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

Written by Sir Leigh Lewis on 20 January 2017 in Opinion
Opinion

Reducing sickness absence is a vital task for leaders, and it must start with some difficult conversations if real progress is to be made 

“Ye can call it influenza if ye like,” said Mrs Machin. “There was no influenza in my young days. We called a cold a cold.”
(Arnold Bennett – The Card – 1911)

 

Like Mrs Machin, a hundred plus years ago, we have gone on developing new names for illness. “Chronic Fatigue Syndrome”, “Repetitive Strain Injury”, “Episodic Acute Stress” all contribute, along still with influenza, bad backs, colds and, increasingly, stress, to the causes of absence that employers encounter amongst their workforce, and which cumulatively add up to the total level of sickness absence they face.

But are we right to focus so much attention on reducing something – sickness absence – which has been with us as long as work itself? As Ronald Reagan once allegedly said: “They say that hard work never hurt anyone, but I figure why take the chance.” 


People Survey 2016: Department of Health points to restructuring as staff morale plummets
Free recording: Download our webinar on the Office for National Statistics' cloud-adoption journey​ 


My own experience – not just from my time at DWP where driving down the then very high level of sickness absence was a constant preoccupation – but also from the organisations with which I am now involved in both the private and not-for-profit sectors – is that it is right. 

That is for two main reasons. First, of course, because of the direct cost and reduction in output which sickness absence brings with it. In the DWP – with, in my time, over 100,000 staff – a reduction of one day in the average annual level of sickness absence per employee was the equivalent of roughly 400 more staff being at work on any given day. 

But secondly, and in my view even more importantly, because there is no doubt that levels of sickness absence in an organisation are a proxy for the health and effectiveness of the organisation as a whole. At its crudest, organisations with high levels of sickness absence tend also to have worse management, poorer performance, lower morale and, in the private sector, worse profitability. 

So what, faced with unacceptably high levels of sickness absence, should employers do? First, in my view, ask themselves whether they are in fact contributing to that level of sickness absence by creating, or at least tolerating, levels of pressure and stress which are substantially higher than they need be. That will never be an easy or comfortable conversation. Organisations face many unavoidable pressures; heightened public expectations, ever greater financial pressures, inescapable staff reductions – none of them can be made to go away. 

But how often do employers add unnecessarily to such pressures through constant reorganisations, unrealistic targets, ever-changing management fads and simple ignorance of the pressures which their staff are facing? Talk to the next nurse, social worker or shop floor worker you meet if you doubt the truth of that. The chief executive who is not prepared to ask if some of that at least applies in their own organisation is certainly at risk of failing to see the reality they face. 

The second essential, however, is to regard sickness absence not as an act of God but as something which can, and must, be managed. While there is no one magic bullet there are some essential pre-requisites:

• Having a sickness management strategy in place. If you have no idea what you’re trying to achieve don’t be remotely surprised if you fail to achieve it

• Being clear that you have systems for recording sickness absence accurately and managers who are clear about their responsibility for operating them. Nothing undermines a sickness management strategy more fatally than not knowing the true scale of the problem

• Setting triggers for when an individual’s level of sickness absence is going to lead to action being taken and then operating those triggers consistently. If they are observed as much in the breach as the reality they will rapidly lose all credibility

• Making clear that neither repeated short term absences nor long-term continuing absence can continue beyond a certain point. This is not about disbelieving medical evidence nor about abandoning care and compassion. It is about being clear that, beyond a certain point, repeated or long-term sickness absence is simply incompatible with delivering the organisation’s objectives

• Last, but by no means least, recognising that the great majority of your staff do want to see the consistent application of your sickness absence procedures. They are as fed up as you with the colleagues who are repeatedly off sick without any apparent consequence – which simply adds to the pressures on all those employees who do come to work day in and day out.  

My own experience is that doing all of the above will not guarantee that your overall level of sickness absence will reduce. But not doing it will almost certainly guarantee that it won’t. Encouragingly, sickness absence levels in the civil service have been falling consistently over the past five years. That suggests that while none of the above is remotely easy, it is entirely possible. 

About the author

Sir Leigh Lewis was permanent secretary at the Department for Work and Pensions from 2005-10. Among his current roles he is vice chair of the homelessness charity St Mungo’s

Share this page

Further reading in our policy hubs

Add new comment

Comments

Paul Woodouse (not verified)

Submitted on 20 January, 2017 - 13:38
I feel that a good place to start is to understand why staff are off sick. In my opinion most is now stress related especially in the lower grades, were staff are being lost, their workload is increasing, not mention trying to run a household on a reduced salary (in real terms) over the last 6 years. not to mention for some in HMRC the possibility of losing their job or doubling their commute to work at extra cost to them also. I'm sure staff would welcome any and all suggestions which might relieve their issues.

Sylvester Lennon (not verified)

Submitted on 20 January, 2017 - 13:51
I agree with all the points Sir Leigh raises but I would also add that there is a responsibility for leaders to regularly get together and ensure that standards are consistent. All too often, it is when you see the record of a long or short term case and the lack of attendance intervention, is one of the biggest contributors to sickness absence.

jonny 21 (not verified)

Submitted on 20 January, 2017 - 14:57
If you make people who are infectious come to work because of trigger points you create more sickness because more people catch the illness Also trigger points if reached in one day mean there is no incentive to come back early you have reached the trigger so you may as well take more sick leave at that stage than needed. Also dragging yourself back before you are ready creates relapses and more sick leave. A good manager manages sickness better than any laid down proceedure and will manage his teams will good moral and pride in their work which current higher management does the opposite as they have no idea what they are doing and should be disciplined for creating extra sick leave and extra costs with their incompetent actions and draconian methods which have clearly caused increase sickness. Managing sick leave in its current form should be abolished and office or team managers should be left to manage

Catriona mackley

Submitted on 20 January, 2017 - 15:19
What a prejudiced piece. If the management applied fair an equal policy across the board , instead of inconsistent approach. People don't become " sick " for no reason , but under this government the work pressure an cut backs with little or no reward has left lots of people demoralised. The author uses "new titled words " for old conditions. Shows a clear an prejudiced bias with no real understanding of the issues faced by civil servants. A clear case of do as I say , not as I do - no wonder people want to leave the civil service when they are being talked down to by people like the author/ management.

Pam Munroe (not verified)

Submitted on 20 January, 2017 - 15:32
Whilst I agree with Sick Absence reporting I hope Hr empathise with genuine cases not leaving the Department open to grievance's where disbelief remains a factor.

Janie J (not verified)

Submitted on 20 January, 2017 - 15:48
In our office staff are very reluctant to go off sick and come in when they are obviously contagious, spreading it round the whole office, including to the managers who do the back to work interviews. It's also the case that long term sick can give a false impression of the overall situation, skewing stats significantly. I would like to think though that those with serious illness such as cancer or requiring an operation would not be made to feel guilty or hounded due to high ranking managers feeling a need to clamp down even more. This has happened in the past, with some astonishing and harsh actions towards staff who were going through horrendous medical treatments and procedures. I think things are more supportive now, it would not be good to see a return to those days.

peeved (not verified)

Submitted on 20 January, 2017 - 16:42
So what about staff who have a long-term illness like cancer, who are undergoing chemotherapy which makes them sick and unable to work? do they get the sack because 'they keep being ill'?

Gjules (not verified)

Submitted on 20 January, 2017 - 16:58
Reading that "Making clear that neither repeated short term absences nor long-term continuing absence can continue beyond a certain point. This is not about disbelieving medical evidence nor about abandoning care and compassion. It is about being clear that, beyond a certain point, repeated or long-term sickness absence is simply incompatible with delivering the organisation’s objectives." made me extremely cross and indignant. I have to say neglecting your staff to the point where they collapse under the unrealistic pressure is incompatible with delivering the organisations objectives. If my workplace had been a good enough employer to look after my health and wellbeing in the early stages so I did not get to the point of almost complete annihilation my sickness period would have been far shorter or avoided altogether. I do not think your sickness policies need to be consistently applied but your staff management and wellbeing policies do. As someone who soldiered on for well over 24 months absorbing more and more work to cover numerous vacant posts and additional work to the extent that I made myself extremely ill with stress and exhaustion, because my CS workplace neither took care of me or cared about me , or the work I did, enough to recognise what they needed to do to support me and that they added "unnecessarily to such pressures through constant reorganisations, unrealistic targets, ever-changing management fads and simple ignorance of the pressures which their staff are facing", my recovery has been very long, slow and difficult. I lay the blame for my long term 'sickness' firmly at the feet of my employer who provided courses on how to keep going with resilience techniques as a way to cope, but didn’t provide the help I required or requested to enable me to get that work life balance that was missing. In the last few weeks before I went off sick I was working longer and longer hours to achieve less and less -= a condition I now know is called presenteeism – your sickness policies do not deal with that because if they did then you as employers would have to do something about the workload you expect people to carry when you refuse to fill vacancies long enough that you end up cutting posts as “well we haven’t had anyone in that post this long, so obviously we don’t need anyone!!!!!”

jonny21 (not verified)

Submitted on 20 January, 2017 - 18:54
The current map is flawed and creates much more sickness absence than when local management d/w managing this Using trigger points not only increases stress it is a major factor in increasing sick absence. Most of the staff who need to legitimately take a days sick which pushes them over the trigger limit decide as they are already now at a trigger point they may as well take more sick leave.before returning to work Alternatively those who are contagious but just short of a trigger point come back to work early infecting many others increasing sick leave Whoever thought the current system up should receive at best a must improve for wasting staff time on a system that produces more sick leave.Any local manager could manage sick leave better using less resources and increasing morale and subsequent productivity Before map came in results were much better and morale higher with a smaller %sick leave than under map It is map that is the problem. Managers should be allowed to manage without imposing detrimental methods on them that take significant resourses

jonny21 (not verified)

Submitted on 20 January, 2017 - 22:54
,MAP is the main reason for increases in sick leave. Trigger points in particular lead to this .EG when a genuine days sick leave results in a trigger you may as well take a full week off rather than just the day as the trigger has been reached any way.Alternatively if someone is infectious approaching a trigger encourages them to return to work to soon infecting others resulting in more sick leave.A good manager should be allowed to manage and would manage sickness far better than using this bullying tactic which just reduces morale and hence productivity Whoever introduced MAP should clearly have been marked unsatisfactory for increasing sick leave by causing more work and stress I believe % of sick leave per employee has increased directly because of the introduction of MAP and triggers. By removing MAP morale will improve less Management time will be needed and sick leave will reduce

jonny21 (not verified)

Submitted on 20 January, 2017 - 22:58
,MAP is the main reason for increases in sick leave. Trigger points in particular lead to this .EG when a genuine days sick leave results in a trigger you may as well take a full week off rather than just the day as the trigger has been reached any way.Alternatively if someone is infectious approaching a trigger encourages them to return to work to soon infecting others resulting in more sick leave.A good manager should be allowed to manage and would manage sickness far better than using this bullying tactic which just reduces morale and hence productivity Whoever introduced MAP should clearly have been marked unsatisfactory for increasing sick leave by causing more work and stress I believe % of sick leave per employee has increased directly because of the introduction of MAP and triggers. By removing MAP morale will improve less Management time will be needed and sick leave will reduce

Trigger (not verified)

Submitted on 23 January, 2017 - 12:55
I work in a big open plan office. One of my colleagues was on a 'sick warning'. He got a chest infection but came into work. His cough was horrendous. Other staff started to get it and it became like a mexican wave working its way down the office. An older member of staff got it and ended up with pneumonia. She was threatened with sickness absence warnings when she was off with that. The overall sick record for the office rose that winter and the management of the sickness trigger points was very much to blame.

rick aston (not verified)

Submitted on 24 January, 2017 - 13:32
I must agree with all the points raised by my learned colleagues, it seems to me that mr lewis is blinkered by getting sickness absence down without one word about people with genuine illnesses who are on the verge of permanent disability sometimes, when they are issued with warnings for being unable to work not that they do not want to.

Janice (not verified)

Submitted on 24 January, 2017 - 15:49
"Illness is neither an indulgence for which people should have to pay nor an offence for which they should be penalised, but a misfortune". Wise words. If someone is found guilty of abusing the system, deal with the abuse but do not penalise sick people.

HW (not verified)

Submitted on 25 January, 2017 - 08:26
An interesting article from Sir Leigh. Nobody could disagree with the points made. After all - who wants to be ill? Who doesn't recognise that there is a cost to sickness absence and an impact on productivity? The key part of Sir Leigh's article is where he asks whether the employer is in fact contributing to sickness absence. Take HMRC as an example where bullying is out of control. HMRC employees raise concerns but in too many cases the cover up machine gets into action. What kind of message do cover ups send to staff as to how their employer values them as an employee and as a human being, and how does that affect their health & wellbeing? Negatively I would suggest. When senior management, including the Chief Executive, are aware of bullying, including law breaking, and yet do nothing it doesn't augur well for a healthy organisation. It contradicts their alleged zero tolerance to bullying. The words are good, but if the actions matched, and bullying were rooted out, one can't help feeling wellbeing would improve. Human beings will, as a fact, get ill. If an employer fails to listen to the employee, their doctor and occupational health advice are they supporting the employee or putting barriers in place. An employer's role should be to support them, not bully them. The question has to be, is there something rotten in the culture of HMRC which causes poor health?

Shame on you (not verified)

Submitted on 2 February, 2017 - 12:41
To answer the question of "peeved" sadly I can verify that with this aggressive management of Sickness that a person with cancer will be moved towards dismissal whilst being off for no more than 3 weeks ( stage 4 Lymphoma ) . If a large department as big as DWP cannot the sustain the hope of a person with serious illness then it must be very precariously managed by the likes of Sir Leigh .

Disgusted Commenter (not verified)

Submitted on 3 February, 2017 - 11:52
To add to the comment from "Shame on you" the aggressive management policy you describe is an absolute disgrace, particularly to be a person with such a serious illness. They are deserving of care, support and hope but are unlikely to get in the Civil Service. There is no loyalty from the Civil Service towards their staff. I served HMRC very well for a very long time and in return was hounded out, not least due to bullying from my line management who were breaking the law, and left to deal with poor health, poverty and homelessness. Showing their absolute indifference and distain towards staff they then tried to cover it all up. Its always shocking to see their 'support' for various good causes because from where I am standing it looks hypocritical; they're an example of how not to do things and are way behind the best private sector employers. Maybe if Sir Jeremy isn't going to do anything about this then perhaps our Prime Minister Theresa May, who appears open to a fresh approach to things, should take a close look at it all.

recollection (not verified)

Submitted on 9 February, 2017 - 14:22
below are the concerns I remember when Sir Leigh ran the DWP - I do not remember him recognising them at the time "So what, faced with unacceptably high levels of sickness absence, should employers do? First, in my view, ask themselves whether they are in fact contributing to that level of sickness absence by creating, or at least tolerating, levels of pressure and stress which are substantially higher than they need be. That will never be an easy or comfortable conversation. Organisations face many unavoidable pressures; heightened public expectations, ever greater financial pressures, inescapable staff reductions – none of them can be made to go away. But how often do employers add unnecessarily to such pressures through constant reorganisations, unrealistic targets, ever-changing management fads and simple ignorance of the pressures which their staff are facing? Talk to the next nurse, social worker or shop floor worker you meet if you doubt the truth of that. The chief executive who is not prepared to ask if some of that at least applies in their own organisation is certainly at risk of failing to see the reality they face."

Contact the author

The contact details for the Civil Service World editorial team are available on our About Us page.

Related Articles

Related Sponsored Articles