HERTFORDSHIRE COUNTY COUNCIL
EMPLOYEE SICKNESS ABSENCE TOPIC GROUP
Agenda Item No:
MONDAY 14 DECEMBER 2009 AT 9.30 AM
WORKFORCE ISSUES - SICKNESS ABSENCE
Report of: Director of Resources & Performance
Author: Louise Tibbert, Assistant Director HR. Tel: 01992 556653.
4b
Executive Member: - David Lloyd
1.0 Purpose of report
1.1 To consider employee sickness absence issues, which are an average of 7.3 days per employee for 2008/9 (including schools) and an average of 9.9 days per employee (without schools) for 2008/9.
The focus is on HCC departments. Teachers and other staff directly employed by schools, are excluded from the scope of this scrutiny process.
1.2 The scope of Scrutiny is to focus on the following areas as agreed in
September 2009:
1. What are the emerging issues on addressing employee sickness absence levels? (see section 2.0)
2. How well do HCC policies and practices enable good management of absence levels? (see section 3.0)
3. What are the priorities for HCC in continuing to reduce absence due to sickness? (see section 4.0)
4. What lessons can be learned from practice elsewhere? (see section 5.0)
1.3 This report provides a broad base of management information relating to the questions above and seeks to assist scrutiny to address the agreed outcomes:
1. That the causes of sickness absence in the workforce are better understood.
2. That clear strategies are identified to drive down absence levels and associated costs as far as possible.
3. That related policies and practices are fit for purpose and enable line managers to manage absence levels effectively within their teams.
Page 1 of 34
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report

CONTENTS & APPENDICES
Section Contents
2.0 Background
3.0
4.0
What are the emerging issues on addressing employee sickness absence levels?
How well do HCC policies and practices enable good management of absence levels?
What are the priorities for HCC in continuing to reduce 5.0 sickness absence?
What lessons can be learned from elsewhere? 6.0
7.0 Overall conclusion
Appendix 1 HCC Non Schools Key Data
Appendix 2 Average working days lost per employee by department
Appendix 3 Length of absence and working days lost by department
Appendix 4 Sickness absence by age
Appendix 5 Occupational health referrals
Appendix 6 Accident rates
Appendix 7 Costs of sickness absence
Appendix 8 Health and Attendance Policy
Page
3-4
4-7
7-14
15-16
16-18
18-19
20
20
21
22
23
23
24
25-33
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 2 of 34

2.0 Background
2.1 The county council’s absence levels for the year 2008/9 were an average of
9.9 days per employee (if schools staff are included the average reduces to 7.3 days per employee). This is an increase from 7.1 days for 2007/8.
2.2 Overall figures are increasing slightly on the previous year. This may be due to a considerable level of change across the council, which creates uncertainty for employees. This has included the TWWW move programme that concluded in
January 2009, as well as range of local service, system and structure changes.
As the SAP self-service system is being rolled out to managers and employees
(due to complete in 2010), sickness absence reporting and the role of line managers is being highlighted and the logging of absence should improve over time – this will increase the recorded absence levels.
2.3 There are some aspects of sickness absence which are relevant to the age of the workforce. CIPD Absence Management Annual Survey Report 2007 quoted “A report by the Health and Safety Executive (Survey on Workplace
Absence, Sickness and Ill Health 2005) published in 2006 found that public sector organisations had on average a higher proportion of women and older workers compared with the private sector, which was a factor in high public sector absence levels.”
2.4 Key absence data for 2008/9:

9.9 days average per employee for non schools (if schools staff are included the average reduces to 7.3 days per employee).

7,801 is the FTE/ 10,924 headcount

107,722.5 days is the total lost for non schools staff (and 258,890.5 in total with schools)

50.2% (53,410 days) is attributable to long term absence of 20 days or more

18.8% (19,953 days) is attributable to medium term absence of 6-20 days

31% (32,946 days) is attributable to short term absence (1-5 days)

10.6 days was the average number of days taken for females and 8.0 days for males

Full time staff took 9.4 days whilst part time staff took 10.3 days

3.6% (388) of employees have a declared disability in non schools

13.5% (14,531 days) of absence is attributable to ‘stress’, 11.6% (12,524.5 days) for muscular skeletal and 21.4% (23,082 days) for other reasons

87 formal cases for sickness absence were ‘open’ in October 2009 with a further 80 cases of more then 20 days duration being identified in October and November 2009.

116 people returned to work as result of case management intervention

1 person was redeployed for absence reasons

In the year to March 2009
£96,629 of non-care temporary staff costs were attributable to sickness absence cover . This compares to £71,988 in the year to March 08.
Data can be found in Appendices 1 – 4.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 3 of 34

2.5 Absence patterns
2.5.1 Absence rates and patterns are linked to a range of factors and more then one factor may be in play at any one time, e.g. changes to services and jobs, management style, culture at unit or departmental level, type of role, mental and physical demands, personal circumstances and personal health history.
2.5.2 The highest averages levels of absence are in ACS (15.6 days), HBS (13.4 days) and Environment (12.4 days)
– these are often higher is parts of each department, e.g. Care in ACS, Warehouse staff in HBS and Drivers and
Schools Crossing Patrols in Environment. Different factors exist in each area.
2.5.3 Different patterns of absence can be linked to age, e.g. older workers over 45 are more likely to take longer term absence and short to medium term absence is more prevalent amongst those under age 45.
2.5.4 The council’s employment policies relating to retirement age are likely to be contributing to a generally aging workforce (since 2006 there has been no compulsory retirement age) and flexible provisions now support people to work longer.
2.5.5 Absence levels often increase in March when the leave year comes to an end
– this may indicate that people use sick leave inappropriately. There are also specific dates in the year when we see absence increase, e.g. Mondays in
December.
2.5.6 Many HCC front line service posts do require agency staffing cover for sickness to maintain minimum staffing levels and to deliver services to often vulnerable people. Whilst we believe there is a correlation between agency costs and sickness absence, no information to support this is currently available.
3.0 What are the emerging issues on addressing employee sickness absence level?
3.1 The county council is a large and complex organisation. It delivers a very diverse range of services across 5 main departments and with10,924 staff
(excluding those based in schools). There are 1,598 managers (grade M1 and above) and many different cultures across all the service areas. Historically this has meant that sickness absence has been managed differently in each area, although a single policy framework has been in place. The council uses a standard framework of good practice policies and targeted interventions to manage sickness absence levels but this is not always used consistently in parts of the council.
3.2 The reasons for sickness absence are captured and monitored via the reporting regimes in place. This shows an increasing prevalence of stress as a cause of sickness absence. It is the highest reason given for absence, i.e.
13.5% or 14,531 days lost in 2008/9. National and public sector data also shows that stress is the top reason for absence. All sectors cites 43% of short term absence is due to stress. For public services this rises to 69%.
(CIPD
Annual Absence Management Survey 2009). Staff and their General
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 4 of 34

Practit ioners (GPs) use ‘stress’ as a term that can cover a wide range of symptoms. It is difficult to determine whether the stress is related to personal or work issues, of both. The council uses the HSE Stress Standards to identify and manage stress.
3.3 Some staff groups are more prone than others to high levels of absence.
Within HCC this includes care workers in ACS who are on shift patterns and working direct with clients so experience some emotional pressure, Herts
Business Services and County Transport services where the work is often physical (collating orders for schools or loading wheel chairs onto transport) and schools crossing patrols where employees are usually older and working outside in all weathers.
3.4 The 2008 Staff Survey highlighted that highlighted that 32% of staff in HBS strongly agreed that work place stress had a negative impact on their sickness and absence, followed by 28% in ACS and 12% in Corporate Services.
3.5 There is an increasing emphasis on delivering good value and good performance of council services. Managers are now under more pressure than ever to reduce the costs of running services and reducing sickness absence is part of this.
3.6 The pace and volume of organisational change is another key factor. Where change programmes are handled well and staff feel engaged and buy into in the process and respond well to change, then absence levels are less likely to rise . It is difficult to track absence data and link it to changes in services as so many factors are often in play.
3.7 Line managers are key to managing sickness absence levels. They establish the ‘culture’ of their immediate team and evidence shows that where line managers are on top of absence and are clear about expectations as well as offering support to people when they are genuinely sick, then absence levels are likely to not be excessive. Line managers are now becoming clearer about the requirements on them to manage absence, as well as other staffing issues.
Some managers are not always confident to talk to staff about health issues or unacceptable absence, or to take ownership of absence within their team.
Training is provided on handling absence to help address some of the above issues.
3.8
The council’s policy and procedures for managing health and attendance are outlined in section 4.0. These are reviewed frequently (the last review was in
2008) to take account of feedback from line managers, learning from individual cases, best practice and changes legislation, including case law. The emphasis is on monitoring and taking early action flagged by triggers. In addition Herts
HR are working with Departmental Boards and line managers to progress known absence cases more quickly, with a view of getting people back to work, dismissed for excessive absence or re-deployed to a more suitable role. A key element of the policy is the use of return to work interviews (used by 74% of organisations in the 2009 CIPD annual survey).
3.9 The average time off for a case of long term absence is currently 232 days, skewed by some long running and complex cases – this has reduced from 260 days due to increased focus on long term cases. These timescales remain far too long so a fundamental review is starting to look at how timescales can be
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 5 of 34

reduced. These long timescales are not unusual in the public sector, and talking to colleagues in the private sector can often feature there also.
3.10 Delays are caused by a number of factors. Many illnesses need a reasonable time for recovery, e.g. after a major operation. Where a medical condition is ongoing, assessments are made by occupational health and may involve reports from GPs and consultants. These take time and require permission from the employee to release information. Medical advice is important to the decision making process, for example to help managers consider support, light duties or other adaptations. Line managers make decisions supported by HR
– this includes a view about whether the council can reasonably be expected to keep employing someone with extended or repeated absence. This decision making process is now under review, particularly in relation to the council being seen as a ‘business’ and for all concerned (HR, OH and line managers) to understand the costs and impacts of absence for HCC as well as the employee.
3.11 A further cultural factor in the length of absence cases is likely to be the council’s sick pay scheme, which is determined by national negotiations. This provides up to 6 months full pay and six months half pay for people employed for 5 years or more. Coincidentally, a few staff will return to work from extended sick leave at the point where their sick pay reduces or is coming to an end.
Local Government and the public sector generally have more generous sick pay schemes that do the private sector, particularly smaller private sector companies. CIPD research from 2009 found that the public sector are more likely to have a range of good policies, generous sick pay and support mechanisms and good practice, but less likely to use them as robustly as the private sector to dismiss people for excessive absence levels. Some of this culture is probably linked to the front line services provided by the public sector which are often enabling and supportive.
3.12 The Government is proposing a change to GP sick note system to be introduced in 2010. The requirement would be for GPs to issue
‘well or fit’ notes signing people as fit to return to work as opposed to unfit to attend. This is a major concern for employers, including the council, who believe that some staff could be m ore likely to call in sick for longer periods. At present a GP’s sick note is required for absences of more than 7 days, including weekends and public holidays. It will be more important than ever for employers to be more robust in establishing a culture of attendance and in addressing sickness absence when it does occur.
3.12 Conclusion from section 3.0

The causes and management of sickness absence are often not straight forward

Some staff groups are more prone to higher absence due to the nature of the work

Management of sickness absence is challenging, particularly when try to reduce the duration of long term absence

Organisation and unit culture plays a part in the way that absence is managed
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 6 of 34


Line managers are key in reducing absence levels by taking ownership, setting standards and managing absence when it arises.

Proposed changes to the GP sick note system may encourage staff to call in sick and so the HCC approach will need to be more robust in future.
4.0 How well do HCC policies and practices enable good management of absence levels?
4.1
Health and Attendance at Work Policy
4.1.1 Refreshed in 2008, this policy provides the framework for managers to address health and attendance issues in their teams. This includes requirements to log absence where accessible via SAP Manager Self service as soon as it occurs, hold return to work interviews to identify and address any issues, close monitoring of sickness at team level and management of excessive absence
(using definitions for short, 1-5 days, medium, 6-20 days and long term absence, over 20 days).
Ultimately employees whose absence levels do not improve or are not sustainable will be dismissed. In addition to the main
Health and Attendance policy, managers are able to access guidance and toolkits. These include specialist advice on dyslexia, mental health and making reasonable adjustments under the DDA. The Health & Attendance Policy is at
Appendix 8.
4.1.2
The Council’s policy reflects the best practice models recommended by various bodies, including ACAS and the Chartered Institute for Personnel and
Development.
4.1.3 One of the Councils approaches to managing Health and Attendance is to promote the health and well being of County Council employees by the early identification of patterns of absence which may reveal a need for appropriate supportive measures on the part of the manager. The focus is also on maintaining service delivery and minimising disruption whilst providing support to get people back to work as quickly as possible.
4.1.4 Line managers, with employees and the trades unions have a responsibility to work together to promote positive approaches to the management of sickness absence. For example, UNISON, have been increasingly aware of the need to reduce absence levels, not least because it protects others staff from higher workloads. The council has provided some training for UNISON stewards so they are aware of the council’s policies and this proved helpful for individual case discussions.
4.1.5 There continues to be a number of challenging and complex cases, particularly where there are also poor performance or conduct issues. Employees who are being investigated or whose manager has raised issues about performance often find this stressful and can respond by ‘going sick’. The council response is to be supportive but also robust in progressing the case and addressing the issues. In these circumstances the HR Case Management Team agree a
‘case strategy’ with the line manager to ensure that a conclusion to all the issues is reached as quickly as possible.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 7 of 34

4.1.6 Herts HR works closely with service departments to reduce absence levels by close case management and using a number of tools. For example, using management information to identify ‘hot spots, reviewing local understanding of policy and practice, and refreshed training of managers and first line supervisors. Absence workshops have been used in a number of areas, including parts of ACS, to explore the issues with managers and agree some targeted interventions.
4.1.7 Colleagues in Health and Safety as well as occupational health also work with line managers to make sure that the best advice and support is made available and is targeted as necessary. Prevention of sickness as well as clear mechanisms for addressing excess absence levels are key. Examples include: developing clear guidance for referral to occupational health for line managers, information for employees at the point they are referred and close monitoring of response times.
4.1.8 The Disability Discrimination Act (DDA) of 2005 requires the council not to discriminate on the grounds of disability and to provide appropriate support and adaptations to individuals where this is reasonable and practicable. The
Council employs 388 staff in non schools with a self-declared disability. Many staff w ho ‘qualify’ for disability within the meaning of the DDA manage their condition well and have a good attendance record. Others become ill and/or disabled to some degree during employment. Support requirements may change over time or as their illness progresses and managers need to keep this under review.
4.1.9 Mental health issues are starting to appear more frequently, often linked to stress symptoms and/or issues about poor work performance. These cases are more challenging to manage, especially is the employee is very ill and cannot engage properly in discussions about their return to work or future employment options. Occupational health are helping HR staff and line managers to get a better general understanding of the vast range of mental health conditions and how to spot issues developing as well as to take appropriate actions as the illness progresses.
A fifth of employers have reported an increase in mental health problems (CIPD annual survey 2009). Early referral to OH and/or their
GP will help people to get back to work as soon as possible
4.1.10 HertsHR are working in partnership with the Herts disABILITY Network (the council’s employee support group for disabled staff) and Work Solutions to onto promote the resources available to line managers to support disabled employees. This includes a Line Manager’s Guide to Reasonable
Adjustments, other HCC policy's that can support disabled employees, Access to Work funding and Work Solutions, including the Work taster Scheme and
Mentoring Scheme.
4.20 Stress Management
4.2.1 The Health and Safety Executive (HSE) estimates the costs to society of work related stress to be around £4 billion each year, while 13.5 million working days were lost to stress in 2007/08.
4.2.2 Carewell, the council’s Employee Assistance Programme (EAP) delivered by
PPC provides information on the number and reasons for contacts from staff.
During 2009/9 there were 186 significant employment issues in the period, representing 24.3% of all cases, higher than the PPC average of 20.8%. The top issues were work stress, disciplinary action and difficulties with Line
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 8 of 34

Manager. Work Stress represented 47.3% of all employment cases, higher than the PPC average of 31.8%, disciplinary at 12.9% is significantly higher then the PPC average of 5%, and difficulties with line manager at 10.2%, also higher than the PPC average of 8.3%.” ( Carewell - Year 4, Annual Report 01
April 2008 to 30 April 2009).
4.2.3 In November 2004 the Health and Safety Executive (HSE) launched some
Management Standards for Tackling Work-related Stress. The standards support the HSE 10-year revitalising health and safety strategy for the United
Kingdom. The Management Standards represent a set of conditions that reflect high levels of health, well being and organisational performance. They enable employers to identify the gap between your current performance and these conditions.

The County Council has worked, over several years, with the HSE to develop the standards (the CSF pilot) and also as their partners (amongst many others) in assessing how well the standards work in an organisational setting.

The manage ment standards are regarded as ‘best practice’ in helping organisations assess the management arrangements in place to address work place stress. The County Council, as a large employer, is expected to follow the HSE Stress Management Standards to help address the legal requirements.
The HSE will take enforcement action where employers fail to undertake an organisational risk assessment. HSE Inspectors are already using checklists based upon the new Management Standards when assessing how well and employer is managing stress in the work place.
There have been a number of Improvement Notices issued by the HSE for failure to carry out a stress management risk assessments most notably against a health trust.
The HSE can also issue Prohibition Notices and could prosecute the county council for failing to comply with H&S legislation.

Good management of stress could mean that any insurance claims by employees against the county council would be mitigated and costs may be reduced.

The council takes action on stress via:
-
A Stress Management work group in place with H&S/Sermu/HR and
Unison representatives
-
CSF pilot in 2004/5
– Full survey of all staff followed by focus groups and an action plan.
-
Surveys have been carried out in all departments (except HFRS
– which already has an approach based upon the standards in place and CSF as they were part of the pilot). Staff surveys contributed to the overall assessment.
-
Focus groups
– held in several departments.
-
Action plans developed by departments – some specific/some related to recent staff survey
-
ACS running stress awareness sessions for their managers in Nov/Dec
2009
-
HSE have confirmed that HCC have reached level 4 (out of 5) of the organisational stress assessment October 2009.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 9 of 34

4.3 Health and Safety at work
4.3.1 The council monitors accidents including those for council employees and is required to report those for employees who were off work for more than 3 days as a result. Correlation to overall sickness absence rates is not significant.
See Appendix 6.
4.4 Occupational Health
4.4.1 The Occupational Health Unit (OHU) provides a specialist, confidential, independent advisory service to managers and individuals, and HR Teams, on all matters relating to the affect of work on health.
4.4.2 The OHU is a ‘nurse lead’ service with three qualified Occupational Health
Nurses and an additional general nursing post (employed on a 0.6 FTE basis) to lead on health promotion activities. The OHU is based at County Hall and there is also a consulting suite at Apsley from where an OH service is delivered, primarily to staff living or working in the west of the county.
4.4.3 The OHU buys in specialist advice from three contracted Occupational Health
Physicians (OHP) each of whom works one day a week for HCC and provide medical advice and expertise to the nursing staff as well as leading on the provision of opinion and advice for the most complex OH referral cases.
4.4.4 In the last two years the OHU has seen a marked increase not only in the number of referrals being made to the Unit but also, in many instances, the complexity of those cases - many of which require ‘follow-up/review appointments which, in turn, place further demands on the resources available.
The OH team have focused o n reducing ‘wait-time’ to see an OH specialist to a minimum. This sustained effort has meant that ‘wait times’ have fallen from an average 5 weeks in 08/09 to the current position of little more than one week.
This has been achieved by bringing in some additional OH Physician time, but most significantly, by an increase referrals being handled by OH Nursing. See
Appendix 5 . Management Referrals are initiated by Line Managers to cover one or more of the following reasons:

To conduct a medical review of an employee with an unacceptable sickness absence record or if any underlying medical problems are causing sickness absence

To assess and advise where an employee has developed perceived work related symptoms

To assess and advise where an employee is returning to work after a prolonged period of sickness absence

To determine an appropriate plan of action for employees on long-term sickness absence with no foreseeable return to work date - These
Referrals may progress to ill health redeployment or retirement
4.4.5 It is thought that a growing recognition amongst managers of the importance of following the Authority’s Health and Attendance policy (which advocates an early referral to OHU) and a concerted effort by senior managers and HR professionals to get managers to take ownership of managing sickness absence is responsible for this increased volume of activity.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 10 of 34

4.4.6 In addition to dealing with management referrals, the OHU undertake a wide range of other Occupational Health activities. These include:

Clinical assessment of those returning to work following long or short term sickness absence

Advice to management on phased return rehabilitation programme

Adjustments to work environment
 Advice to managers on individuals’ fitness for work through preemployment screening (to ensure employees are placed in a work setting which will not exacerbate any existing health conditions or put at risk other staff or service users)

Work-related health surveillance in certain areas of work within the organisation (e.g. night workers)

Advice on Hepatitis B and immunisation.

Health promotion activity.

Advice about and, on occasions, the organisation of, immunisation (e.g.
Hepatitis B, seasonal “flu jabs”)
4.4.7 The more complex OH management referrals may well require access to the employee’s medical records as well as specific information from the empl oyee’s GP or specialist consultant. In these instances a delay in being able to offer advice and information to managers is inevitable. The potential for significant delays in progressing a case should not be underestimated, particularly when an employees requests sight of whatever a GP / consultant writes (as is their right) before consenting to such information being disclosed to the OHU. It is not unusual for administrative staff in the OHU to be regularly chasing GP’s / consultants for the information which the OHU has requested.
Some GPs require payment before addressing any such request.
4.4.8 The demands on the OHU and the impo rtance of keeping to a minimum’
‘waiting times’ for referrals to be dealt with has limited the resource available to develop a more proactive service where greater emphasis is placed on health promotion, encouraging healthy living and playing a part in reducing the chances of staff going off on long term sickness. Blood pressure checks, for example, have proved popular with staff and there have been many occasions where such checks have flagged up possible health issues and a referral to the
GP has resulted in the employees being prescribed medication to manage a condition which might otherwise have gone undetected until a time where more serious symptoms presented themselves.
4.4.9 The OHU is working with colleagues in the County Transport Service (part of the Environment & Commercial Services dept) to address an issue of relative high sickness absence. A two pronged approach is being adopted. Firstly a more demanding standard of physical health at the point of recruitment and secondly, the possibility of a “fast-track” rehabilitation service where physiotherapy is offered to an employee as a means of early intervention, offering the possibility of a significantly earlier return to work, than having to wait for an NHS appointment. This project is still in it’s infancy but a successful pilot may well lead to this being rolled out to other parts of the organisation where a business case suggested that savings could be gained from this sort of initiative.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 11 of 34

4.5
Active case management
4.5.1 As at 30 October 2009 the Council had 87 formal sickness absence cases that were ‘open’ and being actively supported by the Herts HR Case Management
Team (set up April 2009). In total 213 cases have been handled between
October 2008 and October 2009. There are, of course, many more employees whose absence is being addressed at the initial stages by line managers.

Of the 87 cases currently open 16 are for absences of less than 28 days
(intermittent and concurrent)

69 of the 87 open cases are for absences of 28 days or more.

Of the currently open cases 14 are for men and 73 are for women.

Between January 2008 and March 2009 just 15 non-schools employees have been dismissed. This number is relatively low because some will have resigned or been redeployed into a more suitable role. The vast majority returned to work including some with support such as light duties or reduced hours for short time or with adaptations to their immediate working environment.
 Monitoring now includes length of time a case is ‘open’ which as at October
2009 was 232 days and is increasingly reducing as more focus is placed on timescales. The aim is to shorten the length of time someone is off sick, although this is to some extent due the nature of the illness as well as how well it is managed.
4.6
Work/life Balance
4.6.1 The Co uncil has a suite of work life policies called ‘Balance’ and this includes initiatives to promote good health through exercise, stress management, health monitoring, e.g. for blood pressure, on-site massage, reflexology and Thai Chi.
It also provides voluntary benefits such as negotiated discounts to health care and gym membership. There are a number of ‘Fit for Business’ initiatives as part of the run up to the 2012 Olympics, which include healthy eating, support to stop smoking and fitness. Flexible working, which comes in many forms across the workforce, is popular - 70% of staff work flexibly in one way or another and also allows employees to balance work and home more effectively. There is also a link to reducing sickness absence. The council has special leave policies to encourage staff to ask for this in times of family and other emergencies, rather than taking sick leave as had happened in the past.
4.7
Staff with caring responsibilities
4.7.1 The Council strongly supports staff with caring responsibilities. This includes elder care or an adult with disabilities as well as children. Staff can request flexible working to help balance work and care, take up to an extra 20 days
(unpaid) leave a year and use up to 5 days paid leave for emergencies. This helps the council by retaining skills and providing the balance people need for their own wellbeing and helps to reduce sick leave. Over 18% of employees have now declared formally that they have caring responsibilities (other than for children) – and we estimate that this number will increase significantly as people live longer. The County Council has been recognised through a number of national awards for its work with employers who are Carers.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 12 of 34

4.8
Employee Assistance Programme (Carewell)
4.8.1
The council’s ‘Carewell’ scheme, provided by PPC, allows employees and their immediate families to access 24 hour confidential support and counselling for a range of reasons (including work related stress, drug, alcohol and substance misuse). During 2008/9
‘Carewell’ handled 765 HCC contacts/cases. Of these
186 (24.3%) were employment related. Work stress represented 47.3% of these. At point first contact with Carewell during 2008/9 65 employees were absent from work. By the time the contact ended 25 had retuned to work and
21 had a return to work plan in place. Carewell provides valuable support to employees and supports the reduction of sickness absence levels.
4.8.2 The council also provides other initiatives to support employee well-being.
These include health promotion, e.g. healthy eating, smoking cessation advice, blood pressure checks, fitness promotion via the Fit for Business campaign
(supports 2012 Olympic Programme, healthy eating options in staff restaurants, gym discounts.
4.9
Staff Survey 2008
4.9.1 From the staff survey undertaken in September 2008, almost half the respondents felt their workload was overwhelming and felt under pressure due to work and of those 53% felt this was adversely affecting their performance. It also highlighted that 32% of staff in HBS strongly agreed that work place stress had a negative impact on their sickness and absence, followed by 28% in ACS and 12% in Corporate Services. This was an area of concern and required further investigation and action. Herts HR Business Partners have worked with each departmental service board to agree key issues which included workload and workplace stress and produced a related action plan to address them.
Actions that are being progressed include the development of a stress management toolkit for managers, additional support workers to be appointed to improve workload levels, H&S training for managers to be reviewed to include recognising and managing the signs of stress in the workplace and focus groups to be held to identify the key contributors to stress.
4.10
Redeployment
4.10.1 The Council runs a redeployment register of employees who have been displaced from their own job, including for ill health reasons. This helps the
Council to retain skills and keep people in work more suited to their health issues. Four employees were redeployed due to ill-health between April and
October 2009. Line managers can be reluctant to take on employees whose health has been a problem. Finding the right ‘fit’ for the job in relation to the illness or disability can be challenging but important.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 13 of 34

4.11
Role of line managers/Line Manager Training
4.11.1 Line managers are increasingly aware about their role in managing their teams. This includes monitoring and managing sickness absence.
4.11.2 Line manager training on managing sickness absence is available both at induction stage for new managers and via the Herts. Manager Development programme. In addition workshops and briefings are run in those areas where levels are highest. As at October 2009, 255 managers have attended the Lite
Bite on Managing Health and Attendance and more are planned for December
2009 and January 2010. The emphasis is moving from general information to more skills development.
4.11.3 Management information has been much improved since 2007 and now underpins decision making by line managers at team and individual level. The roll out programme for SAP Manager Self Service (MSS) will be complete for main service areas by March 2010. Those managers already using the system are able to run real time reports to review at their team(s) sickness levels, patterns and attendance.
4.11.4 Departmental Management Boards receive regular reports on a range of workforce information including absence levels and actions are agreed to target areas that are too high. For example, action plans have been developed for reducing sickness absence in County Transport Services and also within
School Crossing Patrols.
Details of the agreed actions can be found at
Appendices 6 and 7.
4.11.5 The Strategic Management Board (SMB) also review sickness absence levels quarterly for all departments.
4.10 Conclusion for section 4.0
 The Council’s Health and Attendance policy provides a good practice framework to manage absence, although practice is not always as robust as it needs to be.

Support from HR and Occupational Health is now refocusing on timescales and finding a better balance between the needs of the council as a business and the needs of employees. Timescales overall need to reduce.
Earlier referral and decision making will assist with this.
 The council’s offers a range of well-being and support initiatives, which help to create a culture of wellness and employee responsibility for their own health. This includes additional support for staff who are carers.

Line managers are increasingly aware of their responsibilities for people management and provided with training to support them in relation to managing sickness absence.

Management information is improving and is becoming more accessible to managers. More active monitoring is increasing which is starting to make a difference to the local culture and action being taken.

Stress and mental health issues are a cause for concern, particularly given the ongoing pace of change in the council and across the public sector.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 14 of 34

5.0 What are the priorities for HCC in continuing to reduce sickness absence?
5.1 The costs of absence for HCC are an average of
£749 per person per year and is a decrease from 2007. ( See Appendix 7) . These costs are to some extent hidden. The real impact is for service delivery whether this is on the front line or in middle or back office functions. Most jobs do not get covered when someone is off sick or on annual leave, although managers will often need to reallocate work to other team members if this proves necessary. This places additional pressures on colleagues. It is key therefore that sickness absence is reduced as far as is possible to ensure that services can deliver what is required of them in a timely fashion and that unnecessary pressure on staff is minimised.
5.2 The average cost of absence for 2008 was £784 per employee per year in the public sector (reduced from £906 for 2007). The private sector average was
£666 for 2008.
5.3 Getting people back to work as soon as possible is also important. The longer people are off work the harder it can be to reintegrate them into a team. They can often lose confidence and may need considerable support and possibly retraining to return to work that may have changed on their absence.
5.4 HR is working with managers in areas with significantly higher absence levels to understand and then address the root causes. These may include job design, work load, style of management and level of commitment felt by employees in the unit as well as some more obvious reasons like aging workforce or physically demanding work.
5.5 HR and Occupational Health processes have improved considerably but there is still more to do in providing systems and advice that offer speedier solutions to often complex issues.
5.6 Stress is the main reason for absence in many UK surveys of employers and remain the single highest reason for absence within the council despite significant action being taken using the HSE stress standards. Mental health issues are also increasing. More needs to be done to address this at line managers and service level with support from HR and OH colleagues, particularly as the council is likely to experience significantly more changes to services going forward.
5.7 Up-skilling line managers remains a priority so that they are increasingly confident to address absence once it has occurred but also to better understand the causes of absence in relation to the workplace and to address these. This is being addressed but needs
5.8 Organisational culture is also are area that needs to be addressed. Boards and line managers are increasingly taking ownership of absence and much more active now in monitoring absence levels and taking action.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 15 of 34

5.9 Conclusion from section 5.0

The cost of absence is a concern, although most of this is in lost productive time as opposed to cover costs.
 Reduce high absence levels in ‘hot spot’ areas through assessment of underlying causes of absence

Increase the recognition of the costs of absence generally, regardless of whether replacement staff are required.

Improve processes and decision making to get people back to work as soon as possible, or to exit them from the organisation if this is not possible.

Line manager training will continue to be important, particularly around stress management as well as handling excessive absence as early as possible.

Address some of the cultural barriers to managing absence effectively, particularly in those areas where absence is highest.
6.0 What lessons can be learned from elsewhere?
6.1 Many local authorities use similar approaches to the council to manage sickness absence. This includes assessing past sickness at the recruitment stage as well as return to work interviews, sickness triggers for formal action, occupational health assessments and warnings to improve. The public sector is more likely to have good practice policies and well-being policies in place than the private sector and the county council uses most of those listed in the CIPD annual survey for 2009.
6.2 38% of employers surveyed by the CIPD (annual survey 2009) are now moving towards more robust management of absence as a way of helping to reduce pay bill costs during a recession. Anecdotally, we are also aware of this from discussion with HR colleagues elsewhere. Employers are now increasingly likely to use absence records as one of factors when considering section for redundancy (40% of organisations use absence records
– CIPD annual survey
2009).
6.3 The HR case management team was set up in April 2009 to really focus on a range pf employee issuers including excessive sickness absence. This approach is helping us to manage issues better through mechanisms like case management strategy meetings and agreements with line managers – these are vital for complex cases that may involve poor performance as well conduct or sickness It is relatively usual to find this sort of separation with HR services in the public sector, although we have found a couple of examples in the private sector. Recent discussions with a private sector HR Director indicated that they struggle with timescales and complex cases as much as we do. The private sector do take more risks and dismiss more quickly with a pay off for cases that may go public via an Employment Tribunal. Their culture is also often far less tolerant of excessive absence. There is no available data to bench mark duration of long term sickness cases.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 16 of 34

6.4 A few councils have used an approach where staff call into a central telephone number when they are sick and speak to a nurse. One of the benefits of this approach is collection of management information for those organisations that do not have robust systems in place. The council has considered this periodically but rejected this approach for a numbers of reasons. Set up and running costs are high, often using a third party provider. Staff should be calling their line managers who can then make immediate decisions about cover or reallocation of work priorities if this is required. Line managers need to make sure that sickness is reported and this is increasingly being captured via SAP selfservice so we get real time information about who is off sick that links automatically into the payroll and HR main SAP system. Another mechanism additional to SAP to capture absence would not be helpful and would an extra layer of reporting complexity.
6.5 We collect benchmark data on a range of indicators from neighbouring County
Councils and use these to assess our progress on reducing absence.
County Council
Essex
Surrey
Hertfordshire
East Sussex
Sickness
(non schools)
10.8
10.6
9.9
9.7
County Council
Hampshire
Buckinghamshire
Oxfordshire
Cambridgeshire
Sickness
(non schools)
9.6
8.8
8.1
7.7
The CBI private sector average for 2008/9 is 5.8 days
The CBI public sector average for 2008/9 is 9.0 days
The CiPD public sector average for 2008/9 is 9.7 days.
IRS Employment Review
– research findings for 2008, published in May 2009:

The average UK absence rate was 3.6% of working time, representing 8.1 days per employee.

The cost averaged £601 per employee, but rose to £1,130 for public sector employees. It is difficult to confirm exactly what this cost included, as many organisations do not collect such information and for those that did the vast majority just included the salary costs of the absent employees. It also differs from the CIPD figures for the public sector. Other costs such as overtime, agency costs, lost performance and productivity are unlikely to have been included.

Absence rates tend to be higher in the public sector (9.8 days) and even more so amongst larger workforces (10.4 days)

Healthcare and other care staff were the occupational group with the highest sickness (12.0 days)
The differences in the average absence and cost of absence between the public and private sectors could be explained by a range of factors. For example, there are more women and older worker in the public sector, different roles like social workers and exposure to more difficult public-facing roles in emotionally charged situations.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 17 of 34

6.5 Conclusions from section 6.0

The county council policies compare favourably to other sectors, although practice may be less robust and inhibited by a public sector culture.

The recent development to a more proactive case management style by HR is starting to make a difference in time taken to resolve cases.

A review of single point of contact for sick employees would not support a business case for adoption of this by the council.

The private sector has generally lower absence levels supported by a different culture and more robust approach to absence management as well a different demographics and job roles.
7.0 Overall Conclusion
7.1 That the causes of sickness absence in the workforce are better understood.
This is supported by:

Management information including reasons for absence

Active stress management across service departments supported by HSE level 4 recognition

Focus on hot spots to understand and take action on root causes of absence
7.2 That clear strategies are identified to drive down absence levels and associated costs as far as possible.
This is supported by:

Action plans in service departments as evidenced by senior management witnesses from ACS, Environment and Commercials Services

More robust case management approaches to find business focussed solutions/outcomes within shorter timescales

A range of well-being initiatives including Carewell, health promotion, Fit for
Business, reduced gym memberships

Training and support for line managers

Increased reporting and monitoring of management information including absence levels as away to identify issues and trends and to take early and appropriate action
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 18 of 34

7.3 That related policies and practices are fit for purpose and enable line managers to manage absence levels effectively within their teams.
This is supported by:

The Health and Attendance and related policies demonstrate good practice

Absence is within average levels for the public sector but not as low as the private sector

Use of these by line managers and some HR staff needs to be more robust

Management information increasingly more available to line managers via their PCs - they need to use this more to help with decision making about individuals

The occupational health unit is focused on reducing timescales and has already reduced appointment waiting times.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 19 of 34

APPENDIX ONE: Overview of the existing workforce and absence levels
Key Data for the year to March 2009 (2008/9) – all excluding schools:-

Headcount is 10,924 in non schools (7,801 equivalent whole time (EWT))

71.7% of the workforce is female

48.7% of employees work part-time

3.8% of non schools staff are aged under 25.

22.8% of non schools staff are aged over 55.

3.6% of employees declare a disability

8.5% of employees are from black and minority ethnic backgrounds.

9.9 days are lost per employee for sickness absence
APPENDIX TWO: HCC Average Working Days Lost Per Employee
HCC average working days lost per employee for the year to March 2009
10.5
Statutory Services
9.9
Herts Catering
HBS
8.6
13.4
CBI private sector average 5.8 days
Fire and Rescue
Environment
12.4
Ave days lost all
HCC is 7.3 days
6.2
CSF - Schools
7.4
CSF - Non-Schools
CSF - Libraries
8.5
CBI public sector average 9.0 days
CiPD public sector average 9.8 days
6.5
Corporate Services
15.6
Adult Care Services
0 2 4 6 8 10 12 14 16
There are pockets of higher absence that are skewing the overall figures for the council. ACS, HBS and environment remain high for 2008/9. All these areas employ people on care work, shift work and or in unskilled or semi skilled roles. These tend to be the areas where absence levels are higher.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 20 of 34

APPENDIX THREE: Average Days and Length of Absence by Department
Average Days Absence
Departments
%
Short
Term
1
– 5 days
%
Medium
Term
6 - 20 days
%
Long
Term
> 20 days
Average Days Average Days
Lost (year to Lost (year to
March 09)
All days
August 09)
All days
Adult Care Services
Corporate Services
CSF - Libraries
CSF - Non-Schools
Environment
Fire and Rescue
29.1% 

41.9% 

36.0% 

29.3% 

23.3% 

**31.1% 

HBS 29.0% -

Hertfordshire Catering 38.1% 
Statutory Services

16.4% 
18.4% 

22.1% 

16.9% 

18.6% 

15.9% 

**24.7% 

13.1% 

19.5% 

14.4% 
52.5% 

36.0% 

47.1% 

52.0% 

60.8% 

**44.2% 

57.9% 

42.3% 

69.2% 
15.6 
6.5


8.5 

7.4 -
12.4 

**8.6 

13.4 -

9.9 

10.5 

6.2
9.9


CSF - Schools
Total HCC exc Schs
43.2% 
31.0% 
21.1% 
18.8% 
35.6% 
50.2% 
TOTAL FOR ALL HCC 38.1%  20.1%  41.8%  7.3  7.1 
** These figures are based on SAP absence data only.
Increase/decrease indicators (  ) show comparison of this month's information with the previous month.
The majority of departments have seen a decrease in the five months since March 09 with Libraries being the only department seeing an increase. The total for HCC non schools has dropped from 9.9 days to 9.7 days and the total when schools are included has reduced to 7.1 days.
15.6 -

6.0 
8.8 

7.4 -
11.8 

**8.6 -

10.7 

9.8
8.2




5.9
9.7


My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 21 of 34

APPENDIX FOUR: Sickness Absence and Age
HCC Non-Schools Average Days Sickness per Employee by Age & Gender for year to March 2009
16.0
14.0
12.0
10.0
8.0
6.0
4.0
2.0
0.0
<
20
20
-
24
25
-
29
30
-
34
35
-
39
40
-
44
45
-
49
50
-
54
55
-
59
60
-
64
65
-
69
70
-
74
75
-
79
To ta l
Male Female Non Schools
Our workforce data shows that:

Sickness absence levels increase with age, the highest being between 60 and 64.
 Employees over 55 years of age have 1.5 more days’ sickness than the
HCC average.

Sickness levels drop from the age of 65 and over

Short Medium term absence is more prevalent amongst those under 45.

Long term absence is more common amongst older workers.
This pattern of sickness absence may be relevant to employment policy and practice relating to older workers and will need to be considered. Flexible employment and retirement options may be particularly beneficial
Benchmark data from Buckinghamshire for 2007/8 shows broadly similar patterns overall.
Council
Total
Days
Lost 16 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 & over
Hertfordshire 109737.5 3.25% 15.27% 27.89% 31.08% 20.31% 2.19%
Buckinghamshire 28371.5 4.03% 15.16% 25.02% 29.44% 24.89% 1.47%
Difference 81366 -0.78% 0.11% 2.87% 1.64% -4.58% 0.72%
Please note: The above figures exclude 'Claims based' employees, and Agency workers.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 22 of 34

APPENDIX 5: Analysis of Occupational Health referrals by department /service area 2008/9
Referrals by Dept. / service area
ACS
CSF Libraries
CSF Non Schools
CSF Schools
CSF Youth Services
Corproate Services
Statutory Services
Trading Standards
Environment
HBS
Herts Catering
120
100
80
60
40
20
0
APPENDIX 6: Accidents and incidents which result in sickness absence.
Health and Safety legislation (specifically the Reporting of Injuries, Diseases and
Dangerous Occurrences Regulations 1995) require an employer to report to the
Health and Safety Executive (HSE) any incident or accident taking place at work which causes an employee to be off work for more than three consecutive days.
Figures for HCC for the last five quarters are reported below but relate mainly to schools.
Schools
Others
Q2 Jul-Sep Q3 Oct-Dec
08/09
Q4 Jan-Mar Q1 Apr-Jun
09/10
Q2 Jul-Sep
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 23 of 34

Appendix 7: Cost of Sickness Absence
Department
Adult Care Services
Corporate Services
CSF - Libraries
CSF - non-schools
Environment
Fire and Rescue
HBS (Excl Catering)
Herts Catering
Statutory Services
Average
Headcount
2037
831
773
3326
878
985
258
1445
108
Total Cumulative
Sickness costs
Average
Sick cost per employee
(£) (£)
£2,430,781.41 £1,193.31
£569,875.05 £685.77
£333,774.18 £431.79
£2,504,947.07
£659,349.53
£885,092.15
£753.14
£750.97
£898.57
£237,989.99
£349,948.57
£93,871.13
£922.44
£242.18
£869.18
Non Schools Total 10641 £8,065,629.08 £758
Non Schools Total
Department
Adult Care Services
Corporate Services
CSF - Libraries
CSF - non-schools
Environment
Fire and Rescue
HBS (Excl Catering)
Herts Catering
Statutory Services
Average
Headcount
1957
1012
779
3503
843
1005
229
1480
108
Total Cumulative
Sickness costs
Average
Sick cost per employee
(£) (£)
£2,202,320.36 £1,125.36
£736,422.99 £727.69
£391,391.67 £502.43
£2,545,723.10
£612,898.85
£726.73
£727.04
£1,029,262.81 £1,024.14
£211,832.78 £925.03
£358,778.09
£95,935.03
£242.42
£888.29
10924 £8,184,565.69 £749
% Sick cost of
Cum.
Actual Sal costs
4.5%
1.9%
3.1%
2.6%
2.9%
3.4%
3.6%
3.0%
3.7%
3.0%
4.5%
1.8%
2.7%
2.8%
3.1%
3.0%
3.5%
3.5%
3.8%
3.1%
% Sick cost of
Cum.
Actual Sal costs
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 24 of 34

APPENDIX 8: Health & Attendance Policy (Jul 08)
This document at a glance:
Introduction
Principles
1. Notification and Certification of Sickness Absence
2. Monitoring and Recording Sickness Absence
3. Returning to Work
4. Maintaining Contact
5. Unauthorised Absence
6. Frequent Short Term Sickness
7. Long Term Sickness Absence
8. Capability Review Hearing
9. Retirement Options
Introduction
Whilst recognising that employees may be prevented from attending work through ill health, the County Council has a responsibility to maintain service delivery and minimise disruption. The County Council is therefore committed to managing sickness absence and believes that it is the responsibility of the managers, employees and union representatives to work together to promote positive approaches to the management of sickness absence.
The primary focus of the County Council ’s approach to managing Health and
Attendance is to promote the health and well being of County Council employees by the early identification of patterns of absence which may reveal a need for appropriate supportive measures on the part of the manager.
The idea of a positive attendance culture is supported by the County Council
’s
Balance strategy. This provides details about the County Council
’s approach to supporting employee well-being by encouraging and assisting individuals in the achievement of a healthy work-life balance.
Scope
This policy applies to all County Council employees except for staff employed by
School Governing Bodies and Local Authority Fire Brigades (Grey Book) for whom separate policies exist.
Principles

Good attendance is valued and all opportunities should be taken to acknowledge and recognise good attendance.

Establish an attendance culture where sickness absence is recognised as a serious issue which will be addressed.

Reasonable adjustments will be made as appropriate to take account of any disability of an employee in accordance with the Disability Discrimination Act.

Open communication between managers and employees.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 25 of 34

Notification and Certification of Sickness Absence
Employees must notify their line manager or other appropriate person if they are absent from work due to illness, injury or any other health problem as early as possible on the first day of absence. The employee must also confirm when the sickness started, how long they expect to be away from work and the reason they are sick. In exceptional circumstances, if the employee is too ill to notify their absence themselves then they can arrange for someone to do this on their behalf.
Employees must keep their line managers up to date if the reason for the absence changes or if the absence lasts longer than originally stated.
If the sickness absence lasts longer than 7 calendar days (including weekends and public holidays) then the employee will need to provide a doctor
’s certificate which the employee should immediately send to their manager to confirm the reason and length of absence.
If the absence continues beyond 7 calendar days then the employee must keep their manager informed of the progress of their illness and obtain doctor
’s certificates to cover every day of sickness (from day 8). In cases of continuing absence these should be consecutive. Employees must forward doctor ’s certificates immediately to their line manager who in turn will forward these onto HR Transactions.
Every absence must be certified and recorded to ensure correct payment of sick pay and to ensure that accurate records are maintained. Failure to comply with the certification and reporting procedures may result in loss of sick pay. Misleading or false statements may be dealt with under the HCC ’s disciplinary procedure.
If an employee is absent from work through sickness they must refrain from working elsewhere.
Monitoring and Recording Sickness Absence
All sickness absence must be correctly recorded on HCC ’s SAP Payroll system. The information will be used to produce absence statistics, to monitor the success of
HCC
’s Absence Strategy and to enable employees to be paid correctly.
Each manager is required to monitor sickness absence levels within their team and take further action as necessary when trigger points are reached and/or where there are concerns about an employees absence levels. Managers will receive trigger reports from Herts HR and should take immediate action. Managers must check individuals records at all return to work meetings to ensure that appropriate action is taken.
Returning to Work
Upon return to work following every period of sickness absence the line manager should arrange to meet privately, in an appropriate place, with the employee to conduct a return to work interview. This should ideally happen on the first day back.
Further guidance on carrying out return to work interviews can be found in the
Manager ’s Toolkit.
A record of the meeting must be made on the HCC Self Certification Sickness
Absence and Return to Work Meeting Form and a copy should be sent to Herts HR
Transaction Team to be placed on the employee ’s personal record file. The original should be kept locally by the manager, in a confidential place. A copy should be given to the employee.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 26 of 34

Maintaining Contact
When an employee is absent from work due to sickness it is important that regular contact is maintained between the manager and employee in order to ensure that the employee does not feel isolated, vulnerable or out of touch. The manager may need to reallocate work so that service delivery is maintained. The contact should be handled sensitively and the form of the contact should be agreed with the employee as appropriate. As a minimum the employee should keep their line manager informed throughout the period of absence, on at least a weekly basis. It may be necessary, particularly in cases of long term sickness absence, to arrange to visit the employee at home, if the employee is in agreement. Further guidance on maintaining contact can be found in the Manager ’s Toolkit.
Unauthorised Absence
It is the employee
’s responsibility to make sure they let their manager know at the earliest opportunity if they are unable to report for work and the reasons why.
However where an employee fails to report for work, without informing their line manager, it is important that the situation is investigated and the employee given an opportunity to explain. On the first day of absence the manager should make enquiries of colleagues to try and establish the reason for the absence. Failing this, all reasonable efforts should be made to get in contact with the employee to ask for an explanation for their non attendance. If contact cannot be made please refer to the unauthorised absence policy. If the employee gives their reason as sickness they should be reminded of the sickness reporting procedure and advised, if appropriate, that failure to follow the correct reporting procedures could result in disciplinary action being taken under the County Council
’s Disciplinary Procedure. Discussions with the employee regarding unauthorised absence should be documented in writing and placed on the employee ’s personal record file.
Frequent Short Term Sickness
An employees sickness absence levels should be reviewed when one of the following trigger points is reached or earlier if appropriate:

Three or more instances of absence in any six-month period; or

When an individual accumulates ten or more calendar days absence within any six month period; or

When an absence appears to have a recurring recognisable pattern, for example frequent absenteeism around a weekend.
The manager should consider the trigger points above and if it is felt that there is a potential problem they should convene a 1st Health Review meeting with the employee. In cases where the absence has become a concern the return to work interview will be considered to be the 1st Health Review Meeting.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 27 of 34

The aim of the Health Review meeting is to:

Discuss the absence record.

Explore the reasons for the absence and enable the County Council to have an up-to-date understanding of the latest medical situation and prognosis.

Confirm the expectation of an improvement in attendance.

Identify areas for support.

Discuss the need for a risk assessment.

Consider whether there are any reasonable adjustments which could be made with regard to the employee ’s work.

Set appropriate targets for improvements and an appropriate review period.

Discuss the effect of past and future absences on the organisation.

Please refer to the Manager
’s Toolkit for further guidance on carrying out Health
Review meetings.
The following outcomes may apply:

Advice may be sought from the Occupational Health Unit. Please refer to the
Occupational Health Toolkit.

Other support mechanisms may be identified and implemented. See the Managers toolkit and Guide to Managing Specific Cases.

Reasonable adjustments such as changes in workload, work practices or work patterns may be identified.

A further Health Review Meeting may be arranged to review progress.
The manager should write to the employee within 5 working days of the Health
Review Meeting, confirming the points discussed and actions identified. The employee will be informed of the improvements needed in their attendance and warned of the possible consequences if this is not achieved. A template letter is in
Letters Toolkit.
An appropriate monitoring period should be set between Health Review meetings. If at the end of this period of review the employee has reached a sustained acceptable level of improvement, monitoring should revert back to informal arrangements with return to work meetings occurring in the event of further absences. Where there is no improvement in attendance, a further Health Review meeting should be convened.
The manager should write to the employee to invite them to a second or subsequent
Health Review meeting, giving them at least 5 working days ’ notice and informing them of their right to be accompanied by a trade union representative or work colleague. Managers should seek advice from their Herts HR Business Partner Team before convening a Health Review Meeting. See Letters toolkit for example Letter.
This meeting will reaffirm the issues discussed at the previous Health Review meeting and the same outcomes may apply however the manager (With delegated authority to issue warnings) can issue a first written warning at this 2nd meeting. See guidance in the manager’s toolkit on issuing warnings.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 28 of 34

The manager must write to the employee within 5 working days of the health review meeting confirming the points discussed and actions identified and of the improvements needed in their attendance and warned of the possible consequences if this is not achieved. The letter should also include details of any warning issued, along with the employee
’s right to appeal. An appropriate review period should be set.
A template letter is attached in Letters, Forms and Templates Toolkit.
If there is still no improvement in absence levels by the end of the next review period then a third and final Health Review meeting will be convened. At this meeting the manager (with delegated authority to issue warnings) will be able to issue a final written warning .
Ultimately if there is still no improvement in attendance the manager will need to consider the employees employment position. Where two formal warnings have been issued and these have resulted in no sustained improvement in the employee ’s attendance then a Capability Review Hearing should be convened.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 29 of 34

Long Term Sickness Absence
Long term sickness absence occurs when an employee is absent for a continuous period of at least 28 calendar days.
Early referral to Occupational Health is important. Employees with stress or other mental health problems and individuals with musculoskeletal disorders should be referred to Occupational Health Unit within the first two weeks of the absence because of the likelihood that these conditions will either be recurrent or develop into long term health problems.
A first Review Meeting, with the employee, will be arranged by the manager if the employee absence levels have met the 28 day trigger or sooner if appropriate. The employee is entitled to be accompanied by a work colleague or trade union representative. The manager should confirm the invitation to the meeting in writing giving the employee at least 5 working days
’ notice. See Letters, Forms and
Templates Toolkit . If the employee is unable to attend a meeting in the workplace then it may be appropriate to hold the meeting at the employee ’s home or other mutually agreed location. The Manager
’s Toolkit contains further guidance on holding a Long Term Health Review Meeting.
Where it is expected the absence will be ongoing, advice should be sought from the
Occupational Health Unit. The purpose of gaining Occupational Health advice will be to provide an indication of the likely duration of the employee ’s absence, recovery period and whether any steps can be taken to help the employee make a successful return to work. See Occupational Health Toolkit for further advice on referrals.
Please refer to the Guide to Managing Specific Cases toolkit for further support on specific cases for guidance on different illnesses such as disability related ill health or stress.
Depending on advice received from the Occupational Health Unit, managers with the advice of their Herts HR Business Partner team, if necessary, may agree one or more of the following options:-

Continue to Monitor

Manager to keep in contact with the individual to consult and consider arrangements for their return.

Return to Work on Normal Full Duties

When an employee ’s GP or the Occupational Health Unit states that the employee is fully fit to return to work. The Manager must arrange a return to work meeting with the employee. Please see the Manager
’s Toolkit for further guidance on the return to work interview.

Rehabilitation

An employee may be experiencing difficulties in undertaking the full range of tasks or coping with the work situation and in these cases managers and Herts HR
Business Partner Team should consider whether there are any ways the employee can return to their current job and whether any adjustments may be required. These could include; Phased Returns/modified duties, Reduced or changes in hours or changes in work practices. Please refer to the Managers
Toolkit
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 30 of 34


Redeployment

Suitable alternative positions may be considered where appropriate, although the
County Council will not be obliged to create new positions for this purpose.
See the County County's policy on Redeployment.

Investigation into whether employee may be eligible for ill health retirement Please refer to Section 10.
A Case Review Meeting may be held before agreeing future actions. This meeting should be attended by the employee ’s line manager, Herts HR and Occupational
Health.
Referral to a Capability Hearing for long term absence should take place when advice from Occupational Health has been received and taken into account, all reasonable options for support and individual adjustments to the work place have been considered and appropriate action taken and where ill health redeployment is being actively considered. Please refer to Section 8.
In very exceptional circumstances where an employee has exhausted their entitlement to sick leave on either half or full pay then an extension may be authorised by the Director of People and Property on the recommendation of the department.
The manager should consider before making a recommendation whether the extension by relieving anxiety would materially assist a recovery of health and return to work and whether all available information indicates that the employee will recover fully and return to work. Any recommendations should be made through the Herts HR
Business Partner Team.
Capability Review Hearing
Where there are continuing concerns regarding short term absences and a final written warning has been given, or in the case of long term absence options to enable the employee to remain in their current employment have been unsuccessful or are inappropriate, the employee will be asked to attend a Capability Review Hearing. See the Manager
’s Toolkit for further guidance on convening a Capability Review Hearing.
Once a decision is reached to refer to a capability hearing, a management statement of case should be drawn up.
The purpose of the Capability Review Hearing will be to consider whether there are any further actions that the County Council can take to assist the employee in continuing their employment or whether employment should be terminated due to the employee ’s inability to undertake their duties effectively because of their absence.
The Capability Review Hearing should be convened by a senior manager with authority to dismiss. The employee must be given 10 calendar days ’ notice in writing of the date of the hearing and should be advised that they have the right to be represented by a trade union representative or work colleague. The employee must also receive a copy of the management statement of case with this letter. See letters toolkit for template letter .
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 31 of 34

The Capability Review Hearing may result in one of the following outcomes:

Further support with a date set for review

Dismissal

Ill Health Retirement or Compassionate Retirement
The employee will be informed of the decision in person and also in writing within 3 working days of the hearing. See Letters toolkit for termination letter.
If there is medical evidence that an employee is no longer fit to fulfil the requirements of the job, HCC reserves the right to terminate employment before the expiry of contractual sick pay.
Where decisions have been made to terminate employment on the grounds of ill health the employee has the right to appeal against the decision. This should be in writing within 10 working days to their Director.
Retirement Options
Decisions regarding whether a member of the pension scheme is eligible for benefits are entirely separate from HCC's decision regarding the employee's future employment. The Local Government Pension Scheme requires employers to obtain a certificate from an independent Occupational Health Physician before making decisions on pension benefits. Please see ill health retirement flowchart for further guidance.
Centrally employed teachers should refer to the Teachers Pension Scheme. www.teacherspensions.co.uk
There are three tiers of ill health retirement benefit under which, if a member's employment is terminated because of permanent ill health and the member has at least three months membership, the pension payable is based on the person's accrued membership plus:

Top Tier - 100% of prospective membership between leaving and age 65 where the member has no reasonable prospect of being capable of obtaining gainful employment before age 65, or

Middle Tier - 25% of prospective membership between leaving and age 65 where the member is unlikely to be capable of obtaining gainful employment within a reasonable period of time but is likely to able to be capable of obtaining gainful employment before age 65, or

Third Tier - An employee who leaves local government employment as a 3rd tier member will be entitled to their accrued benefits payable for such time as the member does not obtain gainful employment.
In addition there is a HCC discretionary Compassionate Retirement where in certain circumstances the dismissal may be undertaken as retirement on compassionate grounds. See HCC's policy on Compassionate Retirement for further guidance.
If the member is unhappy with any decision concerning their pension they can appeal under the Internal Disputes Resolution Procedure. The release of pensions on the grounds of compassionate retirement is a discretionary decision and there is no right of appeal.
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 32 of 34

Managers Toolkit

Dyslexia Self Assessment Checklist

Dyslexia Procedure Flow Chart

Guide to Dyslexia

Managers FAQ

Stress Policy Toolkit

Stress Policy

Guide on Risk Assessments

Long Term Sickness Flow Chart

Short Term Sickness Flowchart

Guide to three tier Ill Health Retirement

Guide to Managing Specific Cases

Managers Toolkit
Seeking Medical Advice - Occupational Health Toolkit
Please send the completed AMRA form together with the management refferal form to the Occupational Health Unit. It speeds up the process and avoids delays in seeking medical advice.

Night Workers Questionnaire 07

Night Workers Letter

AMRA Form

Occupational health Unit - Referral Form

Dyslexia Self Assessment Checklist

Dyslexia Procedure Flow Chart

AMRA FAQ

Guide to Dyslexia

Occupational Health Toolkit
My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 33 of 34

My docs/Scrutiny/sickness absence scrutiny 14 Dec- report
Page 34 of 34