Nine ways to ‘mind the gap’ on sickness absence

5 Dec 2017 By Pete Clark

Case management is a method not all HR professionals are familiar with, but it can help in many ways

HR professionals tell me of the challenges they face in managing the return to work of injured and ill staff when sickness absence reports give medical intelligence without an action plan, leaving a gap to fill on the next steps.

New approaches are needed to support employees’ mental and physical wellbeing, and one, more active, method is case management. Still new to some in HR, it involves a clinical assessment of fitness for work and phased return-to-work plans, with direction on the best health therapies, alternative duties and adapted environments. 

Case managers support the employee, motivating them to work on their recovery and become their personal health project manager and trouble-shooter. They also direct line managers on supporting the employee with mutually agreed, timetabled action plans on both sides and progress reports.

Here are nine classic cases where case manager intervention can ease the burden:

1. Fit note support

When staff cannot wait for more than a week to see their GP, or worry about ‘bothering’ them, a speedy telephone assessment with a case manager who is an expert in their condition can be convenient and provide a more accurate diagnosis. A case manager can supply allied health professional fit notes.

2. Mental health

For staff who are open to talking about their mental health and reaching out for help, a case manager-led mental health assessment can plan the most effective talking therapy. 

3. Complex cases

Conditions like fibromyalgia tend to divide medics and are a source of stress for employers. Case managers help staff to stick to GP appointments and manage fatigue, pain, breathing exercises and sleep hygiene.

4. Multiple conditions

Medics and occupational health experts’ focus on the physical injury causing absence, not arising complications like irritable bowel syndrome and depression. Case managers are trained in multiple condition management and in biopsychosocial health, as even a few weeks off from a chest infection can create depression or anxiety where staff dread returning to work. 

5. Mixed workforces

Organisations with both blue and white-collar workers can be an occupational health risk cocktail. While factory and warehouse staff and drivers could well face musculoskeletal injury, office staff may develop back pain, stress, depression or anxiety. It is a lot to manage.

6. High volumes

Sectors like cleaning, catering and security experience higher absence volumes. When many staff report in sick with uncertain health issues, the best approach is an early intervention culture getting people on the right care pathway and back to work.

7. Long-term absence

When individuals are absent for weeks, months or longer, multiple chronic health conditions can arise, mental health can deteriorate and management contact can break down. A sensitive case manager assessment will lead to a plan.

8. Managed termination

When employment may need to end after a lengthy absence, clinical assessments can reveal if an individual has lost the capacity to work, bringing resolution for all. 

9. Remote, isolated workers

With more staff working away from the office, including sales staff, out of sight can mean health is out of mind, though they can face more stress and more pain from bad ergonomics. Telephone assessments for mental and physical health can support them. 

Pete Clark is a qualified occupational therapist and head of corporate and public sector service development at HCML, which specialises in occupational rehabilitation

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