilities, empowering employees, and promoting collaboration [between HR and other supporting stakeholders] can create a healthier, more productive workforce.”

It’s how to overcome any lack of skills and the subsequent hit on productivity that Kate Shoesmith, deputy CEO at the REC, says should drive employers towards more pragmatism when it comes to defining the roles that people on long-term sick could fit into.

She suggests that employers need to ask if all desirable skill traits are necessary for success in a role, or if a position could be part-timed or temporarily filled. They could also ask whether enough is being done to show that potential hires/returnees will be cared for.

“Conversely, this approach helps build a better culture and environment for existing staff,” she adds, “as having an unfilled role builds pressure and can exacerbate any health conditions they have.”

It’s this type of culture, Dale says, that is critical in preventing long-term absences in the first instance. While no single wellbeing initiative can prevent sickness or chronic illness, the aggregate impact can foster a culture of care.

Gethin Nadin, chief innovation officer at Benefex, says that a culture of prevention is likely to be more effective going forward as the UK’s health does not seem to be getting better. By the time a long-term absence is occurring, there is already a crisis.

He says: “By offering more health benefits that proactively protect and reduce employee absence, support better mental health and lower stress, we can intervene and improve the wellbeing of those who are most at risk.”

While what an effective preventative programme or health benefit looks like will vary from business to business, Stern-Gillet says training leadership and occupational health on getting comfortable talking about and supporting mental issues is critical.

“This can help the employee feel invested in, that their manager values them, and helps them want to stay working with that manager,” he adds.

Karl Bennett, wellbeing director at Vivup Benefits, argues if HR leads this development and helps to rework the organisational culture, it can create a view of itself as being a function that facilitates healthy dialogue and great work outcomes.

He says: “Businesses have to look at their organisational culture: is it one of open communication? If not, expecting an employee to open their communication with you during long-term absence is unlikely.”

With absences already costing the UK 5% of its GDP, Nadin says employers must get up to speed around chronic illnesses quicker. No magic fix is coming along, and prevention will lead to increased revenue-generation activities.

“Employers tend to focus almost entirely on those employees who are already off sick. But by then we have already missed significant opportunities,” he warns.

It is here that practitioners say HR can play a central role, by choosing the cost-effective and business-suitable interventions and benefits that build an improved culture, something that Bennet believes will be critical to future success.

Promoting a culture of trust will ensure those with sickness will welcome the opportunity of talking with you, knowing that the organisation has their best interests at heart during their pathway back into work,” he says.


For more on this topic, visit the Health and Wellbeing at Work conference, from 12 to 13 March, at the NEC Birmingham. The two-day event is set to include real-life case studies and panel discussions focussed on workplace health and wellbeing. 

This article first appeared in the January/February 2024 print issue of HR magazine.

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