First evidence emerges of possible impact of recession and austerity on stress and mental health.

Overall sickness absence at record low; long-term absence increases with stress and mental health disorders showing biggest increase; Short-term absence and zero absence rates more or less plateaued; Manufacturers increasingly investing in absence management and paying for treatment; ‘Fit note’ seen as delivering little improvement on old sick note; GPs failing to use electronic ‘Fit Note’; Health & Work Service must focus on tackling long term absence and be mandatory; Call for reform of tax incentives to encourage employers to pay for more treatment

 The Government’s work and wellbeing agenda is under major threat as a survey shows its flagship ‘Fit Note’ programme is failing to deliver on getting people back to work four years on from its introduction, whilst long term absence rates have increased.The 2014 Sickness Absence survey, published by EEF, the manufacturers’ organisation and Jelf Employee Benefits is the UK’s largest business survey on the issue. It shows that overall levels of absence have reached a record low of 2.1 percent, equivalent to 4.9 days per employee per year. This remains around the levels seen over the last few years and suggests, in reality, that the situation has plateaued with big inroads into short term absence already made.

 However, the survey reveals that long term absence has increased, with almost two fifths of companies saying long term absence has increased in the last two years. Whilst this reflects to some extent the fact that short term absence is better managed and, therefore, long term absence occupies a higher proportion of overall levels, the survey highlights an increase in stress and mental health illnesses as a cause of long-term sickness absence.

Commenting, Professor Sayeed Khan, Chief Medical Adviser at EEF said:“Driving down absence rates, helping more employees return to work earlier and, encouraging their wellbeing is critical for our economy. But, despite employers increasing investment in managing sickness absence and, providing their employees with more health related benefits, the improvement in overall absence rates has more or less now plateaued.

 “From now on the focus has to be on reducing long term absence which is only going to happen if we up our game. This must start by making the ‘Fit Note’ work so that it can make real inroads on delivering the objective of reducing unnecessary sickness absence.”Iain Laws, Managing Director – UK Healthcare at Jelf Employee Benefits, added: “A focus on prevention must become a priority for UK employers who need to maintain a competitive workforce within an overall population that is both ageing and ailing. This is not only essential to tackle absence but to also address the less easily identifiable issue of presenteeism (reduced job performance resulting from ill health). This is fundamentally a wellbeing problem with stress and musculoskeletal issues almost certainly mirrored as the main causes as with absenteeism.

 “Furthermore, we believe that every day the Health & Work Service is delayed, it costs UK manufacturers time and money in lost productivity and additional administration in getting employees back to work.”According to the survey, stress and other mental health related disorders have shown the biggest increase in long term absence with just over half of companies reporting it as a cause, an increase of 7 percent in the last five years. A fifth of companies cited it as the most common cause, an increase of 4 percent in the last five years. This possibly reflects, for the first time, evidence of the effect on employees of the long period of recession and austerity.

This increase comes despite more investment by employers in managing sickness absence and, placing employee health and well-being programmes on a par with other business investments. Two thirds of companies now have sickness absence programmes, while 68 percent of companies offer access to occupational health services for employees. Over a quarter of companies also offer employee assistance programmes, health checks and health cash plans.

 Yet, despite these investments, there is increasing evidence that manufacturers are seeing no benefits from the ‘Fit Note’, a programme of which EEF has been highly supportive since its introduction. In addition, employers are still reporting that the quality of the advice given by GPs is poor, despite half of employers saying they have made adjustments to enable employees to return to work.Only 24 percent of employers believe that the ‘Fit Note’ has resulted in employees returning to work earlier, compared to 40 percent who said that it had not. More companies disagree (45 percent) than agree (16 percent) that the advice given by GPs about employees’ fitness for work has improved. The gap between those who rate the advice positively and those who view it negatively has widened substantially over the past two years. Focus groups of employers are reporting they are seeing no improvement in return to work under the ‘Fit Note’ system compared to the old ‘Sick Note’. One third of companies did not receive any ‘Fit Notes’ signed ‘may be fit for work’, a figure which has remained more or less consistent in the four years the ‘Fit Note’ has been operating. 40 percent of companies said there was insufficient information in the ‘Fit Note’ to make a decision on making work adjustments, up from 33 percent in 2012. A fifth of companies had not seen any computer generated ‘Fit Notes’ with employers reporting manual notes were still the most common.

 In response, EEF is making the following recommendations:Government setting a cut-off date by which all GPs and medical professionals in hospitals will have received training in use of the ‘Fit Note’. Setting a similar cut-off date following which all ‘fit notes’ must be computer generated. Spending some of the £170m currently earmarked for the Health & Work Service on the training of all 40,000 UK GPs in Occupational Health. EEF estimates this would cost approximately £6m. Make the Health & Work Service mandatory for employees to be referred as opposed to the voluntary scheme currently proposed. Allow companies to offset the cost of intervention where they pay for treatment against business costs as an allowable business expense. EEF’s survey shows half of companies already do this and a greater incentive would encourage more to do so. This would help employees return to work earlier and help reduce pressure on the NHS. The survey of 335 companies was carried out in Spring 2014.