By Suzannah Brecknell

23 Jan 2017

Civil service leaders have long tried to cut sickness absence rates among their staff. But, asks Suzannah Brecknell, are they looking at the full picture?

First, the good news. Civil servants are – on average – taking fewer days of sick leave each year. In 2007, the average number of working days lost to ill-health (AWDL) for each civil servant was nine. By 2015-16, the figure had fallen to 6.1 days. In some departments, levels of sickness absence have fallen even more dramatically. At the Department for Work and Pensions, a consistent focus from senior leaders and collaboration between HR and occupational health teams has helped to reduce AWDL by 45% since 2005. 

Despite that progress, however, civil service managers are by no means complacent about employee wellbeing. Civil service health and wellbeing champion Jonathan Jones has just started a new three-year programme aimed at sharing the best work already taking place across government to cut sickness absence.

Next, the not-so-good news. Falling AWDL figures may not tell us much at all about the health and wellbeing of staff. “In these job-insecure times, absenteeism is no longer a good indicator of organisational wellbeing,” says Cary Cooper, professor of organisational psychology and health at the Manchester Business School. Instead, he suggests that employers should be concerned about presenteeism – which he describes not just as people coming into work ill, but people arriving for work so dissatisfied or stressed that they do not perform effectively. 

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 “In these job-insecure times, absenteeism is no longer a good indicator of organisational wellbeing" – Professor Cary Cooper of the Manchester Business School

Research from the Sainsbury’s Centre for Mental Health suggests that presenteeism can cost an organisation nearly twice as much as absenteeism in reduced productivity. Then there’s the less-well known issue of leavism. Professor Cooper identified this phenomenon with his then-PhD student Ian Hesketh, who was studying resilience in the Lancashire Police Force. While asking police officers about their absences, Cooper and Hesketh noticed that many police officers were saying they had taken annual leave to complete heavy workloads or used it instead of sick leave so that it would not seem as though they were struggling to cope.

Such scenarios are not unique to the police. Anecdotal reports of similar practices across the public sector abound, prompting CSW to conduct its own research into presenteeism and leavism. An online survey of 1,660 public servants – conducted in September 2016 – found that 18% had taken annual leave instead of sick leave in the last six months. Among civil servants the proportion was lower – 11% said they had taken a day of holiday instead of a day off ill.  

Nevertheless, Cooper says the results are worrying, and points to shrinking headcount as one of the contributing factors. “People are so overloaded at work and so afraid of telling their managers,” he says. “There are fewer people doing more work, and they are also much more vulnerable than have been before. There is no job security. People are just as vulnerable in the civil service as they are in the private sector.” 

Our research supports this: when asked why they had chosen to take holiday instead of calling in sick, 59% of civil servants polled said they did not want to trigger a performance review (this figure fell to 54% across all respondents). The second most common reason – given by 20% of civil servants – was that they were afraid of how their manager would view a sickness absence. Next most popular was “other”, and in the free text boxes there were – alongside people who simply had holiday to use up and decided to take it when not feeling totally well – comments indicating concern about taking too much sick leave, or using annual leave during a “flare up” of a long term condition.  

CSW also asked people whether they had considered taking a sick day in the last six months but decided to work instead, and the reasons behind this. The most common reason – chosen by 20% of civil servants – was that they were afraid to take a sick day. The next most common reasons cited were having too much work to do (13%) and not wanting to let the team down (12%).  

According to Cooper, this should concern employers not only because it makes it harder for managers to spot – and support – colleagues who are not coping, but because the negative effects on individuals and their personal lives if they don’t take their proper leave will feed back into their performance at work. “We do need respite, especially in high pressure jobs. If people are not taking their respite, they are more at risk of illness, and are also more likely to do their job less well over a period of time; their productivity may suffer if they are not taking time away,” he says. 

That view is shared by Zahir Irani, dean of the faculty of management and law at Bradford University. He talks of a “spiral of stress” which occurs when staff feel that taking a day of sick leave will leave them worse off, with more work to do on their return. Responding to CSW’s findings on absence and presenteeism, Professor Irani notes that while, in the past, taking a day off may have been seen simply as something one did to get better, it could now be perceived as a sign of weakness and lack of resilience. 

“The key for us is to work with managers so that they can identify that support at an early stage" – civil service chief people officer Rupert McNeil

“Civil servants don’t want to be off sick"

While days lost to ill-health overall are reducing in the civil service, mental ill-health is an increasingly common reason cited for those days that are taken off. A series of parliamentary questions tabled by Labour MP Jonathan Ashworth last year highlighted that more and more absences in the civil service are caused by stress or other mental health concerns. 

The civil service is not alone in seeing rising levels of mental ill health – a third of employers surveyed by the Chartered Institute of Personnel and Development (CIPD) for its 2016 Absence Management report said they had seen an increase in stress-related absence over the last year, while two fifths have seen an increase in reported mental health problems among employees. 

Sarah Page, the Prospect union’s health and safety officer, sees one common factor behind both the data on mental health related absence, and CSW’s findings on presenteeism and leavism. Having shared our research with Prospect members within the civil service, she told CSW she had received the following feedback: “The problem is all to do with performance management, it’s just so toxic, it’s having such an adverse impact on people and their mental health.” 

She believes the current – and highly controversial – system of civil service performance management, which pressures managers to put a set proportion of their staff into a “must improve” category every year, is a risk to people’s health and wellbeing. 

“Civil servants don’t want to be off sick,” she says. “They’re committed, motivated people but undervalued and overworked. Meanwhile the private sector ditched these sorts of punitive, punishing performance management systems long ago.”

It’s good news, then, that a new performance management system is expected to be in place across many departments later in the year. Page also believes there is good work happening across the civil service to support employee wellbeing, especially in the Cabinet Office’s Civil Service Employee Policy team, which she says offers “thoughtful, balanced guidance for managers”. But her concern is that wellbeing or health and safety teams are often under-resourced and overly reliant on support from charities like the Charity for Civil Servants – who are themselves facing resource pressures.

Judith Smith, head of help and advisory services at the Charity for Civil Servants, adds another reason why civil servants may be using annual leave to manage workloads and sickness: to cope with caring responsibilities. The charity issued over 1,500 “carers passports” in 2015, designed to support staff in balancing work with their caring responsibilities. Despite increasing awareness about the pressures carers face, Smith believes there are still many carers who are not properly supported and who feel they cannot take time off work for their own health when they need it. 

Cooper believes that managers with strong interpersonal skills and a positive approach will be crucial in properly improving the wellbeing and resilience of employees. The phenomenon of using annual leave instead of sick leave may superficially mask the fact that a team member is struggling, he says, but “a good interpersonal and socially skilled line manager should see, day in and day out, that this person is not coping”.  

“A good interpersonal and socially skilled line manager should see, day in and day out, that this person is not coping” – Professor Cary Cooper

In most organisations people are promoted for their technical skills or impressive CV, rather than their people management skills, Cooper says, and when people do receive management training it is often theoretical rather than practice-based, or focuses on issues other than basic people management. 

Irani agrees with the need to equip line managers, but he adds that there could be other ways to address the issues of absenteeism and leavism – such as improving working environments, or supporting flexible working when needed. In some cases managers might need to consider employees’ resilience as well as their CVs when thinking about appointments and moves. “There is a matching issue about creating an environment where you allow people to transit out of [high pressure] roles and move new people into roles based not just on skill sets,” he says. “[Skills] are part of it, but there is an individual resilience factor. Some people are more suited to those jobs than others, while others may find their resilience changes over time.”

“Civil servants don’t want to be off sick. They’re committed, motivated people but undervalued and overworked" – Sarah Page, the Prospect union

All of the people CSW spoke to were broadly supportive of the civil service’s approach to, and track record on, supporting employee wellbeing. And the civil service’s chief people officer, Rupert McNeil, tells us that the organisation tries to “support people so that they can remain at work where possible” and “return as soon as they are ready following sickness absence”. He adds: “The key for us is to work with managers so that they can identify that support at an early stage, so that we can make effective use of occupational health and employee assistance programmes.”   

No one questions the commitment of civil service leaders to improving employee wellbeing. However, with workloads increasing and job security falling, the approaches which have helped to drive down absenteeism may need to change if the civil service is to start tackling the less obvious, but equally important, issue of presenteeism. 

Department in focus: HM Revenue and Customs
Via e-mail, an HMRC spokesperson told CSW about the steps the tax authority has taken to cut sickness absence

What have been the main reasons for HMRC’s success in reducing average working days lost to sickness over the last decade?   
There are a variety of contributing factors such as wellbeing, management focus, supporting colleagues, making reasonable adjustments where required and involving occupational health at the right time.   
Long term absence is the most challenging. We have trained advocates in the business who can help people get the support they need.   

What is the most innovative or interesting thing you are doing to promote wellbeing?  
We’re trialling Health Kiosks in a number of buildings. They’re a very visible commitment to wellbeing and allow staff to monitor their weight, BMI, blood pressure etc, and get a bespoke report on how they can improve their health. Continuing to improve our wellbeing offering is an important part of planning our future regional centre workplaces too. We have also developed “occupational health plus” where a manager and individual can speak to an OH practitioner rather than it just being a paper referral. This provides a richer and clearer picture in order to help people back to work.   

What are your wellbeing/absence management priorities now?   
We have just implemented a new attendance management policy. Embedding this and ensuring it is a success is a priority.   

How has the proportion of absences attributed to mental health concerns changed in the last five years at HMRC?   
Mental ill health, including stress, remains one of the reasons for our absence levels but we can see an improvement in the number of absences related to mental health through the use of our advocates, who offer outstanding support to individuals.  

Early and supportive intervention is important in terms of helping people understand and cope with change, and maintain or return to full performance and attendance. Our new policy encourages managers to consider the support needed at day one where staff report a mental health problem, including taking occupational health advice. We know that organisational change is a well-documented stressor, and our wellbeing and mental health strategies include access to specialist clinical support for people who need that additional help. Communicating the scale and pace of transformation is key too, so we have an ongoing conversation with our staff about building the future HMRC and their part in that.

Mental Health in focus
Data published in response to parliamentary questions shows that some departments have seen significant rises in the proportion of absences attributed to mental health concerns over the last five years – in the Department of Health, for example, the proportion has almost doubled from 15% of absences to 28%. In the communities department there has been a similar increase, from 19% to 32%.  

It is hard to compare figures between departments with confidence, because they each answered the parliamentary question in different ways. Some, for example, gave data on calendar years, others for financial years, while some reported absence caused by stress specifically and others absence caused by any mental health concern.  

In some departments these figures could be attributed to falling headcounts. For example at DCLG the absolute numbers of days lost due to mental ill-health were broadly similar in 2011 and 2015, but its headcount had reduced so the proportions changed.  

There could also be more qualitative reasons, in that staff may experience more stress as workloads rise due to falling headcounts or because of the significant changes which most organisations have undergone or are undergoing. The health department, for example, is undertaking a major reorganisation which it acknowledges has impacted engagement across the organisation and may also have affected employees’ mental wellbeing.  

In response to CSW’s request for comment on their rising rates of mental-health related absence, DH said: “We will continue to raise the profile of mental health issues at work and encourage open reporting of ill-health conditions as this enables us to tailor the health and wellbeing offer and guide staff.”  

A spokesperson for the communities department said: “In the department we have a great range of support for people with mental health issues, including a network of trained Mental Health Ambassadors, Mental Health First Aid training and a Mental Health Support Group for staff experiencing poor mental health or who are caring for someone with a mental health illness.”

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

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