Sick Notes

Sick Notes
How changes in the
workplace and technology
demand a rethink of
absence management
By Ellipse and Professor Cary Cooper, CBE
February 2012
Contents
Foreword p1
Executive summary p2
Glossary of terms p4
IA (Missing in Absence):
M
The problem with current practice p5
I n sickness or in health?
The grey area between absence and working p7
Remote working or not remotely working?
The impact of flexible work conditions p9
A reputation to protect. The effect of
absence management on employer brand p10
Recommendations p12
Appendix p13
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
Foreword
Welcome to Sick Notes, an in depth analysis of the
causes and consequences of mishandled absence and
sickness in UK workplaces. This report comes at a
time when British businesses can ill afford to bear
the burden of either unproductive or overstretched
workforces and marks the launch of InteractPlus,
Ellipse’s new, unique product integrating disability
income protection and absence management.
When we were designing InteractPlus, we were struck by
the sheer volume of literature on absence in the workplace.
At an estimated cost of £32 billion a year
(Absenteeism costing UK business £32 billion a year,
PwC, 2011), it is little wonder that, to date, the debate
has been largely focused on quantifying the financial
impact of absence to UK plc.
But dig a little deeper and there are serious welfare,
management and productivity issues at play. If an
employer can’t reliably say where their people are
and how they are, then they are failing to deal with
the full risks that employee absence and ill health
bring to the workplace.
Employees being absent – legitimately or otherwise –
is hugely disruptive for businesses, especially SMEs.
Yet all too often organisations take a passive approach
to employee wellbeing, particularly where in-house
HR support is limited, as is often the case in smaller
companies.
Unfortunately, many companies’ absence management
processes amount to little more than burying their
heads in the sand with too much bureaucracy, too little
procedure or the lack of any process at all. To that end,
I wanted to better understand the risks of failing to
manage absence adequately and consistently.
Sick Notes
By John Ritchie
CEO, Ellipse
Ellipse invited Professor Cary Cooper CBE, an expert in
organisational psychology, to undertake a piece of research
into the less explored, non-financial issues associated with
absence. He finds unequivocally that the current approach
is not working (in fact one major problem is that there
are so many different approaches used by firms).
Absent employees are getting ‘lost’ in the system, illnesses
are allowed to spiral into chronic conditions and line
managers are burdened with a responsibility they are
often ill-equipped or too ‘time poor’ to handle.
It’s evident that while workplace practices have evolved
significantly in the last decade, in large part due to the
adoption of universal technologies, absence management
has not caught up. This lack of progress frustrates me.
Many people become long-term sick due to factors that
could have been avoided. For employers and employees,
this is causing unnecessary human and financial costs.
And, of course, insurers end up paying out more,
which in turn leads to higher premiums for business.
For me, this is the key point: absence does need to be
actively ‘managed’ and early intervention can improve
people’s health as well as reducing the employer risks
associated with long-term illness.
With advances in technology benefiting so many areas
of work, isn’t it high time organisations embraced it
to benefit staff welfare? Today, capturing absence
information early in order to ensure a better outcome
for employee and employer alike is not only readily
available to companies of all sizes, it is also inexpensive
and likely to provide long-term economies.
I hope our report and the launch of InteractPlus stimulate
fresh thinking around how to reduce the welfare, cultural
and commercial risks of employee illness and goes some
way to helping organisations, big and small, improving
their workplace wellbeing.
How changes in the workplace and technology demand a rethink of absence management
1
Executive summary
For many years, I’ve studied the damaging effects of
sickness absence on individuals and their families, as
well as the huge impact it has on businesses, particularly
smaller firms. Affecting all employers and all but the
very hardiest workers, illness is just a fact of working
life – but it’s not always an inevitability.
Much of it, particularly short-term illnesses that are
allowed to become long-term ones, could be avoided.
The key question for employers, therefore, has to be to
ask what actions could they take to reduce absence,
thereby improving productivity, reducing their costs
and taking better care of their people?
This report examines the cause and effect of sickness
absence, attitudes to absence among employees and
managers and asks why some businesses are more
adversely impacted than others. It also offers advice on
effective absence management.
To inform the analysis, Ellipse commissioned two waves
of research: the first among line managers (who generally
have some responsibility for absence management) in SMEs
and the second among general employees working in SMEs.
In the course of our analysis, clear trends have emerged to
reflect varying degrees of attitudes to absence. We have
coined some new phrases to characterise the different types
of workers and employers in the modern day workplace.
Sick Notes
By Professor Cary Cooper CBE,
Distinguished Professor of Organizational
Psychology and Health at Lancaster University
Many of the results are somewhat surprising, but all help
to paint a much clearer picture of the current approaches
to, and problems with, absence management. What first
struck me is how the changing nature of the workplace –
in particular the relentless march of ‘always on’ technology
– and the current economic environment have combined
to create a serious grey area between the genuine need to take
time off to recover and the implicit pressure to keep working.
For many people, gone are the days when you would
simply phone in sick and sleep off a bout of flu. Today,
we are more a nation of STOICs (Sick Though Often
Inbox Checking), who are neither fully off work nor
fully working, but often doing something in between.
Perhaps due to the prevailing macroeconomic climate
and decreasing job security, the vast majority of people
are still going to work when they’re ill.
(80 per cent)
The Wickie (Working Sickie) is thus a common feature
of the contemporary workplace that most people
will identify with. This is despite the fact that
eight out of ten employers claim to believe that
presenteeism – attending work while sick – is a bad thing.
The pressure to work when ill and failure to address the
condition early on are dangerous and often prove to be a
false economy, contributing in some cases to chronic
medical conditions.
How changes in the workplace and technology demand a rethink of absence management
2
Executive summary
continued
Yet whilst presenteeism is pushing some employees to
the brink, over half of workers still confess to having
‘pulled a sickie’ when they weren’t really ill. Is it any
wonder then that a similar proportion (58 per cent) believe
their line managers view their days off with suspicion?
Perhaps what surprised me the most is that, despite what
many workers believe, line managers claim to be at least
as sympathetic as employees towards illness. Indeed,
they are in fact more understanding of the particularly
sensitive issue of mental illnesses (60 per cent of line
managers compared to 48 per cent of workers).
Given this level of mutual suspicion and ‘false reporting,’
keeping an accurate track of absence can be a real
challenge, one that is not helped by patchy or non-existent
absence management procedures. Our research shows
that the process for managing absence within SMEs
is often confusing, chaotic or poorly thought-out.
58%
Sick Notes
There is a significant amount of variation over how it is
recorded and who is responsible for its management.
With the majority of smaller employers
relying on non-HR personnel to handle sickness, many
managers are required to take on the responsibility
over and above the various demands of their ‘day job.’
(70 per cent)
Aside from the bureaucratic confusion, breakdowns in
communication are also crucial. Passivity, hesitation
and not keeping in touch are real issues in poor absence
management. Due to lack of time, fear of prying or sheer
timidity, absence often goes not only unrecorded, but
potentially overlooked entirely, building up to become
a much bigger problem and cost in the long term.
It is perhaps understandable that organisations are reluctant
to tackle absenteeism head-on as it may force them to
address uncomfortable issues that could come to light as
they investigate the causes behind absence. But managing
it more effectively will significantly benefit businesses,
individuals, the taxpayer and crucially, the economy.
The challenge for employers is to overcome their reserve,
objectively track and treat the problem and ultimately
deepen their understanding of absence in order to tackle
the issue quickly and effectively.
of employees believe
their line managers
view their days off
with suspicion
How changes in the workplace and technology demand a rethink of absence management
3
Glossary of workers and workplaces
We have coined some new catchphrases to help
portray absence in the modern day workplace.
STOIC (Sick Though
Often Inbox Checking)
MIA (Missing
in Absence)
WIMP (Works Ill,
Moans Persistently)
Remote Republic
(flexi-home working –
people working from
outside the workplace)
Wickies (Working Sickies)
SerSkis
(Serial Skivers)
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
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MIA (Missing In Absence)
The problem with current practice
The economic and human wastage that result from
absence are worse than they should be because
employers (and their insurers) find out too late that
employees are going to be off for an extended period
when early intervention could have reduced both the
possibility and duration of long-term absence.
This begs the question, is there is a significant chunk of
MIA workers – Missing in Absence – resulting
from employers who are not recording absence in any
shape or form? Any employer who is not able to cite
their absence rates is failing to control their risks and
may well be neglecting employee welfare.
The root cause is down to a lack of capturing the data
and/or failure to interpret the information in a way
that prompts early, remedial intervention to pre-empt
long-term absence.
The research shows that there is significant variation over
the way employers manage absence. Worryingly, one in
ten (11 per cent) workers claim they either do not know
who is responsible for it or say nobody is responsible.
In such cases, it is unlikely that absence is recorded in
any form, meaning that employers do not have any
gauge on the wellbeing of their people. Equally, workers
will be in a state of confusion over who they should turn
to when they are ill.
Self-reported absence, paper-based processes and patchy
consistency means absences aren’t tracked, managed
or resolved effectively in the majority of organisations,
particularly smaller businesses. While nearly all (90 per
cent) line managers say that a formal procedure exists,
nearly half (41 per cent) admit that they do not follow it.
Burdening ill-equipped line managers
Despite the fact that HR professionals are usually the
people best equipped to record and monitor absence
and take appropriate action – and by this I mean
spotting patterns of sickness so that remedial action
can be taken – line managers spend a lot more time
managing absence than their HR counterparts.
70 per cent of organisations rely on non-HR functions
to deal with it. Half (48 per cent) of workers say that
their line manager is responsible, while in a quarter
(25 per cent) of cases it falls to HR.
Question asked to line managers
If your company has a
formal absence process, to
what extent is it adhered to?
People who don’t
know or don’t
follow it at all
57%
Sick Notes
People follow
it strictly
41%
There is a process but people don’t
necessarily follow it all the time
How changes in the workplace and technology demand a rethink of absence management
2%
5
MIA (Missing In Absence)
The problem with current practice
continued
Almost a half (45 per cent) of line managers report
that the persons responsible for managing absence in
their organisation are either not the best people to deal
with it or are not specifically trained or experienced.
colleague and passing the message on. Sometimes the
process breaks down entirely at the first hurdle and the
message is not communicated to team members at all,
causing confusion.
This is not to say that line managers are in any way
incompetent: on the contrary, many are doing the best
job they can given the constraints.
Then there is the issue of confidentiality and sensitivity,
making it awkward for line managers to ask about
their sick employees’ conditions or suggest remedial
steps such as seeking professional help. This is particularly
acute when it comes to complex conditions like depression.
The point is that line managers are ill-equipped to
manage long-term absence, alone and unstructured –
they should be part of the process, but not critical to it.
Indeed, there are common problems associated with
line managers being responsible for managing absence.
Often they are simply too preoccupied with their
‘day jobs’ to be able to devote any time to it beyond
taking the call (or reading the text) from their sick
In fact, more than half of (59 per cent) workers are not
comfortable discussing personal absence issues with
their line manager and a quarter (24 per cent) say they
simply wouldn’t discuss such issues with anyone at work.
Meanwhile, the majority (54 per cent) say that they would
value an external service to help them recover, suggesting
that using a third party (and, subsequently an objective
service) would help to open up a constructive dialogue.
Question asked to line managers
Do you feel that whoever is responsible for
managing absence in your organisation has
the appropriate expertise to deal with it and
spot potential patterns of illness?
No, they are not
specifically trained in or
have wide experience of
absence management, but
even so they handle it well
16%
55%
No, they are not
specifically trained in or
have wide experience of
absence management and
do not handle it well
3%
3%
Yes, they have the
appropriate expertise in
handling absence
No, I do not feel they
are qualified at all
23%
Yes, they have the
appropriate expertise, but I
do not think they are the best
person to deal with absence
management
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
6
In sickness or in health?
The grey area between absence and working
Employers may be aghast to learn that over half of
workers admit to pulling a sickie when not they are
actually ill. A quarter (26 per cent) have skived at least
twice in the past year.
On the face of it then, it would seem we are only too
happy to take the day off ill. But the reality is much
more complex. Rather than jump to the conclusion that we
are a nation of Serial Skivers (SerSkis) who like to bunk off,
there are many businesses that simply do not pay enough
attention to the work-life balance issues that may be the
root cause of both illegitimate and legitimate days off.
Stressful, long-hours cultures or organisational inefficiencies
can put people under such pressure that they feel like
they are entitled to take a day off, or indeed they dread the
prospect of work so much that they would rather stay at
home. For some employees, they may stay away simply
because they are bored with their job or demotivated.
I’ve frequently seen workplaces where employees ‘choose
to be ill’ on the day of important meetings because they
feel they have been thrown in at the deep end without
the necessary preparation.
In such cases, there are problems in the workplace
which if left ignored will become endemic.
A process that captures absence properly would be
able to spot patterns of absence which may indicate
what is prompting the sickies in the first place.
Sick Notes
Question asked to employees
In the past 12 months,
how many times have
you ‘pulled a sickie?’
12% Once
9% Twice
3% Three times
2% Four times
1% Five times
but I have
29% None
in the past
have never
45% Ipulled
a sickie
How changes in the workplace and technology demand a rethink of absence management
7
In sickness or in health?
The grey area between absence and working
What is a legitimate day off sick?
There is a consensus among both line managers and
employees over the justified reasons to call in sick.
No surprises to learn that flu tops the list as the ‘most
legitimate’ reason to take a day off, with 83 per cent
of workers and 85 per cent of line managers saying so.
Indeed, workers and line managers are fairly united in
their attitudes to different conditions. Around a half of
both sets of respondents say a migraine or a bad back is a
legitimate reason to take the day off, whereas only around
15 per cent say a relationship break up merits a day off.
continued
Mental illness and depression are some of the
most complex and least understood illnesses so it
is encouraging that around a half of workers and a
higher proportion of line managers (60 per cent)
believe depression justifies time off.
Indeed, helping employees tackle mental illness should
be an absolute priority, since it is the leading cause of
long-term absence in the UK (CIPD Annual Survey, 2011).
Research has shown that anxiety and stress – often
aggravated by, or a direct result of, workplace issues
– can spiral into longer periods of absence than even
cancer (CIPD Annual Survey, 2011).
Which of the following do you feel are
legitimate reasons to take time off work?
(LM: 24%)
(LM: 18%)
15%
NEED TO CARE FOR
A DEPENDENT – 56 per cent
(LM: 50%)
(LM: 52%)
INSOMNIA – 19%
Bad back 48%
Employees answers in white and (Line Managers answers in black).
(LM: 85%)
A relationship breakup
49%
Depression
(LM: 61%)
83% Flu
Severe
headache
/migraine
26%
Anxiety
(LM: 33%)
65%
(LM: 64%)
39%
Effects of
alcohol
9%
(LM: 18%)
Being on crutches
(LM: 33%)
Other 5%
(LM: 1%)
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
8
Remote working or
not remotely working?
The impact of technology and flexible work conditions
While new technology has given workers the option of
working on the move or from home and subsequently
blurred the boundaries between absence and presence,
could harnessing the potential of flexible working
conditions form part of the solution to reducing absence?
A significant majority of line managers (70 per cent)
and half of workers think that working at home more
frequently would reduce the hours lost to sickness.
Mainly driven by technology, our patterns of working
have changed significantly in the past decade and
employers today generally adopt an enlightened
approach to flexible working. While we are some
way off becoming a Remote Republic – a nation of
work from home employees – the trend is only likely
to gather pace.
Wickies (Working Sickies)
The enabling nature of technology can, however,
create ambiguity over whether employees should
still be working when they are out of the office.
Many employees feel an obligation either to continue
working from home while ill or to come in to work
despite their sickness and there is strong evidence that
Wickies (Working Sickies) are on the increase: the vast
majority of employees (80 per cent) admit to having
gone to work ill in the past year and most of these have
done it repeatedly.
Sick Notes
Only a quarter (27 per cent) of employees do no work
when they are ill and just recover. Over half (55 per
cent) say they feel guilty about taking a day off sick.
The ubiquity of mobile technology has made staying in
touch almost too easy in some cases, causing people to
feel pressure to keep up with business and respond
even when ill. These STOICs (Sick Though Often Inbox
Checking) may think they are setting a positive example
but the effects can be damaging, both to themselves by
not allowing themselves to switch off and recover (and
thereby potentially creating longer-term health problems)
and to others by setting an ambiguous precedent.
Employers can help to harness the positive effects
of technology by setting out clear guidelines over
working from home where it is practical. People will
be all too familiar with the WIMP (Works Ill, Moans
Persistently), the colleague who comes to work with
a streaming cold and spreads their germs. In such
circumstances, if they feel genuinely well enough to
carry out their day-to-day role, wouldn’t it be better
all round that they stayed at home to work?
How changes in the workplace and technology demand a rethink of absence management
9
A reputation to protect
The effect of absence management on employer brand
At the same time, line managers (80 per cent) are agreed
that absence management affects the organisation’s
ability to attract and retain employees.
In a jobs market where employees place more of a
premium on non-financial benefits and workplace
culture than ever before, a compassionate approach
can help organisations differentiate themselves from
their competitors.
Substantial majorities of workers and line managers
alike say that they believe absence management is an
important factor in the way they view their employer
and its ability to attract / retain talent respectively.
Almost three quarters (72 per cent) of workers say that
the way a company treats sick employees has an impact
on their feelings towards the company. This sentiment is
most keenly felt by younger people, with 85 per cent of
18 to 24 year olds saying it is important, compared with
63 per cent of those over 55. A mere 15 per cent of
employees say it has no impact at all.
This points to the clear conclusion that effective absence
management is highly valued and gaining a reputation
for looking after people will benefit employers in the war
for talent. Increasingly, employees expect their employers
to invest in their wellbeing and it is no longer a ‘nice to
have’, particularly at a time when there is less headroom
to increase salaries.
Employees want to feel confident that that their
employers have their best interests at heart. Businesses
should be seeking to embed wellbeing and absence
management in their culture, regardless of their size,
ambitions or industry.
Question asked to line managers
How much impact does the way
absence is managed have on the
ability of your organisation to
attract and retain people?
61%
23%
Good and fair absence
management creates
employee loyalty and
would help retain staff
Good and fair
absence management
helps attract potential
employees
20%
Sick Notes
I do not feel it has
any impact at all
How changes in the workplace and technology demand a rethink of absence management
10
A reputation to protect
The effect of absence management on employer
continued
Question asked to employees
How much impact does the way your
company treats its employees when
they are off sick have on you and your
colleagues’ feelings about the company?
negligible
impact 13%
a lot 36%
a little 36%
none at all 15%
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
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Recommendations
To tackle absenteeism effectively, the most important thing
employers need to do is to establish a system which allows
them to detect and address the situation early, take
appropriate action and ultimately avoid short-term
absenteeism becoming a long-term problem.
Having a clear picture of who is off and why can help team
leaders to plan efficiently. Armed with the right information,
managers can look at what work is affected, how critical it
really is, and what they need to do to plug the gap.
There is strong evidence that a clear process involving an
automated system to support line managers and HR teams
can instil a level of consistency that can ultimately help
to reduce its incidence and impact.
Having a dedicated team that works with line managers to
deal with absenteeism and other staff-related problems has
the added benefit of relieving line managers of some of the
burden for recording and monitoring absence.
Five steps towards better
absence management
1. Ensure you have a clear and simple procedure
2. Use technology to monitor trends
3. Maintain proactive and positive
contact with the employee
4. Consider external expertise
A few small actions
can make a big
difference to absence
5. Foster a culture of employee engagement
and flexible working
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
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Appendix
About Cary
Cary L. Cooper, CBE, is Distinguished Professor
of Organizational Psychology and Health at Lancaster
University. He is the author/editor of over 120 books
(on occupational stress, women at work and industrial and
organizational psychology), has written over 400 scholarly
articles for academic journals, and is a frequent contributor
to national newspapers, TV and radio.
He has been an adviser to the UN agencies; the World
Health Organisation and the ILO; the EU’s European
Foundation for the Improvement of Living and Work
Conditions and was also the lead scientist to the UK
Government Office for Science on their Foresight
programme on Mental Capital and Well Being (2007-2009).
He is Founding Editor of the Journal of Organizational
Behavior and Editor-in-Chief of the medical journal Stress
& Health. Professor Cooper is also the President of the
Institute of Welfare, President of the British Association
of Counselling and Psychotherapy, President of RELATE,
a national Ambassador of The Samaritans, and a Patron
of Anxiety UK.
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
13
About InteractPlus and Ellipse
InteractPlus
About Ellipse
InteractPlus is Ellipse’s new, unique group income
protection product. It is the first product to combine
income protection cover with an absence management
system, helping ensure illness and disability in the
workplace are actively managed and mitigated.
Ellipse is a specialist group risk insurer offering group
life and group critical illness insurance, as well as
InteractPlus.
During the first stage of launch, InteractPlus is available
to advisers for schemes of up to 300 lives. Later in the
year we will be launching the second phase for schemes
of over 300 lives.
InteractPlus guarantees appropriate, professional
intervention can happen early enough to make a
difference. Early notification and intervention reduces
the cost of short, medium and long-term absence.
Crucially, data about absent employees will be obtained
right from the first day of absence, allowing each absence
to be managed. Where appropriate, medical professionals
will be able to recommend early intervention where it’s
needed allowing people to get the help they need and
get them fit and back to work quicker.
Headquartered in London and led by CEO, John Ritchie,
Ellipse is the trading style of the UK branch of ERGO
Lebensversicherung AG, part of the Munich Re Group.
Registration number:
BR010594.
Registered office:
15 Bermondsey Square, London SE1 3UN.
ERGO Lebensversicherung Aktiengesellschaft is
authorised by BaFin (the German regulator), registration
number 1184 and is subject to limited regulation by the
Financial Services Authority. Details of the extent of
our regulation by the Financial Services Authority are
available upon request.
InteractPlus includes a built-in absence management
service (provided by Absencecare who track and manage
absence notifications) and several specialist medical
providers (who assess referred cases and provide
intervention support and rehabilitation). A trained and
dedicated Ellipse case manager sits at the heart of this
process managing referrals and keeping communications
open between all parties.
Incentivising the early notification of claims, instilling
early intervention triggers and providing personal
advice at the point of support means InteractPlus reduces
the incidence, impact and duration of absence on an
organisation and its people.
As an integrated package, it is more cost-effective for
employers than investing in separate group income
protection and absence management products.
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
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About the research
This report is an in depth analysis of the causes
and consequences of mishandled absence and sickness
in UK workplaces.
Field research was conducted by Opinion Matters
between 250 Line Managers in SME’s employing up to
300 people and 1003 employees of SME’s employing up
to 300 people on 29th November to 6th December 2011.
Both samples were asked 11 questions on their attitudes
to – and awareness of – sickness absence.
For more information
about Ellipse
Please contact either:
Peter Fenner
[email protected];
+44 (0)20 3003 6212
or
MHP Communications
[email protected]
+44 (0)20 3128 8155
Sick Notes
How changes in the workplace and technology demand a rethink of absence management
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