In Confidence

York Hospitals NHS Foundation Trust

Executive Board Meeting

Managing Sickness Absence

1. Introduction

The Managing Sickness Absence paper was endorsed by the Resources Management Committee and the Board of Directors, and discussed at the Executive Board. It outlined an initiative designed to reduce sickness absence and its associated costs at York Hospitals NHS Foundation Trust.

2. The way forward

The Resource Management Committee and Board of Directors considered three options.

Option 1 - Concede that 4.8% is an average acceptable performance roughly in line with the NHS average and take no additional action.

Option 2 - Introduce rigorous monitoring, management and action planning of sickness, and identify it as a key indicator at performance management meetings and at Board level to ensure a real focus on driving down absence rates. In supporting this option, HR would nominate a lead to work in partnership with Occupational Health and to devise an action plan to work in proactively reducing sickness absence across the Trust. Key actions within the plan would include reviewing the present sickness absence policy, targeting areas within the Trust with high levels of absence, and identifying areas of training and coaching of individual line managers.

Option 3 - Ensure much earlier proactive intervention in the first week of sickness, combined with rigorous management identified in option 2, to ensure that any required support and treatment is offered straight away (note 37.5 wte are absent for between 1 and 3 months). This earlier intervention or support might include for example immediate health assessment within occupational health. Dependent on the health issue, there is potentially onward referral to Physiotherapy (musculo-skeletal problems and back/neck problems account for 13.2% [£506.6k. p.a.] of our total sickness. Referral for physio treatment from week one of sickness would reduce this absence). Other support may include involvement of other specialists such as the Manual Handling Service for advice/support in ergonomic assessment, helping to reduce the incidence of musculo-skeletal/back and neck problems and repetitive strain injuries.

Early signposting of the counselling service, or referral through to the clinical psychology service in Occupational Health would facilitate a reduction in the cases of absence related to stress, anxiety or depression (£341.7k. p.a.).

2.1 The agreed approach

Following discussion at the Resource Management Committee and Board of Directors, option 3 was agreed as the way forward as a twelve-month pilot.

2.2 Supporting evidence

Audit of long-term absent staff (6 months plus) at York Hospital shows that the average time elapsed between the first day of sickness and their referral to occupational health by their manager is 15 weeks (for those staff that were referred). 15 out of the total of 47 staff absent for over 6 months had never been referred to occupational health for advice or support.

2.3 Investment Required

This initiative will be established as a twelve-month pilot. The additional non-recurrent investment would be required to deliver the immediate potential cost savings. Additional staff would be needed to focus solely on reducing absence. The key aims for new roles would be to act as champions on sickness absence, identifying and targeting areas with high levels of sickness utilising the available data, to assist line managers in proactively managing sickness absence in line with Trust policy, and to provide the immediate fast-tracking response to make this option work.

Financial summary required here, with reference to financial appendix (summary business case proforma)

3. Key Performance Indicators

The success of this initiative will be measured against the following targets in Year 1:

  • A reduction in the Trust-wide annual sickness absence rate from 4.8% to a quarterly average of 4.3%
  • A reduction in the temporary workforce spend from 4.64% (£1.32m.) to 4.0% of the total bay pill
  • A reduction in the average referral time to occupational health for long-term absent staff, from 15 weeks to 6 weeks
  • An increase in the proportion of long-term sick staff (6 months plus) referred to occupational health, from 68% to 95%
  • A proportionate reduction in the number of long-term sick staff to support the overall agreed reduced absence target
  • The provision of monthly absence data reports to management where requested
  • “Absence meetings” to discuss new and ongoing sickness absence cases involving the line manager, human resources and occupational health to be held every week for departments with sickness above the Trust target
  • Documented return to work interviews in 90% of all cases
  • Coaching for managers where identified to help assist in their management of sickness absence cases
  • The development of a training package to support managers to identify and tackle work-related stress issues amongst their workforce
  • A 15% reduction in the number of manual handling RIDDOR

A full review of the above targets will take place at the end of the year to determine the outcome of the pilot and recurrent finding as appropriate.

7. Recommendation

The Executive Board are asked to approve this Business Case.

July 2007

Appendix 1 Business Case Summary Proforma required here

Investment required

Post

/ Non Recurrent cost
(based on 12month fixed term contracts)
(£000)

1