Appendix 1
BRIDGEND COUNTY BOROUGH COUNCIL
CORPORATE RESOURCES AND IMPROVEMENT OVERVIEW AND SCRUTINY
COMMITTEE
19 APRIL 2010
REPORT OF THE ASSISTANT CHIEF EXECUTIVE – CORPORATE DEVELOPMENT &
PARTNERSHIPS
REPORT OF THE SICKNESS ABSENCE RESEARCH & EVALUATION PANEL
1.
Purpose of Report
1.1
The purpose of the report is to present the Committee with the findings and
recommendations of the Research and Evaluation Panel to date relating to
Sickness Absence.
2.
Connection to Corporate Improvement Plan / Other Corporate Priority
2.1
The key Aims and Priorities identified in the Corporate Improvement Plan 2008 –
2011 have been embodied in the Overview & Scrutiny Forward Work Programmes.
The Overview and Scrutiny Committees engage in review and development of
plans, policy or strategies that support the Corporate Priorities.
3.
Background
3.1
On the 20 May 2009 the Corporate Resources & Improvement Overview and
Scrutiny Committee received a report on sickness absence within the Authority and
the initial results of the Zeal Health Audit.
3.2
In consideration of this issue the Committee received information on the level of
sickness absence from three national studies, which placed Public Sector sickness
absence levels in the UK for 2007/8 between 9.0 and 9.8 days per full time
equivalent (FTE).
3.3
The Committee also considered the level of sickness absence within the Authority
as reported within the 2007/8 Relationship Managers Annual Audit Letter (RMAAL)
which reported an average of 14.8 days per FTE. In considering the difference in
these reported sickness levels the Committee resolved to establish a Research and
Evaluation Panel (the “Panel”) to investigate opportunities to reduce absence levels.
3.4
The project plan for the investigation was presented at the 13 July 2009 meeting of
the Committee and the following Members were identified to sit on the Panel:





Cllr B. Burns (Chair)
Cllr N. Clarke
Cllr M. Gregory
Cllr M. Wilkins
Cllr H. Williams
A-1
Appendix 1
3.5
In addition to this membership, the Panel at its first meeting on 4 August 2009 coopted representation from the Unions for the life of the investigation. At this
meeting the Branch Secretary for UNISON suggested that they would put forward a
representative to sit on the Panel on behalf of all the Unions operating within the
Authority. The Panel therefore accepted the nomination of John Hughes as a coopted member of the Panel.
3.6
The central research proposal of the Panel was twofold:
3.7

To consider the Authority’s existing policy arrangements for managing sickness
absence;

To identify transferable best practice examples of reducing absence within the
public sector.
Investigations by the Health & Safety Executive (HSE) into the management of
sickness absence in the public sector concluded that action is needed in three core
areas: 1

To secure sustained commitment from managers at the top level;

To deliver the right data and systems to support better attendance
management;

To provide leadership and support for line managers.
3.8
In choosing areas for investigation the Panel sought to develop recommendations
to redress any issues that arose in relation to the three areas for action indentified
by the HSE.
3.9
The terms of reference for the Panel were:
1

To undertake stakeholder consultation to determine potential options for
reducing sickness absence and make recommendations on this basis;

To review the roles of the various sections involved in recording and monitoring
absence and identify any changes in process which might be desirable;

To consider management practice and management training in relation to
sickness absence and assess current performance against best practice
examples;

To investigate the viability and potential of any initiatives in line with the
Councils current approach, which can be introduced on a spend to save basis;

To consider the cost of sickness absence to the Authority.
Health and Safety Executive Managing Sickness Absence in the Public Sector November 2004
A-2
Appendix 1
4.
Current Situation / Proposal
4.1
Executive Summary
4.1.1 In undertaking its investigation the Panel recognise that sickness absence is an
ongoing and evolving issue. The formulation of the recommendations which are
presented to the Committee within this report, have been undertaken by the Panel
taking a strategic overview of current methods used in the management of sickness
absence within the Authority. After consideration of the evidence presented, the
Panel developed recommendations under the following categories operational,
reporting, financial, training and partnering.
4.1.2 The Panel would also like to acknowledge that sickness absence levels at an
organisational level decreased from 14.83 days per FTE in 2007/8 to 14.32 in
2008/9. Furthermore substantial reductions have been achieved over the first three
quarters of 2009/10 with a 21% reduction in the total number of FTE days lost from
56,663 to 44,568 over the same period in the previous year.
4.1.3 This improving trend reflects:
–
the high priority that is now given to the management of attendance by the
Corporate Management Board (CMB) and Cabinet;
–
the implementation and monitoring of a new policy that specifies how
attendance should be managed across the Council;
–
dedicated training on the Return to Work Interview process and Attendance
Management policy;
–
increased focus on individual service areas such as Wellbeing that have
experienced particular challenges with sickness absence in the past; and
–
cultural changes within the organisation, in the main part precipitated by the
‘Leadership and Development’ programme which promotes a culture of
continuous improvement.
4.1.4 During the course of the investigation it became apparent that in addition to taking a
strategic overview of sickness absence, there is a need for further investigation
through more targeted analysis. This additional investigation would include the
range of operational issues experienced as a result of sickness absence as well as
analysing the patterns of sickness absence such as the changing incidences of
short and long term absence. The Panel therefore consider that the findings of this
report represent the completion of the first phase of its investigation into sickness
absence only.
4.1.5 The recommendations of the Panel and the categorisation which apply to them are
presented in Table 1 :
A-3
Appendix 1
Table 1: Recommendations of the Panel
No.
1:
2:
3:
4:
Description
The Panel recommends that a project board is set up to manage the issue of sickness
absence for BCBC.
The Panel recommends the development of a clear and coherent action plan which
sets out all the measures and details the range of activities to be undertaken to
contribute to creating a positive attendance culture and therefore reduce sickness
absence.
The Panel supports the Wales Audit Office finding that it is good practice to regularly
report the actual amount of money spent on sick pay and recommends that the
Authority should report on this on an annual basis.
Type
Operational
The Panel recommends that in order to limit the potential of hidden patterns within the
data, more detailed analysis and reporting of sickness absence takes place. This
should include by:
Reporting



5:
6:
Operational
Reporting
Demographic group;
Grade;
Occupation type.
Management information should also distinguish between the number of days lost to
short term and long term sickness absence and state the number of long term
absences this information relates to.
The Panel recommends that further consideration should be give to setting
differentiated targets for:
 short term and long term absences;
 individual seasons (quarters) of the year.
The Panel recommends that the number/percentage of employees taking no absence
in each Directorate should be reported on, as good attendance should be recognised
as well as poor.
Reporting
Reporting
7:
The Panel recommends that a development plan be produced outlining options and
costs for optimising the Trent system and that this plan should be reported back to
Cabinet no later than April 2011.
Reporting
8:
The Panel recommends that self service for entering absence data should be trialed
within one service area to ascertain whether the organisation is ‘culturally’ ready to roll
this out on a wider basis.
Operational
9:
The Panel recommends that attendance on the Return to Work Interview and
Attendance Management training courses should be mandatory for all those with
current line management responsibility.
Operational
10:
The Panel recommends that all new managers or those newly designated line
management responsibilities be required to attend the Attendance Management and
Return to Work Interview Training as part of their probationary period in the new post.
The Panel recommends that in order to identify sickness absence management
training needs that appraisals should be carried out throughout the organisation and
that consideration be given to standardising the period in which appraisals take place.
The Panel recommends that if HR are to continue to provide an additional service to
schools in relation to RTW interviews that schools should be recharged the cost for
the provision of this service.
Operational
13:
The Panel recommends that the Corporate Resources and Improvement Overview
and Scrutiny Committee receive a detailed report regarding the effect/outcomes of the
RTW Interview Training 12 months on from the inception of the course.
Reporting
14:
The Panel recommends that the ‘Managers Guidelines to Accessing and Using the
Occupational Health Service’ is put onto the Intranet and that there is a need for
greater promotional activity by utilising all methods of corporate communication, to be
devoted to the marketing of the OH services available to staff.
Reporting
15:
In light of the impending accommodation review the Panel recommends that separate
accommodation for the counselling service is maintained in order not to prejudice
confidential consultations by staff.
Operational
11:
12:
A-4
Operational
Financial
Appendix 1
16:
Due to the high level of staff sickness absence resulting from stress and
musculoskeletal disorders, the Panel recommends moving to a seven day trigger for
OH for these key absences rather than the existing 15 day trigger in place.
Operational
17:
The Panel recommends that due to the high level of absence related to stress, training
should be made more widely available to:
 managers in identifying and signposting employees experiencing stress; and
 employees in coping mechanisms available to deal with and reduce stress.
The Panel recommends that as many of the best practice examples of OH provision
are undertaken in-house, and recognising the shortage in OH practitioners, that the
potential for shared OH services be explored with other Local Authorities.
Training
19:
The Panel recommends that a report to Cabinet is undertaken to provide a business
case for introducing the early intervention/preventative aspects of best practices
examples such as flu jabs, MSD return to work programmes, MRI scans etc. This
report should be completed no later than April 2011.
Financial
20:
The Panel recommends that there is greater coordination of health and wellbeing
events, that a programme is put together on an annual basis and that information on
these events should be placed and promoted on the Intranet and other forms of
corporate communication.
The Panel recommends that further investigation is undertaken into the feasibility of
introducing the types of health and wellbeing initiatives identified as best practice, with
a view to submitting a report to Cabinet no later than April 2011.
Reporting
The Panel recommends that the project to achieve the Corporate Health Standard is
given a specific budget in order to allow linear progression through the awards.
The Panel recommends that consideration be given to using mediation in instances
whereby this could provide a swift resolution to relevant sickness absence issues.
Financial
18:
21:
22:
23:
4.2
Partnering
Reporting
Operational
The Investigation
4.2.1 The Panel met on ten occasions, which included a mixture of presentations,
consultation exercises and semi structured interviews. The dates on which the
Panel met and the themes of the issues explored are identified below:
1.
4 August 2009
2.
3.
2009
4.
5.
6.
19 August 2009
15
September
7.
22 January 2010
8.
9.
1 February 2010
7 April 2010
10.
9 April 2010
29 October 2009
24 November 2009
7 December 2009




Review of Project Plan;
Co-option of Union representation.
Presentation on MidlandHR – TRENT.
Policies and Practices within BCBC.










Return to work interviews.
Occupational Health Services
Corporate Health Standards;
Tax Free Cycle Scheme.
The cost of sickness absence;
Senior Management Interview.
Interview with GMB and Unison Trade Unions
Cabinet Member & Senior Management Interview;
Absence Management Policy;
Draft recommendations and conclusions.
4.2.2 In addition to receiving presentations and conducting interviews the Panel were
provided with relevant academic, government and industry literature, a complete
bibliography of which is found under section 9 of this report.
A-5
Appendix 1
4.2.3 The Panel would like to thank the following Members and officers for their input into
the Sickness Absence Investigation:


Cllr David Sage
Cllr Huw David
Deputy Leader
Cabinet Member Resources






David MacGregor
Sarah Kingsbury
Julie Bryant
Stuart Charles
Ron Peverley
Richard Watkins
Assistant Chief Executive
Head of Human Resources
Employee Relations Manager
Health and Safety Manager (since left)
Training and Development Officer
Senior Officer, Development


Jane Iles
Neil Birkin
Branch Secretary UNISON
Branch Secretary GMB

Steve Edgell
Cycle Solutions
4.2.4 Through the investigation the Panel also engaged with Remploy who have received
funding through the European Social Fund to deliver a £23 million Wellbeing
through Work programme throughout Wales. As part of the Panel’s engagement
with Remploy opportunities were explored for undertaking a pilot project through
BCBCs ‘Health Works Programme’ specifically relating to absenteeism and this
initiative will now be taken forward by the Wellbeing Directorate.
4.3
Project Planning
4.3.1 The Panel interviewed officers and discussed several distinct areas of the Council
that deal with issues relating to sickness absence. The Panel appreciated the
corporate approach to sickness absence by senior management, however noted
the issue that there was no overall project or action plan set up to deal with
sickness absence holistically.
4.3.2 This can be seen to be in contrast to best practice elsewhere and an example of
the project plan for the Vale of Glamorgan is attached at Appendix A. The different
sections which had some input into increasing attendance at work either directly or
indirectly included the:










Health and Safety Unit;
IMASS – Occupational Health Provider;
Counselling Service;
Transactions Team;
Systems (Trent) Team;
Organisational Development (Training);
Pay and Reward Team;
Health Social Care and Wellbeing Manager (Absenteeism Project);
Policy and Performance Management Unit (reporting absence);
Transport Policy and Development Team (Travel Plans).
A-6
Appendix 1
4.3.3 The Panel consider that by utilising the Centre of Excellence project and
programme management toolkit officers would be able to clarify the roles of
Corporate Management Board (CMB), HR and the other sections involved in
managing and reducing sickness absence. Embedding the principles of the toolkit
will also provide greater assurance that the risks posed to the Authority from
sickness absence are managed effectively.
4.3.4 Corporately coordinating the management of sickness absence through one project
will help to facilitate the alignment of policies and initiatives designed to encourage
attendance at work with policies and procedures intended to discourage
absenteeism. It will also enable work streams, responsibilities and targets to be
identified and clarified and help identify and develop corporate wide initiatives that
can aid in the reduction of sickness absence.
4.3.5 As a result of the Project Planning investigations, the Panel have made the
following recommendations:
Recommendation 1:
The Panel recommends that a project board is set up to manage the issue of
sickness absence for BCBC.
Recommendation 2:
The Panel recommends the development of a clear and coherent action plan
which sets out all the measures and details the range of activities to be
undertaken to contribute to creating a positive attendance culture and therefore
reduce sickness absence.
4.4
Costing Absence
4.4.1 At present BCBC does not record or report on the cost of sickness absence. The
Panel as part of its investigation looked to quantify the financial cost of sickness
absence to the Authority. The Wales Audit Office state that:
It is good practice for an organisation to report regularly on the actual
amount of money paid via sick pay, and to express that as a
percentage of the whole paybill.2
4.4.2 The Panel was provided with the case study at Appendix B to demonstrate the
financial cost of absence for one month within a randomly selected care home. The
Panel was advised that the absence levels within the case study were typical of the
Authority’s three other care homes.
4.4.3 The Panel was informed that this calculation was compiled manually as the Trent
software in its existing form could not automatically calculate the cost of sickness
absence. Within this case study the direct financial cost of absence for one month
was £6,417 attributable to the provision of cover either through existing staff
undertaking overtime or through agency staff. It should also be noted that the cost
of the existing salaries for staff not present was £7,033 and that this figure
2
http://www.wao.gov.uk/1572.asp
A-7
Appendix 1
represents the cost of non productive staff time. This second figure is not however
a direct cost of sickness absence as the salary would be incurred whether the
employee was absent or not.
4.4.4 Extrapolating this over a 12 month period and across the Authority’s four care
homes there is the potential cost of £308,037 per year in cover costs, where a
reduction in sickness absence would generate cashable efficiency savings. The
cost of non productive salary costs in this extrapolation would be £337,560 per
year, where a reduction in sickness absence would not create any cashable
savings.
4.4.5 It is not possible to project these figures across the Authority for two reasons:

the Adult Social Care division has the highest level of sickness absence within
BCBC (standing at 25 days per FTE in 2008/9 compared to 14.3 days for the
whole Authority);

the majority of service areas do not provide cover for employees who are
absent from work due to sickness.
4.4.6 Utilising the Wales Audit Office guidance for calculating the cost of sickness
absence it is possible to generate an indicative cost for absence within BCBC. The
following rudimentary calculation only considers one factor – direct salary cost of
absence and can be used to illustrate the potential scale of the costs associated
with sickness absence. The calculations are based on the following factors:



lowest possible salary for an employee at BCBC of £6.30 per hour in 2008
(spinal column point 4);
the average number of full time equivalents during 2008 of 5,189;
the total days lost through sickness absence in 2008/9 was 74,336.
4.4.7 Evidently the remuneration of employees will vary widely across the organisation,
however for the purpose of this illustration each employee is assumed to be on the
minimum level of salary and no employer overheads have been included such as
national insurance (NI) contributions and superannuation. Within this illustration it
is also important to reiterate that direct salary costs would be payable whether the
employee was absent from or present for work. Increasing attendance in this
example would therefore result only in a non cashable efficiencies. It is also
important to note that the actual cost of absence across the organization would
include several other direct and indirect costs such as:



Overhead costs such as NI and superannuation;
Temporary cover/overtime/agency costs;
Lost productivity;
4.4.8 Although these factors are not included within this illustration reducing sickness
absence which resulted in the payment of the second bullet points would generate
cashable efficiency savings.
4.4.9 It is possible using the sickness absence figures reported in national studies to
show the effect on the Authority if BCBC sickness absence equated to those levels
and this is shown at Table 2:
A-8
Appendix 1
Table 2: Costs Illustration
BCBC
Welsh LA Average
English LA Average3
CBI Public Sector4
CBI Private Sector
Days Per
FTE
14.3
11.5
9.6
9.0
5.8
Total Days
74,336
59,570
49,811
46,698
30,094
Salary Cost
£3.5 million
£2.8 million
£2.3 million
£2.2 million
£1.4 million
No. of Extra
FTE’s
294
235
197
185
119
4.4.10 Within this illustration if BCBC was at the Welsh LA average for sickness absence
the reduced number of lost days per year would be the equivalent of 59 more full
time equivalent employees at work and there would be a non cashable efficiency of
£0.7 million. If BCBC was at the English LA average this would increase to the
equivalent of 97 more full time employees at work and a non cashable efficiency of
£1.2 million.
4.4.11As a result of the Costing Absence investigations, the Panel have made the
following recommendations:
Recommendation 3:
The Panel supports the Wales Audit Office finding that it is good practice to
regularly report the actual amount of money spent on sick pay and recommends
that the Authority should report on this on an annual basis.
4.5
Data and Target Setting
4.5.1 Through the process of the investigation, the Panel was presented with
considerable amounts of data in relation to different aspects of sickness absence
monitoring, some of which is not routinely reported within the Authority.
4.5.2 The National Audit Office considers that:
Accurate, timely and accessible information is the cornerstone of a
successful absence management policy. Managers need information at
an individual level, but an overview of how teams and departments
compare across organisations. Such information provides an essential
indicator of how problems may vary across the organisation.5
4.5.3 One significant problem identified within studies of sickness absence is that most
headline figures mask patterns of absence which, while dominated by sporadic or
short-term absences, are skewed by significant proportions of long-term absence.
Thus for example while many organisations report on the total number of days lost
or days lost per full time equivalent it is often forgotten many employees take no
3
Local Government Sickness Absence Levels and Causes Survey 2006 -2007
4
The Confederation of Business Industry (CBI) Report 2008
5
The National Audit Office Research Paper Current thinking on Managing Attendance
A-9
Appendix 1
absence at all during the year. To limit the impact of hidden patterns within the data
the Work Foundation recommends that absence data should be recorded and
reported by:6





Division/Location;
Occupation type;
Job Level/Grade;
Gender;
Age.
4.5.4 The Panel in its interview with senior management was provided with the sickness
reporting information used within the Authority. This management information
provides an ‘at a glance’ picture of the level of sickness absence across the
Authority. It also provides trend data since the first quarter of 2008/9.
4.5.5 The Panel was informed that significant work had been undertaken to improve data
capture within the organisation and that both Cabinet and CMB were now confident
that the data collected and presented was now accurate.
4.5.6 Examples of the data used by Cabinet and CMB when considering sickness
absence have been recreated in Graphs 1 and 2 below. It should be noted that this
is only a sample of this information and that this data is also broken down at
Division level for each Directorate.
Graph 1: Total Number of FTE days lost per quarter
Number of FTE Days Lost
10000
8000
Children
Communities
6000
Corporate D&P
Legal & Reg
4000
Resources
Wellbeing
2000
0
QTR1
2008/09
6
QTR2
2008/09
QTR3
2008/09
QTR4
2008/09
QTR1
2009/10
QTR2
2009/10
The Work Foundation was formed out of the Industrial Society in 2002
A - 10
QTR3
2009/10
Appendix 1
Graph 2: Average FTE days lost per employee per quarter
6.00
Dayss lost per FTE
5.00
4.00
3.00
Children
2.00
Communities
Corporate D&P
1.00
Legal & Reg
0.00
Resources
QTR1
08/09
QTR2
08/09
QTR3
08/09
QTR4
08/09
QTR1
09/10
QTR2
09/10
QTR3
09/10
Wellbeing
4.5.7 The Panel were pleased to note that trends revealed through interrogation of data
by CMB directly led to specific targeted intervention and this was evidenced for
example by the fact that a full time officer had been seconded to work within the
Wellbeing Directorate to address the high level of sickness absence.
4.5.8 The Panel also considered that it was extremely important to use a variety of
methods to interpret available data. To demonstrate this it can be seen that in
graph 1 the Children’s Directorate (including schools) is responsible for the largest
number of FTE days lost, however this Directorate also has the largest number of
employees. When relating the data to work force size in graph 2 it is shown that
per FTE employee that Wellbeing has the highest level of absence, while the
Children’s Directorate has performance comparable to that of the four other
Directorates.
4.5.9 While existing analysis of information provides a base line to broadly examine
sickness absence across the Directorates and their Divisions, the Panel was made
aware that enhanced profiling of existing data could be achieved through trend
analysis and target setting in relation to:






individual seasons (quarters) of the year;
short term absence levels (less than 15 days);
long term absence levels (more than 15 days);
average absence at Directorate level;
average absence at Division level;
statistical analysis of deviation from average;
A - 11
Appendix 1
4.5.10 This type of additional analysis could be used for example as part of a process to
trigger an exception report to Cabinet each time a Directorate’s sickness level falls
significantly outside that of what could be considered ‘normal performance’. An
exception report could contain for example details of the underlying reasons for
high absence and identifying the methods proposed to reduce it.
4.5.11 As well as exploring the data that is routinely used to manage sickness absence,
the Panel also examined additional data not routinely presented in management
information:
% of Directorate FTE Days
lost
Graph 3: Absence reasons by Directorate (April 2008 – April 2009)
Largest absence reasons by Directorate
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
Children's
Communities
Resources
Wellbeing
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Reason
4.4.12 The information in graph 3 above, was originally presented to the full Committee in
its consideration of sickness absence on 20 May 2009 and can be used to illustrate
how enhanced data analysis can help to identify potentially hidden trends within the
routine management data.
4.4.13 As can be seen the Communities Directorate suffers from a disproportionate level of
absence due to back and neck problems, while Wellbeing Directorate suffers from a
disproportionate level of absence due other musculoskeletal problems. These
disproportionate levels of absence are possibly due to occupational specific issues
related to moving or handling either heavy equipment or people (e.g. Adult Social
Care).
4.4.14 Considering the differing likelihood of sustaining certain types of injury/sickness is
possibly affected by occupation type, it may be beneficial to report on and set
specific sickness absence targets by occupational type as well as by
Directorate/Division.
A - 12
Appendix 1
4.4.15 As a result of the Data and Target Setting investigations, the Panel have made the
following recommendations:
Recommendation 4:
The Panel recommends that in order to limit the potential of hidden patterns
within the data, more detailed analysis and reporting of sickness absence takes
place. This should include by:



Demographic group;
Grade;
Occupation type.
Management information should also distinguish between the number of days lost
to short term and long term sickness absence and state the number of long term
absences this information relates to.
Recommendation 5:
The Panel recommends that further consideration should be give to setting
differentiated targets for:


short term and long term absences;
individual seasons (quarters) of the year.
Recommendation 6:
The Panel recommends that the number/percentage of employees taking no
absence in each Directorate should be reported on, as good attendance should
be recognised as well as poor.
4.6
Systems - Trent
4.6.1 As part of the investigation the Panel was provided with a demonstration of the
Trent system that is used to record sickness absence.
4.6.2 The Panel was informed that significant development work was being undertaken
on the system Phase 1 of which, to correctly assign staff under the correct manager
had been completed. Phase 2 to correctly assign staff to jobs was now in progress.
The Panel also learned that recent work had been undertaken to provide a fix to
avoid potential double counting of absence where an individual had more than one
job role within the Authority such as a person who was a cleaner and a school
crossing patrol.
4.6.3 From the presentation a number of potential issues and development opportunities
were identified. One such issue revealed was that once an incidence of absence
was recorded on the system, it was not possible to change the reason for absence
at a later date. This caused a problem if for example the information had been
entered incorrectly or if the reason for absence changed during the same period off
work.
A - 13
Appendix 1
4.6.4 The Panel also explored the opportunity with officers for ‘self serve’ features
through the Trent system. ‘Self serve’ is a feature that could be developed through
Trent to allow managers and staff to input or view data directly from their own
computer. ‘Self serve’ offers significant efficiencies in time as for example at
present return to work forms are completed by managers either by (part) electronic
or hard copy and returned to HR. Presently HR are then required to enter the
details contained on the form onto the Trent system resulting in a duplication of
effort required to complete the process. Through automating the process
managers could complete the return to work forms online, which would
automatically drop into the Trent system database thereby eliminating related data
input activity which takes place in HR.
4.6.5 Officers confirmed that there was significant potential through Trent for self serve
options that could produce efficiencies however there was a need for a ‘cultural’
change within the organisation to realise this. Potential opportunities for developing
Trent were not constrained to entering sickness absence data but included much
wider applications such as authorisation of leave, viewing of payslips online,
emailing payslips direct to employees, and automating reminders of triggers to
managers for sickness and appraisals.
4.6.6 In the 20 May 2009 report to Committee the Health and Safety Manager also
identified that further development of Trent could allow for more detailed analysis of
sickness statistics which could include:




More detailed analysis of absence causes by directorate and service areas;
More detailed analysis of long term absence causes;
Reporting on absences where return to work forms (RTW) were not completed
or left blank;
Comparison of long term and self certified absences within each
directorate/service area.
4.6.7 The Panel recognised that any system was only as effective as the information
entered into it and noted with concern the level of RTW information which was
supplied as blank or incomplete. The fact that managers could not be relied upon
to complete RTW forms after absence indicates that implementing a self serve
option without the requisite managerial cultural changes to make it effective would
be counterproductive.
4.6.8 As a result of the Systems -Trent investigations, the Panel have made the following
recommendations:
Recommendation 7:
The Panel recommends that a development plan be produced outlining options
and costs for optimising the Trent system and that this plan should be reported
back to Cabinet no later than April 2011.
Recommendation 8:
The Panel recommends that self service for entering absence data should be
trialed within one service area to ascertain whether the organisation is ‘culturally’
ready to roll this out on a wider basis.
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Appendix 1
4.7
Training – Return to Work Interviews
4.7.1 The Panel received a presentation on Return to Work (RTW) Interview training that
is currently provided to managers. Through the presentation the Panel learned that
attendance on the training was not compulsory for managers who had this
responsibility as part of their job role, but rather was driven by the individuals own
motivation for personal development.
4.7.2 The Panel was alerted to the issue of poor attendance on corporate run courses as
a whole, and although as at 29th October 2009 eleven courses had been run with
106 attendees, three more had to be cancelled due to poor attendance.
4.7.3 The Panel considered whether training could be linked to the appraisal system but
were informed that appraisals were not consistently undertaken throughout the
Authority. Officers informed the Panel that planning corporate training as a whole
could be improved if the appraisal system was rigorously applied throughout the
organisation and took place over a set period rather than at different times
throughout the year.
4.7.4 The Panel questioned whether since engaging in the training there had been any
improvement in the quality of the return to work forms and a commensurate
reduction in the number of blank forms returned. However it was felt that it was too
early in the process to establish whether there had been any significant
improvements.
4.7.5 In considering the application of the RTW interview the Panel learned that
responsibility to undertake the interview rested with individual line managers,
however a different system was in place for schools. Currently some Head
Teachers would not undertake RTW interviews unless accompanied by a member
of staff from HR, although this process incurred an extra cost not experienced
elsewhere schools were not recharged for the undertaking of HR visits. In relation
to HR advisors attending appointments for staff that have been on long term
sickness in schools, as at the 22nd of January there were 23 ongoing cases and
these have involved 58 appointments for the advisors. Each appointment could
take up to 2 hours at a time.
4.7.6 As a result of the Training – Return to Work Interview investigations, the Panel have
made the following recommendations:
Recommendation 9:
The Panel recommends that attendance on the Return to Work Interview and
Attendance Management training courses should be mandatory for all those with
current line management responsibility.
Recommendation 10:
The Panel recommends that all new managers or those newly designated line
management responsibilities be required to attend the Attendance Management
and Return to Work Interview Training as part of their probationary period in the
new post.
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Appendix 1
Recommendation 11:
The Panel recommends that in order to identify sickness absence management
training needs, that appraisals should be carried out throughout the organisation
and that consideration be given to standardising the period in which appraisals
take place.
Recommendation 12:
The Panel recommends that if HR are to continue to provide an additional service
to schools in relation to RTW interviews that schools should be recharged the
cost for the provision of this service.
Recommendation 13:
The Panel recommends that the Corporate Resources and Improvement
Overview and Scrutiny Committee receive a detailed report regarding the
effect/outcomes of the RTW Interview Training 12 months on from the inception
of the course.
4.8
Treatment – Occupational Health
Current Provision
4.8.1 In order to asses the services offered to employees absent from work due to ill
health, the Panel considered current occupational health (OH) provision and
compared this to best practice examples.
4.8.2 Currently OH is commissioned from Industrial Medical and Safety Service (IMASS)
who have entered into a three year contract with BCBC to provide OH services.
The Panel were informed that prior to commissioning IMASS, OH had been
undertaken by another provider. IMASS undertake:




Sickness Absence assessments/Ill Health Retirement
Pre-employment Screening
Health Surveillance
Driver medicals
4.8.3 In addition to this the following other services are available to BCBC Employees:


Physiotherapy
Inoculations
Physiotherapy and Hepatitis A/B inoculations are provided via the Princess of
Wales Hospital.
4.8.4 Through interviews with officers the Panel became concerned that the OH services
were poorly promoted throughout the Authority and that in particular the ‘Managers
Guidelines to Accessing and Using the Occupational Health Service’ was not
available on the Intranet.
A - 16
Appendix 1
4.8.5 The Panel was particularly interested in the offering of counselling services,
specifically because of the high proportion of absence related to stress (see graph
3 above).
4.8.6 Within BCBC the category “stress, depression and mental health issues” accounted
for approximately 19% of the all FTE days lost during 2008/9. As reported by the
Health and Safety Unit, absences in this category have an average duration 22
days per incidence, which is significantly higher than the average duration for all
absences which stands at five days.
4.8.7 Through OH employees can access counselling sessions and specialised Cognitive
Behaviour Therapy. At present the Counsellor is contracted to work 25 hours per
week but the Panel noted this Counsellor frequently works in excess of this.
External Counsellors are used to provide group therapy sessions and to assist with
the workload of the in-house Counsellor. The Health and Safety Manager informed
the Panel that in his experience approximately 60% of cases referred to counselling
were not as a direct result of work matters but as a result of home/life issues and
there was not a great deal that could be done to prevent such cases.
4.8.8 The Panel recognised the importance for discretion in the provision of counselling
services and were keen to preserve the separation of such services away from the
main offices. The Panel also expressed concern that there was currently no specific
training available for managers in dealing with employees experiencing stress,
although this type of training had taken place in the past.
4.8.9 The Panel were supplied with the current costs (total £153,557pa excluding
property rental) related to OH provision within the Authority:




The annual cost of our OH provider is circa £116,841 per annum.
The annual cost of external Counselling Services is circa £3,168 per annum
The annual cost of internal Counselling Services is circa £23,580 per annum
The annual cost of Physiotherapy Services is circa £9,968 per annum
4.8.10 In considering the distribution of these costs the Panel were concerned that the
limited resources devoted to Counselling Services may be inadequate to deal with
the high level of sickness absence related to stress.
Best Practice
4.8.11 As part of the investigation the Panel were provided with best practice examples of
OH recognised by the Wales Audit Office or the Health and Safety Executive. The
key differences from current provision are out lined below:
Dyfed- Powys Police
4.8.12 Dyfed Powys Police have adopted a strategy of early intervention for managing
occupational health services. In 2005/2006 the clinical operations budget alone
(£46,335) demonstrated a basic cost saving of £338,340, which does not include
hidden savings such as improved performance. This is equivalent to a saving ratio
of 7:1.
A - 17
Appendix 1




In house Physiotherapy for a number of sessions each week offers
appointments and immediate treatment for Musculoskeletal Disorders (MSDs);
Direct physio consultation without OH physician referrals saving OH physician
resource;
A Wellness Adviser to assist individuals with diet and exercise regimes and to
co-ordinate a force-wide network of volunteer ‘Wellness Facilitators’;
Investment on private specialist consultations and treatment, including
operations and Magnetic Resonance Imaging (MRI) scans. Funding decision
are based on a cost benefit calculation demonstrating a cost saving. Details of
the cost benefit calculation are presented at Appendix C.
Carmarthenshire County Council
4.8.13 Carmarthenshire Council invested £109,000 per annum on resourcing in-house OH
service since October 2005. This has helped to reduce absence from 8.4% – 7.4%
of total FTE days lost, saving an estimated £500,000 of work time. Many of the
elements of the Carmarthenshire service are replicated in BCBC, however, some
key differences are:




Defined service levels including some challenging response times;
“day 7” trigger for key absences e.g. MSDs, Stress,
“Fast tracking” of medical services e.g. MRI consultations;
Regular health promotion: smoking cessation, lifestyle screening etc.
Centrica Gas
4.8.14 Centrica Gas established an innovative Back Care Programme in 2005, to support
employees with a history of back problems. Through a programme of workshops
the organisation has introduced a self-management approach to help employees
experiencing chronic back pain to manage their condition. More than 300
employees have participated in workshops, which have delivered significant results.






Lost time pre-workshops = 1,105 days; lost time post-workshops = 626 days;
73% of those participating in the programme had no related time off work;
The programme delivered a return of £31 for every £1 invested;
69% of participants planned to participate in a daily exercise routine;
One year post-workshop 69% of participants reported reduced pain;
The cost benefit to the business for each participant averaged £1,660.
Barts and the London NHS Trust
4.8.15 Since 1999 the Trust has offered free flu jabs to its employees. Evaluations of the
initiative revealed that immunised staff suffered average annual sickness absence
of 2.4 days per person. This compared with an annual rate of 3.2 days per person
for the non-immunised employees.
4.8.16 In 2001/2002 the average cost of absence was circa £400 per day (direct and
indirect costs), so the saving per immunised member of staff was £318 per person
per year. As 683 employees had the jab in 2001/2 this saved the Trust around
£217,000 in sickness absence. The cost of the jab was approximately £8,000 for
the vaccine itself and the nurses’ time in administering it, with the time staff spent
A - 18
Appendix 1
away from work receiving the jab estimated at £15,500. Total cost of the initiative
was therefore £23,500, with the total net saving generated through this initiative
£193,500.
4.8.17 As a result of the Treatment – Occupational Health investigations, the Panel have
made the following recommendations:
Recommendation 14:
The Panel recommends that the ‘Managers Guidelines to Accessing and Using
the Occupational Health Service’ is put onto the Intranet and that there is a need
for greater promotional activity by utilising all methods of corporate
communication, to be devoted to the marketing of the OH services available to
staff.
Recommendation 15:
In light of the impending accommodation review the Panel recommends that
separate accommodation for the counselling service is maintained in order not to
prejudice confidential consultations by staff.
Recommendation 16:
Due to the high level of staff sickness absence resulting from stress and
musculoskeletal disorders, the Panel recommends moving to a seven day trigger
for OH for these key absences rather than the existing 15 day trigger in place.
Recommendation 17:
The Panel recommends that due to the high level of absence related to stress,
training should be made more widely available to:
 managers in identifying and signposting employees experiencing stress; and
 employees in coping mechanisms available to deal with and reduce stress.
Recommendation 18:
The Panel recommends that as many of the best practice examples of OH
provision are undertaken in-house, and recognising the shortage in OH
practitioners, that the potential for shared OH services be explored with other
Local Authorities.
Recommendation 19:
The Panel recommend that a report to Cabinet is undertaken to provide a
business case for introducing the early intervention/preventative aspects of best
practices examples such as flu jabs, MSD return to work programmes, MRI scans
etc. This report should be completed no later than April 2011.
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Appendix 1
4.9
Prevention - Health and Wellbeing Initiatives
4.9.1 In addition to exploring existing and potential treatments available to employees,
the Panel investigated preventative health and wellbeing measures.
4.9.2 Studies into Health and Wellbeing initiatives have categorised five components that
health initiatives can address:7

Physical Health is influenced by factors such as smoking, alcohol and nutrition;

Emotional Health is an individual’s mental state of being. It is influenced by
stress, the reaction to stress and the individual’s ability to relax and devote time
to leisure;

Social Health is the ability to ‘get along’ with others, such as family members,
friends and colleagues, giving and receiving love or friendship, and feeling
goodwill toward others;

Spiritual Health is the condition of an individual’s spirit, such as having a feeling
of purpose in life;

Intellectual Health is conditioned by an individual’s achievements such as those
experienced at work, hobbies and cultural pursuits or through serving the
community.
4.9.3 It is important to note that each of these factors is interconnected and that
successful workplace health programmes should consider all aspects of an
individual’s health.
4.9.4 Health initiatives generate a variety of benefits for organisations and include:



Reduced medical care costs including absenteeism;
Enhanced productivity; and
Improved organisational image.
4.9.5 Although studies have found the financial benefits of health and wellbeing initiatives
difficult to quantify some evidence does exist to show a positive correlation on an
‘invest to save basis’. Examples of this in the UK include the London Underground
which has seen a return on investment of eight to one following the introduction of a
stress reduction programme.
4.9.6 Studies have also found that a key benefit of health initiatives is in assisting
organisations to attract, recruit and retain quality employees.8 Closer congruence
between the values of employees and the values of the employer is shown to
results in more satisfied employees who will remain with the organisation longer.
Current Provision
7
Harris, J. & Fries, J., (2002), ‘Chapter 1: The Health Effects of Health Promotion in Health Promotion in the
Workplace, edited by O’Donnell, M., 3rdedition, Delmar Thomson Learning, NY.
8
DeGroot, T. & Kiker, S.D., (2003), ‘A meta-analysis of the non-monetary effects of employee health
management programs’ in Human Resource Management, Spring; 42; 1, pp.53-69
A - 20
Appendix 1
4.9.7 The Panel received a presentation on BCBC’s ambition to achieve the Corporate
Health Standard which is the national mark of quality for wellbeing in the workplace.
The standard promotes good practice and supported organisations in taking active
steps to protect and promote the health and wellbeing of their employees. The
standard is awarded at different levels, Bronze, Silver, Gold and Platinum and is
achieved incrementally from the Bronze stage with organisations building through
each stage to Platinum level. Platinum is reserved for exemplar employees
demonstrating business excellence, who take full account of their corporate social
responsibility
4.9.8 The requirements of each stage are presented in tables three and four below:
Table 3: Core Components
Bronze
Silver
Organisational
support for
employee health and
well-being
Communication
via briefings/e-mail/
notice boards
A health and
wellbeing action plan
Recording of sickness
absence data
Employees receiving
and providing
information
Employee health
and well-being
in strategic
documents/polices
Communication via
Internet/Intranet/
newsletters/staff
surveys
Staff attitude
survey and
response
Evaluation of
health and well
being activities
Employee
participation
Table 4: Specific Policies and Activities
Bronze
Silver
Health and safety
policy
Mental health
promotion policy
(can be part of the
health & safety
policy)
Musculoskeletal
disorders policy (can
be part of the health
and safety policy)
Smoke-free policy
Alcohol &
substance misuse
policy
Gold
Platinum
Employee health
and well-being
integrated into
core values
Staff appraisal
or performance
management
Sharing of
knowledge and
experiences
Employees taking
responsibility
for health and
well-being
Staff involvement in
policy review
Focus groups
Partnership
working within the
community
Gold
Platinum
Information
available on health
benefits of smoke
free policy
Systems to allow
staged return to
work
Access to/or
provision of
occupational health
services
Alcohol policy that
is ‘alcohol free’
Mentoring
and sharing of
knowledge and
experiences
Corporate social
responsibility
integrated into
core values
Confidential
counselling
Promotion of
general health
issues
Physical activity
and healthy eating
promotion
Green travel plan
Linking with local
support groups/
helplines/services
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Appendix 1
Physical activity
or healthy eating
promotion
4.9.9 The Panel was advised that whilst the Authority had previously held the bronze
standard but that this had lapsed several years previous and that the immediate
aim was to re-achieve this level again during 2010.
4.9.10 In order to achieve the Standard a number of HR policies had been revised to
reflect the awards requirements such as the ‘Dignity at Work Policy’, with further
policies currently in development including the ‘No Smoking’ and ‘Alcohol
Awareness’ policies. Other health initiatives undertaken as part of working to the
Standard included the ‘Stair Challenge’, free provision of breast sense gloves,
testicular cancer awareness sessions and free eye tests.
4.9.11 The Panel queried what would be required by the organisation to move on to
achieve the next level of the Standard and officers confirmed that there would be
the need for further commitment and funding for stress/mental health awareness
training, staff time to attend smoking cessation, health promotion events and
initiatives as well as active travel arrangements such as changing and shower
facilities and cycle racks.
Best Practice
Cardiff County Council
4.9.12 There is overwhelming evidence that exercise can prevent or delay the onset of
illness or reduce its severity. Considering this Cardiff has implemented an
ambitious cycling scheme, which includes an ‘On Your Bike’ campaign supported
by Active Life Cardiff.
4.9.13 The cycling initiative is a key element of the Council’s physical activity programme,
which includes a commitment to promoting exercise generally.
4.9.14 Initially, the project was concentrated at County Hall where the largest numbers of
employees are located, but the scheme is to be rolled out to other sites in the near
future. The scheme includes:








A cycle pool which includes an electric bike
Cycle parks where employees have their own lockers if they use their own bikes
A travel centre which has maps of the whole city to enable users to plan their
routes
A designated cycling officer who offers one-to-one discussions on suitable
routes
Cycle buddies who will accompany people
Assisted bike purchase schemes and loans are being considered
Council grants in order to purchase a milometer for a bike
Employees are also being encouraged to cycle into work and to use a pool car
while in work.
Unilever
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Appendix 1
4.9.15 Unilever currently employees in excess of 7000 people at 16 different UK and Irish
locations. In 2007 the organisation undertook to benchmark the health of its
employees with 3150 employees participating. Analysis of the data identified the
three highest health risk areas:



54% of employees tested were overweight,
14% had high blood cholesterol levels
68% were not meeting recommended weekly activity levels.
4.9.16 In light of these findings 17% of participants (543 individuals) were immediately
referred to a GP, pharmacist or to the OH team for further health investigation. The
organisation also developed a ‘Health & Vitality Programme’ which is evaluated for
effectiveness on an ongoing basis. Interventions developed through the programme
include:

Creating the right environment for employees to lead healthier lifestyles such as
overhauling on-site eating options with changes to the types of food served;

Running a series of Health Awareness Modules on issues from healthy cooking
to nutritional knowhow;

Introducing an innovative personal coaching system ‘MiLife’ for high risk
employees. Employees are provided with a physical activity monitor worn on
the wrist and a personal set of weighing scales that send data via Bluetooth to
the employee’s online programme. This online programme features tailored
wellbeing support.

Free or subsidised gym facilities, run by trained instructors, at some of the
organisations major sites.
4.9.17 Outcomes from these interventions show:

91% of the 260 employees who started the MiLife programme participated for
the full 12 week duration. On average, employees lost 3.4 kgs, weekly activity
levels increased and blood pressure levels reduced significantly;

Sites with gyms have seen visits increase by as much as 30%;

Healthier catering changes have been held up by the Food Standards Agency
as an example of best practice, with healthy alternatives outselling existing
menus.
Boots
4.9.18 In the UK Boots employs over 70,000 people in stores, factories, warehouses and
offices. The organisation has developed a clear business case for taking measures
to improve the health and well-being of its employees. To capture data the
organisation now undertakes the bi-annual ‘Boots Great Place to Work Survey’.
Results have shown that those stores with higher levels of ‘engagement’ with
initiatives have lower absence rates, higher turnover and a higher profit contribution
(3% higher than targets). Initiatives introduced as part of the programme include:
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Appendix 1

People Packs’ for every employee including health information and freebies e.g.
pedometer, fruit snack, Vitamin C and a waist tape measure;

A new ‘People Programme’ to provide employees with extra support to give up
smoking (Commit to Quit) or be more active (Commit to Get Fit & Healthy);

Healthy Living events including free fruit giveaways, Body Mass Index checks,
and walking/cycling promotion;

A ‘Wednesday Walks’ promotion encouraging employees to take a 25-minute
power walk around the Boots HQ site once a week.
4.9.19 In addition to reduced sickness absence and higher productivity other outcomes
from these interventions include:

“My Health” is now part of the Boots employment brand and the programme has
received financial support from the business;

‘People Packs’ have been distributed to over 65,000 employees and are very
popular;

1,050 employees signed up to Commit to Quit/Commit to Get Fit in 2006. A
further 1,001 employees signed up these programmes in 2007;

Over 500 employees have participated in over 50 ‘Wednesday Walk’ sessions.
Interest in walking at lunchtime has been boosted, especially when linked to
charity campaigns.
4.9.20 As a result of the Preventative – Health and Wellbeing Initiatives investigations, the
Panel have made the following recommendations:
Recommendation 20:
The Panel recommends that there is greater coordination of health and wellbeing
events, that a programme is put together on an annual basis and that information
on these events should be placed and promoted on the Intranet and other forms
of corporate communication.
Recommendation 21:
The Panel recommends that further investigation is undertaken into the feasibility
of introducing the types of health and wellbeing initiatives identified as best
practice, with a view to submitting a report to Cabinet no later than April 2011.
Recommendation 22:
The Panel recommends that the project to achieve the Corporate Health
Standard is given a specific budget in order to allow linear progression through
the awards.
4.10
Attendance Management
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Appendix 1
4.10.1 Through formal interviews with Cabinet, Senior Officers and the Unions the Panel
considered the different perspectives and experiences of the application of the new
Attendance Management Policy.
4.10.2 Discussions between the Panel and invitees revealed:
–
there was recognition that there was a clear need to reduce sickness
absence to ensure the organisation continues to be more effective and
efficient;
–
that there would inevitably be sickness absence and that when this occurred
the aim was to return people to work as soon as reasonably practicable;
–
that the employer had a duty of care to its employees and that sickness
absence should be reduced in a fair and equitable manner;
4.10.3 The Panel discussed opportunities for improving processes such as in the situation
whereby sickness absence and grievances were linked.
4.10.4 One such option put forward for discussion by Panel members was third party
mediation which could provide a solution to such instances. Mediation is carried out
by organisations such as ACAS.
4.10.5 In considering the option for employing third party mediation the Panel was
informed that senior management considered that this may be of benefit in some
instances and were prepared to explore all opportunities which could provide a swift
resolution to issues and return an employee to work.
4.10.6 The Panel received information regarding changes in legislation that may have an
impact on the present Attendance Management Policy. Workers who are off sick for
longer than seven days will now receive fit notes instead of sick notes from their
GPs. Doctors will still be able to say someone is not fit for work, but they will also be
able to spell out aspects of jobs workers can perform.
4.10.7 The Panel was informed that a briefing was being prepared for distribution to all
employees, designed in consultation with the Unions and in accordance with
guidelines produced by the HSE. The Employee relations team have also set up a
dedicated telephone number for employees to use in the event that they are issued
with a fit note and require advice and guidance on what this means for them.
4.10.8 The Panel explored the issues surrounding redeployment of staff, however in light
of the impending changes that would impact on this through the fit note the Panel
decided that this would need more detailed consideration during the second phase
of the investigation.
4.10.9 As a result of the Attendance Management investigations, the Panel have made
the following recommendation:
Recommendation 23:
A - 25
The Panel recommends that consideration
be given to using mediation in
instances whereby this could provide a swift resolution to relevant sickness
absence issues.
Appendix 1
5.
Effect upon Policy Framework & Procedure Rules
5.1
The work of the Corporate Resources and Improvement Overview and Scrutiny
Committee relates to the review and development of plans, policy or strategy that
form part of the Policy Framework and consideration of plans, policy or strategy
relating to the power to promote or improve economic, social or environmental well
being in the County Borough of Bridgend.
6.
Legal Implications
6.1
There are no legal implications at this stage. However, some of the
recommendations may have legal implications and further advice would need to be
given at the relevant time in respect of the implementation of these measures.
7.
Financial Implications
7.1
There are no financial implications at this stage. However, some of the
recommendations may have legal implications and further advice would need to be
given at the relevant time in respect of the implementation of these measures
8.
Recommendations
The Committee is asked to determine:
I.
II.
which if any of the recommendations outlined above it wishes to submit
to Cabinet, subject to any modifications and amendments that the
Committee decides are appropriate.
whether or not it wishes the Panel to progress a second phase of the
investigation as outlined in paragraph 4.1.4.
David MacGregor,
Assistant Chief Executive – Corporate Development & Partnerships
Contact Officer:
Laurence Darley, Scrutiny Officer
Telephone:
01656 643696
Overview & Scrutiny Unit
Bridgend County Borough Council,
Civic Offices,
A - 26
Appendix 1
Angel Street,
Bridgend,
CF31 4WB
[email protected]
9.
Background documents
CRI Overview and Scrutiny Committee Reports 20 May 2009
DeGroot, T. & Kiker, S.D., (2003), ‘A meta-analysis of the non-monetary effects of
employee health management programs’ in Human Resource Management, Spring; 42; 1,
pp.53-69
Finnish Institute of Occupational Health Sickness absence and stress factors at work 2003
Harris, J. & Fries, J., (2002), ‘Chapter 1: The Health Effects of Health Promotion in Health
Promotion in the Workplace, edited by O’Donnell, M., 3rd edition, Delmar Thomson
Learning, NY.
HSE Managing Sickness Absence in the Public Sector November 2004
HSE Survey of Workplace Absence Sickness and Health (SWASH) 2005
Leaker, D. ‘Sickness Absence from work in the UK’ Economic & Labour Market Review
Vol.2:11 November 2008 Office for National Statistics.
LGA Local Government Workforce Overview 2007
LGA Local Government Sickness Absence Levels and Causes Survey 2006 -2007
McQuaid,A. Annual Letter Bridgend County Borough Council Wales Audit Office,
December 2008
The Cabinet Office Analysis of Sickness Absence in the Civil Service 2008
The Chartered Institute of Personnel and Development (CIPD) National Survey 2008
The Confederation of Business Industry (CBI) Report 2008
The National Audit Office Research Paper Current thinking on Managing Attendance
Websites
www.hse.gov.uk/
www.wao.gov.uk
www.theworkfoundation.com/
www.workingforhealth.gov.uk/
A - 27