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The National Institute for Health and Clinical Excellence (NICE) has today (25 March 2009) issued guidance on managing long-term sickness absence and incapacity for work.

It is estimated that in Britain the annual costs of sickness absence and worklessness* associated with ill health is over £100 billion. This new NICE guidance aims to complement existing initiatives; helping reduce the number of employees moving to long-term sickness absence and promote return to work.

The recommendations in the guidance are aimed at all those who have a role in managing long-term sickness absence and incapacity. This includes all employers, employees, managers, workplace representatives, trade unions and professionals, as well as the health service,

Professor Mike Kelly, Public Health Excellence Centre Director, NICE said: “Long-term sickness absence and incapacity for work is a huge issue. It is currently estimated that 175 million working days are lost in Britain due to sickness absence each year and the associated cost is reaching £100 billion - greater than the annual budget for the NHS.

“This new guidance from NICE aims to help employers and employees work together to ensure that when someone is absent from work due to sickness, the right support is available as early as possible, so they can return to work as soon as they are able.”

The recommendations for employers include:
• Identify someone who is suitably trained and impartial to undertake initial enquiries with the relevant employees experiencing long-term sickness absence or recurring short- or long-term sickness absence, particularly those with musculoskeletal disorders or mental health problems.
• If indicated by the initial enquiries, employers should arrange for a more detailed assessment to be undertaken. Relevant specialist/s should undertake the assessment in conjunction with the employee. The assessment could be coordinated by a suitably trained case worker/s.
• Coordinate and support the delivery of any planned health, occupational or rehabilitation interventions or services and any return-to-work plan developed following initial enquiries or the detailed assessment.
• Ensure employees are consulted and jointly agree all planned health, occupational or rehabilitation interventions or services and the return-to-work plan (including workplace or work equipment modifications).

The guidance also recommends that the Department for Work and Pensions (DWP), as well as other organisations which commission services for those who are unemployed and claiming incapacity benefit or ESA, commission and evaluate an integrated programme, including interviews with trained advisers to discuss help needed to help claimants enter or return to work (paid or unpaid). This recommendation relates to a style of programme similar to DWP’s Pathways to Work, with the shared aim of increasing the number of Incapacity Benefit recipients back to work.

Professor David Croisdale-Appleby, Wolfson Research Institute and the School of Medicine and Health, University of Durham and Chair of the Programme Development Group (PDG) said: “The guidance is excellent news for both employees and employers. It is in both parties’ interest that employees get back to work as soon as possible after illness. We are recommending some very simple and straightforward measures that even the smallest employer can implement. These include keeping in regular positive contact with the staff member when they are off sick, thereby ensuring that they don’t feel isolated.”

Dr Richard Preece, Freelance Consultant, Occupational Medicine and member of the PDG said: “Being out of work can have a serious impact on your health, and the longer you are off sick, the harder it is to return to work. This guidance is about, ensuring people who are away from work get access to the right kind of support at an early stage enabling them to return to work sooner. Occasionally that may require specialist expertise from an occupational health doctor or nurse”

Dr Sian Williams, Consultant in Occupational Medicine, Royal Free Hampstead NHS Trust and Director of the Occupational Health Clinical Effectiveness Unit, Royal College of Physicians and member of the PDG said: “The guidance highlights the need to intervene early. But, if the sickness absence continues, the employer could look to appoint a key worker who understands the workplace as well as the health issue itself. This person could be from within the company or externally brought in, but the important thing is that they are able to take an objective view and therefore give objective advice about how that staff member could get back to work.”

Dr Fiona Ford, Senior Lecturer in General Practice, University of Central Lancashire and member of the PDG said: “GPs have a very important role as the first port of call for people who are unable to work due to sickness or disability. This guidance will help GPs to handle requests for sick notes appropriately, to support their patients back into work and avoid long-term sickness absence whenever possible. It will also help employers to know what they can do to make a difference for their member of staff; offering the right support, from the right people, at the right time.”

Notes to Editors

About the guidance

1. Information on this guidance can be found on the NICE website at - www.nice.org.uk/PH19.

2. For this guidance, short-term sickness absence has been defined as absences from work of up to (but less than) 4 weeks, and long-term sickness absence as lasting 4 or more weeks.

3. *Worklessness - A term that is broader than the traditional definition of unemployment. It is used to describe people of working age who are not in formal employment but who are looking for a job (the unemployed). It is also used to describe people of working age who are not formally employed and are not looking for employment (also known as the ‘economically inactive’).

4. Related guidance includes:
• Promoting physical activity in the workplace www.nice.org.uk/PH13 
• Workplace health promotion: how to encourage employees to be physically active www.nice.org.uk/PH13

About NICE

5. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

6. NICE produces guidance in three areas of health:

• public health – guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies – guidance on the use of new and existing medicines, treatments and procedures within the NHS
• clinical practice – guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.