Diane Baylis, clinical risk and education manager at Medical Protection, discusses how to manage the return-to-work process and the importance of helping staff remain in work

Read this article to:

• Understand your role in helping staff to remain in work
• Learn how to manage the return-to-work process
• Discover what guidance is available to you

What do you do when you are too ill to go to work? Do you worry about how your manager will react when you ‘phone in sick’? The response that you receive from your manager can hugely affect how you feel about work and even the length of the sick leave. Research has found that the actions and attitudes of the line manager can be crucial to a person’s successful return to work.¹

It is important to ensure that you are well enough to go back to work if you have had time off due to illness or injury, and to seek advice from appropriate parties when considering when to return. Taking these steps will help to safeguard against any risk an illness or injury may pose to patients. Gaining independent advice, especially if you have been absent for a while, will also ensure that the appropriateness and timing of your return to work is correct, and that you are supported when you do get back to work. With this in mind, it is always best to consult with your treating physician, GP or occupational health department after an injury or illness, if there is any doubt about your fitness to return to work. 

Your role as a manager

As a manager, your role is to be supportive while ensuring you have all the information you initially need from the staff member to keep the practice operating smoothly. When the staff member returns to work you should consider undertaking a return-to-work meeting. The purpose of a return-to-work meeting should be to:

• Welcome the employee back to work
• Have an open dialogue to check the employee is well enough to resume
• Give both parties the opportunity to identify and discuss any potential problems, and arrange for extra support if it is needed
• Assess the type of work undertaken, and any changes that may be needed for a safe return to work.

Undertaking a return-to-work meeting is not a legal requirement, but it is generally considered to be good practice and has been proven to reduce short term absences.¹

Sometimes an employer may need to seek further medical information. However, under the Access to Medical Reports Act 1988², additional information cannot be accessed without the knowledge and consent of the employee.

Returning to work after a long illness

Returning to work after a long illness can be a scary prospect, sometimes worsened by a loss of confidence and potentially impeded by a slow recovery. Employers are encouraged to be open-minded about the potential benefits of an employee returning to work early, on reduced hours or different duties. Therefore, keeping in contact with absent employees in order to keep them updated on the events at work is particularly useful. Arranging a meeting before the return to work will help the employer to draw up a plan for the return.

Phased return to work

A phased return to work may be needed after a long-term sickness absence. Long-term sickness is defined as an absence that lasts longer than four weeks.³ A phased return allows an employee to return to the workplace gradually and at a slower pace; however, timings and duration vary for each case. Research suggests this can aid in recovery and help build up resilience after a long-term absence.¹ The return to work plan should specify the employee’s duties and incremental hours of work, including the timescale to return to normal hours of work. This should be arranged collaboratively and with the full agreement of everyone involved.

Reasonable adjustments

Reasonable adjustments can be made to the workplace to help an employee remain at work instead of taking sickness absence, as well as following a long-term absence. It is important to be aware that where ill health, injury or other impairment meet the relevant criteria under the Equality Act 2010,⁴ discrimination is prohibited and reasonable adjustments to working arrangements must be considered. For example, allowing an employee time off to attend medical appointments, modifying a job description to take away tasks that cause particular difficulty, or giving access to on-site parking would be seen as reasonable adjustments.

Stress-related sickness absence

Occasionally, staff may take time off work due to work-related stress. If stress at work is linked to specific problems, it may be worth thinking about practical adjustments that may help on the return. This is particularly important if the person has experienced difficulties with specific tasks involved in their job. In this case, temporary changes to the job role may provide valuable breathing space and support by reducing immediate workload pressures on their return. However, if changes are needed, the staff member should be fully involved in the decision, and be clear about what their job involves and what is expected of them.

Professional guidance

For doctors, the GMC offers clear and concise guidance within Good Medical Practice:

“If you know or suspect that you have a serious condition that you could pass on to patients, or if your judgement or performance could be affected by a condition or its treatment, you must consult a suitably qualified colleague. You must follow their advice about any changes to your practice they consider necessary. You must not rely on your own assessment of the risk to patients.” ⁵

 It is important that doctors do not work when advised against it by medical staff. When it comes to considering when the time is right to go back to work after a period of ill health or an injury, Medical Protection expects members to comply with the above guidance. The guidance also states that doctors “must support colleagues who have problems with their health; patient safety must come first at all times”.⁵ 

As part of the revalidation process, the Nursing and Midwifery Council requires nurses to confirm that they are:

“in a state of health that ensures they are capable of safe and effective practice without supervision, after any reasonable adjustments are made by their employer. This does not mean there must be a total absence of any disability or health condition. Many people with disabilities or health conditions are able to practise effectively with or without adjustments to support their practice.” ⁶

The Royal College of Nursing also provides guidance on sickness absence issues for nurses.⁷

Summary

Being in work is generally good for people’s health and wellbeing.⁸ When health conditions arise, employers play an important part in, wherever possible, helping staff to remain in work. This can be done by providing support, making reasonable adjustments and providing assistance to enable a return to work. This will ensure they can perform their work duties without risk.

References

1. Hill D, Lucy D, Tyers C and James L. What works at work?: Review of evidence assessing the effectiveness of workplace interventions to prevent and manage common health problems. Health Work Wellbeing Report. Norwich: The Stationery Office (2007).

2. Access to Medical Reports Act 1988.

3. National Institute for Health and Care Excellence, Workplace health: long-term sickness absence and incapacity to work (2009).

4. The Equality Act 2010.

5. GMC, Good Medical Practice (2013).

6. The Nursing and Midwifery Council, How to revalidate with the NMC (2017).

7. Royal College of Nursing. Sickness Advice Guide.

8. Waddell G and Burton A K. Is work good for your health and wellbeing? Norwich: The Stationery Office (2006).