Keep Britain Working and the end of reactive absence management

As the dust settles on the Keep Britain Working review, employers are required to shift from reacting to illness to proactively preventing it.

If you haven’t yet read the 69-page Keep Britain Working report by Sir Charlie Mayfield, the findings will come as no surprise to experienced HR professionals.

One in five working-age adults are out of work, mainly due to health problems. Mental health issues are rising amongst younger employees and disabled people remain locked out of work.

Even more sobering is the statistic that someone leaving work in their 20s will cost the state £1m in their lifetime, with public spending alone unable to address this.

The stakes are high. Productivity remains low. The economy is faltering and HR leaders, including several vanguards, have been tasked with leading the way into absence prevention.

With Sir Charlie Mayfield planning to publish a framework within the year, what are the principles underpinning the new approach and how can you get behind them?

Principle 1: Catch people before they fall

Described in the report as ‘The Healthy Working Lifecycle’ there is much emphasis on open discussion of health and disability needs. This includes making people feel safe asking for help, early intervention and adjustments to keep people in work.

Unfortunately, as the report highlights, the managers who are critical to making this happen lack confidence and capability when it comes to conducting health conversations at work. They can also shy away from managing employees with health-related absences.

We found this to be the case in our Benefits of Early Intervention Study, which revealed that even when managers have access to occupational health support, one in three still wait until the employee goes absent before offering support.

This is despite evidence showing that two-thirds of employees can be prevented from going absent, if referred into Occupational Health before they become too sick to work. However, the solution doesn’t lie in upskilling managers alone, as the Mayfield Report suggests.

All too often, wellbeing policies restrict occupational health support to cases where someone has been sick for a defined period, leaving managers’ hands tied. This is often driven by cost and the belief that support should be reserved until it is ‘necessary’, even though the likelihood of someone still being in work a month later is halved if support is delayed.

Therefore, catching people before they fall requires more than upskilling managers, which can be achieved relatively easily with a one-off workshop. It also requires a shift in policy and mindset, by convincing the business that early intervention is more cost-effective than treating or replacing employees once they become sick.

Principle 2: Make the business case for wellbeing

As the government strives to enable and incentivise employers to act, another key principle of the Keep Britain Working recommendations is using data as evidence for what works. A Workplace Health Intelligence Unit (WHIU) is to aggregate and analyse data.

As evidence accumulates, this is to be reported annually to ministers, to advise on the introduction of targeted incentives and scale adoption. Quantifying the wider benefit to society is anticipated to be difficult, so the focus will be on the reduction in employer losses.

The new focus is anticipated to change expectations on all employers to better measure the link between wellbeing and key business metrics. The challenge will be creating a single source of truth (a centralised pool of data) so that the impact of initiatives, such as stress reduction, for example, can be linked back to sickness absence, productivity and engagement.

This is easier said than done, as many variables will be at play and the existing data is weak, so HR leaders will need to capture benchmarking ‘before’ data, prior to making changes. It may also be helpful to pilot wellbeing initiatives within certain departments or locations, to determine what impact they are having compared to a wider ‘control group’.

If updating systems to collect this data remains a challenge, surveying employees and cross-referencing results can help. Our nationwide Health at Work survey, for example, found that employees given proactive help to stay healthy were eight times more likely to say they felt extremely productive. They were almost three times more likely to take no sick leave.

Similarly, by identifying which metrics matter most to your organisation, and cross-referencing how benefits utilisation and management support is impacting on those metrics, you can glean useful insights to drive your wellbeing strategy forward.

Principle 3: Embrace reasonable adjustments

As little as ten years ago, most industries argued that they couldn’t accommodate any reasonable adjustments. If someone worked on an oil rig, the view was that they had to be able to do their job as stated, or they were unviable in that role.

Over time, it’s been recognised that if someone has developed a back problem that means they can only lift 15kg, as opposed to 20kg, it’s better to have them doing that, or another role on land, than paying them not to work. Especially when there is a chance of recovery.

Logical as this seems, there is still resistance from employers to accept that it’s better to have someone at 80% of their capacity, than not at all. A major reason for this being that reasonable adjustments are often not properly managed and removed once no longer needed.

As a result, cleaners who were ‘temporarily’ taken off hoovering due to a sprain can still be found with hoovering removed from their role many years later. Likewise, office workers ‘temporarily’ allowed to work from home or in another department may remain there decades on. By then, the adjustment can legally become a change in contract, so it gets ‘stuck’.

Essential to resolving this is managing expectations with the employee from the start and regularly reviewing and removing adjustments once no longer required. If the adjustment has become ‘normalised’ for the employee, this might even require reassessing them to determine if it is clinically required or not and promoting the benefits of returning to full duties.

The key objective is to proactively manage adjustments and ensure they aren’t being left in place unless necessary. For example, in the event of the employee becoming long-term disabled, when the business might also have to accept that it’s better to be able to accommodate an experienced employee, in a slightly reduced capacity, than not at all.

Principle 4: Increase employer accountability

While Keep Britain Working is not legislation, its direction could shape future government policy and regulation around workplace health and disability inclusion. As well as best-practice expectations from regulators, industry bodies and investors.

Much as Environment, Social and Governance (ESG) measures have started to transform expectations on employers relating to their environmental policies, Keep Britain Working is intended to make employee wellbeing a new measuring stick for corporate responsibility.

Leaders will come under increasing pressure to create workplaces that support a ‘healthy working lifecycle’ from the moment employees start, whether the proposed framework on this becomes a certified standard or not.

Companies that fail to create a culture that supports people to remain healthy or fall behind the wellbeing of their peers face reputational risks. Just as environmental standards are becoming a factor in procurement, so too will social factors, such as employee wellbeing.

This is to be welcomed, as the current situation is not only unsustainable, but undesirable. Most people come into the workplace wanting to do well and succeed. Although there are huge societal issues now undermining the health of employees, work can be a force for good.

Nine out of ten employees say their employer has responsibility towards their wellbeing and, at a time when public health services are becoming increasingly overwhelmed, employers are becoming a trusted source of wellbeing advice and support.

The challenge is getting leadership buy-in from the top, to create cultures where the health of the workforce is seen as a vital business driver, rather than a costly distraction. That will require HR to step away from ad-hoc initiatives towards data-driven wellbeing strategies.

Janet O’Neill is head of Occupational Health Training for PAM Group

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