Got a problem with long-term absence staff? Time to call the R-Team

Tenuous references to the infamous Hannibal and B.A. Baracus crew aside…If there were ever a time that HR should call for help, it’s with the complex and sometimes thorny issue of long-term absence. This is an area that needn’t – and arguably shouldn’t – be tackled alone. It’s time to call the Rehabilitation Team.

The good news is that you probably need look no further than your existing group income protection (IP) provider for the introductions, access – and generally funding for - all the experts you need.

Group IP providers are now much more than insurers. In fact, they’re probably more akin to service providers these days, offering a huge range of early intervention and rehabilitation services, as highlighted in a recent article in Cover magazine, readers of which are employee benefit consultants and IFAs.

Whilst some group IP providers prefer to have in-house specialists others, such as Generali, prefer to partner with independent experts in their respective fields. However it’s approached, the overriding goal of supporting employers to manage absence is the same.

Long-term absence management

Stress and acute medical conditions remain the top causes of long-term absence (four weeks or more) followed by mental ill-health (i.e. clinical depression and anxiety), musculoskeletal injuries and back pain, according to the latest Absence Management survey by the Chartered Institute of Personnel and Development (CIPD). Nearly a fifth of respondents included home/family/carer responsibilities among their top five causes of long-term absence. ‘Pulling a sickie’ is less frequently blamed for long-term than short-term absence but, nevertheless, 7% include it among their top five causes of long-term absence for all employees.

The top three approaches used to manage long-term absence, according to the CIPD’s survey, are return-to-work interviews, followed by occupational health involvement and sickness absence information given to line managers.

The 3 steps to success

According to the rehabilitation experts that we spoke to for the purposes of this article – experts that Generali regularly partners with – the three key aspects to managing long-term absence may be summarised very neatly as follows:

  • Focus on early intervention.
  • Work with key partners.
  • Ensure ongoing communication.

1. Focus on early intervention

The reason that long-term absence can become a complex issue is that once a person has been out of work for even a few weeks, secondary symptoms can appear. This then triggers a downward spiral. All rehabilitation experts agree that early intervention is much more cost effective – in terms of the impact on group IP premiums as well as absence duration – and it makes the rehabilitation phase much quicker.

Jessica Bavinton, Founder & Clinical Director of chronic pain and fatigue specialist rehabilitation provider Vitality360, explains that it’s important to take a “biopsychosocial” approach to early intervention and rehabilitation, helping employees as well as employers understand the interaction of biological factors, psychological factors and social factors.

“It’s not unheard of for people to end up losing their homes and maybe even their families following an extensive period of absence. Whilst this is at the extreme end of the spectrum, it’s safe to say that long-term absence triggers a downward spiral. The individual’s lost their role, most – if not all – of their earnings, many of their social connections. It’s not uncommon for people to develop a secondary diagnosis of anxiety and depression that starts only after leaving work. Plus they’re generally less mobile and therefore physically weaker. This leads to other symptoms.

“This cycle is complex and absolutely related to time: as time goes on, it worsens. The cases we get quickly are much more fixable. It might just involve doing things differently and staying at work – perhaps working from home or not coming in during rush hour. The key is to just try to stop people going into that cycle.”

2. Work with key partners

In addition to the ‘triage’ style services offered by in-house and independent Occupational Health specialists, Vocational Rehabilitation Consultants are also often called upon to provide initial and ongoing assessments and tailored programmes.

Alex Freeman, a Vocational Rehabilitation Consultant at Absence Management Solutions, says: “We gain a full understanding from all parties to ensure a good, robust return to work plan is put in place. We’ll advise on any support required from other specialty services and also ensure that the individual’s GP is engaged in the process and fully informed in order to provide a Fit Note.

“We also encourage employers to keep in touch with employees. This helps psychologically. For example, in cases of work-related stress the best thing to do is get back to work quickly before it becomes depression.”

Although some employers might worry that they’re harassing the employee by keeping in touch, if it’s handled sensitively and according to need, the opposite couldn’t be farther from the truth. So says, Dr Julie Denning, Consultant Psychologist at Working Towards Wellbeing, specialists in cancer rehabilitation pathways.

“We spend over 50% of our time in work – more time than with our loved ones – so a return to work is a vital part of getting a life back on track,” she says.

“We take a light tough approach to communications during the treatment phase, talking about what they like doing, what they miss, how they’re sleeping, how relevant work is to them at that point.

“During recovery, we’ll have more contact and answer questions such as how to do I talk to my employer, what does a phased return look like, and what are reasonable adjustments. We might also talk to their employer if the employee wants us to.

“We can provide referrals – in conjunction with the group IP insurer – to CBT and physiotherapy, perhaps acupuncture or career counselling. It depends what the individual needs. But everything is couched in a return to work context.”

3. Ensure ongoing communication

In addition to ensuring that employers keep the lines of communication open, it’s also vital for all parties to listen to the individual. In fact, this may be considered the most important aspect, says Melanie Deer, a Consultant Occupational Therapist, who provides a triage service, working closely with certain group IP providers. This service involves carrying out an assessment of a person’s functional ability to carry out normal activities of daily living, including work, in addition to assisting OH to facilitate a graded return to work.

“We look at how a medical diagnosis impacts on a person’s ability to live and work. You have to look at the whole person, not just the medical diagnosis. There’s more to work than earning money – it’s all about the social interaction too. In my experience, most people want to go back to work and in such instances we’d typically design a graded return to work plan with HR, OH and the individual. The most important thing is that the individual is listened to. And ask your group IP provider for help – they’re genuinely there to help people get back into work.”

Teamwork, talking and timeliness….We love it when a plan comes together.