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Dealing with long-term sickness: advice for small businesses

The best course of action in long-term sickness is early intervention – with professional help. Here are some tips for small business owners and managers


Having a member of staff on long-term sick leave can be bad news for everyone in a company.


Quite apart from the financial implications of having to cover a post, colleagues may become overstretched and end up encountering health problems themselves.


And as for the person who is ill, they can become wracked with guilt for letting the team down – something which can itself hinder the healing process.


In fact, recent research published in the journal Occupational Medicine found that in the case of depression-related illnesses, getting back to work can actually aid recovery.


Clearly, a speedy return is desirable for all – providing the employer is flexible and acts sensitively.


But as New Frontiers managing director Julia Feuell said, if you’re a small or medium-sized business, adjusting your rotas and work patterns can be easier said than done.


“Long-term illness can be difficult for small businesses. If you are a business of four and someone is off long term, that’s 25% of your workforce. However, small companies can find they are far too busy running their business to look at any of the reasons behind the health problems.”


Her views are echoed by Dr Gordon Parker, occupational health consultant and president of the Society of Occupational Medicine, who says while larger organisations are getting better at helping employees with long-term health problems get back to work, smaller and medium-sized employers still struggle.


“The barriers facing smaller employers still include inadequate HR, employment law and occupational health advice. Smaller employers are frightened of getting it wrong and so may choose to do nothing proactive,” said Dr Parker.


This is particularly true when the sick note cites work-related stress as the cause of the absence.


“Managers are uncomfortable about contacting the individual in these circumstances for fear of being accused of harassment, and the situation can go on for months, with an increasingly poor prospect of helping the employee back to work.”


The solution, said Dr Parker, is to have clear policies and procedures that set out the responsibilities of both the employer and employee, and to have early expert intervention by an OH professional.


Online resources can help smaller employers understand the principles of managing absence in a supportive way, including good guidance from the Chartered Institute of Personnel and Development, the Sainsbury Centre for Mental Health and the Shaw Trust.


The government is upping the ante with an £11 million cash injection into NHS Plus, a network of NHS occupational health departments across England which supplies OH services to non-NHS employers.


The investment will fund pilot projects across six areas – London, Bradford, Newcastle, Plymouth, Worcestershire and Liverpool. Services on offer to SMEs will include individual and group-based counselling, alternative therapies and injury rehabilitation. They’ll be offered in partnership with local GPs and some will even be mobile.


The pilots are part of the government’s response to Dame Carol Black’s report for the Department of Work and Pensions, Working for a Healthy Tomorrow, which found that ill health costs the UK £100 billion a year – £40 billion of which is related to mental health.


In the report, Dame Carol called for a new approach to work-related health services, focusing on keeping people healthy at work, targeting people in the early stages of sickness and helping them to return to work after illness.


The initiative has not come a moment too soon for the likes of Dr Parker, who bemoans the fact NHS Plus has been something of a Cinderella service for too long.


“There have been injections of capital funding (to improve NHS Plus) and improved communication and management, but more advertising needs to be done to raise awareness among SMEs,” he said.


“Other providers of occupational health services are raising their profile, and the aim has to be to get all employers – large and small – to think ‘occupational health advice’ early in an employee’s absence, before despair sets in on either side.”





Working for a Healthier Tomorrow: key findings



  • The economic cost of sickness absence is over £100 billion a year, greater than the current annual budget for the NHS.
  • Many smaller organisations tend not to have access to an occupational health scheme.
  • GPs often feel ill-equipped to offer advice to their patients on remaining in or returning to work.
  • The current sickness certificate should be replace by a ‘fit note’ to switch the focus from what people can’t do to what they can do.
  • There is insufficient access to support for patients in the early stages of sickness, including those with mental health conditions.

Download the full report from workingforhealth.gov.uk (pdf)

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