Archived decisions

    audit 2001/2002

    Review of Sickness Attendance Management

    Hampshire Fire & Rescue Service

    INSIDE THIS REPORT

    PAGES 2-4

    Summary Report

    · Introduction

    · Background

    · Audit approach

    · Acknowledgement

    · Main conclusions

    PAGES 5-12

    Detailed Report

    · Policy

    · Operation and training

    · Monitoring and review

    · Occupational Health Service

    PAGES 13-15

    Appendix 1

    · Action Plan

    Introduction

      The management of sickness absence has received much attention in recent years, with a Cabinet Office report recommending that the public sector should aim to reduce sickness absence by 30 per cent. There have always been Audit Commission Performance Indicators (ACPIs) and Best Value Performance Indicators (BVPIs)on the level of sickness absence and it is also an area which is subject to benchmarking comparisons between public and private sectors, with an unwritten assumption that sickness absence is not well managed, and therefore higher, in the public sector.

      Sickness absence carries a measurable cost and is also directly related to continuity of service delivery. In common with all public bodies, fire brigades are expected to operate efficiently and effectively within existing financial constraints. It is essential that best use is made of all available resources in the delivery of high quality service, and maximising the availability of staff is clearly a major element of this. High levels of absence and ill-health retirements are wasteful in terms of the loss of individual skills to the service, the availability if personnel for work, personal difficulties and financial resources.

    Background

      Hampshire Fire & Rescue Service's Corporate Plan for 2001/02 states that the Service has `experienced higher than average levels of long-term sickness during the year, which has contributed to a significant overspend in pay budgets'.

      In acknowledging the high levels of sickness absence, the Service has included in the Personnel function's performance management plan a specific key task to reduce sickness absence. The aim being that improved monitoring at both corporate and local levels would enable stated initiatives to be better targeted. This Service key task directly aligns with the aspiration, stated within the Corporate Plan, that by 2003 the Service will reduce by 20 per cent the number of working days lost through work-related injuries and ill-health of staff.

      To assist the Service in implementing its absence reduction strategy, we have made an assessment of the current systems and those to be installed in the following areas:

      · Policy

      · Operation and Training

      · Monitoring and Review

      · Occupational Health Service (OHS).

    Within each of these areas we have worked closely with the Service to consider the Service's current position compared with best practice principles and have identified issues for the Service to consider in effectively managing sickness absence.

    Audit approach

      The Service is currently undertaking the introduction of the new SAP accounting system and with it a revised system for monitoring sickness absence. Accordingly, to ensure that we provided the most timely support to inform the Service's planning and to contribute to the robust development and implementation of effective sickness management, we proposed to undertake the project in three stages:

      · appraise and comment on the action plans after the first stage of implementation, offering advice and guidance both in relation to project management and best practice

      · evaluate the new SAP system and its introduction, post implementation

      · give formal evaluation and feedback to SMT/Fire Authority.

      The work included:

      · discussions with officers involved in the compilation, management and monitoring of sickness absence data

      · review of policy documents and sickness absence processes and data

      · reference to national models of good practice and comparator authorities.

    Acknowledgements

      We would like to thank all managers and staff for their assistance and co-operation in the course of this review.

    Main conclusions

    Policy

      The Service has taken positive steps to secure better management awareness and responsibility for sickness absence management at all management levels, and has supported various proactive initiatives to address key issues. The Personnel function has made clear progress in identifying aims and achievements for sickness monitoring within its function timeline. Further work and training will be needed to ensure the Service aspires, to, and achieves, good practice and to assess the effectiveness of sickness management post SAP implementation.

    Operation and training

      For the first time, the Service has clearly articulated expectations and deliverables for sickness management, with specific roles and responsibilities for each management level. Management training for this has started and the introduction of Integrated Personal Development System will link roles and competences which should go a significant way to addressing the increasing issues of stress management for uniformed staff. This should also ensure that a more structured approach to return to work interviews is adopted to provide managers with a further tool to manage sickness absence, especially regular short-term absences.

    Monitoring and review

      It was anticipated that the introduction of the SAP accounting system in April 2002 would facilitate improved and robust sickness absence management. However, the delay in implementation by Project Enterprise has meant that accurate recording and monitoring has only partially been achieved and that management still must rely on historical/predictive data to track trends and sickness levels and take appropriate action. It is crucial to ensure that the new system is sufficiently flexible to meet the needs of the Service: for example, in allowing remote input of data and producing relevant and timely management reports on frequent short-term absences. The current status of SAP implementation means that the Service has significant problems in achieving effective sickness attendance management and it is crucial that this situation is expedited with Project Enterprise at the earliest possible date.

    Occupational Health Service

      The re-establishment of the OHS to function solely within the Service has enabled the service to take positive steps in developing proactive strategies to further address sickness issues. For example, the service is currently undertaking a pilot muscular/skeletal care project to reduce sickness absence due to injury, and a Welfare Adviser, Service Fitness Adviser and second OH nurse have been recruited to support employees remaining at, or returning to work. However, within the Service, the issue of stress management and awareness is only seen as important at senior management level to the successful delivery of the service, although there is increasing evidence of both officers and support staff experiencing stress due to increased workloads and service expectations. Further work is needed to reduce risk to performance on sickness management.

Status of our reports to the Fire Authority

    Our reports are prepared in the context of the Statement of Responsibilities of Auditors and Audited Bodies issued by the Audit Commission. Reports are prepared by appointed auditors and addressed to Members or officers. They are prepared for the sole use of the audited body, and no responsibility is taken by auditors to any Member or officer in their individual capacity, or to any third party.

    - SECTION 1

    Policy

      Sickness policies, procedures and an overall strategy should be in place within the Authority to ensure the best use of resources and skills and the delivery of a high quality service. All staff should understand, and be committed to, their role in achieving this corporate aim. Sickness absence management should be championed at senior management team level and discussed/monitored on a regular basis. It should be seen as a key component of the total HR strategy, linking to the development and operation of other HR policies and procedures.

    Best practice

    Current status

    Recommended action

    It should form part of an overarching dynamic and strategic approach to workplace health, and an integral part of the fire authority's health and safety and personnel policies.

    Detailed as part of the Personnel and Training and Health and Safety key tasks for 2002/03 and 2003/04. Part of Personnel corporate plan for 2002/03 to 2007/08.

    Also forms regular agenda item, with the relevant BVPIs, at the quarterly SMT meeting.

    		  

    There should be a single policy document for sickness management which covers all staff and clearly defines roles and responsibilities for individuals and departments.

    Currently within Service Order (SO) 1/2/8.

    There is an increased level of training for managers programmed on attendance management.

    Management training on attendance management must be undertaken and regularly reviewed. This should be linked to IPDS.

    It should incorporate a commitment to health promotion and lifestyle counselling to encourage a healthier workforce.

    This is implicit in SO 1/2/8. OHS&W has its own strategic objectives (seen in timeline on website).

    Covered in Section 8 of Service Orders.

    		  

    The policy should show how its impact will be monitored, progress measured and how it will be regularly reviewed.

    OHS&W involvement is documented in the Corporate Plan on the website.

    SMT get quarterly reports on the trends/costs of sickness.

    Within the current review, the measurement of impact needs to be developed, with key deliverables and responsibilities set out clearly by function. For example, absence levels which will trigger a formal sickness monitoring interview should be agreed.

    It should specify how sickness absence should be recorded, monitored and analysed to identify patterns and trends, and to enable effort to be appropriately targeted.

    Evidenced within SO 1/2/8. although not in specific detail.

    Absence reports are submitted on a quarterly basis; these include costings and the impact of sickness on ridership numbers.

    It is important to ensure that SAP guidelines/protocols are in place, and appropriate training on input and reporting received.

    Best practice

    Current status

    Recommended action

    It should state explicitly the role and function of OHS, including the balance between preventing sickness and treating it and the criteria for access to its specialist services.

    Mentioned in SO 1/2/8. The main focus is found in Section 8 of SOs.

    The policy should set out what management information should be collected and to whom it should be provided. This information should include the cost of sickness absence. Definitions and standards should be clear, including protocols which take account of patient confidentiality.

    Management Information is collected and circulated, but is not specifically documented in the policy. Costs are given to SMT on a quarterly basis.

    OHS&W has a confidentiality charter. It is intended to develop a similar charter for Personnel (although there is no time scale for this at the moment).

    The protocol on confidentiality is now accessible on the Service website.

    A procedural note should be sent to all team leaders and managers.

    Protocols for staff/medical confidentiality concerning employees should be developed and circulated to all relevant managers.

    The policy should be communicated to all staff with continuing follow-up communication (including the Home Office Workbook `Managing Absence from Work') to ensure the issue remains current, and there should be a member of the top management team who is responsible for `championing' the issue of sickness management.

    OHS&W publish regular bulletins on routine notice via PROFS. There are regular promotions and specific mail-shots (eg on stress/trauma). As part of induction for all staff, there is an introduction to SOs.

    DCFO is the `champion' on issues of sickness management.

    It will promote a supportive rather than punitive approach.

    SO 1/2/8 follows this approach (although many uniformed managers see the policy as too soft).

    It emphasises the importance of managers recognising their responsibility to take action in dealing with attendance management and not abdicating this role to corporate personnel.

    Training should emphasise the crucial factor of management responsibility to ensure the effective application of this policy. This will need effective change management.

    Best practice

    Current status

    Recommended action

    It will establish procedures for identifying factors in the workplace that cause or contribute to ill health, and for addressing these.

    Although return to work interviews are undertaken to establish cause of sickness absence, including factors in the workplace, they are still conducted on an ad hoc basis.

    Health screening is undertaken as part of the induction process and for all staff over 40 and night workers. There is voluntary screening for all staff every two years.

    Return to work interviews must happen as a matter of course. Random sampling should be undertaken to assess whether procedures are being applied consistently. Managers must ensure that completion of self-certificates by their staff.

    SECITON 2

    Operation and training

      There should be clear protocols for reporting and monitoring sickness absence. Appropriate skills training should be given to all relevant managers to enable them to fulfil their management responsibilities effectively and without unnecessary stress. Staff/managers should understand the cost of sickness absence and corporate targets for effective management.

    .

    Best practice

    Current status

    Recommended actions

    There should be flexible working procedures which allow absence for domestic reasons without the need to go sick.

    A policy for covering `emergency' situations is currently being developed.

    Further work is needed on flexible working procedures.

    It should specify how to report sickness and to whom, including the details required when reporting an injury on duty or any other injury and the reporting procedure when returning to work. It should specify what records should be kept and for how long. It should provide for all injuries/
    accidents, on or off duty, to be appropriately investigated and documented.

    Such information is given out with contracts for new starters, and is also available in FM/112/8 on sickness monitoring and the Injury on Duty form from OHS&W.

    The revised staff handbook is about to be circulated to staff. This includes details on the procedures/processes and roles/
    responsibilities relating to attendance management.

    Protocols should be attached to the revised SO as an appendix. This should include instructions on appropriate record keeping.

    It will specify clearly the responsibilities and accountabilities of individuals, line managers, brigade management, and members of the fire authority.

    Reference is made to this in the current SO.

    It will be included in the forthcoming introduction of IPDS.

    Should be included in management competences.

    The policy should specify what contacts should be maintained with staff off sick and allocate responsibility for maintaining those contacts. It should state who should visit and how often - ie appropriate arrangements for maintaining supportive, effective and regular contact with personnel absent from work due to sickness.

    Evidenced by SO 1/2/8. Managers guidance notes are also available.

    		  

    Best practice

    Current status

    Recommended actions

    The policy should specify the use of `return to work' interviews, including after a period of compassionate leave, and training should be available to those conducting both these and structured sickness review interviews, to ensure they are undertaken in a supportive manner, resulting in agreed outcomes and adequate recording.

    This is included in SO 1/2/8.

    Training is covered under a separate SO, but it doesn't talk about interviews after compassionate leave. This is currently under review and due to be update in 2003.

    The policy should set out the criteria for `modified duties' to be offered to staff returning from sick leave. The employee and their manager should be included in the discussion about duties to be performed.

    This is covered in SO 1/2/8. OHS&W are consulted and monitor progress.

    The Policy should set out criteria/establish trigger points for management interventions that are appropriate and effective with timely and effective referrals to the OHS. It should include documentation required from management when referring a case to OHS specialists.

    Evidenced in SO 1/2/8. There is also a management guidance note available.

    It will require the Fire Authority to be regularly informed about sickness absence and the associated costs.

    Quarterly reports on the cost of sickness are given to SMT.

    Annual performance figures on attendance management are given to the Fire Authority.

    Regular Management briefings should include a report on the cost of sickness so that staff understand the financial implications of sickness absence.

    It will include arrangements to provide support for employees suffering from drug and alcohol-related illness, substance abuse and stress.

    There is a drug and alcohol policy already in place. Stress awareness training is about to be introduced, with the pilot study in Control Room. A substance misuse policy is also about to be introduced.

    .

    It should differentiate between management of sickness and the use of other `capability' measures.

    This is detailed in SO 1/2/8.

    SECTION 3

    Monitoring and review

      It is impossible to implement sickness reduction effectively without suitable monitoring tools. Accurate data is required for line managers to monitor attendance and identify individuals with poor attendance for appropriate action/support. Intervention protocols should be appropriate to the patterns of sickness absence. An integrated personnel system should be developed to enable the production of timely and relevant management information and facilitate informed action for improvement. This should also promote local ownership to allow line managers to monitor the accuracy of the recording system.

    Best practice

    Current status

    Recommended actions

    Sickness should be counted in hours to take account of long working days due to flexible shifts or short working days due to part-time or civilian staff working. There should be clear protocols for checking data.

    Sickness can be counted in hours or days or both.

    The data is not checked at the current time.

    Staff should validate their own records, including sickness.

    Sickness should be categorised according to the WHO classification.

    Not at the current time. It is also unclear whether SAP uses WHO categorisation.

    The Service should use categorisatation consistent with other Services to effect appropriate comparison of performance.

    The collection of data should be computerised, and the system should be capable of producing a range of reports to enable effective sickness absence monitoring at any level of the organisation. This should include a graphics package to portray the pattern of absence. All data collection systems should be integrated and compatible.

    This is currently under development. Current sickness absence data is not readily available/out-of-date.

    It is a key issue for the Service to ensure that SAP implementation incorporates all reporting elements which will support effective absence sickness monitoring. For example; SAP is not yet sufficiently robust to be able to track those who abuse the sickness recording system.

    Project Enterprise should expedite this situation as a matter of urgency.

    Sickness levels should be discussed at management meetings as a standing item and taken into account when considering promotion, transfers, and in annual appraisals.

    There are regular management review meetings with OHS and case conferences on a monthly basis.

    SAP should provide trigger point reports.

    Sickness levels are not considered in appraisals/transfers at the moment, although they might be addressed before a promotion offer is made.

    Further work is required to ensure a consistent approach. Each management level should receive the necessary information to effectively monitor/manage sickness absence.

    Sickness records should be checked before an appointment is made.

    SECITON 4

    Occupational Health Service

      An OHS should take a proactive approach to providing advice and guidance to management and staff to reduce risk of occupational disease or disorder and to promote a healthy lifestyle. And increase morale and motivation. Information on sickness absence should be shared in confidence with the personnel function to facilitate the identification of trends and effective communication.

    Best practice

    Current status

    Recommended action

    An integral OHS should be provided. Senior managers should have access to medical professionals when required. There should be mechanisms for monitoring the standards of service delivered.

    Yes. Clear targets and performance measures are published on the website. Regular reporting and summaries are given to the Senior Management Team.

    Local performance indicator(s) on sickness absence should be developed and implemented.

    The level of clerical/administrative support should be sufficient to ensure that the professional specialists spend the maximum time using their specialist skills.

    Yes. There is a full time admin support post at OHS&W.

    		 

    The balance between treatment and prevention should be clear.

    Yes. Preventative action is taken via Bulletins/mail-shots. A Service Physical Fitness Adviser has taken up post acting as an internal consultant on all aspects of physical fitness and then health of employee groups. Regular health screening has been introduced and a muscular-skeletal care strategy developed.

    		  

    There should be swift access to physiotherapists and associated professionals. It should be possible for specialists to provide fast-track treatment to speed up return to work by use of specific funding or other means.

    Private funding to specific professionals is available and assessed on need by the Personnel Manager.

    Individual staff financial contribution to specific treatment has been introduced.

    The back care pilot originally run in `B' division is to be extended county-wide.

    		 

    Wide use should be made of OHS specialists' advice: for example, when devising training and recruitment packages.

    OHS has some input to recruitment training. Will have an active role in the management training for sickness absence.

    		 

    Best practice

    Current status

    Recommended actions

    There should be specific provisions made to deal with stress- for example; regular interviews with a psychologist or professional counselling.

    Employee Support Line/
    Welfare Adviser/OHS&W/
    stress booklets and training/
    referral to Marchwood Priory available. Pilot study on stress management in the Control Room was completed in 2002.

    Stress management is a specific key task for OH for 2003/03.

    Stress management should be recognised as a key issue to be addressed more widely though the Service. Line managers and employees should be actively engaged and involved in addressing this issue.

    The Control Room action plan identified in the Stress Management pilot should be implemented.

    1

    Action Plan

Page

Recommendation

Priority

1 = Low

2 = Med

3 = High

Responsibility:

Job title/name

Agreed

Comments

Date

5

R1 Management training on attendance management must be undertaken and regularly reviewed. This should be linked to IPDS.

3

5

R2 Within the current review, the measurement of impact needs to be developed, with key deliverables and responsibilities set out clearly by function.

3

5

R3 SAP guidelines/protocols must be in place and appropriate training on input and reporting received.

3

6

R4 A procedural note on management information should be sent to all team leaders and managers.

2

6

R5 Protocols for staff/medical confidentiality concerning employees should be developed and circulated to all relevant managers.

3

6

R6 Training should emphasise the crucial factor of management responsibility to ensure effective application of attendance management policies.

3

Page

Recommendation

Priority

1 = Low

2 = Med

3 = High

Responsibility:

Job title/name

Agreed

Comments

Date

7

R7 Return to work interviews must happen as a matter of course. Random sampling should be undertaken to assess whether procedures are being consistently being applied. Managers must ensure the completion of self-certificates by their staff.

3

7

R8 Further work is needed on flexible working procedures.

3

7

R9 Protocols should be attached to the revised SO as an appendix. This should include instructions on appropriate record keeping.

3

8

R10 Regular management briefings should include a report on the cost of sickness so that staff understand the financial implications of sickness absence.

3

9

R11 Staff should validate their own records, including sickness.

3

9

R12 The Service should use categorisation of sickness consistent with other Services to effect appropriate comparison of performance.

3

Page

Recommendation

Priority

1 = Low

2 = Med

3 = High

Responsibility:

Job title/name

Agreed

Comments

Date

9

R13 Action must be taken as a matter of urgency by the Service/Project Enterprise to ensure that SAP can produce essential management reports on sickness absence.

3

10

R14 Each management level should receive the necessary information to monitor/manage sickness absence effectively.

3

10

R15 Local performance indicators on sickness absence should be developed and implemented.

3

11

R16 Stress management should be recognised as a key issue to be addressed more widely though the Service. Line managers and employees should be actively engaged and involved in addressing this issue.

3

11

R17 The Control Room Stress Management action plan should be implemented.

3