Rehabilitationandsickness-absence management.

What is the current state of knowledge?

  1. The largest randomised controlled pilot from the Department of Work and Pensions (DWP) ever, the Job Retention and Rehabilitation Pilot (JRRP, see literature references ) has provided evidence that several return to work interventions do not improve people returning to work any quicker or them staying in work for any longer compared to no intervention at all. For people who are off work with self reported mental health problems, also including work-related-stress, the rehabilitation efforts tested evenhad a negative effect, making it more difficult for people to return to work than when they did not receive any support at all. Often these types of research suffer from initial delay times in contacting/selecting and engaging with the ill employee. This is one of the key issues that competent and informed about the work place occupational medical advice can help overcome.

    This research provides a persuasive argument for high quality occupational medical advice that aims to remove ambiguity about the reasons for sickness-absence, takes decisions and clarifies responsibilities of the stakeholders involved as soon as possible.

  2. After approximately 6 weeks off work it becomes steadily and quickly more difficult to return to work. After 6 months having been off work the chance of ever returning to work decreases dramatically.

  3. There is little evidence to date that the introduction of the stress management standards has made a measurable impact on the health of the working population or on the reduction of sickness-absence.

How can OHRMS Ltdsupport you?

  1. Our aim is to provide you with high quality and effective policy advice to enable you to set up all relevant health management procedures and processes for your organization. Of course this includes advice on the best available evidence for sickness-absence management.

  2. We currently can offer sickness-absence management clinics for your employees in Aberdeen and Kinross or, after agreement, in your own premises.

  3. We will consult with your organisation how best to arrange a management referral. It is advisable that the manager always shares the exact content of a referral with the employee before the meeting with the occupational health professional takes place.


Further reading: what are the likely consequences of the research findings for the health management in your organisation?

  1. Sickness-absence management should be an integral part of the management of all health matters relevant to the workplace, such as Health & Safety, fitness for work and health surveillance in your organization.

    Buying occupational health advice and support exclusively for sickness-absence management may very well be perceived by employees as a further pressure to reduce sickness-absence by management/HR. Sickness-absence management of individuals, as important as it is, does not always visible impact on workplace health risk management. A singular focus on sickness-absence management, when at the same time employees may perceive the workplace as unsafe and/or to cause ill-health risks, may impact negatively on the relationship between an employee and your occupational health service. Consequently employees and/or line-managers may be less inclined to accept the advice given in occupational health assessments. Such a situation could quickly compromise the usefulness and acceptability of occupational health services.

    Rather than just an advisor regarding sickness-absence management, an occupational health physician should really be used as an advisor regarding all health matters in the workplace. To become effective in such a role suitable integration in the overall health risk management approach of an employer is required. This could for instance include regular workplace assessments, policy input and participation in the organisation's health & Safety committee meetings. In other words, act as a competent advisor as referred to by Regulation 7 of the Management of Health and Safety at Work Regulations.

  2. The JRRP research from the DWP also provides indirect evidence that some low cost types of case management, especially where employees have common mental health challenges, are less effective and could easily become counter-productive. This could cause employees to be off work for longer than necessary.

    In our opinion this provides a strong argument for integrated occupationa health provision where your occupational health/medical advisors are integrated in the overall health (and safety) management systems in your organisation.

  3. Sickness-absence has to be managed pro-actively and quickly.

    In most circumstances it is advisable to start the process of how to return to work within 2 weeks of the sickness-absence occurring. The line-manager plays a critical role in this process. It is vital that managers maintain contact with their employee. The first priority should be to understand the cause(s) of the sickness-absence and to start mapping out a way to address the relevant health issues. This is where competent occupational medical advice can make all the difference.

  4. Nothing is more damaging to a speedy return to work if both the employee and the manager are unsure how best to proceed and uncertainty is allowed to set in. With common mental health problems, such as anxiety and minor depression, it is also key to 'get in'quicklywith support in order to 'get out' quicklywith a successful rehabilitation back to work. Any avoidable delay in opening the discussion with an employee can carry a heavy cost penalty for all concerned down the line.

  5. Effective sickness-absence management requires clear understanding and transparency of the process by all stakeholders.

    Occupational health consultation and advice requires frank and open communication by all stakeholders, giving due regard to the requirements of medical confidentiality, informed consent and access right of the employee to their medical reports. It is therefore important that your organisation has robust and fair policies regarding sickness-absence management in place. It is also important that management provides clear information about the work, organisational requirements and clear questions regarding an individual's return to the work path.
OHRMS Ltd 2012