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The sick note is to be replaced by the fit note, as some employers are offering incentives to stop us calling in ill. But how far should bosses go to stop us taking sickies?
You wake up and feel unwell.
Do you a) go into work, or b) call in sick?
The answer should be straightforward – but for many people, taking a sick day can be an uneasy experience.
Am I ill enough to justify the time off? Will my boss believe me when I call in? Do I need to feign a croaky voice to prove just how unwell I really am?
Absences through sickness cost the British economy £10bn a year. With pressure on all employers to tighten their belts, this is one area where many are seeking to make savings.
And in last week’s budget Chancellor Alistair Darling suggested cutting the number of sick days in the NHS in England could save around £555m.
Free cars
But can an employer cut the number of days lost to sick leave while respecting workers’ rights to take time off when ill? Many are naturally suspicious that absentees may be "pulling a sickie" – taking a day off when they are not unwell.
One employer taking a lead is Merseyside Fire and Rescue, which rewards 100% attendance.
Four years ago the service introduced an "absentee incentive scheme", which occupational health manager Paul Blanchard-Flett says has halved the sickness absence rate.
In 2003-2004, each employee was taking an average of 11.36 days off per year. By 2008-2009, that fell to just over 5.5 per person per year.
Mr Blanchard-Flett says the organisation achieved this through a range of measures, including tracking the patterns of sick leave, offering staff telephone counselling for any reason, and helping people with getting back to work after illness.
There are also prizes for full attendance – anyone who goes 12 months without a day off sick is entered into a draw with the chance to win a family hatchback. And workers who have managed to go three months without absence can win £1,000 in cash or department store vouchers.
More than 80% of the 1,500 employees qualify for the car prize draw – a winner is picked at a ceremony. "The cost of the incentive scheme is minor in comparison with the cost savings that are made," explains Mr Blanchard-Flett.
However, he is cagey when asked about fake sick days, instead focusing on the raft of measures that encourage people back to work.
‘Softer edge’
On average, a public sector employee takes 9.7 sick days per year, compared with 6.4 days in the private sector, according to research by the Chartered Institute of Personnel Development.
"We know that there are higher levels of stress related absence in the public sector," says Ben Willmott from the institute.
"We think this is likely to be because there’s a higher proportion of challenging public-facing roles – teachers, nurses, social workers, police officers, people having to deal with the public in emotionally charged instances."
Mr Willmott says there can often be a "softer edge" in how the public sector manages sick leave – with a lower chance for instance, of absences being noted in appraisals. This leads some to suggest that public sector workers are more likely to pull a sickie.
But recent research by the TUC counters this, suggesting public sector workers are more likely to go into work if they are unwell, fearing they would otherwise let down their colleagues.
Dial-a-nurse
The CIPD research suggests that approximately two-thirds of working time lost to absence is accounted for by short term sick leave of up to seven days. Only 17% of time is lost through absences of longer than a month.
At Coventry City Council a new scheme is being trialled to drive down the amount of time – and money – lost through short term absence.
Under a pilot scheme, which began in December, staff who feel unwell must ring an NHS-qualified nurse – instead of their boss – to tell them they’re not coming in.
They are asked a series of questions to work out what their illness is, and when they might be able to be fit to return to work.
After the conversation, the nurse sends an e-mail or text message to the line manager informing them of the employee’s illness and likely return date to work. While the council stresses the nurse isn’t there to catch out potential skivers, there is a clear implication that the introduction of a nurse will filter out the genuine and the fake callers.
The council hopes the service will reduce absence levels by 30%, and at the same time the amount of money it spends on agency fees to cover staff off sick, which currently stands at between, £4m to £5m.
A heavy night?
Initiatives to reduce the number of "sickies" taken exist in both the public and the private sector. For instance, employees at Tesco do not get paid for the first three of days of their sick leave. The policy applies to staff who joined the supermarket chain after 2004.
A spokesman said the scheme was successful: "Staff retention is very high, staff absence is very low… it suggests our staff are very happy in their jobs."
The company operates a policy of flexible working so anyone who needs time off to attend a hospital appointment won’t necessarily lose out. The spokesman stresses the scheme needs to be seen alongside the other pay and pension benefits staff get.
When looking at ways to reduce the days lost to sickness absence, employers also need to look at why people aren’t coming into work. Aside from being genuinely ill, unions and trade organisations say more could be done to improve working conditions – with stress often a major cause of illness.
"We often perceive the sickie as – ‘I’ve had a heavy night and I want to stay under the duvet today’ – but often if you look at it it’s to do with stress in their work and their home life," says Neil Carberry of the Confederation of British Industry.
More support for workers to deal with emotional problems is often cited as one way to help people engage more with their jobs. Carberry argues that if people are managed well and feel involved in their job they are more likely to want to be in work, and less inclined to take an occasional sick day.
Fit notes
A slightly different approach is advocated for those taking longer term absences from work. The CIPD research shows that if someone has been off for work for six months they only have a 50% chance of returning to work.
Easing someone back to work, as well as cutting the sick leave bill, is the driving force behind the new "fit notes" which will be introduced across the UK from 6 April.
Under the old-style sick notes, a GP would either sign someone off from work, or suggest they are well enough.
The new fit note, which is presented to the boss, still allows for that, but also allows a doctor to suggest ways a person could get back to work in stages. For instance if someone has broken their leg playing rugby – the fit note might suggest ways the person could conduct some business at home, or change their duties in the office, to ensure they are still active in the workplace.
Mr Willmott hopes the notes will encourage more conversation between doctor and patient about getting back into things, but concedes that even these will not stop the "small proportion of malingerers" who don’t want to work at all, and would still be able to convince their GPs and their bosses that they’re too sick to work.
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