Wednesday, 18 May 2016

Workplace Absence: Prevention and Presenteeism

In an article entitled “Prevention is better than cure” from Mourant Ozannes, the anonymous writer says:

“Whilst some sickness absence is unavoidable and should be treated with appropriate sensitivity, there are strategies which businesses can employ to reduce sickness absences, and in turn reduce the possibility of claims for personal injury and unfair dismissal.”

This is very much the same stance which comes across in the JEP report entitled “Health take tough new stance on absenteeism”, where it is reported that Health Department staff who have taken at least three sick days in the last six months could face dismissal unless their attendance improves, under a policy designed to dramatically cut absences.

And the Ozannes article is also vague and rather irresponsible in how it reports on illness:

“The Office of National Statistics reported that of all employees who took at least one day off work in 2010, around a third stated that a minor illness (cough, cold, flu, sickness) was the cause of their absence.”

Is influenza considered to be a “minor illness”?

The medical textbook, “Minor Illness Or Major Disease?” says that “The influenza virus is also spread by close personal contact and sneezing but produces a much more serious and potentially life-threatening condition in some at-risk groups, e.g. in the elderly, those with respiratory conditions, and those with chronic diseases. “

And the CDC website includes “People with a body mass index (BMI) of 40 or greater”, noting that “Even healthy people can get the flu, and it can be serious.”

The CDC also notes that “Most people who get influenza will recover in a few days to less than two weeks, but some people will develop complications (such as pneumonia) as a result of the flu, some of which can be life-threatening and result in death.”

Develop flexible leave policies that encourage workers to stay home, without penalty, if they are sick. Discuss other human resource policies with staff, including administrative leave transfer between employees, pay policy for sick leave, childcare options, and what to do when ill during travel.

The trend I see increasing is a presumption of guilt: if someone is absent, it seems almost assumed that this is probably not necessary, and is occurring for a variety of reasons apart from real sickness.

As the New York Times notes. “putting pressure on the presentee only serves to fortify the status quo. It treats illness as a threat to productivity rather than a source of suffering.”

But what is the result of a climate of fear, in which employees feel pressured to come into the workplace regardless? A recent article on the Tough Nickel website notes the downside of this:

“Presenteeism refers to reporting to work when ill and thus not working to full capacity.1 Common examples of illnesses that fail to keep employees at home include allergies, migraines, the cold and flu, back pain, and Norovirus (winter vomiting virus).”

It notes that in the first instance, workers who are ill but drag themselves into the office will not work as productively anyway:

“When employees work sick they fail to work mindfully -- that is, in the present moment, giving focused attention to the task. Instead, they are less productive because they are distracted by thoughts and sensations of their illness. Symptoms of their illness thus compete for their attention, on top of all the usual office distractors.”

“Working sick may result in decreased work output, reduced time spent on work tasks, lower quality work, more mistakes, and poorer staff morale while the sick employee is present.”

And it also adds that there may be significant risks to work colleagues:

“Presenteeism may likewise carry consequences for the employee's colleagues and customers when the illness carries the risk of contagion.”

This is something also mentioned in a report by Thorn Baker Recruitment:

"More than four in five (82%) employees have become ill as a result of another colleague coming into work when they are unwell (81% in 2013). 18% say this happens to them all the time, which is likely to result in a loss of productivity across several members of staff."

So what should employers do? Tough Nickel suggests this:

“Employers can have a major impact in discouraging presenteeism. Providing employees with paid sick leave is an important step in supporting workers to make smart choices. Companies can also offer clear, practical guidance on what conditions should prompt employees to stay home, and they can educate employees about the many risks of presenteeism.”

And Thorn Baker notes that:

"Many employers are also failing to communicate to their staff that they value employee health and wellbeing. Only 28% of staff believe this is the top priority in their organisation, compared to 44% who believe cost efficiency is valued more. More than a third (36%) of employees feel their output in relation to business profits is more important to their organisation than their wellbeing."

It is that which seems to be wholly absent from the new strategy adopted by Health

The CDC suggests there should be written policy guidelines by employees, and it also says that Employers should

“Encourage sick workers to stay home. The CDC recommends that workers who have a fever and respiratory symptoms stay at home until 24 hours after their fever ends (100 degrees Fahrenheit [37.8 degrees Celsius] or lower), without the use of medication. Not everyone who has the flu will have a fever. Other symptoms could include a runny nose, body aches, headache, tiredness, diarrhoea, or vomiting.”

What is alarming about Health’s reported strategy in particular is that sick nurses or even ancillary staff in a hospital, coming to work out of a climate of fear which encourages “presenteeism” will also put vulnerable patients at risk.

I note that Health is using the Bradford Factor.  There is little serious consideration of the Bradford factor by professional statisticians, but the paper entitled “Job Satisfaction and Absenteeism interface in Corporate Sector” by Prof. V.P. Thirulogasundaram and Dr.P.C.Sahu note its weakness:

“Many employers use statistics such as the Bradford factor that do not distinguish between genuine illness and absence for inappropriate reasons. As a result, many employees feel obliged to come to work while ill, and transmit communicable diseases to their co-workers. This leads to even greater absenteeism and reduced productivity among other workers who try to work while ill.”

And the academic researched paper ‘Too scared to go sick’—reformulating the research agenda on sickness absence” (Phil Taylor, Ian Cunningham, Kirsty Newsome and Dora Scholarios) notes this trend:

“The managerial preoccupation with the ‘problem’ of absence has amplified in recent times. A new moral panic certainly appears to be upon us. Popular discourse insists that malingering is endemic in ‘sick note Britain’, with workers ‘swinging the lead’, or, to use the currently fashionable term, taking ‘duvet days’. “

“Particular opprobrium is directed at public sector workers, whose absenteeism levels are compared unfavourably with those in the private sector. Driven by austere budgets, public sector organisations have taken concerted action against their allegedly misbehaving workforces. Both short-term absences, a category associated with workers ‘throwing a sickie’, and long-term sickness, which statistically contributes most to absence rates, are subject to increasing employer intervention “

That is not to say there may not be cases of absenteeism which are unnecessary and unrelated to illness, but what is needed at this stage is a more balanced approach than that reported in the JEP, which seems largely driven by concerns about PR than objective studies (which would actually cost money).

For more on presenteeism, see:

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