Barriers and Success Factors in Absence Management - CIPD
Barriers and Success Factors in Absence Management - CIPD
Barriers and Success Factors in Absence Management - CIPD
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<strong>Barriers</strong> <strong>and</strong> <strong>Success</strong> <strong>Factors</strong> <strong>in</strong><br />
<strong>Absence</strong> <strong>Management</strong><br />
Dr Mark Simpson<br />
AXA PPP healthcare<br />
<strong>CIPD</strong> 18 th June 2004
“Our employees are our greatest asset. I<br />
say we sell them”.
Today’s topics<br />
1. What’s the big picture<br />
2. Sickness absence <strong>and</strong> human health behaviours<br />
3. Manag<strong>in</strong>g absence – what works<br />
4. Case management <strong>and</strong> the role of occupational<br />
health services
What’s the big picture<br />
• <strong>Absence</strong> levels<br />
• Unpaid overtime<br />
• Health & productivity
<strong>Absence</strong> costs – what’s the bidd<strong>in</strong>g<br />
• £ 11.6 billion – CBI
<strong>Absence</strong> costs – what’s the bidd<strong>in</strong>g<br />
• £ 11.6 billion – CBI<br />
• £ 13.8 billion – <strong>CIPD</strong>
<strong>Absence</strong> costs – what’s the bidd<strong>in</strong>g<br />
• £ 11.6 billion – CBI<br />
• £ 13.8 billion – <strong>CIPD</strong><br />
• £ 39.0 billion – Norwich Union
But - Unpaid resource………<br />
• 23% of people work extra hours every day<br />
• 64% stay late at least once a week<br />
• Half of all workers take work home<br />
• 40% “f<strong>in</strong>d it necessary to work weekends”<br />
• 45% of overtime is unpaid (Abbey National<br />
Survey)<br />
• Britons work 5.2 hours extra per week<br />
(Labour Force Survey)
Lost hours…..<br />
• S<strong>in</strong>ce 40% of overtime is unpaid,employers<br />
get 2.1 hours per week free<br />
• This equates to £1065 per employee per year<br />
• Or £26 billion “free” to employers<br />
• Or more than twice that “lost” through<br />
sickness absence
Health, Productivity <strong>and</strong> Presenteeism<br />
• “Presenteeism” = The degree to which an<br />
<strong>in</strong>dividual is present while work<strong>in</strong>g<br />
consider<strong>in</strong>g their health”<br />
• For depression, lost productivity costs are x5<br />
as great as absence costs
Knowledge Capital vs Labour Costs<br />
Low<br />
Knowledge Capital<br />
High<br />
High<br />
Labour Costs<br />
Low<br />
Insurance Sales<br />
Force<br />
McDonalds<br />
Microsoft<br />
Aston Mart<strong>in</strong>
Human capital costs
The economic burden of health <strong>and</strong> disease is<br />
measurable on the bottom l<strong>in</strong>e<br />
• ………..but you need the data to prove it!
Sickness absence <strong>and</strong> human health<br />
behaviours
Two questions for you to consider<br />
1. When did you last have a 2 week holiday<br />
2. Have you ever been off sick for 4 weeks or longer
Nobody said this was easy!
Prevention - Key Messages<br />
• Sickness <strong>Absence</strong> is not necessarily about<br />
be<strong>in</strong>g ill<br />
• <strong>Absence</strong> is determ<strong>in</strong>ed by health<br />
behaviours as much as by health per se<br />
• Previous absence usually predicts future<br />
absence<br />
• Medical conditions/diagnoses will not<br />
predict future absence
• You won’t have to manage absence (as<br />
much) if you recruit the right people……...<br />
• ……but you may have to manage presence<br />
<strong>and</strong> productivity
Taylor - Contrast<strong>in</strong>g absence patterns <strong>in</strong> an<br />
oil ref<strong>in</strong>ery (1967)<br />
Four groups of employees<br />
• Frequently sick ( 5+ spells/year)<br />
• Long term sick ( > 60 days/year)<br />
• Never Sick ( No absence <strong>in</strong> 8 years)<br />
• Control group
Key F<strong>in</strong>d<strong>in</strong>gs<br />
• Pre-employment health non-disclosures distributed<br />
evenly amongst all absence groups<br />
• <strong>Absence</strong> groups correlate with other employment<br />
behaviours lateness,occupational <strong>in</strong>juries<br />
• Frequently sick had x3 absence spells as controls but<br />
no difference <strong>in</strong> distribution of illness causes<br />
• Never sick almost unanimous <strong>in</strong> enjoy<strong>in</strong>g their work<br />
• 30 % of never sick had significant medical problems<br />
• Personality traits were associated with different<br />
absence groups<br />
• Never Sick - Introversion<br />
• Long Term - Neuroticism<br />
• Frequently - Extroversion
The real “Hawthorne Effect”<br />
• 1927 - 1932 Hawthorne Plant, Western<br />
Electric Company, Ill<strong>in</strong>ois
The real “Hawthorne Effect”<br />
• 1927 - 1932 Hawthorne Plant, Western<br />
Electric Company, Ill<strong>in</strong>ois<br />
• Led by Harvard Bus<strong>in</strong>ess School<br />
Professor Elton Mayo
The real “Hawthorne Effect”<br />
• 1927 - 1932 Hawthorne Plant, Western<br />
Electric Company, Ill<strong>in</strong>ois<br />
• Led by Harvard Bus<strong>in</strong>ess School<br />
Professor Elton Mayo<br />
• Initially study <strong>in</strong>tended for 1 year but<br />
extended to 5 years - why
What did the studies show<br />
• Initially <strong>in</strong>tended that study should <strong>in</strong>vestigate<br />
physical/environmental effects of workplace<br />
• light<strong>in</strong>g<br />
• temperature<br />
• humidity
What did the studies show<br />
• Initially <strong>in</strong>tended that study should <strong>in</strong>vestigate<br />
physical/environmental effects of workplace<br />
• light<strong>in</strong>g<br />
• temperature<br />
• humidity<br />
• Then moved on to psychological aspects<br />
• breaks<br />
• management style<br />
• work<strong>in</strong>g hours<br />
• self determ<strong>in</strong>ation
Results<br />
• Everyth<strong>in</strong>g worked!<br />
• Which is why the study lasted 5 years
Results<br />
• Everyth<strong>in</strong>g worked!<br />
• Which is why the study lasted 5 years<br />
“The need for recognition, security <strong>and</strong> sense of<br />
belong<strong>in</strong>g is more important <strong>in</strong> determ<strong>in</strong><strong>in</strong>g<br />
worker’s morale <strong>and</strong> productivity than the<br />
physical conditions <strong>in</strong> which they worked”
Manag<strong>in</strong>g absence - what works<br />
An idea<br />
<strong>Absence</strong> is<br />
managed
A Caveat is this real research<br />
“There is a tendency <strong>in</strong> much of the published<br />
literature to assume the proven validity of certa<strong>in</strong><br />
approaches <strong>and</strong> to focus any evaluation entirely<br />
on the frequency of it’s use - i.e. to evaluate the<br />
extent of consensus rather than the<br />
effectiveness of the policies themselves”<br />
BOHRF/Anne Spurgeon 2003
Health Vs HR Interventions for <strong>Absence</strong><br />
Health<br />
Health Awareness<br />
Health Promotion<br />
Health Risk<br />
Assessments<br />
Private Intervention<br />
Risk Assessments<br />
Stress <strong>Management</strong><br />
Occ. Health Strategy
Health Vs HR Interventions for <strong>Absence</strong><br />
Health<br />
HR<br />
<br />
Health Awareness<br />
<br />
Record<strong>in</strong>g absence<br />
<br />
<br />
Health Promotion<br />
Health Risk<br />
Assessments<br />
<br />
<br />
Tra<strong>in</strong><strong>in</strong>g/Support<strong>in</strong>g<br />
Managers<br />
Sick pay structure<br />
<br />
Private Intervention<br />
<br />
P & D Reviews<br />
<br />
<br />
<br />
Risk Assessments<br />
Stress <strong>Management</strong><br />
Occ. Health Strategy<br />
<br />
<br />
<br />
Recruitment/Selection<br />
procedures (DDA)<br />
<strong>Absence</strong> strategy<br />
HR Board<br />
Representation
Case management <strong>and</strong> occupational<br />
health services
Different perspectives – where is the<br />
common ground<br />
• FD - wants to m<strong>in</strong>imise costs<br />
• HR - wants to compete at recruitment<br />
- wants to manage absence<br />
• Intermediary - wants to broaden product portfolio<br />
- gets <strong>in</strong>volved <strong>in</strong> contentious claims<br />
• L<strong>in</strong>e manager - wants employee back asap<br />
• Employee – vary<strong>in</strong>g commitment <strong>and</strong> motivation<br />
• GP - wants to get best deal for patient<br />
• Union rep - wants to manage employee <strong>in</strong>terests<br />
• Lawyer - adversarial relationship<br />
• Insurer - wants to m<strong>in</strong>imise claims liability
The athletic model - what can be done<br />
• Athletes generally recover from <strong>in</strong>juries quickly<br />
• Results from treatment model <strong>in</strong> which common<br />
recovery goal shared by all<br />
• Cl<strong>in</strong>icians aim<strong>in</strong>g for functional not medical<br />
recovery<br />
• Coach / Manager plans return programme<br />
• Team members supportive<br />
• Like for like <strong>in</strong>juries x3 faster return to work when<br />
athletic rather than occupational causation
Integrated Healthcare <strong>Management</strong><br />
Employee<br />
assistance<br />
programme<br />
Occupational<br />
health<br />
Case<br />
<strong>Management</strong> System<br />
Employers<br />
liability<br />
CLIENT<br />
Health <strong>and</strong><br />
Safety<br />
Private<br />
Medical Cover
Case management pr<strong>in</strong>ciples<br />
1) Early Capture of Events<br />
Manage Expectations <strong>and</strong> Timeframes<br />
2) Case <strong>Management</strong><br />
Reduce Recovery Delays +/- Illness Behaviour<br />
3) Treatment Pathways<br />
Ensures Consistent Cl<strong>in</strong>ical <strong>Management</strong><br />
4) Intervention Outcomes<br />
Data Warehous<strong>in</strong>g<br />
5) Co-ord<strong>in</strong>ation of Events<br />
Allows Alignment <strong>and</strong> Integration of these Processes
Integrat<strong>in</strong>g Multiple Programmes for<br />
Maximal Benefits<br />
Best practices for<br />
controll<strong>in</strong>g costs<br />
also control absence<br />
Return to<br />
Work<br />
Policies <strong>and</strong><br />
Practices<br />
Common<br />
Case<br />
<strong>Management</strong><br />
S<strong>in</strong>gle Po<strong>in</strong>t of<br />
Intake <strong>and</strong> Claims<br />
Report<strong>in</strong>g<br />
S<strong>in</strong>gle Internal<br />
Programme<br />
Manager
……..<strong>and</strong> to f<strong>in</strong>ish...<br />
….a short quiz!
The follow<strong>in</strong>g short quiz<br />
consists of 4 questions <strong>and</strong><br />
tells whether you are qualified<br />
to be a "professional".<br />
The questions are not that <br />
difficult, so don’t cheat by <br />
look<strong>in</strong>g ahead!.
Question Number 1<br />
How do you put a giraffe <strong>in</strong>to a refrigerator
The correct answer is:<br />
Open the refrigerator,<br />
put <strong>in</strong> the giraffe <strong>and</strong><br />
close the door.<br />
This question tests<br />
whether you tend to<br />
do simple th<strong>in</strong>gs <strong>in</strong> an<br />
overly complicated<br />
way.
Question Number 2<br />
How do you put an elephant <strong>in</strong>to a refrigerator
Wrong Answer: Open the<br />
refrigerator, put <strong>in</strong> the<br />
elephant <strong>and</strong> close the<br />
refrigerator.<br />
Correct Answer:<br />
Open the refrigerator, take out<br />
the giraffe, put <strong>in</strong> the elephant<br />
<strong>and</strong> close the door.<br />
This tests your ability to th<strong>in</strong>k<br />
through the repercussions of<br />
your actions.
Question Number 3<br />
The Lion K<strong>in</strong>g is<br />
host<strong>in</strong>g an animal<br />
conference. All the<br />
animals attend<br />
except one. Which<br />
animal does not<br />
attend
Correct Answer:<br />
The Elephant.<br />
The Elephant is <strong>in</strong> the<br />
refrigerator.<br />
Remember<br />
This tests your memory.
OK, even if you did not answer<br />
the first three questions correctly<br />
you still have one more chance<br />
to show your abilities.
Question Number 4<br />
There is a river you must cross. But crocodiles <strong>in</strong>habit it.<br />
How do you manage it
Correct Answer: You swim across. Why<br />
All the Crocodiles are attend<strong>in</strong>g the Animal<br />
Conference.<br />
This tests whether you learn quickly from your<br />
mistakes.
Accord<strong>in</strong>g to Andersen Consult<strong>in</strong>g Worldwide,<br />
around 90% of the professionals they tested got<br />
all questions wrong.<br />
But many preschoolers got several correct<br />
answers.<br />
Anderson Consult<strong>in</strong>g says this conclusively<br />
disproves the theory that most professionals<br />
have the bra<strong>in</strong>s of a four year old.
Thank you!