Using rehabilitation services to manage long-term absence
Absence from work cost Britain's employers 17bn in 2009, as the average employee took six days off sick, according to a recent survey of absence and workplace health by the CBI and Pfizer.
Although only 5% of absence spells became long-term, they accounted for 20% of all time lost in the private sector and 36% in the public sector.
When it comes to managing sickness absence, the Health and Safety Executive (HSE) estimates that for every £1 spent on vocational rehabilitation and return to work services, the return is £12. The CBI survey shows that companies are increasingly aware of the benefits of rehabilitation programmes, with 95% of organisations now having a formal absence policy – a rise of 10% compared with 2007. Having said that, there remains some confusion and a lack of understanding among employers around exactly what’s involved in vocational rehabilitation.
What is meant by vocational rehabilitation?
In short, vocational rehabilitation is whatever helps someone with a health problem to stay, return to and remain in work. This definition is important, as often people hold the misconception that rehabilitation is linked only to severe injury. Employers have a key role within this, and according to the Vocational Rehabilitation Task Group "there is strong evidence that proactive company approaches to sickness and the temporary provision of modified work and accommodations are both effective and cost-effective".
Most rehabilitation companies operate independently, providing services to a range of insurers, solicitors and third party administrators. The best rehabilitation service providers bring together medical case managers and vocational consultants to provide expert assessments and treatment advice, as well as managing and negotiating return to work arrangements.
The concept of rehabilitation
Although much long-term absence is as a result of musculoskeletal injuries or mental stress, there are often no straightforward ‘medical’ reasons for the absence. Understanding where there may be conflict at work, a poor fit to the role or general unhappiness — and addressing the root causes of these issues — is also a vitally important part of the rehabilitation process.
In a nutshell, the concept of rehabilitation is founded on early intervention. Once a diagnosis has been made, a medical case manager co-ordinates treatment plans and supports reintegration. The rehabilitation approach is individually-tailored, with the case manager advocating for the individual. It is about managing the best and most effective means to reintegration back to health and employment and, in the majority of cases, ensuring the early and safe return to graduated or full-time employment. In this way, rehabilitation is win-win for both for the employer and employee.
Early intervention is the key to success
Creating a culture in which staff members seek support early on, knowing that the expertise to help them is available, should be the foundation of any rehabilitation management approach. The longer a person is off sick, the less likely they are to ever return to work. Indeed, research from the British Society of Rehabilitation Medicine has found that if an individual has been off work for six months, there is a 50% chance of a return to work. After 12 months, this falls to 25%. Taking early action ensures that short-term issues don’t become long-term problems.
Meeting legal obligations
Rehabilitation professionals can also act on behalf of the employer to ensure they are legally compliant and exercise appropriate duty of care to their employees. So, for example, if an individual on long-term sick leave is classed as disabled under the Disability Discriminations Act, the employer has a legal obligation to ensure that ‘reasonable adjustments’ are made. Similarly, when an individual is injured at work, if their employer demonstrates genuine concern and provides access to independent rehabilitation services, they are less likely to seek compensation further down the line.
The benefits and advantages of using rehabilitation services
Much time, stress and effort can be saved for both the employer and employee when professional rehabilitation services are engaged to manage the process. So, for example, an individual on long-term sick leave is unsure how to navigate round their employer or the medical system, this in turn adds to their stress and pain and generally results in even longer periods away from work. By providing employees and their line managers with access to experts who can provide the correct information and simplify the process, return to work can be faster and much more effective.
At Chartis Medical and Rehabilitation, early and effective medical intervention impacts on average claim costs by over 25%, demonstrating the type of significant cost benefits associated that can be associated with rehabilitation services.
Managing return to work
While the goal is always to get people back to work as quickly as possible, graduated and phased return to work programmes allow individuals to ease back into the role at a level that is right for them. For rehabilitation professionals, an important part of this process is going into work with employees to do their jobs with them and ensure they are truly fit for purpose.
Rehabilitation case study
A warehouse operative, aged 28, on a salary of £15,000 per annum, sustained a hernia while lifting an object at work and immediately went off sick. The employee had been advised that surgery on the NHS would take six months and that they would be unable to work during this time. The Chartis MR case manager, gained appropriate consent from the employee and arranged for the private funding of the surgery. The surgery was organised five weeks later. Medical recommendations and appropriate rehabilitative support helped the employee to return to suitable duties and he did not pursue his claim. Outsourcing the rehabilitation management, including the treatment and return to work plan cost just £3,022, a cost effective solution for both the employer and the employee.
Three top tips for managing long term absence
1. Early intervention – creating the right culture and taking action to address potential issues before they become long-term problems is key.
2. Think outside the box – focus on what people can do, not what they can’t do when it comes to return to work.
3. Use professional rehabilitation services – engaging a third party provides a cost effective solution to managing long term absence and also ensures legal obligations are met.
Melanie Summers is managing director of Chartis Medical and Rehabilitation (Chartis MR) and Chair of British Association of Rehabilitation Companies.