Line Manager Behaviour and Return-to-work
Workshop summary report: Research exploring line manager behaviours in facilitating
successful return-to-work of employees on long-term sick leave due to anxiety and
depression, back pain, heart disease or cancer
Introduction to project
Sickness absence costs employers approximately £11 billion per year i with long term
sickness absence contributing up to 75% of absence costs ii. There is an urgent need to
improve the effectiveness of returning employees to work, particularly following long-term
sickness. Much of the responsibility for supporting employees’ return-to-work falls on line
managers who, in turn, are likely to look for guidance from Human Resource (HR) and
Occupational Health (OH) professionals. However, little is known about the
behaviours/competencies managers need in order to facilitate a successful return-to-work.
To address this, the research team from Goldsmiths, University of London has been
commissioned by the British Occupational Health Research Foundation, with the support of
the Chartered Institute of Personnel Development, the Health and Safety Executive and
Healthy Working Lives to examine the line manager’s role in the return-to-work process. The
aim is to produce guidance that will help to improve organisations’ and line managers’
effectiveness at facilitating employee return-to-work. This report provides a summary of the
first stage in this research: a series of workshops with HR and OH professionals.
Method
The research team conducted five workshops for HR and OH professionals iii. A total of 78
OH professionals and 64 HR professionals attended the workshops to explore a range of
issues relating to employee return-to-work, following long-term sickness absence. The
principal questions explored were: what line manager behaviours facilitate employee returnto-work following long term sickness absence due to anxiety and depression, back pain, heart
disease or cancer; and what behaviours represent barriers to employee return-to-work
following the same health conditions.
To elicit the line manager behaviours, participants were asked to draw from their own
experiences of employees who had returned to work following a period of long term sickness
absence due to anxiety and depression, back pain, heart disease or cancer, either
successfully or unsuccessfully. With each case they were asked to note the positive and
negative behaviours the manager had demonstrated throughout the process. These
behaviours were discussed within groups and common themes were extracted from case
studies.
In addition to discussing line manager behaviour, workshop delegates were also asked to
discuss a number of current issues facing Occupational Health and Human Resource
professionals. The data from these discussions are currently being analysed and will be
published in due course.
Findings
In total there were 57 themes identified after all the data had been collated. While this figure
is high, many of the themes, although titled differently, had similarities. The most commonly
reported themes are summarised below and examples of positive and negative behaviours as
well as the number of groups reporting each theme are provided in Table 1 and information
on each theme is as follows. Data from one group could not be used as no specific examples
of line manager behaviours from case studies were recorded.
Themes:
Communication - Communication appeared to be the emerging dominant theme and one
group stated this to be the most important factor in the return-to-work process. The
participants suggested that if the manager communicates with the employee at an early stage
of their sickness absence and then regularly throughout it, the return-to-work is more likely to
be successful. It was agreed that there is a need for good communication between the
manager and OH and HR whilst the employee is absent or returning to work.
Emotional and practical support - Participants suggested that as the employee is returning
to work, the manager must show both emotional and practical support. If the manager
exhibits consideration, empathy and a genuine interest in the well being of the employee,
then they are more likely to feel valued and so return to work successfully. In addition to this,
it was suggested that the manager should work with OH and HR to plan the return-to-work
process and accommodate practical support such as a phased return-to-work, a buddy
system or allowing time off to see physiotherapists and counsellors.
Flexibility - Linked closely to practical support is the need for the manager to be flexible in
their approach to the returning employee. They must be willing to consider alternative roles
and temporary adaptations to the employee’s job during their rehabilitation into the workplace.
Manager’s knowledge - The manager’s knowledge of the return-to-work process and of the
employee’s condition was considered important. Where the manager could draw upon past
experience of the return-to-work process following long term sickness absence, they were
able to deal more efficiently with the returning employee. Where the return-to-work was
unsuccessful, it was identified that the manager had initially failed to understand and spot the
presenting symptoms of the employee’s illness and then lacked the knowledge to obtain help
from other professionals whilst the employee was returning to work.
Manager and employee relationship - The pre-existing relationship between the manager
and the employee was highlighted as playing a role in the return-to-work process. If the
manager has a good relationship with the employee before the long term sickness absence,
then they are more likely to trust them and so accommodate their needs whilst they are
returning to work.
Referral – Finally, the timing of the referral to OH has an impact on the success of the returnto-work process. If the employee is referred quickly to OH in the initial stages of their illness
or subsequent long term absence then they are more likely to return-to-work successfully
later on.
Table 1: Summary of common themes
Theme
Communication
Emotional
support
Practical support
Flexible
Knowledge
Manager and
employee
relationship
Referral
Examples of positive manager behaviour
Examples of negative manager behaviour
-Maintained contact with employee throughout
absence
-Good communication between the manager
and OH/HR
-Early communication and then kept in regular
contact with the employee
-Regular contact by telephone and home visits
-Considerate
-Sympathetic on the return-to-work
-Making employee feel valued
-Showed concern, interest and empathy
-Respect for confidentiality of employee
-Manager struggled with difficult conversations
-Manager did not contact the employee for a
long time
-Manager did not tell anyone that the
employee was off sick
-Frightened and avoided contact
-Manager supported OH and HR involvement
through the phased return
-Allowed the employee release to go to
counselling sessions (6 in total)
-Encouraged the employee to try a phased
return-to-work. Met with HR and employee
and all agreed the phased return
-Introduced a buddy system
-Supported physio sessions- costs and time off
-No empathic behaviour following return-towork
-Withdrawn due to fear
-Cynical towards employee
-Hostile towards employee
-Mistrust of employee and sarcastic
-Manager exclude OH and external health
professionals in case-load meetings
-Manager did not accept the OH or GP advice
regarding staff fitness to work
-Didn’t discuss possible rehab plans- no
attempt to get the person back to work even if
they took up lighter duties
-Failed to cover parts of the workload while the
employee was absent
-Manager reduced the targets for the
employee so they were under less stress
-Flexible and willing to consider roles and
temporary adaptations
-Allowed employee to continue to work as it
was her wish
-Experiences of the process in the past gave
the manager more confidence
-Manager sorted out all of the paper work for
the employee
-Professionalism
-Unwilling to accommodate recommendations
by OH even on a temporary basis
-Manager focussed on what the employee
couldn’t do rather than what they could do
-Lack of flexibility and reluctance to consider
phased return and required changes
-Manager misread anxiety about job as anxiety
about back injury
-Lack of knowledge, understanding and value
of the different parties involved
-Line manager did not spot that stress was
causing the presenting illness
-Good relationship with the member of staff
-The manager originally cared and trusted the
employee
-Employee and manager trusted each other
and so were happy with the decisions made
-Early referral and involvement of OH
-OH referral by the second week
-Blame the employee and state that they are
unable to cope with reasonable requests
-Poor understanding and distrust of the
employee, unable to accept diagnosis and
responsibilities
-Late referral to OH
-Taking too long to refer to treatment
No.
groups
reporting
(out of 24)
23
13
13
10
9
7
5
Next stages for the research
The preliminary data collected from the workshops will form the foundations of the research.
However, it is important to note that the themes were developed from the perspectives of OH
and HR professionals only. Therefore, to build on this information, the views of managers
and employees who have direct experience of the return-to-work process need to be
established. In April/ May 2009 telephone interviews will be conducted with managers who
have dealt with employees on long term sickness absence due to anxiety and depression,
back pain, heart disease or cancer and employees returning to work after a long term
sickness absence due to the same health conditions. In June/July a questionnaire study will
be conducted with both managers and employees. Together these three studies will provide
valuable information on the effective and ineffective line manager behaviours associated with
return to work following long term sickness absence.
Once complete, this research aims to develop guidance material for Occupational Health and
Human Resource professionals, and line managers to help manage the return to work of
employees.
For further information or to participate in the next stage of this research please
contact Ben Hicks at b.hicks@gold.ac.uk or on 07881 915 776. Alternatively, visit the
website: http://homepages.gold.ac.uk/pss01bh.
Department of Health (2004) ‘Choosing health: making healthier choices easier.’ London: DH
Unum Limited, Institute for Employment Studies (2001), ‘Towards a better understanding of
sickness absence costs.’ Dorking: Unum
iii
The workshops were held at the HSE (23/2/9 for OH), the CIPD (24/2/9 FOR HR), Loughborough
University (26/2/9 for OH) and Healthy Working Lives (13/3/9 OH and HR).
i
ii