Special report: What's the state of sickness absence in the civil service?

Written by Suzannah Brecknell on 23 January 2017 in Feature
Feature

Civil service leaders have long tried to cut sickness absence rates among their staff. But, asks Suzannah Brecknell, are they looking at the full picture?

First, the good news. Civil servants are – on average – taking fewer days of sick leave each year. In 2007, the average number of working days lost to ill-health (AWDL) for each civil servant was nine. By 2015-16, the figure had fallen to 6.1 days. In some departments, levels of sickness absence have fallen even more dramatically. At the Department for Work and Pensions, a consistent focus from senior leaders and collaboration between HR and occupational health teams has helped to reduce AWDL by 45% since 2005. 

Despite that progress, however, civil service managers are by no means complacent about employee wellbeing. Civil service health and wellbeing champion Jonathan Jones has just started a new three-year programme aimed at sharing the best work already taking place across government to cut sickness absence.

Next, the not-so-good news. Falling AWDL figures may not tell us much at all about the health and wellbeing of staff. “In these job-insecure times, absenteeism is no longer a good indicator of organisational wellbeing,” says Cary Cooper, professor of organisational psychology and health at the Manchester Business School. Instead, he suggests that employers should be concerned about presenteeism – which he describes not just as people coming into work ill, but people arriving for work so dissatisfied or stressed that they do not perform effectively. 


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 “In these job-insecure times, absenteeism is no longer a good indicator of organisational wellbeing" – Professor Cary Cooper of the Manchester Business School

Research from the Sainsbury’s Centre for Mental Health suggests that presenteeism can cost an organisation nearly twice as much as absenteeism in reduced productivity. Then there’s the less-well known issue of leavism. Professor Cooper identified this phenomenon with his then-PhD student Ian Hesketh, who was studying resilience in the Lancashire Police Force. While asking police officers about their absences, Cooper and Hesketh noticed that many police officers were saying they had taken annual leave to complete heavy workloads or used it instead of sick leave so that it would not seem as though they were struggling to cope.

Such scenarios are not unique to the police. Anecdotal reports of similar practices across the public sector abound, prompting CSW to conduct its own research into presenteeism and leavism. An online survey of 1,660 public servants – conducted in September 2016 – found that 18% had taken annual leave instead of sick leave in the last six months. Among civil servants the proportion was lower – 11% said they had taken a day of holiday instead of a day off ill.  

Nevertheless, Cooper says the results are worrying, and points to shrinking headcount as one of the contributing factors. “People are so overloaded at work and so afraid of telling their managers,” he says. “There are fewer people doing more work, and they are also much more vulnerable than have been before. There is no job security. People are just as vulnerable in the civil service as they are in the private sector.” 

Our research supports this: when asked why they had chosen to take holiday instead of calling in sick, 59% of civil servants polled said they did not want to trigger a performance review (this figure fell to 54% across all respondents). The second most common reason – given by 20% of civil servants – was that they were afraid of how their manager would view a sickness absence. Next most popular was “other”, and in the free text boxes there were – alongside people who simply had holiday to use up and decided to take it when not feeling totally well – comments indicating concern about taking too much sick leave, or using annual leave during a “flare up” of a long term condition.  

CSW also asked people whether they had considered taking a sick day in the last six months but decided to work instead, and the reasons behind this. The most common reason – chosen by 20% of civil servants – was that they were afraid to take a sick day. The next most common reasons cited were having too much work to do (13%) and not wanting to let the team down (12%).  

According to Cooper, this should concern employers not only because it makes it harder for managers to spot – and support – colleagues who are not coping, but because the negative effects on individuals and their personal lives if they don’t take their proper leave will feed back into their performance at work. “We do need respite, especially in high pressure jobs. If people are not taking their respite, they are more at risk of illness, and are also more likely to do their job less well over a period of time; their productivity may suffer if they are not taking time away,” he says. 

That view is shared by Zahir Irani, dean of the faculty of management and law at Bradford University. He talks of a “spiral of stress” which occurs when staff feel that taking a day of sick leave will leave them worse off, with more work to do on their return. Responding to CSW’s findings on absence and presenteeism, Professor Irani notes that while, in the past, taking a day off may have been seen simply as something one did to get better, it could now be perceived as a sign of weakness and lack of resilience. 

“The key for us is to work with managers so that they can identify that support at an early stage" – civil service chief people officer Rupert McNeil


“Civil servants don’t want to be off sick"

While days lost to ill-health overall are reducing in the civil service, mental ill-health is an increasingly common reason cited for those days that are taken off. A series of parliamentary questions tabled by Labour MP Jonathan Ashworth last year highlighted that more and more absences in the civil service are caused by stress or other mental health concerns. 

The civil service is not alone in seeing rising levels of mental ill health – a third of employers surveyed by the Chartered Institute of Personnel and Development (CIPD) for its 2016 Absence Management report said they had seen an increase in stress-related absence over the last year, while two fifths have seen an increase in reported mental health problems among employees. 

Sarah Page, the Prospect union’s health and safety officer, sees one common factor behind both the data on mental health related absence, and CSW’s findings on presenteeism and leavism. Having shared our research with Prospect members within the civil service, she told CSW she had received the following feedback: “The problem is all to do with performance management, it’s just so toxic, it’s having such an adverse impact on people and their mental health.” 

She believes the current – and highly controversial – system of civil service performance management, which pressures managers to put a set proportion of their staff into a “must improve” category every year, is a risk to people’s health and wellbeing. 

“Civil servants don’t want to be off sick,” she says. “They’re committed, motivated people but undervalued and overworked. Meanwhile the private sector ditched these sorts of punitive, punishing performance management systems long ago.”

It’s good news, then, that a new performance management system is expected to be in place across many departments later in the year. Page also believes there is good work happening across the civil service to support employee wellbeing, especially in the Cabinet Office’s Civil Service Employee Policy team, which she says offers “thoughtful, balanced guidance for managers”. But her concern is that wellbeing or health and safety teams are often under-resourced and overly reliant on support from charities like the Charity for Civil Servants – who are themselves facing resource pressures.

Judith Smith, head of help and advisory services at the Charity for Civil Servants, adds another reason why civil servants may be using annual leave to manage workloads and sickness: to cope with caring responsibilities. The charity issued over 1,500 “carers passports” in 2015, designed to support staff in balancing work with their caring responsibilities. Despite increasing awareness about the pressures carers face, Smith believes there are still many carers who are not properly supported and who feel they cannot take time off work for their own health when they need it. 

Cooper believes that managers with strong interpersonal skills and a positive approach will be crucial in properly improving the wellbeing and resilience of employees. The phenomenon of using annual leave instead of sick leave may superficially mask the fact that a team member is struggling, he says, but “a good interpersonal and socially skilled line manager should see, day in and day out, that this person is not coping”.  

“A good interpersonal and socially skilled line manager should see, day in and day out, that this person is not coping” – Professor Cary Cooper

In most organisations people are promoted for their technical skills or impressive CV, rather than their people management skills, Cooper says, and when people do receive management training it is often theoretical rather than practice-based, or focuses on issues other than basic people management. 

Irani agrees with the need to equip line managers, but he adds that there could be other ways to address the issues of absenteeism and leavism – such as improving working environments, or supporting flexible working when needed. In some cases managers might need to consider employees’ resilience as well as their CVs when thinking about appointments and moves. “There is a matching issue about creating an environment where you allow people to transit out of [high pressure] roles and move new people into roles based not just on skill sets,” he says. “[Skills] are part of it, but there is an individual resilience factor. Some people are more suited to those jobs than others, while others may find their resilience changes over time.”

“Civil servants don’t want to be off sick. They’re committed, motivated people but undervalued and overworked" – Sarah Page, the Prospect union

All of the people CSW spoke to were broadly supportive of the civil service’s approach to, and track record on, supporting employee wellbeing. And the civil service’s chief people officer, Rupert McNeil, tells us that the organisation tries to “support people so that they can remain at work where possible” and “return as soon as they are ready following sickness absence”. He adds: “The key for us is to work with managers so that they can identify that support at an early stage, so that we can make effective use of occupational health and employee assistance programmes.”   

No one questions the commitment of civil service leaders to improving employee wellbeing. However, with workloads increasing and job security falling, the approaches which have helped to drive down absenteeism may need to change if the civil service is to start tackling the less obvious, but equally important, issue of presenteeism. 


Department in focus: HM Revenue and Customs
Via e-mail, an HMRC spokesperson told CSW about the steps the tax authority has taken to cut sickness absence

What have been the main reasons for HMRC’s success in reducing average working days lost to sickness over the last decade?   
There are a variety of contributing factors such as wellbeing, management focus, supporting colleagues, making reasonable adjustments where required and involving occupational health at the right time.   
Long term absence is the most challenging. We have trained advocates in the business who can help people get the support they need.   

What is the most innovative or interesting thing you are doing to promote wellbeing?  
We’re trialling Health Kiosks in a number of buildings. They’re a very visible commitment to wellbeing and allow staff to monitor their weight, BMI, blood pressure etc, and get a bespoke report on how they can improve their health. Continuing to improve our wellbeing offering is an important part of planning our future regional centre workplaces too. We have also developed “occupational health plus” where a manager and individual can speak to an OH practitioner rather than it just being a paper referral. This provides a richer and clearer picture in order to help people back to work.   

What are your wellbeing/absence management priorities now?   
We have just implemented a new attendance management policy. Embedding this and ensuring it is a success is a priority.   

How has the proportion of absences attributed to mental health concerns changed in the last five years at HMRC?   
Mental ill health, including stress, remains one of the reasons for our absence levels but we can see an improvement in the number of absences related to mental health through the use of our advocates, who offer outstanding support to individuals.  

Early and supportive intervention is important in terms of helping people understand and cope with change, and maintain or return to full performance and attendance. Our new policy encourages managers to consider the support needed at day one where staff report a mental health problem, including taking occupational health advice. We know that organisational change is a well-documented stressor, and our wellbeing and mental health strategies include access to specialist clinical support for people who need that additional help. Communicating the scale and pace of transformation is key too, so we have an ongoing conversation with our staff about building the future HMRC and their part in that.


Mental Health in focus
Data published in response to parliamentary questions shows that some departments have seen significant rises in the proportion of absences attributed to mental health concerns over the last five years – in the Department of Health, for example, the proportion has almost doubled from 15% of absences to 28%. In the communities department there has been a similar increase, from 19% to 32%.  

It is hard to compare figures between departments with confidence, because they each answered the parliamentary question in different ways. Some, for example, gave data on calendar years, others for financial years, while some reported absence caused by stress specifically and others absence caused by any mental health concern.  

In some departments these figures could be attributed to falling headcounts. For example at DCLG the absolute numbers of days lost due to mental ill-health were broadly similar in 2011 and 2015, but its headcount had reduced so the proportions changed.  

There could also be more qualitative reasons, in that staff may experience more stress as workloads rise due to falling headcounts or because of the significant changes which most organisations have undergone or are undergoing. The health department, for example, is undertaking a major reorganisation which it acknowledges has impacted engagement across the organisation and may also have affected employees’ mental wellbeing.  

In response to CSW’s request for comment on their rising rates of mental-health related absence, DH said: “We will continue to raise the profile of mental health issues at work and encourage open reporting of ill-health conditions as this enables us to tailor the health and wellbeing offer and guide staff.”  

A spokesperson for the communities department said: “In the department we have a great range of support for people with mental health issues, including a network of trained Mental Health Ambassadors, Mental Health First Aid training and a Mental Health Support Group for staff experiencing poor mental health or who are caring for someone with a mental health illness.”


Further reading: Former DWP perm sec Sir Leigh Lewis on how to reduce sickness absence in the civil service

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Suzannah Brecknell is CSW's senior reporter. She tweets as @SuzannahCSW

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Anonymous (not verified)

Submitted on 23 January, 2017 - 12:47
HMRC surely cannot be an example of how to deal with sickness absence as their whole culture is often responsible for creating ill health. They are among the worst employers. For example, if they had a meaningful bullying policy which was then enforced robustly across the board (i.e. no untouchables) instead of such misconduct and law breaking being covered up with management support, ill health would not arise in the first place in many cases. 'health kiosks' sound like insignificant window dressing while relentless bullying goes on unchecked. Prevention is always better than cure.

janie J (not verified)

Submitted on 23 January, 2017 - 12:46
The trigger points for when a warning will be given have been changed again and again. 4 individual days in a year now trigger a warning. Of course Civil Servants are afraid to go off sick. This winter our office has regularly been full of sick people after a few came in with chest infections and bad colds and, with air conditioning, it spread like wild fire. That factor applies across the grades. The most vulnerable are, ironically, those that do the back to work interviews with the still sick people. I find this article the height of irony given the draconian and Victorian measures that have been imposed on staff in recent years, with the 4 individual day trigger point being utterly ridiculous. The bottom line is that people get sick - that's part of being human. Staff can and do get disciplined for very low levels of sick leave. One bout of actual flu that can knock a person sideways is enough to have the member of staff fearing being off sick at all for the rest of the 'rolling year'. The overall figure for departments is skewed by long term sick, which should really be a separate equation. However, several on long term sick in our large office are off for cancer treatment, so I would like to think that they would be supported. In previous years even they would have been hounded when off sick, so at least that has changed. But then again a law change was needed to help there - it is now disability discrimination to harrass those undergoing cancer treatment.

Anon (not verified)

Submitted on 24 January, 2017 - 09:31
An interesting perspective from your department. We all want to see people supported - this benefits individuals to recover, and sooner, and to increase the efficiency of an organisation. Any change to the law is to be welcomed - although its sad that a public sector employer would need the force of law to do the right thing - to help those who are disadvantaged and for the benefit of the wider economy. The question has to be will the civil service abide the law? HMRC has a bad history of not following the equality act 2010. What I see from HMRC are a few superficial announcements which merely give the veneer of caring. Of course, the elephant in the room, with people spending a significant part of their lives at work, is that a rotten culture causes and/or contributes to ill health. HMRC do not say what assessment they have carried out as to how much their workplace environment e.g. bullying, poor management, lack of training/support etc impacts on people's health & wellbeing.

Super Sam (not verified)

Submitted on 23 January, 2017 - 14:05
Really interesting article. All so poignant to people on the sharp end of operations. Whilst there is such a pressure to deliver the undeliverable, the health and wellbeing of our most precious resource will suffer. Our people are human beings first and employees second. The quicker this supportive guidance is cascaded to line managers, the better it will be for the individuals who urgently need our support.

Anon Comment (not verified)

Submitted on 23 January, 2017 - 20:55
An interesting article but the answers from the interview with HMRC don't actually provide much detail about what HMRC are doing to improve the wellbeing of staff. Its full of management speak such as "communicating scale and pace of transformation" and having an "ongoing conversation" but what does this mean in terms of what will be done differently in the future in comparison to whats happened in the past? HMRC talk of a 'new policy' of supporting those with mental ill health, including referral to occupational health, from 'day one'. However this is not new policy at all. As far I can see it was existing policy to refer from 'day one' - the unhelpful reality is some managers were not doing this. Perhaps HMRC could tell us what they are doing to ensure their 'new policy' is going to start being implemented in practice? The idea of Health Kiosks is all well and good but in 2017 the general public are well informed about health matters and those HMRC staff most likely to take advantage of health advice are also most likely to be the same people who would take the opportunity to get such advice from gyms, health centres and community pharmacies. Would this taxpayer money not be better spent on ensuring managers on the frontline receive professional management training both to support staff and to raise productivity? Could some money be invested tackling the significant issue of bullying in HMRC, as evidenced by staff survey results and personal accounts of abuse? Where bullying has been covered up, and victims further mistreated for raising a complaint, what message does this send to staff about how safe or otherwise it is to blow the whistle on wrongdoing? What impact do HMRC think brutal bullying followed by management supported cover ups have on the health and wellbeing of human beings? The HMRC does not give any indication as to what assessment, if any, they have undertaken as to how the workplace creates and/or contributes to ill health. They cannot possibly bring about any meaningful change to the health of their workforce without understanding the core issues driving poor health. Employees spend a significant part of their lives at work so it would be remiss to think of wellbeing as a topic in isolation without consideration to the workplace environment. Any positive steps to make the workplace at HMRC more healthy are to be welcomed but I fear this is the art of positive sounding communication without any change in culture. Decreasing sickness absence figures will only tell part of the story, and we will only know whether actions have matched the fine words when we can see staff survey results improving and people freely telling us that HMRC is a safe and healthy place to work - I am afraid the failure to learn lessons from the past indicate there is a very long way to go.

Anon (not verified)

Submitted on 24 January, 2017 - 10:23
HMRC`s health kiosks are in very few locations and I would bet that most staff have never even heard of them. HMRC has reduced the number of sick absence days through the introduction of a tougher, more stringent approach to sick absence and a faster track to dismissal. This has led to more presenteeism. HMRC staff (even those in locations which are secure and will become a regional centre) are more demotivated and demoralized now than at any other time in the department`s history. Senior leaders in the department steadfastly ignore the results of the staff survey and the staff comments posted on the Newsboards which give them all the information they need to tackle the underlying reasons for the increase in work-related, mental health symptons. Front-line managers often bear the brunt and the increase in the number of managers who are now experiencing mental health issues is both significant and telling.

HW (not verified)

Submitted on 24 January, 2017 - 10:39
In November 2016 Sir Jeremy Heywood was reported as 'disappointed' at bullying within the civil service. No mention of bullying in HMRC's interview about health & wellbeing though. They've missed the obvious. Sir Jeremy should be more than disappointed, the bullying in HMRC is inhumane. Bullying by certain staff is even covered-up using taxpayer funded resources, even with the knowledge of senior management, subjecting the victims to a secondary 'kicking'. It gives a clue as the organisational culture, values and morals of HMRC, and until they change no blood pressure checks are going to make any significant difference to the wellbeing of the workforce (even if sickness absence stats look good by encouraging more of those with contagious infections into the office) .

rick aston (not verified)

Submitted on 24 January, 2017 - 11:14
The report above is indicative of an employers seemingly total indifference to their employees state of health, in mind and body, as long as the job gets done and the "stats" are good no one seems to care how you are, save for a few individuals who think the Draconian methods used are outdated and need changing urgently

Simon Bravery (not verified)

Submitted on 24 January, 2017 - 15:18
A good interpersonal and socially skilled line manager should see, day in and day out, that this person is not coping” – Professor Cary Cooper This is quite difficult if the manager is managing from a distance and has little face to face contact with team members

Anonymous - Dep... (not verified)

Submitted on 25 January, 2017 - 16:17
The Department of Health (DH) has just soared up as the worst performing Department in terms of the staff survey. It is no surprise that mental health absence has risen in DH from 15% to 28% - but how much research, how many articles and how many changes and re-organisations will happen before Sir Jeremy Heywood applies real common sense, opens his eyes and stops what is going on across the civil service. You simply cannot pour 2 pints into a pint pot - it doesn't fit - it pours all over. Do that to an individual and they go off with stress. And as DH loses circa 500 staff this spring with circa 10,000 years of experience dancing out the door, how can those left simply pick it all up? as ever nothing can or will be dropped and Ministers require everything yesterday. On top of that there are powerful ALBs like NHS E taking control from DH - so how can this all work? Alongside that staff have left in droves and there are now over 300 vacancies at Grades 6 and below. Would you do this in the private sector? So how can the new Perm Sec - Chris Wormwald give assurance to Sir Jeremy Heywood that his Department is now well placed to deliver on the massive Health and Social Care agenda. Or is this all part of a plan to control, demoralise and destroy staff whilst pushing them to braking point where they resist little, accept any treatment - it is just about survival. Not a good place.The comments below, and frequent discussions refer to bullying which is a consequence of too little resource to deliver too big of a task with little, if any, real strategic vision and leadership from SCS. What a shame. Of course the Performance Mgmt system is there to challenge those at the bottom - whilst at the senior level they reward themselves for deliver a DH 2020 programme based on a flawed and illegal process using a single form. It beggars belief - delusional indeed and obvious to all who open their eyes - it is just like the Emperor's new clothes and no-one will be accountable. Fingers at the end of the day will point to the previous perm sec who left after announcing the re-organisation. So no accountability, no follow through and no adherence to employment law and good practice. Yes looks like the Brilliant Civil service is here.........

Secret One (not verified)

Submitted on 2 February, 2017 - 15:07
A really good article but I found the interview with HMRC a little sickening to read though. The very fact of the extremely nasty bullying which goes on within the department, which some senior managers are only too happy to support sadly, disqualifies them from having anything instructive to say when it comes to promoting well being. Its a toxic workplace: when they understand and deal with that reality, things may move in a more positive direction for staff wellbeing.

CS (not verified)

Submitted on 21 February, 2017 - 09:32
What have been the main reasons for HMRC’s success in reducing average working days lost to sickness over the last decade? Answer - we have terrified staff into not taking sick leave when they needed to. We have put a culture of fear in place that has forced sick staff to come into work and infect others. Those others have then got sick, and also been too afraid to take sick leave. Well done.

Anonymous (not verified)

Submitted on 22 February, 2017 - 11:36
Staff are promoted to management grades with little or no experience in people skills this is very true. But what about the promotion of staff with disabilities( all in the name of political correctness & equal opportunities) where that person is deaf and has absolutely no idea of the strengths & weaknesses of his/her staff does not make any attempt to engage with their staff and as a result there has been some quite serious incidents in bad judgement which has resulted in members of this managers staff going off sick due to stress

Paul (not verified)

Submitted on 13 March, 2017 - 14:35
Where does this leave it when, working for HMRC, I was asked by my manager to take two days leave to recover from a medical procedure, rather than take sick leave?

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