HR director Vicki Field, with advice from medical director Dr Preethi Daniel, both of London private GP clinic, London Doctors Clinic, discuss the return to work interview questions that employers should be asking their staff
This is an edited version of an article that first appeared on the Business Advice website
The CIPD calculates that absence per head costs £522 per employee, with the average absence being 6.6 days per annum (2017 data). These costs include sick pay for absent employees, but there are also hidden costs which include the cost of cover, reduced performance, the impact on colleagues and missed business opportunities.
Absence has a significant effect on the bottom line of a business, but companies also want healthy and happy employees, who are fully engaged at work. Identifying any potential health issues early, and helping employees to address these, is a good sign of a caring employer; therefore, managing absence is one of the most important aspects of a comprehensive HR strategy.
Managing absence involves three ‘ms’: measuring, monitoring, and managing. These must be done properly in order to reduce the cost of absence within a business.
Return to work interview
The best way to manage absence is to ensure that employees provide as much information as possible. We need to know the level of absence (measurement), we need to analyse the information (monitor) and we need to have targeted strategies at a company and individual basis (management).
This information is captured in a return to work interview, where the manager welcomes the employee back and has a discussion with them about the reason for absence. The interview should ensure a check to see if they are well enough to return to work, and this is the opportunity to discuss any concerns about levels of absence. The interview is generally written up in a form.
Consistency across the company is important and, therefore, a well-written and comprehensive absence management policy is at the heart of a proper approach to managing absence. Such a policy should cover the process and obligations that the employee and manager will follow, and will be clear about the purpose of the return to work interview.
Everyone can get sick, and so the meeting should not be designed to worry the employee about taking time off for genuine sickness. No-one wants a sick employee coughing in the office, and spreading their germs. Fear of taking sick leave can lead to ‘presenteeism’, which can create further issues – either the illness being spread or shared, or higher absence as the person becomes more ill, leading to more time off. It also harbours a sense of the employer being uncaring which can lead to demotivated employees.
What should the interview cover?
The back to work interview should be a non-confrontational meeting to discuss the absence, and should be held on the first day back; this is to ensure that the employee is aware that their absence was noticed, to provide any support to help them return to work, and to identify if there is a wider issue which might need closer attention.
Introducing ‘trigger points’ is a helpful way to identify concerning traits; these can help to shape a specific absence plan conversation. The Bradford Factor is a common trigger tool which pays more attention to the number of absences than the length of absences. However, many companies develop their own such tools to meet their needs such as ‘three separate periods of absence over three months’, or ‘twice being absent on a Friday’.
Once an employee hits a trigger point the manager is able to discuss concerns in the return to interview. As a result, the form you use should be pre-populated with the absences of the employee to date, how many times this year they have been absent and the length of those absences. HR or the manager can then look to see if there are any trends developing.
What trends might we see?
Intermittent and random short-term sickness
In these cases there may be some malingering (unjustified absence), genuine and unconnected illnesses, or an underlying condition. If the latter, studies show that identifying these issues early can lead to the most positive outcome for the employee and the company.
“Often underlying chronic conditions, such as stress might show up as regular, but intermittent absences,” says Dr Daniel. “A medical review can help you identify if there is a chronic condition and give you the tools to manage it most effectively. Low back pain is a common reason for absences at work and any mechanical pain issues, such as low back pain or repetitive strain injuries, need a robust health and safety assessment at work”.
If the absence is malingering, the formalisation of a back to work interview can introduce an element of ‘fear factor’ where the employee realises that the company is measuring and monitoring absence, and that there will be consequences for continuing to take ad hoc days off.
Long-term absence is generally considered to be over four weeks, and requires specific management. It could indicate an illness which constitutes a disability under the Equality Act 2010 which would need to managed in a particular way. Under the Act, the definition of a disability is ‘a physical or mental impairment that has a substantial and long-term negative effect on someone’s ability to do normal daily activities’. ‘Substantial’ is more than minor or trivial and ‘long-term’ means 12 months or more.
Dr Daniel is clear about the need for medical advice. “Long term stress, or a formal diagnosis of anxiety or depression, needs a thorough review of what treatment they’ve had or what is recommended by their medical practitioner on their return to work. As a doctor, I may suggest a patient goes back on reduced hours or a phased return initially to let them settle back in. These can be formalised with a return to work ‘fit note’.
“Furthermore, an operation, and the subsequent recovery, may require employees to return with altered duties – such as avoiding heavy lifting or walking for too long. Medical input is crucial in identifying if the person has a disability, and the employer will be given advice about other reasonable adjustments. Not all long-term absence is related to a disability and, once an employee is considered to be fit to work, the interview gives the manager the opportunity to understand the support that the employee may need to return to work in their previous capacity.”
What return to work interview questions should be asked?
The practice needs to understand the reasons for the absence; encouraging an open dialogue helps to provide more detail about the illness, and fleshes out the data. The more in-depth the information, the easier it is to identify trends, and understand if there is anything that the practice can do to support the employee on their return.
There may be occasions where the employee is uncomfortable about sharing certain information with their manager (eg. discussing breast cancer with a male manager) and, at this point, it’s important they are aware that they can have the meeting with a third party such as HR.
“As a clinician, I often tell patients they do not have to reveal any details unless they want to,” says Dr Daniel. “I give them a comprehensive letter stating the facts, and any adjustments that need to be made. The adjustment could be sitting someone closer to the toilets if they have Crohn’s disease, for example, or allowing employees to snack often if they have diabetes. This often needs to be shared with HR, who are at liberty to request the input of an independent doctor if they wish.”
Managers and HR are not medical experts so having a relationship with an OH provider or doctor can assist with understanding the implications of a specific illness. It is helpful to clarify anything that can or should be done to support the employee back into work, the likelihood of future absence and anything that can be done to reduce the risks of future absence. Discussing these options in the return to work interview sends a positive message to the employee that the practice values them.
There will be times where absence is too high for the practice to tolerate, either because of pressure on other employees, or the costs of the absence, or the impact on business operations. In these cases, in conjunction with the absence policy, a capability policy should be clear on the steps that the practice will take to manage people whose absence becomes unsatisfactory.
The capability policy allows the company to have formal meetings with employees with the objective of encouraging them to reduce their levels of absence. In these instances, it is invaluable to have an occupation health practitioner or a regular GP to ensure this process is robust, and provides the best support for both employee and practice.
Employees should be given a fair amount of time to rectify their behaviour, if possible, bearing in mind some chronic conditions – such as Crohn’s or kidney disease requiring dialysis – are unlikely to improve. If there is no improvement, the outcome can be a fair dismissal.
Measuring, monitoring and managing absence has an impact on the bottom line of the business, and on the well-being and motivation of employees.
Health information is sensitive, and your absence policy should be clear on how data is being held, and how it is shared. Generally, if the practice is reporting on absence statistics, this should be generalised and anonymous; the specific information is only used on a need to know basis within the company.
The Health and Safety Executive has information on return to work interviews and how to keep in contact with employees.