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Overzealous sickness absence policing fails to consider causes of ill-health

I have been researching workforce health and wellbeing for almost 20 years. I have looked at the causes, costs and consequences of sickness absence, presenteeism, patterns and at the trends in workplace health and the management practices likely to improve wellbeing.

During this time, and especially in recent years, I have become concerned by three important issues that continue to receive insufficient attention from employers and policy-makers.

The first is lack of acknowledgement of the size of the problem – along with the likelihood that it will get worse. As UK workers age in the next 20 years or so, their health and wellbeing are likely to deteriorate still further, with almost 20 million developing some kind of chronic or long-term health condition. Despite this hard fact, many employers still fail to consider employee health and wellbeing as part of strategic thinking.

In more enlightened organisations, health and wellbeing ‘strategies’ may be introduced to encourage staff to eat healthily, to take exercise or quit smoking – addressing lifestyle and behavioural issues among employees who want to make changes to their health. However, my abiding concern is that too many employers convince themselves that these practices can have a major impact on employee health – and that they don’t need to be so concerned with prevention, early intervention or rehabilitation.

Second, and linked to this concern, is the stubborn tendency of too many employers to focus on the symptoms of ill-health at work. Absence from work, for many managers, is an aspect of behaviour that has to be controlled through attendance-management policies and practices.

Such policies usually dictate when and how absences should be reported, when return-to-work interviews should be conducted and when absence ‘trigger’ points have been reached. But absence ‘control’ is not enough: over-zealous absence policing may improve the attendance indicators, but it fails to consider the causes or contributing factors of ill-health. These include work organisation, job design and people management.

These factors relate more to the fabric of organisational culture or the style of management being adopted, the approach to managing change or the climate of employee relations. Very few organisations see these as ‘wellbeing’ issues at all, unfortunately.

The third issue is the role of healthcare benefits. I was recently shown the healthcare benefits package of a large employer. It was presented as an impressive part of its health and wellbeing strategy and offered a number of generous benefits to employees and their families, which I am sure were competitive and highly valued. When I asked what impact these benefits had on sickness absence, productivity or customer service, nobody could answer. Indeed, the company didn’t even keep data on sickness absence. It could, however, tell me in detail about the take-up of the subsidised gym membership and how its benefits package compared to its main rivals’. And it occurred to me that, for many employers, healthcare benefits are really about attracting and retaining staff and that it was naïve of me to expect them to have anything much to do with workplace health and wellbeing.

A healthier workforce could bring a range of business, economic and social benefits. Productivity would improve, as would resilience, creativity and customer service. The advantages of investing in the health of the workforce are becoming ever more apparent. And over the next 20 years, the disadvantages of not investing will be ever more difficult to ignore.

Stephen Bevan (pictured) is director of the workforce effectiveness centre at the Work Foundation