Carrot or stick? How are UK employers managing absence?

Blog posts

27 Jun 2019

Stephen Bevan, Head of HR Research Development

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Unless they have been living under a rock for the last decade, most UK employers will have noticed that workforce health has been a priority for government, among business lobby groups, within the HR profession and among providers and conference organisers. The debate about the causes and consequences of stress at work, for example, has been going on for much longer than this. Every employer will also know that sickness absence from work can also have immediate and long-term business consequences, both financially and operationally. Having policies and practices in place to mitigate these challenges make rational business sense, especially if we want to tackle the UK’s productivity challenge. So, in 2019, what do we know about what UK employers are doing each day to manage employee absence and health after a decade which has seen an unprecedented increase in information, guidance, support and resources aimed specifically at helping them to do this better?

Yesterday the Department of Work and Pensions (DWP) released an early summary of a survey of 2,500 UK employers which they have commissioned from Ipsos-Mori. Sickness absence and health in the workplace: Understanding employer behaviour and practice provides some tantalising headline findings which shed light on how employers see their role in managing employee health, the steps they take to manage absence and return to work, their use of external support (such as occupational health) and, importantly, the extent of the differences between large and small employers. While a more detailed analysis of the data and some accompanying qualitative research will be published later in the year, I’ve taken a look through the summary report and have the following initial observations about some of the findings.

First, employers – especially the larger ones – seem to have got the message that looking after the health of the workforce makes business sense and represents good practice. Over 9 in 10 agreed, for example, that there is a link between work and health and that they as employers have some responsibility to encourage employees to be healthy. However, their reasons for holding these views may not be as altruistic as they first appear because compliance with their legal obligations and preserving the organisation’s reputation were the most important reasons given for investing in workforce health.

Second, the gap in practice between large and small and medium employers (SMEs) remains significant. For example, 92 per cent of large employers say they offer access to occupational health (OH) support compared with only 18 per cent of small employers. Similarly, 70 per cent of large employers give employees access to Employee Assistance Programmes (EAPs) or other counselling services compared with 20 per cent of small employers and large employers are more likely than small firms to offer sick pay above the statutory minimum (77 per cent compared with 26 per cent). Clearly, policy makers and providers still have a challenge to engage more small employers in the wellbeing ‘agenda’, given that SME’s employ such a large proportion of the UK workforce.

Third, the survey sheds a fascinating light on a range of employer practices. The most commonly used intervention to prevent workforce health problems is health and safety training (much of which is a legal requirement), cited by 77 per cent of employers, with line manager training and health promotion trailing somewhat with around a quarter of employers using them. The survey also shows a strong reliance on the internet (47 per cent of employers, mainly SMEs) as a source of advice and support to employers when seeking to manage employees with long-term health conditions. With larger employers still preferring to use OH expertise here, it seems that – for SMEs – Google is in danger of displacing OH providers as the information source of choice. This could be a challenge given the wide range of generic advice available on the web and the difficulty for the uninitiated in finding reliable, evidence-based advice.

Fourth, perhaps by design, there is no mention in the report of the relationship between employers and healthcare professionals (HCPs) such as GPs, physiotherapists or psychologists. The survey confirms that mental health and musculoskeletal problems are the most common health problems encountered by employers, but  the advice given by GPs on Fit Notes, or the role of vocational rehabilitation in managing return to work, do not feature in the survey responses. I find this puzzling given the efforts over many years to encourage communication between all of the stakeholders in helping employees to get back to work as soon as possible.

Finally, in an appendix full of tables, I found a couple of statistics which I found especially interesting. When asked which policies employers ‘mostly’ use to manage sickness absence, 58 per cent reported that they have no policies in this area, with 29 per cent saying that they use a sickness absence policy, 20 per cent reporting that they ‘mostly’ use their disciplinary policy and 15 per cent using a ‘wellbeing at work’ policy. When only those employers who report having a policy to manage absence are included in the analysis, the proportion ‘mostly’ using a sickness absence policy rises to 72 per cent but so too does the proportion using their disciplinary policy (49 per cent).

These data suggest that, even after years of research, policy innovation, targeted communication and support aimed at employers and pilot schemes and incentives aimed at getting employers to embrace workplace health, we still find that more employers are using disciplinary procedures to manage absence and employee health than they are using wellbeing policies.

Workforce health is a major priority for the government and IES has been actively involved in conducting research to improve the evidence base to support policy developments in this field. In an announcement this week the government said that it would be consulting on offering small and medium employers a conditional rebate to support those who manage staff on sickness absence and help them get back to work. In the same announcement a ‘right to request’ workplace adjustments was also floated.

This latest survey provides us with a helpful snapshot of how UK employers are managing absence and employee health at a time when absence rates are falling and concern about productivity remain high. The big challenge remains how to engage the large number of SMEs for whom sickness absence may occasionally represent a serious threat to their finances and business survival. As ever, there is a tussle between ‘carrots’ and ‘sticks’ – incentives or tougher measures to ensure compliance with existing legal duties (including the duty of care). Despite some positive news about employer awareness about workforce health and a growing acceptance that they must play a part in managing absence more effectively, the survey results offer a sobering reminder of how much more we have to do to get employers to engage in wellbeing practices which are evidence-based, preventative and effective.

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Any views expressed are those of the author and not necessarily those of the Institute as a whole.