• paying salaries or sick pay to absent workers;
• reduced productivity;
• compromised customer satisfaction;
• increased demands on other staff;
• finding, training and paying for temporary cover.

The flip-side of absenteeism is presenteeism, namely employees coming to work when they are really too ill to work productively. Presenteeism can actually be counterproductive due to lost productivity and, in the case of infectious illnesses, because employees risk infecting others when they come to work ill. For this reason, employers/managers should be trained to spot the symptoms of physical and mental illness and be aware of the support that’s available to reduce the impact of employees’ ill health on the organisation. Otherwise they risk allowing issues to mount up and cause even greater disruption in the future.

So what aspects should organisations consider when working towards making the workplace healthier?

• Work speed: When someone is ill, the speed at which they work reduces and their accuracy, judgement and reactive skills can be impaired. Are they really being productive? Would they make a better recovery if they were at home? What can you do to support them?

• Contagiousness: If someone is contagious, they could infect other members of the team and cause a far greater drop in productivity than if they had stayed at home.

• Spotting the symptoms of stress/depression: The symptoms of stress and depression may not be obvious, but low morale in the workplace can rub off on other people. One person’s stress can soon spread to the team.

• Word-of-mouth: How someone is supported through a period of sickness can reflect positively or negatively on an organisation’s reputation. What are your employees saying about you and how you deal with employee health?

• Rewards: The rewards for being a flexible employer will be evident in the commitment and loyalty of your staff. If you go the extra mile for them, they will go the extra mile for you.

• Reputation: If you are known as a great employer, you will find great people.

• Employee rights: Are you aware of employee rights when considering how to handle employees who are affected by long-term ill-health?

• Liability: Are you aware of your liability if someone has an accident at work while you knew they were unwell?

• Employment law: Are you aware of your rights when considering dismissal due to ill health?

The Health for Work Adviceline offers free, immediate, professional help to organisations who want to support employees who are experiencing ill health at work and safeguard the productivity of their organisation. Information can be sought online or by calling Freephone 0800 0 77 88 44.

*Black, C. and Frost, D. (2011) Health at work – an independent review of sickness absence London: The Stationery Office

Photo by aramc via Flickr, under Creative Commons Licence

This week (7-13 May) is Deaf Awareness Week. According to figures from Action on Hearing Loss, one in six of the population of the UK suffer from some form of hearing loss of which approximately one third are below retirement age. Hearing loss may be down to a number of factors, including:

• the ageing process;
• diseases of the ear;
• noise-induced hearing loss (a particular risk in noisy working environments);
• genetics.

People who are not used to interacting with individuals who are deaf or hard of hearing often become concerned that they will cause embarrassment if communication doesn’t run smoothly or worry that they may draw too much attention to a person’s hearing impairment. The most important thing to remember is that there is no ‘one size fits all’ approach to communicating with people who suffer from full or partial hearing loss because people will communicate differently depending on their communication needs. For example, people with profound deafness may well use mainly sign language, whilst those with partial hearing loss may rely on hearing aids, note-writing, lip-reading, etc.

By far the best way to ensure that team members with hearing impairments are able to contribute in the working environment and form positive relationships with others in the organisation is to ensure that employees are offered deaf awareness training to overcome communication barriers. Some simple techniques involved in positive and fruitful communication with people with hearing loss include:

• ensuring you have the person’s attention, that you are facing them directly and that they can see your face clearly;

• identifying the topic that you are going to speak about (perhaps distribute a written agenda for a meeting beforehand) and speaking clearly and at a steady pace;

• offering visual clues by making good use of body language and facial expressions;

• re-wording sentences in case of misunderstanding (it may be just one word in the sentence that is causing the comprehension problem).

In addition to vital staff deaf awareness training, specialist equipment is also available for use in the workplace to make it easier for an employee with a hearing impairment to work effectively. Equipment in the workplace could include:

• a telephone typewriter, which allows a person with a hearing impairment to type a telephone conversation instead of speaking. The National Relay Service relays the conversation to each caller;

• audio loop – a wire loop that is designed to encircle a particular area (such as a conference room) and provide amplified sounds to a person’s hearing aid;

• FM and infrared listening systems, which have multiple personal receivers that can be fitted with headphones or ‘neck loops’ for hearing aid wearers (e.g. in meetings or training sessions).

Employers need to be aware of their legislative responsibilities towards people with hearing impairments including making reasonable adjustments to allow them to continue working (more information can be found in our guide on supporting an employee with hearing loss).

Workers are protected from excessive noise levels at work by the Control of Noise at Work Regulations 2005, however, in many cases, it may be the noise levels in the workplace itself that are causing employees to develop hearing problems. In noisy working environments (e.g. manufacturing plants, building sites, car workshops, etc.) and environments in which a person’s hearing is critical (e.g. fire and rescue services, the police force, teaching, musicians, etc.) employers should undertake a noise risk assessment to establish whether a noise health surveillance programme needs to be implemented. Employers should also:

• provide appropriate hearing protection, where necessary;
• train employees on hearing protection and procedures;
• monitor employees’ exposure to noise in the workplace.

For further guidance on protecting employees from noise in the workplace, or supporting employees with hearing loss, call the free Health for Work Adviceline on 0800 0 77 88 44.

1. A team member is off on long-term sickness absence

One of your team has been off work for just over a month, which is putting extra pressure on the rest of the team. Sales are down and customer complaints are up. You are unsure what to do next but want to be supportive to the employee whilst protecting your business.

2. You suspect you may be experiencing staff truancy

A member of your workforce is frequently off sick. Whilst the various reasons she gives for her absence sound plausible, you can’t help but wonder whether they are entirely authentic. You are concerned about the effect her frequent absences may be having on the morale of other members of the team.

3. You are unsure about terminating someone’s employment due to chronic illness

An employee has a serious health problem which means he will be off work for the foreseeable future. It has created mounting pressure on your workforce and has begun to affect business efficiency. You are now considering terminating his employment to protect your business.

4. You are worried about a staff injury at work

Your team say they are happy lifting heavy equipment but you know some suffer from backache from time to time. You’d like to know how to make it easier for them to raise their concerns and/or follow a procedure that is already in place.

5. You are unsure whether you can contact an employee’s GP

You’d like to talk to an employee’s GP about a complicated health issue that is now affecting the rest of the team. However, you are not sure whether you are permitted to do this or whether you should consult with the employee first.

6. A staff member has just been diagnosed with a serious health condition

You’ve just been told that an employee has a chronic illness. Naturally, you are concerned about him and want to do what you can to help him and support the rest of team.

7. You want to check on the health of applicants during the recruitment process

You are about to begin a major recruitment drive and, having had issues in the past with absenteeism, you would like to protect your business by checking whether new recruits are fit to do the job.

8. You want to learn about dealing with staff anxiety in this challenging economic climate

As a small business you are vulnerable during the financial downturn. Your employees are feeling increasingly stressed about their family finances and are also concerned about their job security. You want to support your staff and ensure that they stay motivated.

9. You suspect that an employee is actually not well enough to work

A member of the team appears to be unwell but is continuing to come to work. You have heard that presenteeism (i.e. coming to work when ill) can be as much of a problem as sickness absence but you’re not sure how to broach the subject without causing offence.

10. Some major changes are taking place at work and you want to manage staff stress levels

Your small business is about to go through a major restructuring process. Understandably, employees are worried about their jobs and how the changes will affect them. Motivation and productivity are down as a result. You would like to support staff and help keep morale up at this stressful time.

If any of these scenarios strike a chord with you, it would be well worth contacting the Health for Work Adviceline to receive professional, immediate and free advice (0800 0 77 88 44). Advice can also be sought online by searching for information on our online knowledge base, asking a question online, or using our ‘live chat’ function.

Photo by Alex E. Proimos via Flickr, under Creative Commons Licence

Last week (April 22-28) was Depression Awareness Week, which helped raise the profile of depression through events held across the UK. A person who is depressed will experience a combination of a wide range of possible symptoms continuously over a period of weeks or months, including:

• low mood and sadness;
• low self-esteem;
• feeling irritable, tearful, anxious or worried;
• finding it difficult making decisions;
• decreased interest in things that a person would normally find stimulating.

Depression is more widespread than many people may imagine (it is estimated that approximately 10% of the population of the UK will experience depression at some point in their working lives) and the costs of depression and associated sickness absence are a major drain on the UK economy.

Depression in the workplace, if not addressed, can have a widespread negative influence on an organisation. A person suffering from depression is likely to become less productive and take time off work due to sickness. In addition, a sufferer’s low mood can negatively affect morale amongst the person’s colleagues/team members thus lowering productivity even further.

Supporting an employee who appears to be suffering from depression is not an easy task for a manager/employer, but it is a very important one. Talking openly and sensitively with the employee to ascertain the reasons for their unhappiness (i.e. are the employee’s issues work related or personal?) would be the first stage. If it transpires that the person is experiencing problems at work then managers/employers should address the issues identified by the employee (e.g. anxiety over workloads, problematic relationships with colleagues, etc.).

Employers could discuss modifications to the employee’s role/hours, if this is beneficial, and should encourage individuals to talk to their GP to find out what support is available to them. The most important thing from an employer’s perspective is to remain approachable and receptive so that an employee suffering from depression feels supported and confident about opening up about their problems. For more guidance, call the free Health for Work Adviceline on 0800 0 77 88 44.

Photo by Pink Sherbert Photography via Flickr, under Creative Commons Licence

A significant amount of research has been done into the health effects of disrupted sleep-wake cycles (experienced by shift workers), which are associated with various health conditions, including:

• heart disease;
• bone fractures;
• cancer;
• diabetes;
• obesity.

People who do shift work experience disruption of their internal body clock (or circadian rhythm) by working at night and then sometimes having trouble sleeping during the day (or by trying to maintain some kind of normality in their routines when they aren’t working). This can cause:

• fatigue and sleeping difficulties;
• disturbed appetite and digestion;
• social and domestic problems.

Now new research which set out to test the theory that people who disrupt their body clock increase the risk of metabolic syndrome and diabetes (the results of which were published in Science Translational Medicine in April 2012) has concluded that changes to normal sleep patterns do indeed:

• cause the body to struggle to control sugar levels;
• alter the metabolism;
• increase the risk of obesity and diabetes (some participants in the study did, in fact, develop early symptoms of diabetes within weeks).

Whilst these results come from a limited study (21 participants) under laboratory conditions, the results do corroborate theories that have been held for some time about the effects of shift work on the metabolism.

Employers who employ shift workers have a duty to assess the risks associated with shift work and reduce the negative impact it can have on the health of employees. Various pieces of legislation protect the rights of employees and would be relevant for shift workers including managing the risks of shift work (the Health and Safety at Work etc Act 1974 and the Management of Health and Safety at Work Regulations 1999). The Working Time Regulations 1998 (as amended) and other industry-specific legislation impose specific requirements on employers with regard to the number of hours worked and how these hours are scheduled. For guidance on looking after the health of shift workers, call the free Health for Work Adviceline on 0800 0 77 88 44.

This year’s World Day for Safety and Health at Work focuses on the promotion of OSH in an increasingly ‘green’ economy. A ‘green’ economy is based on the creation of environmentally-responsible jobs that benefits workers (through a decent wage) and the environment (by preserving or enhancing the environment, e.g. reducing waste, pollution and carbon emissions). Truly green jobs must integrate OSH into all areas (through risk assessment and management measures), including:

• design;
• procurement;
• operations;
• maintenance;
• sourcing;
• recycling policies;
• certification systems;
• OSH quality standards.

Periods of economic insecurity may increase the risk of employers cutting corners with regards to OSH as their attention is drawn increasingly to organisational survival. However, it is vital for organisations not to lose sight of the importance of employee health and wellbeing. After all, what hope is there for organisational success without dedicated input from employees – an organisation’s most important asset? That’s why the Health for Work Adviceline offers free guidance for employers in England about existing employee health issues or protecting the good health of staff. Advice can be sought by phone (0800 0 77 88 44) or online either by searching for information on our online knowledge base, asking a question online, or using our ‘live chat’ function.

Photo by Trygve.u via Flickr, under Creative Commons Licence (Armenian Red Cross Youth)

HIV (Human Immunodeficiency Virus) weakens the body’s immune system and can progress to AIDS (Acquired Immune Deficiency Syndrome), which interferes with the immune system and makes sufferers susceptible to infections. Although HIV cannot be cured, it can be effectively treated (if diagnosed early) so that HIV may not progress to AIDS. This means that the 70,000+ people living with HIV in the UK can continue to be productive members of the workforce.

There is no obligation on employees to tell their employers about their HIV status except in certain professions (e.g. surgery or dentistry where there is a risk of exposure to bodily fluids or blood). In some jobs, workers may actually face the risk of HIV infection through accidental direct exposure to infected blood (e.g. some healthcare workers and laboratory technicians) mainly as a result of an accident with a needle/syringe.

The availability of antiretroviral therapy (ART therapy) means that most people who are HIV positive should not become too ill to work. However, if HIV does become symptomatic (i.e. the person starts suffering from related infections) it may be necessary to disclose HIV status as the person may require time off work due to illness or may require certain adjustments to be made to their job role, hours of work, etc. in order to allow them to continue working.

From an employer’s perspective, the most important thing is to ensure that a person suffering from HIV is not discriminated against in the workplace. People living with HIV are legally protected from discrimination in the workplace and during recruitment under the Equality Act 2010 , which, for example, prohibits the use of pre-employment health questionnaires before the offer of a job has been made.

Discrimination in the workplace can take various forms, including:

• Direct discrimination (e.g. when an employer treats an HIV-positive employee less favourably than others).

• Indirect discrimination (e.g. when conditions or rules in the workplace disadvantage HIV-positive employees).

• Associative discrimination (e.g. when a person suffers discrimination because of their association with a person suffering from HIV).

• Harassment (e.g. offensive or intimidating behaviour intended to make a person’s existence in the workplace difficult or untenable).

• Victimisation (e.g. unfair treatment of an HIV-positive employee who has made a complaint about harassment in the workplace).

Employers need to be aware of their responsibilities towards employees with HIV in order to ensure that they are treated fairly and with dignity. Organisations should have the right procedures in place to manage complaints about harassment or mistreatment in the workplace (which can also help avoid costly and complex tribunal cases). Staff should be provided with information on diversity and equality, and awareness of HIV should be raised within the organisation in order to prevent discrimination and stigma.

If an employee suffering from HIV becomes too unwell to continue their job role, employers should try to find alternative work that may be more suitable. However, employers are not legally-bound to create more suitable employment if there is nothing else available in the organisation or if no reasonable adjustments can be made to the role to permit the person to continue. In this case (as with any other illness) the employer is entitled to terminate the employee’s employment.

Information for employers on their responsibility towards employees with HIV can be found on the National AIDS Trust website (a charity dedicated to transforming society’s response to HIV). In addition, information on supporting employees with HIV or other health conditions can be sought from the Health for Work Adviceline on 0800 0 77 88 44.

Photo by shawnzrossi via Flickr, under Creative Commons Licence

New guidance published in the Journal of Clinical Medicine at the end of last month has called on doctors to explore the potential job-related causes of asthma when diagnosing patients. The guidance also recommends that doctors seek consent from sufferers to communicate with their employer to advise them of the diagnosis and of the need to protect the employee from further exposure.

According to Asthma UK (a UK charity dedicated to improving the health and wellbeing of those affected by asthma) 5.4 million people in the UK are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12). Approximately one in six people of working age who develop asthma have work-related asthma, where work has either caused or aggravated their condition.

The guidance, produced by the Royal College of Physicians and funded by NHS Plus, advises hospital doctors to question patients with respiratory problems about their jobs, the materials they work with and whether their symptoms improve when they are away from work. They also need to be aware of those jobs that carry particular risks (e.g. laboratory work, work in the chemical industry, etc.). Doctors are also being urged to not rely solely on the patient’s history but to conduct tests (e.g. peak flow measurements at/away from work and skin-prick tests for allergy to substances that could potentially be causing the illness).

Substances used in a wide range of industries have been shown to cause occupational asthma, including those used in:

• baking;
• motor repairs;
• woodworking;
• chemical processing;
• farming;
• cleaning;
• textile, plastics and rubber manufacturing;
• healthcare and dental care.

In order to manage a case of occupational asthma effectively, the condition must be diagnosed quickly and the employee should be protected from further exposure to the cause of the asthma, particularly as a person’s symptoms might be brought on by exposure to extremely low concentrations of a respiratory sensitiseronce they have been sensitised to it (see our guide to respiratory sensitisers on our knowledge base). In order to achieve this, doctors should carry out a full assessment of a patient’s symptoms and history in order to allow for a full diagnosis.

According to Professor John Harrison, Director of NHS Plus:

“About 70% of the UK workforce does not have access to occupational health care. This makes it vital that hospital doctors and respiratory specialists are assessing asthma patients for potential work-related causes and advising appropriate treatment and preventative measures. By following this guidance they will offer their patients the best chance of recovery. The guidelines will benefit all doctors and healthcare professionals caring for people of working age, a long standing goal of NHS Plus.”

Employers who suspect that an employee’s respiratory problems may be occupational asthma, or who are concerned about any other employee health issues, can call the free Health for Work Adviceline on 0800 0 77 88 44.

• a telephone survey of employers who had used the service;

• 50 in-depth qualitative telephone interviews with employers who used the Adviceline services;

• regular contact between the evaluation team and Adviceline services’ staff.

Most employers who took part in interviews were very satisfied with the way in which their calls were handled. Getting through to advisers worked smoothly and call-backs were promptly received. The level of professionalism and approach of the advisers was also viewed positively.

Some headline figures:

• 92% of users found the service useful (66% of these found the service very useful).

• 93% of users would recommend the service.

—————

Elements of the service that users liked most were that it offers:

• someone to talk to;
• free support;
• help from advisers who understand callers’ issues;
• impartial/neutral advice;
• tailored advice;
• help finding the right information (signposting);
• help finding specialists (signposting).

Employers were attracted to the service for a number of reasons, notably that:

• it was free;

• it appeared to be a ‘one-stop shop’;

• it offered immediate, impartial and trusted advice and access to support.

• an important and legitimate source of confirmation about actions they had already taken or were considering taking in response to an employee health problem (i.e. reassurance that they were taking the right approach);

• a good source of information about where to go for further support (i.e. signposting).

• Information about gaining access to occupational health (OH) services (e.g. for an OH assessment).

• Guidance about an individual’s sickness absence.

• Advice about an employee’s physical health.

• Advice on an employee’s mental health condition.

• Guidance on sickness absence relating to more than one employee.

• Consulting a third party (including face-to-face or local OH services) for further support or advice.

• Contacting the employee who was off sick.

• Changing the employee’s role or working conditions.

• Putting together a return to work plan.

• Conducting a risk assessment.

Calls were received from most industries although the highest number of calls in England came from ‘health and social care’ (i.e. nursing homes and other care organisations, dentists, GP practices and some charitable organisations) perhaps because of a relatively high level of sickness absence in this sector*.

—————

Service users by size of organisation:

The majority of service users were from SMEs with 10-49 employees. Organisations with fewer than ten employees (micro employers) were under-represented in the sample of users compared to their number in the Great Britain population of SMEs, which may reflect the lower incidence of sickness absence in small as opposed to medium-sized firms, and the difficulties in reaching this group.

—————

It is clear that the Adviceline services are valued by organisations so we are very glad to have been given the go-ahead to continue with the services for the foreseeable future. Following the pilot stage and the feedback we received from service users we have extended the service we offer to include greater provision of information online for those who prefer the opportunity to find information on staff health issues without necessarily having to speak to an adviser in the first instance. Advice can now be sought in three ways:

• Telephone advice on Freephone 0800 0 77 88 44.
• Self-service information through access to an extensive, intelligent, on-line knowledge base on our website.
• On-line communication with a contact centre by submitting a question to the support team, or ‘chatting’ directly with a member of the team (a form of instant messaging).

To find out more about the service we offer, visit our website and online knowledge base (constantly updated with guides on employee health topics). Or, if you’re after immediate answers to staff health queries, call us on 0800 0 77 88 44 to speak to an OH professional.

Photo by gwire via Flickr, under Creative Commons Licence

RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995) puts duties on employers, the self-employed and people in control of work premises to report:

• serious workplace accidents;

• occupational diseases;

• specified dangerous occurrences (near misses).

Currently, timescales set out for the reporting of accidents and occupational diseases are as follows:

• Death or major injuries must be reported immediately either online or by calling the Incident Contact Centre on 0845 300 9923.

• Injuries that cause a person to be incapacitated (i.e. absent from work or unable to do work that they would normally be expected to do) for over three days must be notified within ten days of the incident using the appropriate online form (that can be found on the HSE website).

• Cases of disease should be reported as soon as a doctor notifies you that your employee suffers from a reportable work-related disease using the online form ‘Report of a case of disease’.

As from 6 April 2012, however, RIDDOR’s requirement for reporting injuries causing incapacitation for over three days will change:

• Injuries that cause a person to be incapacitated (i.e. absent from work or unable to do work that they would reasonably be expected to do as part of their normal work) for over seven (no longer three) days must be notified within fifteen (no longer ten) days of the incident using the appropriate online form.

Employers and those with responsibilities under RIDDOR must still keep a record of all injuries causing incapacitation of over three days (i.e. in an accident book) and it is recommended that organisations record all incidents and near misses in order to help them identify and address areas for improvement in their safety performance.

Luckily, RIDDOR-reportable incidents are relatively infrequent but organisations need to know what to do in case any injuries or notifiable diseases do occur. Guidance on reducing injuries and ill health in the workplace can be sought from the Health for Work Adviceline, as well as advice on complying with legislative requirements. Call for free on 0800 0 77 88 44 to speak to an occupational health professional.

•  small and medium-sized enterprises (SMEs) with fewer than 250 employees generally have little or no access to occupational health (OH) support to help them deal with employee sickness absence or employee health issues at work;

• the business case for investment in the health and wellbeing of employees is inadequately understood by employers.

In response to the findings of this 2008 review, a number of measures were undertaken including the introduction of the ‘fit note’ (switching the focus from what employees are too ill to do to what they can do) and the introduction of an occupational health advice lines service (the Adviceline services) geared towards offering tailored advice and support to employers/managers in smaller organisations on employee health issues.

The Adviceline services were designed to test and promote the demand for OH services amongst SMEs and the pilot phase of the service ran from the end of 2009 until March 2011. Specifically, the Adviceline services aimed to provide SMEs with early and easy access to high quality advice concerning employee health issues. Three services were set up for the pilot phase covering:

• England (Health for Work Adviceline).

• Scotland (Healthy Working Lives).

• Wales (Health at Work Advice Line Wales).

The evaluation of the performance of the Adviceline services produced for the DWP** reported on in this two-part blog takes into account the results of all three services. Where possible, however, this blog will highlight results specific to the Health for Work Adviceline (England).

Data from the pilot phase was collected using:

• a telephone survey of service users conducted four to eight weeks after using the service;

• in-depth qualitative interviews conducted by phone with service users (recruited through the survey) which took place some months after using the service;

• regular face-to-face and telephone contact with staff providing the service to identify process issues.

Overall, the evaluation of the Adviceline services was extremely positive and the services offered during the pilot phase were assessed as:

• having been successful in targeting SME employers who needed help to manage an employee’s health problem in the workplace;

• being highly valued by users and appearing to be addressing a genuine desire for professional OH support among SMEs (the overwhelming majority (more than 90%) found it useful and stated that they would recommend it to others);

• providing fast access to professional advice.

Part 2 of this blog (to be posted on 11 April) will look at the feedback received from service users in more detail, and how experience gained during the pilot phase has influenced the design of the service going forward. In the meantime, if you’re looking for help with employee health issues, call the free Health for Work Adviceline on 0800 0 77 88 44.

Photo by amandabhslater via Flickr, under Creative Commons Licence

Purple Day (the 26^th March each year) is an international grassroots effort dedicated to increasing awareness about epilepsy worldwide. People in countries around the world are invited to wear purple and host events in support of epilepsy awareness. Purple was chosen to represent the day based on the colour lavender, which is the international colour for epilepsy; the lavender flower is also often associated with solitude, which is representative of the feelings of isolation many people affected by epilepsy and seizure disorders often feel.

Epilepsy affects over 50 million people worldwide or approximately one in 100 people (more than multiple sclerosis, cerebral palsy, muscular dystrophy and Parkinson’s disease combined) yet it is a very misunderstood (and therefore feared) and stigmatised condition.

Epilepsy is a condition of the brain that is characterised by recurrent seizures (when there is a sudden excessive electrical discharge that disrupts the normal activity of the nerve cells in the brain). Approximately one in ten adults will experience at least one seizure during a lifetime (seizures can take many different forms, including  muscle spasms, uncontrolled movements, altered awareness, odd sensations, ‘losing a few minutes’ and not knowing what has happened, or convulsions) although having one seizure does not constitute epilepsy (epilepsy  is characterised by multiple seizures). If epilepsy is successfully controlled by medication, a person may be seizure-free so there is no reason why they shouldn’t lead a normal working life.

Employers need to carry out a risk assessment of employees diagnosed with epilepsy in order to identify any possible safety risks to the employee or others in the workplace. As epilepsy affects each person differently and every workplace is different it is not possible to have set guidelines for risk assessments for people with epilepsy. Each person must be assessed individually for any potential risks to health and safety that they may face at work. A risk assessment may indicate that a person’s epilepsy would have little effect on their ability to continue with their job, that some changes may be needed (i.e. avoiding the use of dangerous machinery) or, in some cases, that certain parts of a person’s job pose too much risk and should therefore be avoided. Information from the risk assessment (and subsequent re-assessments) should then be used to make reasonable adjustments in the workplace (see our guide ‘Making workplace adjustments’).

More information on epilepsy can be found in the guide on our website (‘Employees suffering from epilepsy’) or further guidance on epilepsy in the workplace (or other employee health issues) can be sought from the Health for Work Adviceline on 0800 0 77 88 44.

Photo by www.traveleden.com/brighton via Flickr, under Creative Commons Licence

Problems with stress are on the increase so employers will need to become proficient at recognising the signs of escalating stress amongst employees and offering them support. Managers and employers should remain approachable by maintaining an ‘open door policy’ in order to encourage staff to come forward with their issues. This is clearly in the interests of the organisation as employees who are dealing with prolonged stress will not generally be at their most productive even if they have not yet shown any signs of stress-related illness. As some people are able to tolerate much higher levels of stress than others before becoming ill, employers/managers should err on the side of caution if they suspect that an employee may be struggling to cope by sensitively broaching the subject with them with the aim of alleviating their stress.

Some questions employers could ask themselves when trying to prevent an escalation of employee stress could include the following (more information can be found in our blog from September 2011) about helping employees deal with stress in the workplace):

• Are employees completely clear what their roles and responsibilities are, and what is expected of them?

• Are potentially stressful periods counteracted by periods of fewer tight deadlines? Are employees able to predict what their workload might be over the coming weeks rather than being surprised by sudden high workloads for which they were not prepared?

• Do employees have the resources available to them that are required for them to do their jobs?

• Are workplace conflicts developing within the organisation? If so, are they being dealt with before they escalate?

It is vital for employers to monitor sickness absence trends in order to keep track of the reasons for employees’ absences and to try to make it more likely that they will be at work in the future. In cases where an employee appears to be taking high levels of sickness absence, employers should be seen to be taking steps to remedy the situation so as not to damage the morale of others in the team/organisation.

For advice on managing sickness absence or supporting employees who are suffering from stress-related issue, or for guidance on any other employee health-related queries, call the free Health for Work Adviceline on 0800 0 77 88 44.

Photo by Maxwell GS via Flickr, under Creative Commons Licence

The first part of this blog (‘Why do people become stressed?‘, 14 March 2012) looked at the question of why some people are more prone to stress than others. This second part of our ‘focus on stress’ will look at short-term and long-term stress and the symptoms that may signify a problem.

Occasionally we are all faced with situations that we find difficult to cope with. For some, these situations can become extremely stressful and this stress can manifest itself in a number of ways, including:

• rapid heartbeat and breathing;
• sweating;
• cold hands, feet or skin;
• ‘butterflies’ or feelings of nausea;
• tightening of muscles a tense feeling;
• dry mouth;
• muscle spasms;
• headaches;
• fatigue;
• shortness of breath.

Generally, once the stressful situation is over, people suffering from short-term stress can recuperate and get back to normal. In some cases, however, stress is prolonged or long-term and can cause a number of physical/behavioural and mental/emotional effects, which can be damaging over time. For some, the build-up of stress can ultimately culminate in ‘burn-out’ (i.e. an inability to cope). Symptoms of longer-term stress can sometimes be difficult to pinpoint, mainly because people adapt to feeling the way they do. These symptoms can include the following:

A certain amount of pressure at work can help to focus the mind and encourage people to work more productively, yet this pressure can easily give way to stress, which can be damaging if left unchecked. The third and final part of this ‘focus on stress’ blog (to be posted next week) will look at how employers/line managers can support employees who are struggling with stress. Guidance on reducing stress levels in the workplace can be sought from the free Health for Work Adviceline on 0800 0 77 88 44.

Photo by University of Salford via Flickr, under Creative Commons Licence

Due to the number of enquiries we receive about stress on the Health for Work Adviceline website (by far the most popular topic over the past few months), we shall be running a sequence of three blogs over the coming weeks about stress in the workplace. Stress is recognised as being a growing issue, which, when left unchecked, can lead to other mental health conditions (e.g. anxiety and depression), or physical health issues (e.g. high blood pressure, fatigue, etc.).

The Absence Management survey (October 2011) by the Chartered Institute of Personnel and Development (CIPD) and corporate healthcare provider Simply Health, found that stress is the most common cause of long-term sickness absence for both manual and non-manual employees – the first time this has been the case in the 12 years the report has been published.

So, why do people become stressed?

Being in employment is generally accepted to be good for a person’s health, wellbeing, morale, confidence and feeling of self-worth. However, the demands placed on a person at work can sometimes exceed what they can cope with and this is generally when work-related stress develops. People who work full-time spend a significant proportion of their lives at work. If their workload is unmanageable, the working environment is not conducive to performing well, or perhaps relationships with co-workers or line managers aren’t as positive as they could be, people can become very disheartened at work, which can lead to a build-up of stress. Similarly, people may be negatively affected by what’s going on in their lives outside work and these issues, combined with work pressures, may cause stress to develop.

Part of the problem with dealing with stress is that it affects people very differently – what is extremely stressful for one person may not seem at all stressful to another. This means that a person’s stress may sometimes be misconstrued as an over-reaction or, within a work context, perhaps as a pretext for avoiding certain work tasks. Sometimes it may be quite clear why a person is feeling stressed (e.g. financial problems, relationship issues, bereavement) but at other times it may not be so obvious to others. This is because some people unintentionally put themselves under pressure due to their own psychological make-up (e.g. a predominantly pessimistic outlook, lack of assertiveness, perfectionism or unrealistic expectations) whilst people who are naturally self-confident and positive may put themselves under less pressure yet perform equally well.

The second part of this blog (to be posted next week) will look at the symptoms of short-term and long-term stress. In the meantime, more information on stress in the workplace can be found in our guide on workplace stress. Or for help with specific queries, contact the Health for Work Adviceline on 0800 0 77 88 44.

Photo by khawkins04 via Flickr, under Creative Commons Licence

This year’s national No Smoking Day is taking place on 14 March 2012. Most of us don’t need to be reminded of the significant health risks associated with smoking, such as:

• heart disease (the main cause of death amongst smokers);

• cancer (e.g. lung cancer, pancreatic cancer, cancer of the larynx and mouth);

• COPD (chronic obstructive pulmonary disease) and emphysema;

• strokes.

Despite the risk of significant health damage and potential death (around half of regular smokers will eventually die due to smoking, according to Ash, July 2011) approximately one sixth of the adult population of the UK smokes (22% of men and 21% of women). Encouragingly, this is a significantly lower figure to 1974 when nearly half of the adult population were smokers (Ash, July 2011).

A positive move was made in the UK from 2006-2007 (Scotland, Wales, Northern Ireland and finally England) when it became illegal to smoke in all enclosed workplaces. Employers, managers and those in control of premises are now required to take reasonable steps to ensure that staff, customers, members and visitors do not smoke in buildings. This has been a positive step towards protecting non-smokers from second-hand smoke which is another major health risk (it has been estimated that non-smokers exposed to passive smoking have their risk of lung cancer raised by about a quarter*.

The chemicals in cigarettes can cause a whole host of other health effects which, whilst not as terrifying as cancer and heart disease, can be unpleasant and have a significant detrimental effect on an individual’s health. These include:

• raised blood pressure;

• fertility problems;

• worsened asthma;

• eye problems (e.g. cataracts, macular degeneration);

• accelerated skin ageing.

From the perspective of employers there are significant gains to be made from encouraging staff to give up smoking. A report by the Faculty of Public Health and the Faculty of Occupational Medicine stated that “an estimated 34 million days a year are lost in England and Wales through sickness absence resulting from smoking-related illness”. Further reductions in productivity stem from smokers taking regular smoking breaks at work. Employees are an organisation’s main asset so keeping them healthy should be considered a priority. Free, professional help is available from the Health for Work Adviceline (0800 0 77 88 44) for organisations that want to achieve this aim.

Image by teach mama via Flickr, under Creative Commons Licence

A survey of 2,000 people conducted for Cancer Research UK has produced some worrying results. It appears that many people (around 40% of people according to the research) delay going to see their doctor about health symptoms that are troubling them either because they are concerned about wasting their doctor’s time or because they are worried about what the doctor might find. This is particularly concerning as cancer that is detected early can be treated much more effectively. On a more positive note, however, the number of people dying from cancer is falling overall and death rates from three of the UK’s most common cancers (breast, bowel and male lung cancer) have dropped to their lowest level for almost 40 years (Cancer Research UK). Survival rates are improving and many cancer patients are going on to lead normal, active lives after treatment.

Some cancers cause early warning signs/symptoms although these are often ignored, particularly as they aren’t unique to cancer and could be presumed to be something far less serious. These symptoms include:

• fatigue;

• lumps;

• bowel/bladder problems;

• bleeding;

• pain that is persistent, severe, or can’t be attributed to anything else;

• faster than expected weight loss.

Anyone experiencing symptoms that seem unusual for them should visit their doctor rather than waiting to see whether they resolve themselves. Employers can play an important role in encouraging staff not to put off visits to the doctor and may find the whole host of campaigns designed to raise awareness of particular conditions helpful. For example, the Great Daffodil Appeal is run every March by Marie Curie and aims to get people to wear a daffodil in support of Marie Curie nurses and raise money to help the charity provide more free care to people with terminal cancer and other illnesses. Organisations that become actively involved in these campaigns can help raise awareness and encourage dialogue about topics that might otherwise remain shrouded in stigma and taboo. Employers can also promote healthy lifestyles as an important way of helping to prevent cancers, perhaps by promoting the healthy lifestyle quiz.

Organisations requiring advice on supporting employees suffering from cancer or other illnesses (including their legislative responsibilities), or those that want to find out more about preventing staff illness or sickness absence from negatively affecting their organisation, can get help from the Health for Work Adviceline website or by speaking to an occupational health nurse for free on 0800 0 77 88 44.

Image by markhillary via Flickr, under Creative Commons Licence

Following demands for formal regulation, three new standards have been/are being developed under the guidance of the British Standards Institute (BSI) to provide guidance on managing psychosocial risks (stress) in the workplace and a structured framework for effectively managing risks, adopting best practice in organisational management and exceeding legal requirements. The standards are set out in PAS (Publically Available Specification) documents (standards) and it is hoped that all three PAS documents will have been introduced and form part of organisations’ wellbeing or stress management policies by the end of 2012.

Work-related stress (i.e. when work demands exceed a person’s capacity to cope) is a significant cause of illness and sickness absence. Well-designed jobs and workplaces, and good management practices, can help prevent stress problems from escalating. The aim of the three new standards is to provide a clear and quality-controlled route for effective stress management across any sector:

• PAS 1010 (Guidance on the management of psychosocial risks in the workplace): Guidance and good practice on assessing and managing psychosocial risks at work, and implementing a risk assessment and policy for dealing with stress. This standard was published in 2011.

• PAS 1011 (Management Competencies and Standards): This standard is based on management standards and competencies. It provides guidelines for managers to ensure they have the core knowledge to implement their organisation’s policy and to understand their own responsibility in relation to the policy and managing stress. This standard will be available sometime in 2012.

• PAS 1012 (Resilience, Well-being and Returning to Work): This standard (available sometime in 2012) is split into two parts:

• The first part provides guidance in relation to prevention or resilience in the workplace by individual employees taking personal responsibility for their own wellbeing.

• The second part lays out clear procedures to ensure that employees receive an effective return to work programme.

According to BSI Standards, standards are “codes of best practice that improve safety, efficiency, interoperability and facilitate trade”. Implementing BSI standards helps organisations ensure that they are working to the same standards of best practice as other organisations in their industry, and that they can improve their systems and processes in order to achieve excellence. These three new stress standards will help organisations ensure that they are doing all they can to tackle stress in the workplace. For more information about supporting employees who are suffering from stress, or for help with any other employee health issues, call the free Health for Work Adviceline on 0800 0 77 88 44.

The initiative is supported by the Department for Transport, WWF and the TUC and its founding members include:

• Business in the Community (BITC);

• Microsoft;

• Nokia;

• Nuffield;

• Regus;

• Vodafone UK;

• Transport for London (TfL).

According to Gordon Frazer, Managing Director at Microsoft UK, flexible working is important for organisations that want to remain competitive:

“It’s no longer viable for businesses to stick to rigid, inefficient ways of working if they want to compete successfully in the market.”

Remote/flexible working can have a number of benefits including:

• allowing organisations to grow without necessarily needing a larger workplace;

• attracting better staff by:

• showing commitment to employees’ work/life balance;

• not necessarily requiring employees to live in the local area (therefore being able to recruit from a wider pool of people);

• improving staff retention as people have the flexibility to work when, where and how they want to;

• (very importantly) helping to keep staff happy and motivated, which could reduce levels of sickness absence and increase productivity.

Information on the benefits of flexible working can be found on the Anywhere Working website, which also includes case studies about organisations that have already adopted flexible working practices. Employers who are interested in providing opportunities for flexible working need to be aware, of course, that care needs to be taken to ensure that the implications of flexible working have been considered and the correct procedures have been put in place to ensure that remote staff:

• remain motivated;

• don’t feel isolated;

• are performing as well as they should;

• have all the necessary equipment and facilities in place to be able to work productively away from the workplace.

For more information on flexible working, see the Anywhere Working website or to find out more about the possible health benefits of flexible working, or to discuss any employee health-related issue, simply contact the free Health for Work Adviceline on 0800 0 77 88 44.

• establish their strengths and weaknesses in terms of health and wellbeing;

• pinpoint ways to improve health and wellbeing practice;

• demonstrate their commitment to the health and wellbeing of the workforce.

So what are the benefits of demonstrating commitment to employee health and wellbeing? It is generally accepted that healthy, happy employees will be more productive, committed and loyal to an organisation, which may well impact on an organisation’s bottom line. In addition, keeping the workforce healthy may reduce sickness absence levels and related costs, which makes good business sense. Furthermore, employers are obliged under law to protect the health of their staff so looking after the health and wellbeing of employees helps fulfil legislative responsibilities.

Employers can sign up to the Charter using a self-assessment form (to find out what they are already doing right and where they need to improve) and a registration form. Once they have registered, an informal chat with an assessor will permit organisations to ask any further questions and receive a portfolio to gather evidence. Once an employer has gathered all the necessary evidence an assessor will do a site visit to verify it and point out any other information that may be required before receiving the Charter Award, which lasts for two years.

The Charter focuses on three key areas:

• Leadership:
  • For example, is there active support from senior management in the area of health and wellbeing (e.g. providing time and skills, developing an action plan, and monitoring and reviewing)?
• Culture:
  • For example, is health and wellbeing embedded into the culture of the organisation, is the working environment a healthy one, and are staff made to feel valued and included?
• Communication:
  • For example, is communication within the workplace effective and does it meet the needs of the workforce?

The standards are split into three levels because the Charter recognises that smaller employers may find it hard to achieve the same level of activity as larger organisations:

• Commitment: This demonstrates a real commitment by small organisations.
• Achievement: Good achievement for medium-sized organisations.
• Excellence: The level that large organisations should strive for.

Organisations that are committed to looking after the health and wellbeing of employees stand to gain in many ways (e.g. reduced levels of sickness absence, better staff retention, healthier and more productive staff, and improved staff morale and loyalty). For guidance on employee health issues along the way, organisations in England can contact the free Health for Work Adviceline.

A significant proportion of respondents (26% – more women than men) report they have experienced mental health problems while in employment. Interestingly, more than half (53%) of people who describe their mental health as poor say they always go to work when experiencing poor mental health and 42% say they sometimes do. This suggests that managing people with mental health problems in the workplace is just as important as managing their absence when they go off sick.

Perhaps unsurprisingly, significant numbers of respondents reported that going to work with poor mental health affects their ability to do their job. This is a challenge for employers who will clearly want to keep staff at work but will want to avoid the problem of presenteeism (i.e. staff coming to work when they are really too ill to function effectively). Respondents reported a number of difficulties when at work with poor mental health, including:

•  finding it difficult to concentrate;

• difficulty juggling a number of tasks;

• taking longer to do tasks;

• being put off by challenging tasks;

• being less patient with customers and clients;

• reduced ability to make decisions;

• increased likelihood of conflict with colleagues;

• more difficulty learning new tasks.

So, taking into account that more than a quarter of respondents have experienced mental health problems and more than half of people who describe their mental health as poor say they always go to work when experiencing mental ill health with some significant impact on their ability to do their jobs, what did employees report about the support they receive in the workplace?

Only four in ten respondents would feel confident disclosing a mental health problem to their employer or manager, while only one in four say their organisation encourages staff to talk openly about mental health problems. Those respondents who have disclosed mental health problems, however, reported quite positive experiences. Of the 43% of respondents (more women than men) who described their mental health as poor and have disclosed their stress or mental health problems to their employer or manager, 73% said they had not experienced any adverse treatment as a result and only 13% of respondents reported having received no support at all – the significant majority reported having received a lot of support or some support.

Employers/managers have an important role to play not only in supporting employees who are at work with mental health conditions, but also in supporting those who want to return to work after mental illness (an important part of a person’s recovery). Of course, employers are not expected to deal with an employee’s problems themselves. Instead, they should learn to recognise signs that somebody is struggling at work, encourage employees to talk about their issues and know where to find professional advice. A good starting point is the Health for Work Adviceline for immediate, professional guidance and signposting to relevant services, where necessary. Call 0800 0 77 88 44 for more information.

Image by ausserirdische sind gesund via Flickr, under Creative Commons Licence

It’s Eating Disorders Awareness Week from 20-26 February 2012, a time to shed some light on the serious issues of eating disorders, to inform people about them and try to remove some of the stigma surrounding them.

Clearly, individuals make decisions about what and when they eat depending on a variety of factors such as the time of day, levels of hunger, nutritional considerations, personal preferences, etc. However, people whose eating routine is determined predominantly by an intense fear of becoming overweight are classed as suffering from eating disorders, and they risk seriously damaging their health as a result.

Eating disorders can take a variety of forms:

• eating too much;
• eating too little;
• using harmful ways to get rid of calories (e.g. inducing vomiting or taking laxatives to encourage the emptying of the bowels).

There are three most common eating disorders:

• Anorexia nervosa: This condition is characterised by an intense fear of gaining weight, which will make sufferers try to keep their weight as low as possible by denying themselves food. The condition is more common in men than women and usually develops during teenage years.
• Bulimia: Bulimia is more common than anorexia nervosa and the vast majority of sufferers are women. The condition is characterised by consuming large amounts of food in a short time then deliberately being sick or using laxatives to empty the bowels.
• Binge eating: Binge eating (episodes of uncontrollable eating) usually affects males and females equally and usually appears later in life (between the ages of 30 and 40). Due to the difficulty of precisely defining ‘binge eating’, it is not clear how widespread the condition is.

Signs of a potential eating disorder might include:

• Regularly missing meals.

• Being preoccupied with being overweight despite appearing to other to be in no need of losing weight.

• Being unwilling to eat in public or only eating low-calorie foods.

• Regularly going to the bathroom after eating meals.

The causes of eating disorders can be quite complex (e.g. depression and emotional distress, social pressures, the need to feel ‘in control’ of one aspect of one’s life) so it isn’t always easy for a sufferer to ascertain the reason for the problem. The treatment route should involve a professional counsellor or nutritionist who specialises in eating disorders who can give advice on other available options such as counselling, therapy, support groups, etc. Information on eating disorders and available treatments can be found on the NHS Choices website. For guidance on supporting an employee you fear may be suffering from an eating disorder, call the Health for Work Adviceline on 0800 0 77 88 44.

It isn’t necessarily the nature of a person’s movements that cause the musculoskeletal pain (they are often ordinary movements such as bending, straightening, gripping, holding, twisting, clenching and reaching). It is the fact that a person may make the same movements repetitively, often at speed and using force, and with no recovery time between movements that makes them hazardous. In some cases the person’s work may be poorly designed, which means that their work position or posture is awkward.

The most common symptom associated with musculoskeletal disorders is pain although some sufferers report joint stiffness, muscle tightness, ‘pins and needles’ and redness and swelling of the affected area. Musculoskeletal disorders can range from mild to severe and, as they are cumulative in nature, can be measured depending on the severity/longevity of the pain and the extent to which the pain affects a person’s ability to work:

• Early signs: Aching/tiredness of the affected limb may occur during the work shift but disappears when the person stops working and does not affect the person’s ability to work.
• Signs that the condition is progressing: Aching/tiredness occur early in the work shift and persist at night, and may make it difficult for the person to do repetitive work.
• Advanced condition: Aching, fatigue, and weakness continue constantly and the person may struggle to sleep and perform light duties.

In order to limit the number of cases of musculoskeletal disorders organisations should perform comprehensive risk assessments and ensure they comply with existing legislation and good practice guidance. Musculoskeletal disorders can cause acute symptoms however they can develop gradually, be cumulative and could lead to loss of productivity, sickness absence and, potentially, occupational disability. Employees feeling any pain or discomfort should be encouraged to report it to their line manager. Any individual experiencing musculoskeletal pain should seek advice from their GP.

Free advice on employee health issues is available for organisations on England from the Health for Work Adviceline. Call 0800 0 77 88 44 to find out more about looking after the health of your staff, including preventing employee health problems caused by their work.

Image by Jim Bahn via Flickr, under Creative Commons Licence

Employee health screening (or ‘lifestyle assessment’) can be used to help identify potential risk factors for future poor health and areas to focus on in order to optimise wellbeing. As an organisation’s employees are its most important asset, it makes sense to do what can be done to detect illness, where possible, and to promote a healthy lifestyle – keeping employees healthy and productive arguably makes sound financial sense. Recent estimates place the cost of sickness absence to the UK economy at £100 billion each year (source: 2011 independent review of sickness absence in the UK), which highlights the importance of keeping people healthy and in work, where possible.

Health screening/lifestyle assessment usually comprises a combination of tests such as blood pressure reading, cholesterol tests and lifestyle analysis (e.g. alcohol intake, smoking habits, physical activity etc.) which aim to give the individual an overview of their current health status and help detect disease or risk factors early so that a referral can be made to the individual’s GP for onward management. This is important as people may be aware that they have health issues but have not been tested to determine the risk that these problems may potentially present to their health.

Employee health screening (lifestyle assessment) offers a variety of benefits both for organisations and the individuals who work for them, including:

• reduced sickness absence levels;

• improved productivity;

• improved morale and loyalty amongst employees, particularly as health screening demonstrates that employers care about their staff and are dedicated to helping them stay healthy.

Common health screening tests include:

•  Blood glucose levels.

• Blood pressure and pulse rate analysis.

• Cholesterol testing.

• Vision screening.

• Lung function tests.

• ECG (to detect abnormal heart rhythms and investigate the cause of chest pains).

• Height, weight and body mass index (BMI) tests.

• Health and lifestyle interviews including discussion of family history of health issues.

The Health for Work Adviceline advisers can offer guidance on how to access lifestyle health assessments in your area appropriate to your organisational needs and budget. When a programme of health screening is commissioned, you can ask to be provided with an anonymised organisational report which may highlight areas for further interventions.  For guidance, speak to an adviser for free on 0800 0 77 88 44.

Image by redeyeˆ via Flickr, under Creative Commons Licence

As we saw in the first part of this blog (Obesity and its effects) being overweight/obese can put people at risk of some serious health issues such as coronary heart disease, type 2 diabetes, certain cancers, etc. A survey carried out by Personnel Today in 2005 of more than 2,000 HR professionals in organisations of all sizes set out to investigate respondents’ views on obesity and the way they treat overweight people. The results were fairly shocking – an amazing 93% of respondents stated that during the recruitment process they would choose to hire a person of ‘normal weight’ over an obese individual purely on the basis of their weight.

Interestingly, whilst almost 50% of respondents in the survey believed that obesity negatively affects employee output, around three-quarters admitted that their organisation was doing nothing to actively tackle staff obesity. Despite being a serious and growing problem, obesity isn’t a topic that is often discussed openly in the work environment. But, why?

It may have to do with the stigma surrounding obesity. It is assumed by many that obesity is something that could be controlled by the individual (i.e. by not over-eating), which suggests that obese individuals are somehow lacking in willpower or self-control and can lead to them being stigmatised. Related to this is the fact that it is common for people to feel more sympathetic towards those whose obesity can be put down to a health condition (e.g. thyroid problems) as though this makes it somehow ‘excusable’.

In addition, many believe obesity to be caused by emotional problems so they steer away from the topic for fear of ‘opening a can of worms’ by probing for information. (It is generally acknowledged that people find it much easier to discuss physical health issues than mental health problems for precisely this reason.)

Because of the rising levels of obesity in the UK it is a problem that employers increasingly have to face. Because employers are legally obliged to assess any risks to staff and take reasonable steps to reduce these risks, it should really be clear from the outset whether a person’s weight is likely to prevent them from doing their job safely and effectively. However, some people may become obese as a result of underlying health conditions such as diabetes, arthritis or depression. If an individual’s functional ability is impacted as a result of the obesity or other illness, the Equality Act 2010 may apply.

Whilst not covered by legislation, organisations should promote healthy lifestyles and wellbeing amongst employees so that people become more aware of making healthy choices. Employers will also need to be aware of any discrimination against obese individuals in the workplace and take steps to put an end to it.

Ultimately, obesity and obesity-related illness can cause a significant drop in employee and organisational productivity, so everything possible should be done to deal with the issue for the sake of the individual as well as the organisation. For guidance on this complex issue, contact the Health for Work Adviceline on 0800 0 77 88 44.

Image by aussiegall via Flickr, under Creative Commons Licence

In this first part of a two-part blog on obesity and work, we’ll be looking at what actually constitutes obesity, and how it can affect people. The second part (to be posted tomorrow) will investigate employers’ responsibilities towards employees who are obese.

Obesity is a major (and growing) problem in the UK, particularly among young adults. The number of obese adults in the UK has nearly tripled since 1980 and has come to be known as ‘the obesity epidemic’. It has been estimated that around 60-70% of men (and 50-60% of women) in the UK are classed as being ‘overweight’ and around 25% of men and women in the UK are classed as being ‘obese’ (Department of Health, Obesity General Information).

Generally, assessment of whether a person is overweight/obese is made by:

• calculating body mass index (BMI);

• measuring waist circumference.

To calculate BMI a person’s weight (in kilograms) is divided by the square of their height (in metres). So, for example, a person weighing 75 kg who is 1.70 metres tall would perform the following calculation:

BMI = 75 / (1.70 x 1.70) = 26

The table below gives an indication of how to interpret BMI measurements using the UK classification of BMI.

Measuring waist circumference can also give some idea of whether a person is at risk of developing weight-related health issues. This is because it is not only a question of how much weight a person is carrying, but where they are carrying it. People who carry excess fat mainly around the waist (people who are ‘apple-shaped’) are at greater risk of developing health issues that people who carry excess weight around the hips and thighs (‘pear-shaped’). So if two people are measured as having the same BMI, the person with the larger waist measurement will be considered to be at greater risk of health problems.

Overweight or obese individuals can experience a whole host of day-to-day issues, including:

• tiredness and a lack of energy;
• shortness of breath or difficulty managing sudden bursts of physical activity (e.g. running for a bus);
• increased perspiration;
• skin irritations;
• difficulty sleeping;
• back and joint pains affecting mobility.

In terms of health problems, overweight or obese individuals are at an increased risk of developing:

• type 2 diabetes;
• high cholesterol;
• high blood pressure;
• coronary heart disease;
• stroke;
• fertility problems;
• stress incontinence (leaking urine when laughing, coughing, etc.);
• gallstones;
• cancers (including colon, breast and womb cancer);
• gout;
• fatty liver.

So, it is clear that obesity is a serious issue that will progressively cause problems for working-age adults as more people become obese and obesity increasingly becomes a topic that employers/line managers need to broach with staff. However, as we’ll see in the second part of this blog (to be published tomorrow), obesity isn’t something that people find easy to discuss openly and can therefore be very difficult to manage.

If you are worried about obesity and its effects in your organisation/team, visit the Health for Work Adviceline or call 0800 0 77 88 44 for free, professional advice.

According to Macmillan Cancer Support (which offers support and information to people affected by cancer) more than one in three people will be affected by cancer at some point in their lives so the likelihood is that most people will know people who are suffering from cancer. Cancer can occur at any age although the risk of developing cancer increases with age. The most common cancers for men and women are:

Importantly for employers, cancer is now covered as a disability under the remit of the Equality Act 2010 either because the illness itself may limit a person’s day-to-day activities, or because possible effects of the illness (such as depression, which may occur as a result of the diagnosis) can be classed as a disability. Because of this, employers must offer appropriate support to employees suffering from cancer in order to fulfil their legislative duties.

Being diagnosed with cancer does not necessarily mean the end of someone’s career. Whilst participation in (and recovery from) treatments may mean a certain amount of time off work, not all cancer sufferers take long-term sickness absence. However, because no two cancer diagnoses are the same, employers need to remain flexible when working with employees to decide on issues such as:

• what they are and are not capable of doing;

• how their treatment is likely to affect their ability to work (how long they may need to be off work, etc.);

• what adjustments should be made to their work in order to allow them to continue working (in so far as this is possible);

• whether they need to be restricted from specific working environments (e.g. exposure to infection sources during chemotherapy);

• discussion of any external support services that could be of help;

• what on-going support employees feel they may need.

For advice on supporting an employee who has been diagnosed with cancer, or for help with any other employee health issues, call the free Health for Work Adviceline on 0800 0 77 99 44. In addition, the Chartered Institute of Personnel and Development (CIPD) has a downloadable guide on its website entitled ‘Cancer and working: guidelines for employers, HR and line managers’, which offers guidance for employers on dealing with the issues arising at different stages of the illness.

Image by Colin_K via Flickr, under Creative Commons Licence

The terms ‘occupational health’ (‘OH’) and ‘health + safety’ (H&S) can be confusing. They are both very important but are often mistaken for each other, and both encompass a wide range of activities, which overlap with each other to a certain degree.

The mere mention of H&S is enough to make some people groan as they conjure up images of over-zealous health and safety inspectors and overly-stringent health and safety rules. In reality, however, H&S is a vitally-important discipline defined by the Health and Safety Executive (HSE) as “preventing people from being harmed by work or becoming ill by taking the right precautions and providing a satisfactory working environment”.

OH could be described as “the promotion and maintenance of physical and mental well-being of all staff and the prevention of ill health”. It is about the effects of work on a person’s health and ensuring that employees are fit for the work they do.

H&S practices may appear to be pro-active (preventing risk) and OH practices re-active (dealing with employee health issues once they occur). However, there is significant scope within OH to monitor employee health and prevent illness before it occurs.

The differences…

One way of considering the difference between H&S and OH might be to consider the difference between accidents and illnesses. For example, some work practices may put employees at risk and therefore need to be tightly controlled (e.g. production lines, organisations that require staff to work with heavy machinery, toxic substances, etc.). These safety aspects would be controlled by health and safety legislation. Similarly, particular types of work can put employees’ health at risk (e.g. lead poisoning or noise-induced hearing loss, stress or musculoskeletal disorders, etc.). The process of trying to prevent ill health, monitoring employee ill health and helping employees stay at work or return to work during/after illness might fall under the remit of a person involved in the provision of OH services.

The similarities…

The cross-over between the two disciplines is present in the areas of ‘risk assessment’ (ensuring that processes and policies are put in place to reduce work-related ill health). If the aim of H&S is to make working environments as safe and risk-free as possible, then risk assessment is vital. The same goes for OH: as OH sets out to check prior to exposure that employees are satisfactorily assessed for fitness to do their allocated jobs, to ensure that employees do not carry out tasks that they are unable to do due to a health issue, and to monitor the health of staff who at risk of developing occupational disease due to their work (health surveillance), then risk assessment is vital on all counts. One other notable similarity between the two disciplines is that they both require commitment and involvement from both employers and employees.

It is often the case that more attention is given to health + safety issues in the workplace because these are easier to quantify and manage than OH issues. For example, it is easier to work out what has caused an accident at work than to assess whether an employee’s on-going health problems have been caused by, or exacerbated by, the working environment.

Any organisation whose employees are suffering from health issues that are affecting their ability to do their jobs would benefit from OH guidance. The Health for Work Adviceline offers free, professional advice on employee health issues with the aim of reducing sickness absence and keeping people and organisations healthy and productive. Visit the website or call Freephone 0800 0 77 88 44 for more information.

The symptoms of MS fluctuate and worsen over time, which can be a challenge at work and can lead sufferers to step out of work prematurely unless they are offered support to help them to continue. Because sufferers require additional support in order to work effectively, they may feel vulnerable at times of economic downturn when there is a real risk of job losses.

Some of the symptoms of the condition can limit sufferers’ ability to work, including:

• fatigue;

• depression and anxiety;

• limitations in mobility;

• reduced dexterity;

• slurred speech;

• urinary and faecal frequency and urgency;

• cognitive impairment causing memory and concentration difficulties.

Whilst there is no cure currently available for MS, there are interventions that can significantly reduce the impact the condition has on the lives of sufferers and their ability to remain in employment. In fact, continued participation in work for people with long-term conditions is now a specific goal in the new NHS Outcomes Framework and interventions now focus on the capacity of individuals with MS, rather than their incapacity.

When an employee is diagnosed with MS, an employer/line manager will need to begin to understand the condition and how to support the employee. It is important that employees are clear about their duties under the Equality Act 2010 not to discriminate against people with disabilities. Because the symptoms of MS fluctuate over time particular consideration needs to be given to creating a flexible working environment and making necessary adjustments to help people with MS to stay in or return to work. For advice on supporting employees with MS or other health conditions, call the Health for Work Adviceline on 0800 0 77 88 44.

1. Free telephone advice for employers on Freephone 0800 0 77 88 44.
2. Self-service information through access to an extensive, intelligent, on-line knowledge base.
3. On-line communication with a contact centre by submitting a question to the support team, or ‘chatting’ directly with a member of the team (a form of instant messaging).

The launch of this enhanced service follows the publication in November 2011 of the Government’s independent review of sickness absence (the Review) undertaken by health and business experts Dame Carol Black (expert adviser on health and work to the Department of Health) and David Frost (former Director General, British Chambers of Commerce). The Review found that all too often the sickness absence system pushes people away from work and that employers, especially those who do not have their own occupational health services, find it very hard to get independent, bespoke advice for more complex sickness cases.

Each year around 11 million employees in the UK take sick leave and, while most people return to work, around 300,000 people go on to claim health-related benefits. This costs the taxpayer £13bn a year and causes the country as a whole to miss out on £15bn in economic output. Overall, working-age ill health and sickness absence cost the UK economy more than £100 billion each year. The impact is particularly significant for small businesses for whom the cost of sickness absence is around £700 per employee per year (CIPD, 2010) – a substantial cost for small businesses to cover.

Building on the success of a pilot service, which provided over 2,000 one-to-one advice sessions and achieved a 98% satisfaction rate and over 4,000 website visits per month, the new Adviceline provides swift access to individually-tailored and free professional advice and guidance that aims to enhance business performance, increase productivity and improve staff morale. With this new service, managers in small businesses based in England can now access precisely the type of advice and support they told the Review they needed by getting help:

• finding the information and support they need to help an employee experiencing ill health;
• developing a plan to deal effectively and sympathetically with employee sickness absence;
• establishing how to manage similar problems in the future, should they occur;
• thinking differently about their business and the returns they will get from investment made in maintaining a healthy workplace.

By managing sickness absence more effectively at an organisational level and improving the health and wellbeing of employees, SMEs will also make a significant contribution to the health and wellbeing of the economy at a time when it is most needed.

“The Health for Work Adviceline provides managers in small and medium-sized businesses with access to high quality professional occupational health advice, getting employees back to health and back to work.” (Dame Carol Black – expert adviser on health and work to the Department of Health)

“The Health for Work Adviceline is a significant element of the Government’s plan to create healthier workplaces.

“It gives small and medium sized businesses access to professional and tailored occupational health information, advice and guidance. This means that employers can support the health of their employees to reduce incidents of sickness absence, help their timely return to work following mental or physical ill health absence, and help to reduce the numbers claiming sickness benefits.” (Lord Freud – Work and Pensions Minister)

“A healthy workforce is key to a successful, healthy business and this free Adviceline is good news for small businesses… Employers can now receive professional advice that is tailored to their needs, helping them to retain an employee’s services or assist them back to work sooner after a period of sickness absence.” (Sayeed Khan – Chief Medical Advisor for EEF, the manufacturers’ organisation)

• an increase in workplace stress due to the economic downturn, rising job insecurity and increased pressures on employees to perform to their best ability in order to retain their jobs;

• the increased use of complex technology, which means added pressure on employees to keep up with technological developments and be able to work more quickly, efficiently and productively;

• problems outside work that can negatively impact on a person’s ability to cope at work (e.g. domestic issues, financial or relationship problems, etc.).

It is becoming increasingly important for employers/line managers (and colleagues) to be able to recognise mental health problems and know how to offer support to those who are suffering from mental illness. Despite the fact that the World Health Organization has estimated that depression will rank as the second-leading cause of disability in the world by the year 2020, mental ill health has been stigmatised, which prevents many sufferers from coming forward to discuss their problems.

Because of this stigma, MIND (the leading mental health charity for England and Wales) describes workplace stress as the ‘elephant in the room’: it exists but, all too often, it is ignored. It is testament to how seriously mental health in the workplace is being taken that the MINDFUL EMPLOYER initiative, which is aimed at increasing awareness of mental health at work and providing support for businesses in recruiting and retaining staff, is constantly getting more signatories to its Charter for Employers who are Positive about Mental Health. Organisations that have signed up to this charter (a voluntary agreement seeking to support employers in working within the spirit of its positive approach to mental health) employ more than one-and-a-quarter million employees in the UK.

Sadly, struggling with mental health issues becomes too much for some people. Some can have suicidal thoughts and others go on to act on those thoughts and attempt suicide. In 2009, 5,675 people in the UK committed suicide (Samaritans Suicide Statistics Report 2011). In recent decades the number of young men committing suicide has increased whilst suicides among women have fallen, although the reason for this is not fully understood.

In many suicides there has been a long history of mental health problems, mainly:

• depression;

• eating disorders;

• schizophrenia.

In some cases, however, there may be no recorded history of mental health issues, which makes it much harder for others to predict a suicide attempt. It may be that changes in a person’s life could be enough to lead someone to attempt suicide without there being any known history of mental illness, e.g.:

• relationship breakdown;

• having to face up to debt or a court case;

• loss of a job or home;

• acute or chronic physical illness;

• alcohol or drug abuse;

• social isolation.

Where there is concern for somebody’s mental state, or where a person has implied that they may be considering suicide, it can be very difficult to know how best to support the person and ensure that they get the help they need. Other than listening to what the person has to say (without making judgements or trying to offer solutions), and letting them express their worries and their concerns, it is best not to try to do anything without having sought professional guidance first. Encourage the person to seek help as soon as possible from their doctor, or help them access local counselling services or charities such as The Samaritans. Where there is concern that a person is in immediate danger, it is advisable to call the emergency services (999). Guidance on where to go for help can be sought from the Health for Work Adviceline on 0800 0 77 88 44.

Photo by Genista

Our penultimate blog of 2011 highlighted how the stresses and strains of the festive season can affect people’s health (Risks to health during the festive season). Many people become stressed in the pre-Christmas period as they struggle to cope with gift-buying, financial pressures, managing workloads, etc. Those hoping for some kind of reprieve in January may be disappointed as January is considered by many to be the most stressful month of the year:

• The weather can be dismal and there are no major national holidays to look forward to until Easter (which seems a long way off at the beginning of the year).

• The world can seem a little bleak after the bustle and excitement of the Christmas period and many suffer from the post-holiday blues (or a ‘holiday hangover’) after all the excitement of the Christmas season. To make things worse, on the first working day of 2012, large parts of the UK were faced with heavy rain and gales causing localised flooding and treacherous driving conditions  – not good for those who need to commute to work or who travel as part of their job.

• The pressure to keep to New Year’s resolutions can be an additional source of stress, particularly as these often concern emotive issues such as giving up smoking or losing weight.

• Many people start the year under the shadow of financial worries after the Christmas season.

• Many are worn out after two weeks of celebrations and begin the year with a weakened immune system and a higher susceptibility to colds and flu.

• The holiday season can put extra strain on family relationships, so some people may return to work feeling anxious about relationship issues.

Employers should try to be aware of the possibility increased stress levels at the beginning of the New Year and could support employees, perhaps by:

• helping them to prioritise work;

• maintaining an ‘open door’ policy so that employees feel they are able to discuss their issues with line managers/employers;

• looking out for signs of stress/low mood in employees and enquiring about their wellbeing (some people may not feel confident asking for help with work or personal circumstances but may accept help if it is offered);

• organising an event in January for staff to look forward to (perhaps a team social event (e.g. bowling) or a sporting charity fund-raising event to bring people together, keep them fit, and give them something to aim for).

For advice on how to support employees, call the free Health for Work Adviceline on 0800 0 77 88 44.

Photo by Arkadiusz Benedykt

According to a report from the Department of Transport (2008) 8,620 road accidents occurred in 2008 when a driver was over the legal limit for alcohol, and 2,020 people were killed or seriously injured as a result. Whilst these figures are frightening, accidents involving drink driving have decreased dramatically over the past 30 years, although a lot still needs to be done to further reduce the number of drink driving-related road incidents.

In the UK, the alcohol limit for drivers is:

• 80mg of alcohol per 100ml of blood;

• 35mg per 100ml of breath; or

• 107mg per 100ml of urine.

Unfortunately it is impossible to work out categorically how many units a person can consume before exceeding their blood alcohol content (BAC) legal limit (i.e. the percentage of alcohol in the blood), as the speed that alcohol enters the blood stream will vary dramatically depending on a number of factors, including whether a person has an empty stomach or is drinking with food over a prolonged period. Tiredness will also affect the concentration and absorption of alcohol into the blood stream.

Therefore, the key to avoiding driving over the limit is to plan ahead by choosing a designated driver before setting off, or working out how to get home using public transport or a taxi. Planning ahead is crucial to avoid the risk of simply nominating the person who has drunk the least: in this case the designated driver may still be over the legal limit.

Driving when over the legal limit can have serious implications. Not only are drink drivers putting themselves and other drivers, pedestrians or cyclists at very real danger, but they risk losing their licence and possibly their job, which can send people into a downward spiral of financial difficulties.

Employers and employees must be aware of the risks of driving or operating machinery the day after a big night out in order to avoid accidents at work. Whilst it is impossible to measure how much alcohol we can drink before reaching the BAC legal limit, the rate at which alcohol burns off is measurable: it burns off at almost precisely .016 BAC per hour (about equal to one standard drink each hour). This rate is true regardless of body size, which means that a petite female burns off alcohol at the same rate as a tall obese male.

More information on drink driving and the legal alcohol limit can be found on the Drinkaware website. A guide on drugs and alcohol in the workplace can be found on the Health for Work Adviceline website, or free guidance can be sought on the effects of alcohol on a person’s ability to work on 0800 0 77 88 44.

Photo by coljay72

So, Christmas is nearly upon us. The season of goodwill…or a period of increased stress? A time for charity and giving…or for feeling pressured to supply the perfect gifts for everyone? A time for happy families to enjoy the festive season together…or a time to be sad about what we haven’t got, or about people who are missing from our lives?

For many, the Christmas period can be tinged with sadness or nostalgia, yet there is an expectation on us to be (at least outwardly) full of joy and happiness. Everyone is struggling to juggle work and personal commitments: as lovely as it is to watch our children performing in their school plays, it often means taking time off work at precisely the time of year when we could do with buckling down in order to get through our workload before year end. Then, instead of relaxing at the weekends, many of us find ourselves trying to carve a path through masses of shoppers in pursuit of Christmas present bargains, or over-indulging at Christmas parties when an early night might have been what our body was yearning for.

People are potentially at risk of developing health related issues associated with increased stress levels at this time of year. A permanent or significant increase in blood pressure (hypertension) can increase the risk of heart disease, stroke and kidney problems. The pressures of the festive season (especially when combined with a difficult economic climate) can exacerbate stress and mental health issues such as anxiety and depression. Stress can also be a trigger for migraines or severe headaches.

Employers/managers can help prevent stress at work by being aware of their employees who may be struggling to cope perhaps by:

• helping employees to prioritise work and setting realistic deadlines helps reduce stress;

• maintaining an open-door policy so that employees feel confident to discuss issues rather than bottling them up and ‘soldiering on’;

• saying a proper ‘thank you’ to employees to demonstrate that they are valued and that their efforts aren’t going unnoticed.

For more help with recognising signs of stress or anxiety in your employees, or to get advice on making adjustments to prevent people becoming overwhelmed by stress, call the free Health for Work Adviceline on 0800 0 77 88 44.

Photo by limaoscarjuliet

David Cameron has spoken out strongly about his intention to end Britain’s ‘sick note culture’ after being shocked by the figures contained in the latest review of sickness absence (the Review) by Dame Carol Black and David Frost. According to the Review, sickness costs the British economy £15b each year and causes a total of 140 million lost working days.

The Government believes that at least one in five of those who are on long term sickness absence should either never have been signed off work in the first place, or could go back to work. The Prime Minster is alarmed that businesses are being hit with a yearly bill of £9b because of the 300,000 people who are slipping out of work and on to sick pay and welfare benefits.

A report for Downing Street has suggested that three quarters of GPs admitted they had signed people off sick for reasons other than their physical health. Due in part to this revelation, Mr Cameron is strongly in favour of the creation of an independent assessment service to take over the job of assessing whether people should be signed off work on long term sickness absence, as recommended by the Review.

According to the Prime Minister:

“Every year more than 300,000 people fall out of work and on to health-related benefits. Many… fall ill, get signed off by their GP, their fitness isn’t checked again; and before they know it they’re on a conveyer belt to a life on benefits.

“Of course some of these people genuinely can’t work, and we must support them. That’s only fair. But it’s also fair that those who can return to work should be supported to do so. We need to end the something for nothing culture.”

These are fraught economic times (globally and for countries in Europe). EU member states such as Greece, Spain and Italy are struggling with mounting national debt and a battle to stay in the Euro, whilst Britain became the only EU member state last week to refuse to sign a new inter-Governmental accord designed to save the euro because of the Prime Minister’s fears that Britain would lose control over its own financial destiny.

In these difficult economic times it is more important than ever that jobs are created, and that people who are fortunate enough to have jobs actually manage to keep hold of them. Many businesses, particular the smaller ones, may struggle to see how they can have any major impact on what are essentially national and European problems, or may be too busy focusing on their own business’s survival to be overly concerned about what’s happening at a macro level. However, it is clear that employee health and productivity are inextricably linked and, therefore, that businesses whose employees’ sickness and absence issues aren’t effectively managed, are going to struggle to remain productive and profitable. Free, professional and expert guidance can be sought from the Health for Work Adviceline on 0800 0 77 88 44.

The Review was based on some fundamental premises:

For most people of working age, the right work is good for their health and well-being.

1. For most people, worklessness is harmful.
2. Much sickness absence and inactivity follows common health conditions which are compatible with work (although sometimes it means a different kind of work) if people are given the right support.
3. There should be minimal delay in making an adequate assessment of an individual’s capability to work.
4. Despite best efforts, some people are too unwell or disabled to work and their needs should be answered adequately and promptly.

The Review made a range of recommendations, which are summarised below.

• Changes should be made to the current sickness absence system to improve its efficiency and its effectiveness in restoring people to work.

• Sickness certification should be improved so only those who are truly too unwell to work are declared completely unfit for work.

• The Review recommended the introduction of an Independent Assessment Service, which would relieve GPs of the task of signing people off on long-term sickness.

• Changes to the tax and regulatory regimes to enhance employers’ role in sickness absence management.

• Recommendations designed to bring the worst performing parts of the public sector up to the standards of the best (due to wide variations in practice across public sector organisations).

• The creation of a state-run job-brokering service to help those with long-term health conditions, who may not be able to do their current job, find another job they are capable of continuing with.

• Measures to improve the effectiveness and efficiency of the benefits system, and to speed up and improve assessment of work capability in order to get people back to work sooner.

Dealing with sickness and absence can be complex and most employers will need to seek guidance at some point on their legislative requirements towards employees, how best to support employees who are ill and/or off work, and how to minimise the negative impact of employees’ sickness and absence on their organisation. For professional, free, immediate advice, call the Health for Work Adviceline on 0800 0 77 88 44.

Photo by Mike Cattell

As winter sets in employers need to be aware that workers who are exposed to cold, wet or icy conditions may be at risk of sustaining injuries or becoming ill. In the more mild regions of the UK people aren’t used to sudden drops in temperature and many people struggle to cope when they are faced with bouts of wintery conditions.

The winter of 2009–2010 in Europe, for example, was unusually cold and in mid-December 2010 snow and cold weather caused widespread disruption across large parts of the UK (e.g. the South East, East Anglia, the East Midlands and Yorkshire). Large numbers of people had to abandon their cars as roads (even motorways, in some cases) became impassable; some were trapped in their cars awaiting rescue. Around 20 people were reported to have died during the snow and sub-zero temperatures in the UK during the final month of 2010.

Slips on ice and snow are obvious risks during freezing weather conditions although there are particular illnesses that are associated with cold conditions including hypothermia, frostbite and chilblains. Employers have a duty to ensure they have done all that is reasonably practicable to prevent employees having accidents or becoming ill due to their work. Different considerations about working conditions will be necessary depending on the type of work done by employees:

• Office-based workers: Do employees really need to be in the workplace, or could they work from home during wintery conditions? Is the office temperature at least 16°C or does additional heating need to be supplied?

• Outdoor workers: Employees working outside must be provided with adequate protective clothing to ensure that they remain warm and safe (e.g. hats, gloves, safety boots and high-visibility padded jackets). Risks identified in the initial risk assessment may pose even more danger in bad weather conditions (e.g. the risk of slipping whilst climbing ladders or working at heights).

• Company drivers: Ideally employees should avoid driving in dangerous weather conditions unless the journey is absolutely necessary (according to the Health and Safety Executive (HSE) up to a third of all road traffic accidents involve somebody who is at work at the time). Employers should keep abreast with the latest weather reports and base decisions on whether or not to allow company drivers to set off on journeys on risk assessments.

Employers seeking advice on how to fulfil their responsibility to ensure the safety of their employees during periods of bad weather can get tailored, one-to-one, free guidance from the Health for Work Adviceline on 0800 0 77 88 44.

Unfortunately, some organisations may feel they don’t have the time or resources to listen to staff (and actually act on the information they are given). And some successful businesses may mistakenly presume that they simply need to continue doing as they are already doing in order to sustain their level of success.

Listening to employees can bring a whole host of benefits, including:

• enhanced work processes and increased productivity as problems are solved more rapidly;

• improved staff engagement from staff who realise that their feedback makes a meaningful difference;

• better rapport between managers and employees based on trust and respect.

Healthy, happy employees will be more productive, but keeping staff healthy isn’t simply about helping people get better once they are ill, but about preventing illness in the first place. Communicating with staff, listening to their concerns and, importantly, taking their comments on board and acting on them, can encourage staff health and wellbeing and alert managers to potential issues before they develop. And staff who feel valued and equal to their managers are much more likely to want to stay healthy and remain at work.

For more advice on keeping staff healthy at work, or to find out more about supporting employees who are already ill, call the free Health for Work Adviceline on 0800 0 77 88 44.

Examples of invisible illnesses include:

• post-traumatic stress disorder (PTSD);

• mental health issues such as anxiety, bipolar disorder and depression;

• diabetes;

• LUPUS (an incurable immune system illness);

• fibromyalgia (musculoskeletal pain and fatigue disorder);

• multiple sclerosis (MS);

• ME, chronic fatigue syndrome, post-viral fatigue syndrome;

• arthritis

• cancer;

• heart disease;

• epilepsy.

Some of these illnesses are not yet well understood by the medical profession (in fact, it is common for doctors who qualified before 1990 not to have learned anything about fibromyalgia). They are historically very hard to diagnose and very hard to find treatment for. Because of this, they are sometimes labelled as psychosomatic complaints (i.e. psychiatric problems that are not really physical at all). This does a dis-service to sufferers of these illnesses, many of whom are in severe, chronic pain.

On-going, persistent pain will clearly have an impact on the quality of a person’s life and can lead to other issues such as depression, relationship breakdown and difficulty continuing to work. In the majority of cases, people suffering from chronic invisible conditions would benefit from carrying on with work, even if they are unable to perform their work role as before. For advice on how chronic invisible conditions can affect people in a work context, and for help supporting sufferers of chronic disease, call the free Health for Work Adviceline on 0800 0 77 88 44.

• improve back-to-work advice for individuals on a period of sickness absence;
• improve communication between individuals, GPs, and employers on what a patient can do and how a patient’s condition could be facilitated in work;
• reduce sickness absence;
• support people with health conditions to stay in work or return to work more quickly;
• contribute to creating new perspectives on the link between work and health, and improve awareness and understanding of the importance of work for good health.

Between February and May 2011, 45 in-depth, semi-structured interviews were carried out with a non-random, selected sample of GPs in England, Scotland and Wales in order to find out about:

• GPs’ experiences of using the fit note;
• what role GPs feel they play in giving return-to-work advice;
• how the fit note has influenced their role perceptions.

The findings of the report (‘An evaluation of the Statement of Fitness for Work: qualitative research with General Practitioners’) show that:

• the fit note has become a consultation tool that GPs use to initiate and guide negotiations with patients about returning to, or starting, work;
• many GPs believe their patients return to work earlier than previously because work has become more of a focus in their consultations;
• barriers to the successful use of the fit note include GPs’ confidence in dealing with conflict, and unwillingness to damage relationships with patients.

The Black/Frost independent review of sickness absence, which was published on 21 November 2011, acknowledges the difficulties some GPs face when making decisions about signing people off on long-term sickness absence, and has recommended the use of an independent assessment service to make this decision, in place of GPs.

One of the recommendations of the research was for the creation of a simple guide to the benefit system for GPs. Based on requests from GPs, the Department for Work and Pensions (DWP) had already begun work on such a guide before the report’s findings became available and it is available on the DWP website.

The Health for Work Adviceline is not only available to help employers deal with employee health issues, but can also offer guidance to GPs who are unsure about how a person’s health problems may affect their ability to work. Call 0800 0 77 88 44 for free, professional advice.

The report will recommend the creation of a new independent assessment service which would assess whether people are too ill to work.

According to the authors of the review, GPs do not have sufficient time to perform in-depth assessments of individuals, and they haven’t had training in occupational health, which can make it difficult for them to make decisions on an individual’s ability to continue working.

The proposed assessment service would assess a person’s functional capacity and would make recommendations about a person’s ability to return to work immediately (or with workplace adjustments), or whether the person is not fit to return to work at all.

Dame Carol Black and David Frost, who were asked to consider radical changes to deal with the human and financial cost of sickness absence in the workplace in their new review, hope that this new service, if implemented, would allow up to 20% of the 300,000 people currently off work in the UK to get back to work sooner. This would help reduce the £15bn cost to the UK economy each year due to lost economic output.

Other changes expected to be recommended in the report include:

• tax incentives for firms to take on or retain staff with long-term conditions;

• the payment of Job Seekers’ Allowance rather than Employment Support Allowance (for a period of three months) to people who are signed off sick. This means they would receive less money and would have to prove they were looking for work;

• Government-backed help to find a more appropriate job for those who can no longer do what they have been doing.

For guidance on helping your staff get back to work after illness, or for advice on any employee health matter, call the Health for Work Adviceline on 0800 0 77 88 44. The Black/Frost report will be available on the Health for Work Adviceline website once it has been published.

• Mark Bayliss from the UK Rehabilitation Council, which works to ensure access to high-quality medical and vocational rehabilitation services in the UK);

• Paul Campbell from the GMB trade union (a campaigning trade union with members in every part of the UK economy);

• Iain Hovell from Rentokil Initial;

• Terry Birch (an employee at Citilink, which is part of Rentokil Initial).

Mark Bayliss (from the UK Rehabilitation Council) explained that he believes the UK has a good workplace safety record but is not so good at rehabilitation (i.e. getting people back to work) because (according to Mr Bayliss):

• rehabilitation is generally under-resourced and under-valued in the UK even though getting people back to health/work as quickly as possible has been shown to be the best approach;

• some employers still hold the opinion that ill employees are not their concern (whilst, in reality, evidence has shown that organisations that look after their staff are more productive and profitable).

Whilst many small employers view rehabilitation services as an extra expense, Mr Bayliss views rehabilitation as a business investment, which pays for itself very quickly.

Terry Birch, a driver for Citilink (which is part of Rentokil Initial) who was injured at work, spoke on the programme about the high level of support he received from his employer. He simply called his organisation’s Accident Helpline, which organised everything and provided physiotherapy the following week. Of course, Rentokil Initial is a huge organisation with vast resources in comparison to small businesses, but the notions behind Rentokil Initial’s new system of support for employees (described on the programme by Iain Hovell) apply to all organisations, regardless of their size, namely:

•  preventing injuries/illness;

• alleviating employees’ suffering in case of incidents;

• getting employees back to work as soon as possible.

He admits that his organisation benefits greatly from this approach in terms of saving on the costs of replacement staff, re-training, etc. but suggests that employees possibly benefit even more.

Paul Campbell from the GMB spoke of his experiences employees who have been signed off work due to work-related injury or long-term illness and have received no contact from their employer throughout their absence except a letter warning of potential disciplinary action. He explained that whilst many employees presume that their contract will remain in place if they are signed off as unfit for work due to medical reasons, some employers still perceive the contract to have been broken.

There is no doubt that it is in everyone’s interests to keep people at work and support employees who want to return to work after illness/injury. For more guidance, speak to the free Health for Work Adviceline on 0800 0 77 88 44.

*This edition of ‘You and Yours’ can be listened to on the ‘You and Yours’ website until Wednesday 24 November. Some editions of the programme are converted into transcripts, which are also available on the website, although these do not appear for approximately one month after the programme is aired.

National Anti-Bullying Week coincided this year with the publication of a report at the beginning of November by the University and College Union (UCU) entitled ‘The growing epidemic: Work-related stress in post-16 education’ (available from the UCU press office), which revealed that four-fifths (81%) off staff in higher education found their job stressful in 2010 compared to three-quarters (74%) in 2008. The report also found that the well-being of staff in higher education was considerably lower than recommendations from the Health and Safety Executive (HSE) in a number of key areas, including support from managers.

Shockingly, only around half (45%) of those surveyed said they were never subjected to workplace bullying. The report marks the launch of UCU’s 2011 ‘Anti-stress and Bullying Week’ which runs from 7-13 November and will see UCU branches at colleges and universities throughout the country hold events on how to combat stress and bullying in the workplace.

The late Tim Field (a world authority on bullying and psychiatric injury), who himself suffered a breakdown after workplace bullying, became passionate about the topic of understanding and dealing with bullying at work. In 1996 he set up the UK National Workplace Bullying Advice Line (no longer in operation) and then an information website, Success Unlimited (later Bully Online), a resource on workplace bullying and related issues. According to Tim Field, there is a clear connection between workplace bullying and workplace stress:

“There’s only one way of dealing with stress – that’s to identify the cause and then work to reduce or eliminate that cause. I believe bullying is the main, but least recognised, cause of stress in the workplace today.”

Harassment and bullying are both major causes of workplace stress, and differ from each other fundamentally. Harassment can take the form of physical, verbal or non-verbal conduct, which is unwanted by the target. Conduct which makes an individual feel harassed is harassment even though that may not have been the intention of the harasser. Bullying is always intentional, and can be defined as the persistent use of offensive behaviour, which gradually undermines a person’s self-esteem and confidence. Workplace bullying has a negative impact on the work environment, including (to name a few):

• significantly higher rates of sickness absence;

• high employee turnover;

• high costs of training and retraining (to replace absent staff);

• low workforce morale;

• poor industrial relations.

For help with issues of workplace bullying, and to prevent the negative impact it may be having on your organisation, call the Health for Work Adviceline on 0800 0 77 88 44.

Photo by e-MagineArt.com

Long term conditions are conditions that cannot be cured but can be managed through medication and/or therapy. Examples of long term conditions include diabetes, asthma, coronary heart disease, chronic obstructive pulmonary disease (COPD) and mental health issues.

Living with a long term condition is a major theme in this year’s Self Care Week, which is running from 14-20 November. Self-care can be described as taking control of your condition and looking after yourself (e.g. taking medicine properly, exercising, etc.). (More information on Self Care Week can be found in a recent blog on this site).

Many people who suffer from long term health conditions report that they have missed out on training and work opportunities, and can find it hard to manage their work despite their condition. However, employers should give those with long term health conditions the same chances as others even though they may require substantial flexibility due to pain, fatigue, unpredictable symptoms and health appointments, which can all conflict with an employer’s needs for reliability.

As part of the Public Health Responsibility Deal, the Department of Health Health@Work network has published practical guides on chronic conditions for both employers and employees, which are available on the NHS Choices website. The guides (which have been endorsed by Dame Carol Black, National Director for Health and Work) aim to help organisations support employees who are suffering with long term health conditions.

It is generally accepted that working in a well-managed and safe environment is good for a person’s general health and wellbeing because it offers a whole host of benefits above and beyond financial gain (e.g. a sense of identity, belonging and achievement). Work is also considered to be beneficial for those suffering from chronic health conditions not least because being in work can aid recovery and rehabilitation, and improve a person’s quality of life and wellbeing. It is advisable for employers to seek advice on helping employees deal with long term medical conditions at work to ensure that all important factors have been taken into consideration. For immediate, free advice, call the Health for Work Adviceline on 0800 0 77 88 44.

It just so happened that this news story was being reported at around the same time as the UK’s National Stress Awareness Day on 2 November 2011, and less than one month previously the Chartered Institute of Personnel and Development (CIPD) published its 2011 Absence Management Survey, which highlighted that stress is the most common cause of sickness absence in Britain and leads to over 13 million lost working days per year at a cost of £3.7 billion.

The announcement of Antonio Horta-Osorio’s struggle with stress at work served as a clear reminder that stress is something from which nobody is immune (however famous, wealthy or happy they may appear to be). Because people respond differently to stressful situations, and because some people will find situations stressful that may not cause much concern for others, it can sometimes be difficult to have sympathy for a person who claims to be suffering from stress. However, we should avoid being judgemental as we don’t always know what else is going on in a person’s life that may make them less resistant to extra pressure.

Modern life seems to be fraught with everyday anxieties, which aren’t necessarily bad in themselves; a certain amount of stress can in fact be a good thing in order to spur us on to achieve. However, when stress becomes prolonged or excessive it can have a negative effect on a person’s health and wellbeing, and on their ability to be productive at work. Advice on dealing with work-related stress, and physical and mental health issues, can be sought from the free Health for Work Adviceline on 0800 0 77 88 44.

•  keeping fit and healthy;

• knowing how to self-administer required medicines;

• understanding how to treat minor ailments;

• learning how to live with a long-term condition;

• seeking help, when needed.

The Department of Health has described self-care as:

“the actions people take for themselves, their children and their families to stay fit and maintain good physical and mental health; meet social and psychological needs; prevent illness or accidents; care for minor ailments and long-term conditions; and maintain health and wellbeing after an acute illness or discharge from hospital”.

This year’s campaign builds on the success of the campaigns run in 2009 and 2010 by the Department of Health, and is being run this year in partnership with the Self Care Forum. The Self Care Forum was established in May 2011 with the specific aim of encouraging people to adopt the principles of ‘self-care’ and to embed self-care into everyday life.  Members of the Self Care Forum include patients, GPs, nurses, pharmacists, and health service managers.

Research has shown that proactively supporting self-management and focusing on behaviour change can have an impact on clinical outcomes and emergency service use. The Self Care Forum supports this notion and believes that living healthy lives is an important component of self-care, which prepares us for dealing with commonly­-occurring and/or long-term conditions.

Self Care Week 2011 is an opportunity for organisations and networks to raise awareness of the importance of self-care by promoting the campaign in newsletters, events, or through web buttons/banners on on-line and off-line materials. Free resources are available to download from the Department of Health website.

Whilst employers have a duty to promote and protect the health of their employees, the burden of responsibility cannot be placed on them alone: individuals must make personal choices and take responsibility for their own health and lifestyle. However, by promoting self-care to staff, employers will improve their business by helping to keep their main asset (their employees!) healthy and productive.

For more information on employee health issues, call the free Health for Work Adviceline on 0800 0 77 88 44.

However, whilst the smallest businesses rarely suffer from long-term sickness absence, it has a big impact and the costs can be high when they do. In response, the Forum for Private Business (FPB) is calling on the Government to introduce a small employer’s relief for the recovery of Statutory Sick Pay (SSP), which would be available to all firms with a bill for annual national insurance contributions of less than £45,000.

Currently the percentage threshold (PT) scheme is used to calculate how much SSP employers can claim back. The PT scheme means that many small firms either have to spend time doing complicated calculations, or they have to spend money on buying in help.

40% of small business employers who took part in the survey claimed that dealing with holiday entitlement, and sickness and absence is one of the most difficult aspects of employment law. According to the FSB, the process for the recovery of SSP needs to be simplified so that small firms can reclaim the costs more easily. This is of particular importance in the difficult economic climate.

According to John Walker, national chairman of the FSB:

‘Small firms act like a tight knit family and value the contribution their staff bring to the business. Research shows that staff in small firms are often more committed and loyal. But employees do have time off sick and sickness absence is one of the most complex pieces of employment law bosses’ have to deal with.”

The issue of employee sickness absence will be focused on comprehensively in the upcoming independent review of workplace sickness absence from Dame Carol Black (UK National Director for Health and Work ) and David Frost (Director General of the British Chambers of Commerce), which is due to be published in the coming months. Free, confidential support is also available for employers/managers who are facing employee sickness absence issues from the Health for Work Adviceline (0800 0 77 88 44).

Regular maintenance of equipment is an important and necessary activity. The term ‘maintenance’ covers many activities, including inspection, testing, measurement, replacement and adjustment, and is carried out in all sectors and workplaces. It has a vital role to play in eliminating workplace hazards and providing safer and healthier working conditions. Insufficient/inadequate maintenance can cause serious (and potentially deadly) accidents or health problems.

At the same time, however, maintenance is a high-risk activity, which is also heavily subcontracted by organisations that consider maintenance to be a specialised activity which does not belong to their core business or which requires expertise not present in the company. EU data has shown that outsourcing maintenance work increases the risk of accidents occurring. It is estimated that around 15-20% (depending on the country) of all accidents and 10-15% of all fatal accidents are related to maintenance operations (EUROSTAT data).

The work should be planned and a risk assessment should be carried out before any maintenance work is begun. Workers should be involved in this process as those carrying out a maintenance task are often in the best position to identify hazards and the most efficient ways of dealing with them. The work area should be made safe (e.g. preventing unauthorised access) and the people performing the maintenance work should be equipped with the proper tools and equipment to do the work safely (including personal protective equipment – PPE). The work should be monitored and safe working procedures need to be followed at all times. The process needs to end with checks to ensure that the job has been completed satisfactorily.

Employers can get more information on how they can ensure that maintenance work is performed safely in their organisation by calling the Health for Work Adviceline on 0800 0 77 88 44.

The changes came about because it was considered that UK regulations were incompatible with EU law and aim to bring clarity on time limits, which makes it much clearer to suppliers what is needed, and by when, in order for them to challenge a decision.

Time limit for challenging procurement decisions

The key change to the regulations is that the time limit within which unhappy vendors can lodge proceedings in relation to a procurement decision (i.e. for the breach of EU procurement rules) has changed. Proceedings must be brought by the vendor within 30 days of the date of knowledge of the issue that gives rise to the suspected infringement, although the Court may extend this to a maximum of three months if there is good reason. The new time limits for bringing a claim are set out in the Public Procurement (Miscellaneous Amendments) Regulations 2011 and do not affect cases where the date of knowledge occurred before 1 October 2011.

Starting proceedings

Under the amended public procurement regulations, proceedings are commenced when a claim form is issued. The claimant is now required to serve the claim form on the contracting authority within seven days after the date of issue.

In the current economic climate it is particularly challenging to gain and maintain new contracts. Changes to regulations can make it even harder for organisations that are focusing on ensuring on-going business success to ensure that they aren’t breaching legislation. This can further compound the strain on managers and employees, potentially causing stress, stress-related health issues and subsequent sickness absence. For guidance on where to go for more information about your legislative requirements, and for help with other work health issues including dealing with stress in the workplace, call the free Health for Work Adviceline on 0800 0 77 88 44.

Employers are increasingly going to have to develop and implement new working arrangements that take into account the shift in demographic. The motivation of older workers to continue to work could be greatly improved if more attention were paid to both their physical working environments and the way in which they are managed.

In general, older workers are positive about work (something that was demonstrated in a previous blog: ‘Younger employee feeling more stress at work’), and they are generally realistic about their capabilities and aspirations. Certain misconceptions about older workers continue to prevail in some quarters, including the perception held by many that older workers aren’t able to learn new skills, will become ill more often than younger staff, or aren’t sufficiently adaptable to new tasks and environments. These prejudices will have to be tackled as the average age of the workforce continues to increase.

From the perspective of employee health and wellbeing, the ageing workforce and the removal of the DRA have meant that employers may be faced with a completely different set of issues around health at work. By law, employers should be protecting older workers, including carrying out risk assessments and training, and they will need to consider issues such as workplace design and necessary adjustments, flexible working, and regular health checks. For information on how to support older workers in your organisation, and for guidance on fulfilling your legislative responsibilities, call the free Health for Work Adviceline on 0800 0 77 88 44.

The Government’s overall strategy for public health is set out in the White Paper Healthy Lives, Healthy People. The White Paper makes clear that everyone has a part to play in improving public health, including Government, business, non-governmental organisations (NGOs), and individuals themselves. The Government’s approach to improving people’s health is based on:

• positively promoting ‘healthier’ behaviours and lifestyles;

• adapting the environment to make healthy choices easier;

• strengthening self-esteem, confidence, and personal responsibility.

Based on the premise that industry can help to contribute to public health goals, the Public Health Responsibility Deal was announced by the UK Government in March 2011. Partners signed up to the Responsibility Deal have committed to take action to improve public health, although this action in no way replaces Government national policy or communication of public health messages. This action is expressed as a series of pledges covering food, alcohol, physical activity and health at work:

• Core commitments: these define the scope, purpose, and high-level ambitions of the Responsibility Deal.

• Collective pledges: the collectively-agreed action that members of a given sector will take in support of a particular core commitment.

• Individual pledges: these are specific to a particular organisation or sub-group within a sector, and have been developed by them and approved by the relevant network chairs and the Department of Health.

• Supporting pledges: these underpin all the collective and individual pledges. They define the operating principles and processes of the Responsibility Deal.

The signatories of the Public Health Responsibility Deal are mainly large organisations, including supermarket chains, food outlets, and food and drink manufacturers and retailers. However, all organisations, however small, have an important part to play in encouraging their employees to adopt a healthy lifestyle, and looking out for their mental and physical health. Investing in the health of your staff makes sound commercial sense in terms of business performance and productivity. For help achieving this, call the free Health for Work Adviceline on 0800 0 77 88 44.

Now research conducted by XpertHR (‘Are fit notes fit for purpose?’) has found that more than 85% of employers are not convinced that GPs are making it clear in the fit notes what needs to be done in order to get employees back to work. The research results suggest that:

• four out of 10 employers struggle to interpret what is being asked of them by GPs because of a lack of detail regarding the basis on which an employee could return to work, and a lack of understanding on the part of GP of the nature of the employee’s work/workplace;

• one third of employers find it hard to implement GPs’ suggestions.

However, the research also suggests some more positive outcomes since the introduction of the fit note, including a perception amongst some employers that:

• dialogue between employers and employees about the return to work has improved;

• the system appears easier to administer;

• the inclusion of an option for a phased return to work, followed by amended duties, is a positive step.

One criticism that was made of the new system is the common need to speak to an occupational health professional in order to get clarification on the advice given by GPs; organisations who do not have access to occupational health services may find it difficult to assess precisely what adjustments would allow the employee to return to work on the basis of a few short words on a fit note. In addition, employers will have to consider whether a ‘half-fit’ employee poses any additional risks in terms of health and safety, and what measures would need to be put in place in order to deal with such concerns.

Luckily the free Health for Work Adviceline is available from 9am to 5pm Monday to Friday to help organisations with fewer than 250 employees to consider these issues, along with any other employee health-related queries. And there is a call-back form on the website (www.health4work.nhs.uk) in case of calls outside these hours (calls will be returned within 2 hours of the next working day) – 0800 0 77 88 44.

The survey was based on online questionnaires conducted with 592 employees across all sectors. Some key results include that:

• the proportion of organisations reporting stress as the most common cause of absence for non-manual workers has risen from 24% last year to 33% this year;
• stress affects 21% of manual workers and is now level with acute medical conditions as the main cause of long-term sickness absence;
• connections were made between increased volumes of work and stress-related absence, and between (lack of) job security and mental health problems.

Employers have a responsibility to look after the mental and physical health of their employees. In order to prevent problems as stress levels escalate, employers should try to create a workplace culture in which employees are able to discuss issues as they arise. More information on employers’ roles in dealing with stress can be found in a recent blog (‘Stress at work – not just an employee issue‘) on the Health for Work website, as well as from the advisers on the free Health for Work Adviceline (0800 0 77 88 44).

The Luxembourg Declaration on Workplace Health Promotion describes workplace health promotion (WHP) as “the combined efforts of employers, employees and society to improve the health and well-being of people at work”. It goes on to say that WHP can be achieved through a combination of:

• improving the work organisation and the working environment;

• promoting active participation;

• encouraging personal development.

WHP enhances the work environment and company culture, whilst improving organisational productivity and efficiency. Approaches to WHP will vary from organisation to organisation and are often closely linked to the outcomes of risk assessments, however, they may include:

• actively involving employees in work environment, workplace health promotion, and decision-making processes;

• an organisational commitment to improving the health of the workforce including measures to enhance wellbeing at work, for example:
• guidance on healthy eating;
• advice on healthy lifestyles, such as smoking cessation support,  enabling flexible or home working, encouraging physical activity, and promoting an active and healthy culture at work and home;

• offering courses for managers on how to deal with stress and tension within their team.

Employers who would like guidance on implementing a WHP initiative in their organisation, or who would like advice on any other employee health-related matter, can call the free Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

The new AWR stipulate that, after 12 weeks in the same job, temporary agency workers will be entitled to the same basic working and working conditions (e.g. terms and conditions relating to pay, working hours, overtime, holidays, rest periods, access to vacancies and to other facilities) as those who have been recruited directly by the company.  The new regulations do not apply to areas such as pension schemes, company sick pay, maternity/paternity leave or redundancy (more information can be found on the Directgov website).

Temporary workers (namely PAYE temps, workers who supply their services through an umbrella company, and those who are supplied by an agency) will only start to accrue the 12 weeks qualifying period after the regulations come into force on 1 October 2011 (even if the assignment started before that date).  Once agency workers have worked in the same role for the same end-user for 12 continuous calendar weeks (regardless of how many hours they work each week) they will qualify for equal treatment.

The flexible labour market in the UK is an essential resource for many UK companies and the economy as a whole. The new regulations aim to address inequalities faced by agency workers, many of whom may have been working on secondment at an organisation for months or even years. These perceived inequalities include issues such as lower earnings, no overtime provision, not being able to apply for internal job vacancies, and not benefiting from the same annual leave entitlement as permanent employees.

Employers need to aware of their responsibilities regarding the health and safety of all employees. Temporary agency workers often face particular problems because they may not be familiar with an organisation they are working in or its particular hazards. Employers need to concentrate on good practice in terms of employee health, including communicating health and safety information, and undertaking risk assessments and health surveillance programmes, where necessary.

For more information on the new agency workers regulations, or on looking after the health of temporary or permanent staff in your organisation, contact the free Health for Work Adviceline on 0800 0 77 88 44 to talk to an occupational health professional.

• blast removal, burning and stripping of old lead paint;

• scrap-processing activities, including recovering lead from scrap and waste;

• working with metallic lead and alloys containing lead, e.g. soldering;

• lead smelting, refining, alloying and casting;

• manufacturing leaded glass;

Symptoms of lead poisoning vary depending on the amount of lead that enters the body:

• Low levels of exposure can cause memory and concentration problems, muscle and joint pain, and can affect nervous system function.

• High levels of exposure have been associated with nerve disorders, digestive problems and, in extreme cases, death.

Unfortunately, many individuals show no outward signs of lead poisoning so a person could have an elevated blood lead level yet appear healthy and show no signs of lead poisoning. However, early signs of lead poisoning include fatigue, headaches, irritability and a metallic taste in the mouth. Later signs of lead poisoning include memory problems, nausea, kidney problems, weight loss, constipation, and weak wrists or ankles.

Lead enters the bloodstream and accumulates in organs (especially the liver, kidneys and brain), tissues, bones and teeth. Prolonged and repeated exposure increases the levels of lead in the body. Some lead is excreted through bodily fluids, however, the remainder is stored in the bones and is virtually impossible to remove once it has settled in the skeletal system. Pregnant women should be especially cautious of lead exposure as lead can pass the placental barrier from the mother to the unborn child, which can poison the fetus before birth.

Employers have a duty by law to protect employees from the dangers of lead poisoning. Risk assessments should be performed for employees who are likely to be exposed to lead and precautions should be taken to protect workers whose blood lead levels may become dangerously high. These precautions include:

• putting in place systems of work and controls (e.g. extraction ventilation equipment) which must be kept in good working order;
• offering information on the health risks associated with lead and precautions to take;
• training staff on control methods and protective equipment;
• providing staff with washing, changing, refreshment facilities.

The Health for Work Adviceline can help employers understand their responsibilities towards employees who are exposed to lead, including measuring the amount of lead in the air, issuing staff with respiratory protective equipment if the levels are above the occupational exposure limit, and arranging for blood tests to measure lead levels. For free advice from an occupational health expert on this or any other employee health issue, call 0800 0 77 88 44.

In dealing with stress at work, organisations would do well to view the problem within the context of prevention rather than cure. If employers and line managers can learn to recognise signs of stress and the conditions under which stress is likely to occur, and then work proactively with employees are who at risk of being affected by stress, they can significantly reduce the negative impact of stress on employee performance and productivity.

A certain amount of stress can lead to greater productivity, particularly when the stress is confined to a limited period (e.g. preparing and delivering a presentation, finishing a report). Problems can occur when stress becomes chronic and continuous with no discernable beginning or end.

Some questions employers could ask themselves when trying to prevent an escalation of employee stress could include the following:

• Are employees completely clear what their roles and responsibilities are, and what is expected of them?

• Are potentially stressful periods counteracted by periods of fewer tight deadlines? Are employees able to predict what their workload might be over the coming weeks rather than being surprised by sudden high workloads for which they were not prepared?

• Do employees have the resources available to them that are required for them to do their jobs?

• Are workplace conflicts developing within the organisation? If so, are they being dealt with before they escalate?

Unfortunately, employers aren’t guaranteed a stress-free workplace even if they have done all they can to control the work environment, as some people are simply more susceptible to stress than others and may have problems despite an employer’s best efforts. The Health for Work Adviceline (0800 0 77 88 44) can advise managers on reducing potential causes of stress within their organisations, as well as recognising signs of stress in employees. By identifying the conditions or situations where stress may occur, and then thinking proactively about managing those conditions, employers can have happier and healthier employees who are more willing and able to contribute towards achieving an organisation’s goals.

There are two main types of work-related dermatitis:

• Irritant contact dermatitis: This can occur as a result of the skin coming into contact with a substance and causing cell damage. A single exposure to a substance causes an acute irritant dermatitis within minutes/hours after exposure. Chronic irritant contact dermatitis is due to multiple exposures over time, often to several irritants and at low levels. This dermatitis can take many months or years to appear.

• Allergic contact dermatitis: This is a permanent condition which occurs when individuals become allergic or sensitised to a substance to which they are exposed. Any subsequent contact with the substance would result in a flare-up of the condition.

The NES has revealed that 80% of newly-diagnosed work-related skin problems are cases of eczema caused by exposure to irritant substances. Jobs that carry a high risk include hairdressing, catering, dentistry, nursing, construction and any other professions that involve repeated exposure to chemicals and irritants.

The responsibilities of employers are enshrined in the Control of Substances Hazardous to Health Regulations (COSHH), which were first introduced in 1989 and have been updated since, notably the COSHH Amendment Regulations that came into force on 6 April 2005. The 2005 amendments enforced a single Workplace Exposure Limit (WEL) that must not be exceeded in a given timeframe for various substances in the workplace. These are listed in the EH40 document on the Health and Safety Executives (HSE) website, and all employers should be aware of EH40 and the limits for individual substances (although not all substances that can trigger occupational dermatitis are hazardous substances that are included in EH40).

It’s vital that employers are aware of these challenges faced by staff who suffer from work-related dermatitis. Employers need to ensure that they:

• assess whether employees are working with hazardous substances (EH40);
• ensure they comply with the COSHH regulations:
  • assess risks;
  • provide adequate control measures and ensure their use and maintenance;
  • provide information, instruction and training;
  • provide health surveillance in appropriate cases.
• seek advice on any substances they think may be causing problems (the Health for Work Adviceline [0800 0 77 88 44] can offer guidance);
• ensure they are complying with the Personal Protective Equipment at Work Regulations 1992 (more information can be found on the HSE website).

Coping with eczema in the workplace can be extremely difficult. Sufferers can find it difficult to talk about their condition at work, perhaps not wanting to make a fuss, or finding it difficult explaining that they can’t perform certain activities because of their condition. And research shows 20% of hand eczema sufferers experience prolonged sick leave and a similar number have had to leave their jobs because of the condition. Employers who would like more advice on fulfilling their legal responsibilities and supporting staff who are suffering from contact dermatitis can call the Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

From today (12 September 2011) organisations now have to notify the HSE of any injuries and incidents reportable under RIDDOR via the HSE website. Employers who are unsure whether an accident is RIDDOR reportable in the first place can find more information on the ‘What must I report?’ section of the HSE website. The website provides seven new forms, one of which should be completed (see below). It will be submitted directly to the RIDDOR database and employers will receive a copy for their records:

• Report of an injury.
• Report of a dangerous occurrence.
• Report of an injury offshore.
• Report of a dangerous occurrence offshore.
• Report of a case of disease.
• Report of flammable gas incident.
• Report of a dangerous gas fitting.

All incidents can be reported online, however, a telephone service [Incident Contact Centre - 0845 300 99 23] will remain for reporting fatal and major injuries only (Monday to Friday, 8.30 am to 5 pm).

The ‘Infoline’ telephone service, which currently provides a basic information service to callers, will end on 30 September 2011. Businesses and members of the public seeking information and official guidance on health and safety can use the knowledge bank on the HSE website.

For most businesses, a reportable accident, dangerous occurrence, or case of disease is a comparatively rare event. However, it is vital that they are reported quickly in order for risks to be assessed. For more information on reducing injuries and ill health in the workplace, call the free Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

It’s clear that healthcare workers need to be particularly vigilant about not passing the flu virus on to the patients in their care, but it’s actually in the interests of all organisations to ensure that those who are entitled to the flu vaccination actually receive it, which will help keep sickness absence and subsequent reductions in productivity and customer service in check. Flu is a highly contagious acute viral infection that affects people of all ages regardless of general health and fitness, and it is one of the main causes of short-term sickness absence in UK workplaces. Vaccination is the simplest and most effective way of safeguarding against the spread of flu within the workforce each winter.

The NHS Employers website (www.nhsemployers.org) highlights some popular (and dangerous) myths about seasonal flu, some of which are listed below (adapted from the NHS Choices website):

• Myth 1: “Healthy people don’t get seasonal flu.” Anyone can contract the virus whether they are generally healthy or not. Around 15-20% of the population gets flu each year and could pass it onto others, including those who are at risk of serious illness.

• Myth 2: “Flu is a mild illness so I don’t need to be vaccinated.” For most people, flu is simply unpleasant. However, it can be much more serious, and globally accounts for 3-5 million cases of severe illness and between 250,000 to 500,000 deaths each year.

• Myth 3: “The side effects of the vaccination are really bad – it gives you flu.” The flu jab contains no live viruses so cannot give you the flu. For most people the side effects are very mild (soreness around the site of the injection and occasionally some aching muscles or slightly raised temperature).

• Myth 4: “I’ve had the flu jab before so I don’t need it again.” People need to be vaccinated each year.

• Myth 5: “I’ve heard the vaccine doesn’t work.” The virus mutates so the vaccine cannot provide total protection, but it can give 60-70% protection for healthy adults.

• Myth 6: “I can’t have the jab because I’m pregnant.” Pregnant women should have the flu vaccination at any stage of their pregnancy. Having the vaccine protects their baby from flu over the first few months of life.

• Myth 7: “The flu jab contains pork products.” There are no pork-based products or processes used in the manufacture of the seasonal flu jab.

• Myth 8: “You’re infectious after having the jab, so you shouldn’t have close contact with anyone for a period of time after you’re immunised.” The vaccine won’t make you infectious to anyone so it’s safe to carry on as normal.

The flu jab is recommended for those in certain ‘at risk’ groups who are at greater risk of developing complications from flu (e.g. pregnant women; people with chronic asthma, diabetes, chronic heart disease; the over 65’s; frontline health or social care workers), but people outside these recommended groups can make arrangements to pay for a flu vaccination privately, if desired. In an uncertain economic climate it’s imperative that organisations keep their employees at work and fully productive so it’s well worth encouraging employees in ‘at risk’ groups to take up the vaccine. For guidance on this issue, or any other employee health-related matter, call the Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

Employers and line managers need to learn to recognise the key factors that can contribute to mental health problems before they take root as they will be far less serious and damaging if they can be identified early enabling timely support to be offered to employees. And investment in current employees is less expensive than recruiting and retraining new staff. Some potential warning signs that may suggest mental ill health include:

• an increase in unexplained absences or sick leave;
• poor performance;
• poor-time-keeping;
• increased use of alcohol, drugs, tobacco or caffeine;
• frequent headaches and backaches;
• withdrawal from social contact;
• poor judgement/indecision;
• constant tiredness or low energy;
• unusual displays of emotion, e.g. frequent irritability or tearfulness.

Many people suffering from mental health problems will be wary of speaking to their colleagues or line managers about their issues because of the stigma associated with mental illness; many fear how their family, friends and colleagues will react. Staff awareness campaigns, e.g. ‘National Depression Awareness Week’, ‘National Stress Awareness Day’ (which is due to take place on 2 November 2011) play an important role in de-mystifying mental health problems and making people aware that they do not need to suffer in silence.

People with diagnosed mental health issues may be regarded as having a disability under the Equality Act 2010, which states that it is unlawful for a disabled person to be treated less favourably because of their disability, without a justifiable reason. The act states that it is unlawful for employers to fail to make reasonable adjustments to accommodate a worker with a disability. ‘Reasonable adjustments’ for somebody with mental health issues may include:

• allowing flexible working;
• facilitating the handover of certain tasks to another employee for the short-, medium- or long-term;
• encouraging a trusted colleague to make themselves available for chats, when needed;
• ensuring that there is a place for the employee to take a break, when needed.

By calling the Health for Work Adviceline (www.health4work.nhs.uk), employers can get immediate, free access to occupational health professionals who can offer guidance on supporting an employee with mental health problems, fulfilling legislative responsibilities, and keeping staff healthy and productive (0800 0 77 88 44).

Although employees and line managers generally recognise the value of taking a lunch break for wellbeing (43% of workers are encouraged to take a lunch break by their employers), it seems that longer hours and workplace pressures are stopping staff from taking the necessary breaks at work. A quarter will only take a lunch break if they feel their workload allows it, while 13% of employees skip meals in the workplace altogether. Some workers report their workload as the main reason for skipping lunch breaks, whilst others feel pressure from their bosses to remain at their desks.

For some employees, stress results in other poor dietary habits: 19% claim they overeat at work and nearly 15% of employees believe their health is affected because they are eating unhealthily at work as a result of longer working hours.

The results showed that nearly a third (30%) of employees say they are unlikely to take a lunch break. It appears that one barrier to healthy eating in the workplace is the limited availability of healthy eating options. Of those employers who offer food in the workplace (45%), over a third (38%) apparently mainly offer unhealthy options. And the consumption of unhealthy food and beverages such as caffeine and sweet foods can lead to irritability, insomnia and dehydration.

Employers have a role to play in encouraging employees to eat healthy food in the workplace and take regular breaks from their desks. A cultural shift towards proper breaks at work would improve overall employee wellbeing and productivity, even if these breaks were short, frequent changes of activity away from the desk rather than one, longer lunch break. Workers who don’t eat properly or take regular breaks are unlikely to remain productive throughout the day, which will ultimately cost organisations money. Guidance can be sought by employers from the Health for Work Adviceline on 0800 0 77 88 44 on keeping staff healthy and well enough to work to their full potential.

However, there has historically not been much in the way of guidance on what a first aid kit should contain. This means that in the event of an emergency, some organisations find that their first aid kits lack the essentials, or include out-dated or inadequate components that are of limited use to the first aider. For example, often first aid kits don’t contain enough wipes, plasters or sacks in which to dispose of dressings, so employers might have to buy additional supplies to supplement their kit.

The British Healthcare Trade Association has been working with the British Standards Institute (BSI), to create a new British standard for first aid kits in the workplace. The BS 8599-1 standard (published in June 2011) recommends the correct number of particular components for small, medium, large or travel-size kits and also recommends how many kits are needed depending on the size of the organisation. It sets the minimum level that first aid kits should conform to and should be followed by manufacturers of first aid kits and anyone who assembles first aid kits in the workplace. The new BS 8599-1 standard takes into account more modern and functional products encompassing a wider range of common workplace risks. Some changes include:

• increased number of disposable gloves, which are now required to be nitrile, which are far more dextrous than vinyl gloves and eliminate possible latex allergies;

• fewer triangular bandages as they are no longer used for the immobilisation of limb injuries;

• introduction of smaller absorbent wound dressings for finger injuries, where a plaster will not be sufficient;

• introduction of tearable non-woven, hypoallergenic adhesive tape to secure bandages without using safety pins;

• introduction of water-based sterile gel burn dressings (which do not require any pre-cooling with water) and a conforming bandage to secure it;

• introduction of a resuscitation face shield to provide a protective barrier for first aiders administering mouth-to-mouth resuscitation.

The BS 8599-1 standard gives recommendations on the amount and size of the first aid kits necessary for different workplace environments based on the category of risk (low risk: e.g. shops, offices; medium risk: e.g. warehousing, light engineering work; high risk: e.g. construction, work with chemicals) and the number of employees. Requirements are set concerning marking and information to be supplied by manufacturers.

Requirements are also given for the container holding the components. The container should be able to fit all of the relevant components inside and close securely, and should be clean, dustproof and provide protection for the contents in a workplace environment.

Workplace first aid kits can be complemented by other items that have been identified during a risk assessment, if necessary. Where there are unusual hazards that are specific to a particular workplace environment, workplace first aid kits should be supplemented with additional, appropriate components.

It is very important for employers to ensure that they fulfil their legal responsibilities by offering immediate and appropriate first aid help to employees. Guidance can be sought by employers from the Health for Work Adviceline (www.health4work.nhs.uk) on the first aid supplies they should be making available to staff by calling 0800 0 77 88 44.

Whilst women are entitled to return to the same job after ordinary maternity leave, research undertaken by Reabur (www.reabur.com), which asked 1,926 employers their opinions on new mothers returning to work, seems to suggest that employers don’t necessarily think positively about women returning to work after their maternity absence.

The majority of employers who responded to the survey (64%) did not expect women to return to work after maternity leave regardless of their role within the organisation. And 16% of employers said that they didn’t actually want female employees coming back after their maternity leave, citing fears that new mothers would have a ‘reduced level of concentration’ once they returned to work and would ‘lack enthusiasm’ when compared to a newly hired member of staff.

Many women find it hard returning to work after maternity leave. Not only do many mothers experience physical barriers to returning to work (perhaps because they are often responsible for rushing back from work to collect children from childcare) but having a child is a life-changing event, which can change the way women feel about aspects of their lives; many mothers report reduced levels of confidence after having children, which can affect their ability to slot back into their former working role.

It is good practice for employers to keep in touch with female staff during their maternity leave as this will help new mothers keep abreast of what’s going on in the workplace, which will make the return to work less daunting. It is also important for employers to manage the return to work phase in a structured and efficient (yet supportive and sensitive) way. Many new mothers really do want to return to work and continue contributing to the organisation they work in.

Employers need to be aware of their responsibility towards ensuring the health and wellbeing of new mothers who have returned to work. The Management of Health and Safety at Work Regulations 1999 include regulations that protect the health and safety of new and expectant mothers who work. Employers should already have done a risk assessment during pregnancy, but may well need to do another once the employee returns to work, for example if she is still breastfeeding. Employers can seek advice on ensuring the health and wellbeing of new mothers, or on related issues such as flexible working, by contacting the Health for Work Adviceline (www.heath4work.nhs.uk) on 0800 0 77 88 44.

An article published in the American Journal of Epidemiology in March 2011 outlines research undertaken at the University of Western Australia, Perth, which set out to investigate whether sedentary behaviour is associated with specific types of colorectal (large bowel) cancer. The study compared 918 patients with confirmed colorectal cancer with a control group of 1,021 people not suffering from the disease. Data was collected on their lifetime job history, lifestyle, diet, level of recreational physical activity and use of medication.

The researchers found that, compared with those who did not spend any time in sedentary work, workers in sedentary jobs for 10 years or more are doubling their risk of developing cancer in the lower area of the bowel (distal colon). They were also shown to be 44% more likely to develop rectal cancer. Worryingly, the study suggests that exercise done outside work hours does not appear to counteract the harm done by long periods of sedentary behaviour.

According to NHS Choices, it is possible that prolonged sitting itself is not having the effect upon bowel cancer risk, but that it is a marker for another possible risk factor that is actually behind the association, for example, obesity, poor diet or low levels of vitamin D. Growing numbers of people work in jobs that involve prolonged periods of sitting. The health effects of this type of work, and strategies to modify any adverse effects, are important areas for further research.

About 30,000 people a year are diagnosed with bowel cancer in England and Wales, a disease which has a high mortality rate, perhaps because many ignore the early warning signs. Despite the fact that someone is diagnosed with bowel cancer every 15 minutes in the UK, public awareness of the disease and its symptoms is poor, and many people delay visiting their GP when they have concerns. Some people may be more susceptible to bowel cancer than others. For example, the risk of contracting bowel cancer rises from the age of about 50, and risk factors may include a diet high in red/processed meats, an inactive lifestyle, high alcohol consumption and smoking, and being overweight.

It is in an employer’s interests to help employees remain physically and mentally healthy: healthy employees will be happier and more productive and therefore more able to make a positive contribution to an organisation’s objectives. If you would like advice on how to implement a health and wellbeing policy in your organisation, or promote issues such as maintaining a healthy diet, alcohol awareness and quit smoking campaigns, call the Health for Work Adviceline (0800 0 77 88 44) to get expert advice from occupational health professionals.

New official statistics show that the number of workers killed in Britain last year has increased. The Health and Safety Executive (HSE) has released provisional[i] data for the year April 2010 to March 2011, which estimates the number of workers killed as 171. This marks an increase from the 147 work-related fatalities recorded in the previous year – the lowest number on record[ii].

Despite this increase, however, Britain has had the lowest rate of fatal injuries to workers compared to the four other leading industrial nations in Europe (Germany, France, Spain and Italy) over a six-year period (according to Eurostat figures – http://epp.eurostat.ec.europa.eu).

Whilst fatal injuries are thankfully very rare events, they are most likely to occur in some of the historically most dangerous industries, such as construction, agriculture, manufacturing, and waste and recycling. According to Judith Hackitt, the HSE Chair:

“The increase in the number of deaths in the last year is disappointing, after an all time low last year. However, we must remember that we still have one of the lowest rates of fatal injury anywhere in Europe.

“The fact that 171 people failed to come home from work to their loved ones last year reminds us all of what we are here to do. It is a stark reminder of the need to ensure that health and safety remains focused on the real risks, which exist in workplaces not on trivia and pointless paperwork.

“We all have a role to play – employers, employees and regulators – and leadership is fundamental to maintaining and improving our performance even further. In a world of work which is constantly changing we must all continue to review what we do and how we do it and strive to become even more effective at managing risks which cost lives.”

Employers have a legal responsibility to assess and manage risks in the workplace, regardless of the size of the organisation. Accidents and ill health can ruin lives and damage businesses. Whilst organisations aren’t expected to eliminate all risk, they are required to protect people as far as ‘reasonably practicable’. Employers can seek guidance on this matter from occupational health practitioners by calling the free Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

[ii] Further information on work-related fatalities can be found on the HSE website (http://www.hse.gov.uk/statistics/fatals.htm).

In accordance with these regulations, a company which builds hot-tub deckings using Western Red Cedar wood bonded with isocyanate-based glue, was sentenced after failure to control the risks of exposure to wood dust and adhesives at its plant. The company was prosecuted by the Health and Safety Executive (HSE) for failing to control or assess the substances which are known to cause ill health and severe allergic reactions between August 2006 and April 2008.

The firm was investigated after an employee suffered anaphylactic shock in February 2007 and reported the incident to the safety watchdog. The 45-year-old worker was taken to hospital with severe breathing difficulties after using an adhesive and being exposed to wood dust while sanding frames, but the company failed to carry out its own investigation into the cause of the employee’s ill-health.

The firm continued to use the same materials despite not:

• carrying out a risk assessment to identify materials likely to cause allergic reactions;

• telling employees about the risks of working with such substances;

• pinpointing which employees were exposed to risk;

• providing any health surveillance for employees.

HSE inspectors also found that local exhaust ventilation was inadequate to control exposure to the harmful wood dust and glue vapours, and whilst staff had access to overalls, gloves and masks on site, no training, guidance or rules were provided regarding their use.

Occupational health surveillance (watching out for early signs of work-related ill health in employees exposed to certain health risks) is distinct from general health checks; the decision to carry out health surveillance would stem from pinpointing health hazards during a risk assessment. Employers who want advice on issues such as which type of health surveillance to choose, how and when to carry out the assessment, and who to involve in the process, should speak to the Health for Work Adviceline (www.health4work.nhs.uk – 0800 0 77 88 44) for further guidance.

Every employee in the UK has a basic annual leave entitlement of 5.6 weeks, which amounts to 28 days every year for full-time workers and pro-rata for part-time employees. The European Union’s Working Time Directive states that employees should be taking a minimum of 20 days leave every year. The minimum holiday entitlement was increased by the Labour Government in 2009 from 20 days per annum to 28 days but despite this increase, the UK still has one of the least generous annual leave entitlements in Europe.

It’s widely accepted that workers feel compelled to work longer hours and take fewer days off during times of job insecurity and economic uncertainty in order to get through heavier workloads and work to tighter deadlines. The YouGov/Croner research reveals a notable difference between age groups, with 14% of 18-24 year-olds surveyed saying they always work during a holiday compared to only 3% of the 55+ age group.

Whilst some employers may think that employees who work during their holidays are demonstrating a strong commitment to the organisation, it may actually reveal an underlying problem of over-work, which the Working Time Regulations are explicitly trying to protect workers from. Paid annual leave is an important factor in ensuring that every worker receives a rest period and time to spend with family and friends in order to avoid the exacerbation of stress issues.

For better or worse, today’s technology is making it increasingly easy for people keep tabs on incoming messages, for example using smart phones to access data remotely through the Internet. This flexible working has significant benefits for employees and organisations under the right circumstances, but people must learn to switch off completely when they are making use for the holiday time to which they are entitled.

According to Amy Paxton, Croner’s Senior Employment Consultant:

“Work-related stress is now recognised as a very serious occupational health issue. Poor management of the risks involved can be very costly to employers in a number of ways, including high levels of absenteeism, increased staff turnover, recruitment costs and insurance premiums, low staff morale and productivity, personal injury claims and enforcement action.

“Furthermore the organisation’s stress management policy should be reviewed as working during annual leave may be seen as an indicator that work-related stress is not being properly managed and is, ultimately, a failure of the employer’s duty of care to their employees.”

Employers who fear that an employee may be at risk of over-work and subsequent stress issues and/or physical or mental health problems, can get guidance from the Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

Risks on hot, sunny days are twofold: trying to stay cool in the heat, and the harmful effects of the sun’s rays. Frequent exposure to damaging ultraviolet (UV) rays (an invisible form of radiation emitted by the sun) causes sun damage. It is believed that UVA rays penetrate deep into the skin and are the major source of early ageing and skin cancer, and that UVB rays primarily access the surface of the skin and are the key source of sunburns. Because we are exposed to these rays every day, regardless of whether there is cloud coverage or not, it is recommended that those who work outside use sunscreen products on a daily basis year-round.

Anyone can get skin cancer, but people with fair skin and light eye colour tend to be at higher risk than others. Cancer Research UK provides a list of risk factors for getting skin cancer, which can be found at http://www.sunsmart.org.uk/skin-cancer-facts/whoisatrisk/. Checking the UV index lets you know just how strong the sun’s rays are on a particular day so employers can warn staff. The Met Office offers a national UV index at http://www.metoffice.gov.uk/weather/uk/uk_forecast_uv.html, which can be searched by postcode.

It is common for outdoor workers, particularly in the construction field, to neglect any type of sun protection, as their attention is focused on industry-specific hazards and other crucial aspects such as personal safety and the safety of others. In addition, sunscreen products may have a less than positive reputation as being non-absorbent and greasy which may cause unrelated difficulties in the workplace. However, sunscreen products have been greatly improved in recent years, and innovations such as fast-absorbing, non-greasy products make application much quicker and easier. Employers should, where possible, encourage outdoor workers to stay in the shade between 11am and 3pm but must also encourage workers to apply sunscreen on all uncovered areas including behind the ears, the backs of hands, the face and neck. Sunscreens will not completely block all of the sun’s harmful rays so outdoor workers must also have access to appropriate sun protection clothing (e.g. sun flaps attached to hardhats, loose-fitting cotton long-sleeved workwear). Eyes should also be protected with sunglasses that block UV rays to prevent cataracts and other eye problems caused by the sun’s rays.

Employers who feel that they require guidance on their responsibilities towards outdoor workers can call the Health for Work Adviceline (0800 0 77 88 44) to find out how to protect staff from the long-term and short-term effects of exposure to the sun – www.health4work.nhs.uk.

• employees coming to work with a hangover;

• staff drinking socially at lunchtime thus becoming less productive and, potentially putting the safety of other employees at risk;

• sickness absence through prolonged alcohol misuse outside of work.

A specific aspect of potential over-use of alcohol is drinking covertly at work. It is actually illegal to drink alcohol in safety-sensitive jobs or jobs involving driving. Otherwise the regulation of alcohol at work is down to an employer’s specific policy. Employers do have a duty under the Health and Safety at Work etc Act 1974 to look after the health, safety and wellbeing of their employees. This means that employers must take action if they fear that an employee is putting other staff at risk by consuming alcohol. Employers also have general duties under the Management of Health and Safety at Work Regulations 1999 to conduct risk assessments.

Any discussion with the employee about their suspected alcohol consumption at work must be dealt with sensitively according to the organisation’s alcohol policy. It could be a case of simple misconduct in which case employers can turn to their disciplinary procedures. However, it may be that the drinking is the manifestation of a drinking problem, in which case employers will need to decide how best to manage the situation and support the employee:

• What has caused the alcoholism: depression, stress, personal issues?

• To whom can the employer turn to get more information on the individual’s personal circumstances?

• What adjustments may need to be made at work to support the employee?

• Can the employee continue working whilst their case is being dealt with?

In some situations there may be a case for considering screening workers in safety critical jobs, but screening is only likely to be acceptable if it is part of an organisation’s occupational health and safety policy and developed in consultation with staff. However, screening cannot be seen as a solution in itself. Awareness programmes will help with preventing problems from developing in the first place, and assistance must be provided to those who have already been pinpointed as having a problem.

By calling the Health for Work Adviceline (0800 0 77 88 44 – www.health4work.nhs.uk), employers in small and medium-sized organisations can get access to free, immediate advice on employee health issues, including guidance on how to deal with alcohol issues in the workplace.

Back pain and other work-related upper-limb disorders can become debilitating if left untreated. People increasingly have sedentary lifestyles so it’s vital that employers prioritise the health of their staff by investing in thorough risk assessments and swift access to rehabilitation services, even though many incidences of back pain won’t necessarily have been caused by the work environment in the first place.

Geoffrey Podger, Chief Executive of the Health and Safety Executive (HSE) commented in 2006 as part of the HSE’s Better Backs campaign: “Surprisingly back pain will affect as many as four out of five people in Britain, and results in 4.5 million days off work a year. Employers are losing up to £335 million a year…”

Risk factors for back pain can be broadly grouped into physical risk factors and psychological risk factors. The most important physical risk factors include:

• frequent heavy lifting;
• twisting and bending;
• static postures;
• repetitive work;
• vibration.

Psychological risk factors include:

• distress;
• mental stress;
• job dissatisfaction.

It’s important to try to create a safe working environment that’s free from risk factors as far as is practicable. Working in collaboration with staff to discuss potential issues will enable employers to create a place of work where employees can function safely and productively. More guidance on employers’ responsibilities to their staff can be sought from the free Health for Work Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44.

The removal of the compulsory retirement age not only raises practical issues for employers in managing older workers, but also across the workforce more generally in a wide range of areas such as succession and workforce planning, performance management and ensuring consistency and fairness in policies and practices. Work-related health problems will also need to be addressed with an older workforce. These could include considerations to enhanced workplace design for office workers or a review of equipment designed to reduce the physical demands for those who undertake heavy manual handling as part of their role. It is important to remember that the removal of the DRA will have implications for all employees in terms of career expectations and advancement.

The removal of the DRA is an opportunity for employers to review practices and processes for managing employees and their performance fairly and in line with anti-discrimination legislation. Good people management is the best way to adapt to the removal of the DRA: talking to employees and allowing them opportunities to communicate openly and regularly about your expectations of them, their performance and future plans, is essential. Employees of all ages should be treated fairly and consistently.

According to Rachel Krys, Campaign Director of leading age campaigners:

“Growing numbers want to and have to work beyond 65. Outdated policies which prevent this group working increase the burden on the already creaking state pension provision and ignores the fact we are living longer and healthier lives.

“Employers without retirement ages experience a greater focus on performance, a reduction in recruitment costs and the retention of talent, whatever the age.”

Employers in small and medium-sized organisations can get guidance on the very particular health issues that may be experienced by older workers from the Health for Work Adviceline (www.health4work.nhs.uk) by calling 0800 0 77 88 44 during normal office hours. The website has a call-back form for calls outside office hours.

• Workload management: 39% of younger employees believe that their employer is using the recession to justify asking them to do more, compared with 24% of older workers*.

• Resources: 34% of younger workers are concerned about having insufficient resources at work to do their job effectively, as opposed to 22% of workers in their sixties.

• Work pressure: 40% of younger employees frequently suffer from stress at work, while 31% feel obliged to work long hours – both higher proportions than any other age category.

• Work-life balance: 39% of younger employees are unhappy with their work-life balance (the highest percentage of all age groups).

• Health at work: 32% feel that stress at work frequently impacts negatively on their health (5% more than workers in their fifties and 10% higher than those in their sixties).

So what do these figures mean for employee engagement, i.e. a partnership between an organisation and its employees in which organisations respect the personal aspirations of their employees who, in turn, are committed to achieving an organisation’s objectives? It’s clear that these negative perceptions of the working environment are unlikely to encourage employee engagement, something that Sukhi Ghataore, Director at GfK NOP (UK) sees as an essential part of business success:

“During tough times, engaged employees and a united workforce are a necessity, not a luxury. Engaged workers want their employer to succeed, want to remain with them, and want to go the extra mile.”

Compared to some countries where organisations reported relatively high levels of employee engagement from younger employees (e.g. Macedonia where 36% of younger employees reported being “highly engaged”), only 12% of 18-29 year olds in the UK reported the same high level of engagement. The Health for Work Adviceline (www.health4work.nhs.uk) advisers can give guidance on securing commitment to an employee engagement strategy in your organisation in order to minimise stress at work – 0800 0 77 88 44.

*All figures: GfK Custom Research.

• the substantial impact of long-term absence on SMEs (e.g. statutory sick pay and overtime costs, manpower issues, the potential backlog of work) all of which are hard to deal with in smaller organisations;

• managers who are not always trained in absence management;

• business owners who are themselves quite likely to work through illness and possibly not seek medical advice for fear that it may impact negatively on their ability to work and fulfil their overall business strategy;

• the high proportion of reported cases of occupational health injuries that occur in SMEs (82% according to the HSE, 2006*) perhaps due to the ‘dangerous’ activities carried out by many SMEs (e.g. manufacturing, construction, agriculture) and the perception that risk management is too costly;

• poor understanding of the concept of occupational health and how it can contribute to business success;

• a resistance to calling on external services due to the fear of potentially high costs involved.

The Health for Work Adviceline (www.health4work.nhs.uk) is mentioned in the article as one of the approaches that has been devised in order to deliver occupational health advice within the SME market. It is widely recognised that the health of individuals is linked to their ability to effectively participate and contribute in their work, and the impact of ill health on small businesses is significant, yet very few provide help and support to staff who suffer from ill health. It is easy for busy small business managers to overlook the importance of staff health as they strive to deliver business improvement and growth. The Health for Work Adviceline service recognises this and so provides free, quick and easy access to effective professional advice and guidance in this key area – 0800 0 77 88 44.

*HSE. (2006). “Six SME case studies that demonstrate the business benefit of effective management of OH health and safety”.

In accordance with these regulations, a Southampton-based decking company (Millbrook Furnishing Industries Limited), which builds hot-tub deckings using Western Red Cedar wood bonded with isocyanate-based glue, was sentenced after failure to control the risks of exposure to wood dust and adhesives at its plant. The company was prosecuted by the Health and Safety Executive (HSE) for failing to control or assess the substances which are known to cause ill health and severe allergic reactions between August 2006 and April 2008.

The firm was investigated after an employee suffered anaphylactic shock in February 2007 and reported the incident to the safety watchdog. The 45-year-old worker was taken to hospital with severe breathing difficulties after using an adhesive and being exposed to wood dust while sanding frames, but the company failed to carry out its own investigation into the cause of the employee’s ill-health.

The firm continued to use the same materials despite not carrying out a risk assessment to identify materials likely to cause allergic reactions, not telling employees about the risks of working with such substances, or pinpointing which employees were exposed to risk. It had also not provided any health surveillance for employees. HSE inspectors also found that local exhaust ventilation was inadequate to control exposure to the harmful wood dust and glue vapours, and whilst staff had access to overalls, gloves and masks on site, no training, guidance or rules were provided regarding their use.

Health surveillance (watching out for early signs of work-related ill health in employees exposed to certain health risks) is distinct from general health checks; the decision to carry out health surveillance would stem from pinpointing health hazards during a risk assessment. Employers who want advice on issues such as which type of health surveillance to choose, how and when to carry out the assessment, and who to involve in the process, should speak to the Health for Work Adviceline (www.health4work.nhs.uk – 0800 0 77 88 44) for further guidance.

In 2010-11, 171 people were killed at work, compared to 147 in 2009-10. The biggest increase in fatalities came in the broad category of ‘services’ where 47 workers died compared with 33 the previous year. The construction sector saw a rise in deaths from 41 to 50, and there was an increase from 24 to 27 deaths in manufacturing organisations. In the water, sewerage waste and recycling sector, where accident levels are notoriously high, the number of deaths more than doubled from four to 10. A decline in the number of deaths was seen among agricultural workers (figures down five from 39 to 34).

Judith Hackitt, chairman of the HSE, has called the increase in British workplace deaths “disappointing”, but has also pointed out that the UK still has one of the lowest rates of fatal workplace injuries of anywhere in Europe. The overall death total for 2010-11 was still less than the five-year average for the UK, and it’s been suggested that the figures for last year were lower because of the recession. Commenting on the figures, she said:

“We all have a role to play – employers, employees and regulators – and leadership is fundamental to maintaining and improving our performance even further. In a world of work which is constantly changing, we must all continue to review what we do and how we do it and strive to become even more effective at managing risks which cost lives.”

A risk assessment is an important tool to protect employees and businesses from accidents and ill health. Employers are legally required to assess the risks in the workplace so a plan can be put in place to control the risks. This process helps employers focus on those risks that have the potential to cause harm, most of which can be readily controlled by straightforward measures. Call the Health for Work Adviceline for guidance on how to ensure the workplace is a healthy one for your employees – 0800 0 77 88 44 (www.health4work.nhs.uk).

The Work Foundation produced a report on presenteeism (based on qualitative interviews with 25 teams of employees and an online survey of 510 employees) in April 2010 (http://tinyurl.com/2e58erq) which outlined some very interesting findings:

• Presenteeism is associated with a significant related fall in performance standards: employees with higher levels of sickness presence had significantly lower performance scores compared with those with lower levels of sickness presence.

• Employees with a greater number of days of sickness presence reported higher levels of anxiety and lower levels of psychological wellbeing.

• Employees with higher levels of sickness presence also had higher levels of absence.

Three main factors (two of them work-related) were linked with higher levels of presenteeism, including:

• personal financial difficulties (very relevant during times of economic/labour market uncertainty when employees are less likely to want to take time off work due to illness);

• work-related stress;

• perceived workplace pressure (from senior managers, line managers and colleagues) to attend work when unwell.

The findings from the research suggest that presenteeism can act as an indicator of employee health and wellbeing, with higher levels of presenteeism signalling poorer health and wellbeing. On this basis, one of the key recommendations made by the report is for organisations to concentrate on health and wellbeing in the workplace as a whole, not just on absence management, as improving health and wellbeing will reduce both absenteeism and presenteeism.

This focus on employee health and wellbeing might include:

• health promotion initiatives such as advice about exercise and diet;

• being supportive, offering encouragement and being willing to talk to employees about their concerns, views or issues;

• allowing staff some control over how and when they work.

Calling the Health for Work Adviceline (0800 0 77 88 44 – www.health4work.nhs.uk) gives employers access to expert occupational health advice including guidance on staff health and wellbeing tailored to meet the exact requirements of each individual organisation. Callers to the Adviceline are given immediate guidance, an action plan, and signposting to other specialist providers, where applicable.

Each year around 150 million working days are lost in the UK to sickness absence of which over 25% is longer-term absence, a proportion of which ultimately leads to worklessness and reliance on benefits.

The scope of the independent review of sickness absence, which is due to be published in late summer 2011, is to:

• explore how the current sickness absence system could be changed to help people stay in work and reduce overall costs;

• examine whether the balance of these costs are appropriately shared between the state, individuals and employers;

• make tangible recommendations for system change;

• ensure that recommendations for change are consistent with promoting private sector growth and minimising burdens on business, in particular, small and medium-sized businesses.

Under the current system employers bear the costs of short-term sickness with the State (and ultimately the taxpayer) absorbing the cost of longer-term ill-health. Over 300,000 people leave work each year to claim sickness-related benefits, which makes up around half the total flow on to Employment and Support Allowance (ESA). Once out of work these people face an even greater risk of their health deteriorating further, and the potential of themselves and their families falling into poverty. Ministers are determined to end this vicious cycle and are clear that in these difficult economic times, the country cannot afford to continue to bear these costs.

One important remit of the review will be to examine what tends to work well elsewhere in the world, especially in Europe, and what lessons the UK could learn or implement. Some countries are more focused on encouraging employers to take occupational health advice very early on, which would help facilitate return-to-work and encourage people to take account of their health conditions. The Health for Work Adviceline (which was awarded further funding on the same day in February 2011 after a successful pilot programme) plays an important role in this regard, by allowing employers to quickly and easily access expert advice on employee health issues to reduce their impact on the organisation and the individual – www.health4work.nhs.uk (0800 0 77 88 44).

Whilst there is a risk of this happening, employers should be careful not to assume automatically that sickness absence during major sporting events is not genuine. As employers may have grounds to be suspicious about some employees, particularly where they have a history of short-term sickness absence, their sickness absence policy becomes an essential document. Of course employers who have tracked absence patterns will have more information on which to base their assumptions.

Employers who are suspicious about an employee’s absence should investigate further by questioning the employee when he/she initially reports the absence, or by conducting return-to-work interviews, which can help identify short-term absence problems at an early stage. They will also provide an opportunity to begin dialogue with staff about underlying issues, which might be causing the absence.

There are various approaches organisations could take to cure what’s sometimes labelled as ‘summer sickness’, which prevails mainly on sunny or sporting days. A lot will depend on the size of the organisation and the resources available:

• Planned absence is always much easier for employers to plan for than unscheduled absence so it might be advisable to send out reminders to staff well in advance that annual leave needs to be booked for sporting events. Alternatively, employers could consider offering unpaid leave.

• Employees could be offered the chance to work at home and schedule their work around sporting or other summer events (so long as employees are clear about the work that is expected of them whilst working from home). To this end, employers could avoid the costs associated with unplanned absenteeism.

• Organisations could also offer flexible working hours in the workplace to allow for people arriving later than 9am or leaving earlier than 5pm. However, core hours and adequate cover may need to be agreed to ensure services or operations are not unduly affected.

• If all else fails, organisations could offer the opportunity and facilities to watch sporting events at work, which would increase feelings of camaraderie between staff.

The more positive the working environment, the less likely it is that employees will be tempted to take unscheduled time off work for reasons other than sickness. The Health for Work Adviceline (www.health4work.nhs.uk) can offer guidance to employers seeking to achieve this. By calling 0800 0 77 88 44 and speaking to an adviser, employers can get advice on the various methods of improving the working environment and reducing absence, including:

• offering encouragement to employees and showing an interest in them in order to increase employee loyalty;

• giving regular performance feedback to staff  to let them know where they stand and make work a more enjoyable experience;

• letting employees know what is expected of them by establishing specific performance standards, goals, and deadlines, and communicating them clearly;

• providing assistance writing a sickness absence policy or amending an existing one.

Unison is threatening to ballot its 1.2 million members if “destructive” changes to public-sector pension schemes go ahead. Unison’s move follows industrial action ballots already conducted by the National Union of Teachers (NUT), the Association of Teachers and Lecturers (ATL) and the Public and Commercial Services union (PCS) – all prompted by amendments to pension schemes and other public-sector reforms.

Low turnouts in strike ballots mean that the majority of union members did not vote for industrial action. The threat of strike could well create increased stress for those in the education sector, who already report significant stress levels. In fact, HSE research in 2000 (‘The Scale of Occupational Stress’) found teaching to be the most stressful profession in the UK, with 41.5% of teachers reporting themselves as ‘highly stressed’.

Individuals will be under pressure to decide for themselves whether to take part in the strike or break the strike and risk repercussions from colleagues. And some younger teachers might not be so willing to join a strike about pensions, which seem a long way off for those at the beginning of their careers. Furthermore, talk of a possible public sector strike has also begun causing some friction between public and private-sector workers as private sector workers ask why those in the public sector shouldn’t suffer the same cuts in pension rights already seen by them.

It’s important for managers/employers to demonstrate an awareness of stress and to be able to recognise signs of stress in their employees, especially during periods of increased tension and uncertainty. The Health for Work Adviceline advisers (www.health4work.nhs.uk) can offer guidance for employers on managing stress in the workplace and supporting employees who are struggling with stress-related issues. Call 0800 0 77 88 44.

Engaging with employees on a regular basis (e.g. by having regular reviews in order to discuss any on-going concerns) will allow employers/managers to keep up-to-date with how employees are feeling about their job role, the organisation as a whole, relationships with colleagues, personal issues, etc. It can also help employers understand the personalities of individuals, how they interact with each other, and how these factors are relevant to potential stressful situations.

Employers need to learn to recognise the signs that stress may be getting the better of an employee, for example:

• They seem to have lost their enthusiasm for the job. Not all employees will be happy all the time, but it should be seen as a warning sign if somebody regularly has a negative attitude towards their work, colleagues, or the organisation as a whole.

• They are working too hard. From an employer’s perspective it’s nice to see commitment from staff, but employees should not regularly be working overly long hours. If employees don’t seem to be able to manage their workload during normal working hours it may be that they are no longer working productively (perhaps due to stress), or their workload is simply too great. Either way, it’s up to employers to have dialogue with them to try to resolve the situation.

• Relationships at work seem to be suffering. Interaction between colleagues won’t always be harmonious, but employers need to be aware of deterioration in relationships.

Awareness of stress, stress recognition and early identification is something that doesn’t necessarily come naturally, even to the best managers, so it’s important to seek guidance in this matter. Broaching the subject of stress with an employee who isn’t coping well can be a tricky matter for fear of causing offence or appearing to criticise.

However, employers have a general duty to ensure the health of their employees at work, which includes taking steps to ensure they don’t suffer stress in the workplace. This includes having open dialogue with employees and consulting with them about prospective changes to tackle problems. By calling the Health for Work Adviceline (0800 0 77 88 44) you can get access to expert advice to help you ascertain whether you have sufficient measures in place to prevent workplace stress – www.health4work.nhs.uk.

Some organisations opt to offer cash-based incentives to employees, for example for 100% attendance over a given period. These have been shown to improve attendance to a certain degree (mainly when introduced with other management initiatives to manage sickness absence) although there are concerns that these incentives may encourage presenteeism and fail to deal with the underlying causes of absenteeism.

Perhaps a better way to incentivise attendance is through incentive schemes as part of wellness programmes. Wellness programmes are essential to the long-term survival of all businesses as they can reduce costs associated with lost productivity and absenteeism and therefore result in improved performance. They can take various forms involving:

• workplace risk assessments;

• referral to specialist nurses or doctors following long-term or short-term intermittent sickness absence;

• lifestyle health assessments;

• health promotion initiatives including campaigns and health events;

• counselling support for staff experiencing home or work-related difficulties affecting their ability to work;

• signposting to smoking cessation advice;

• active workforce programme e.g. lunch time walks, cycling club, 5-a-side tournaments;

• employee assisted programmes.

In order for organisations to develop an attractive and suitable health and well-being programme which includes incentives (e.g. discounted gym membership) , it’s essential that they record sickness absence accurately and differentiate between absence due to non-health-related reasons.  The collection of data will provide information about the five main reasons for absence, which will provide the basis for developing a suitable and targeted wellness programme for their organisation.

If you would like to know more about incentivising attendance as part of wellness programmes, or any other occupational health issue, you can contact the Health for Work Adviceline (www.health4work.nhs.uk)on 0800 077 88 44 for free confidential advice.



The trust dismissed 75 people through a ‘formal management process’. It reveals that 56 of the dismissals related to sickness absence. However, the trust was able to help 85 members of staff back to work after long-term absence.

In February the Audit Commission published a report that said the NHS could save £290m by reducing staff sickness rates, which costs the NHS an estimated £1.7bn annually. There are many costs associated with sickness absence including ‘direct’ costs such as statutory sick pay, the cost of replacement staff, and loss of output. In addition, there are also other costs that are harder to quantify such as lowering of morale amongst employees who have to do extra work to cover for those who are off due to sickness, and the cost of managing sickness absence.

Managing sickness absence in a robust way helps all businesses reduce costs and improve business efficiency. The worst performing businesses lose an average of 12 days per year for each employee due to physical conditions and mental health problems, such as anxiety or depression. The effect on the profitability of a small business can be dramatic. The Health for Work Adviceline (www.health4work.nhs.uk) can provide small and medium businesses with advice on managing sickness absence to improve business sustainability and profitability. Call 0800 0 77 88 44.

David Salisbury, Director of Immunisation at the Department of Health, has said that getting people in at-risk groups to understand that they are actually at significant risk from the seasonal flu outbreak is crucial to increasing the uptake of the flu jab.

He spoke of two issues:

-          Communicating the importance of being immunised to at-risk groups before the beginning of the flu outbreak.

-          Getting ‘hand-hygiene’ messages through to everybody once the flu season has begun.

Sickness absence during the winter season impacts heavily on the UK economy as illness spreads more readily due to people spending more time indoors in heated environments. Seasonal flu usually lasts up to a week but can leave employees feeling unwell for some weeks after, continuing to affect an employee’s productivity even when they are back in the workplace. And, of course, organisations may get hit quite badly by the outbreak with a few members of staff off work at the same time, which can significantly compromise a smaller organisation’s ability to remain productive.

Whilst it’s generally accepted that health practitioners are the best people to communicate the importance of the flu jab to their patients, employers and managers also have an important role to play in encouraging their staff to have the vaccine if it is available to them.

Last year the flu-jab advertising campaign that had previously targeted those most at risk was cancelled, and some have blamed this lack of promotion on the slow uptake of the vaccine initially. The Health for Work Adviceline received a significant number of calls last year from people trying to find out where they could go to be immunised. Reminding at-risk staff of the importance of being immunised against seasonal flu should form part of employers’ focus on the health and wellbeing of their employees. Call the Adviceline (www.health4work.nhs.uk) on 0800 0 77 88 44 to find out how you can be proactive in preventing sickness absence in your organisation this winter.

The standard and accompanying training courses (to be developed by Nottingham University) are most likely to be used by HR managers/specialists, occupational health and safety managers/specialists, managers and owners of small and medium-sized businesses, and employee representatives that wish to:

• establish a strategy and process to manage the psychosocial risks (a major cause of stress) associated with their activities, and protect workers and others who could be exposed to such hazards;
• implement, maintain and continually improve their psychosocial risk-management process and related practices;
• assure themselves of their conformity with stated occupational health and safety and psychosocial risk policy.

Organisations should manage their psychosocial risks (risks associated with work organisation and the social context of work which have the potential for causing psychological or physical ill health) as much as its organisational culture and employee relations. According to the BSI, psychosocial risks at work are a significant trigger to stress and if the guidelines help reduce this, it could save businesses in the EU €20 million (£17.98 million) a year.

In addition, employers actually have a responsibility to be proactive in preventing work-related stress. According to the Health and Safety Executive:

“All employers have legal responsibility under the Health and Safety at Work Act 1974 and Management of Health and Safety at Work Regulations 1999 to ensure the health safety and welfare at work of their employees. This includes minimising the risk of stress-related illness or injury to employees.”

According to Dr Stavroula Leka, Associate Professor in Occupational Health Psychology, University of Nottingham, “The PAS will assist organizations to implement best practice in the area of psychosocial risk assessment and management so that they can promote good health among their staff.” It is generally accepted that employee mental and physical health and wellbeing are crucial to business success, yet many businesses struggle in this area. Particularly in smaller organisations, time and financial constraints make it difficult for managers to get to grips with employee health issues, particularly where no in-house occupational health resources are in place.

The Health for Work Adviceline (www.health4work.nhs.uk – 0800 0 77 88 44) has been set up with the specific aim of helping businesses with fewer than 250 employees to get immediate advice and support to help an employee experiencing ill health, develop a plan to effectively and sympathetically deal with employee sickness absence, and establish how to deal with similar problems in the future, should they occur.

Many organisations are increasingly embracing the concept of flexible working in order to ensure the health of their employees. Working from home using smartphones or ‘cloud hosting’ is one way of helping employees to be productive even if they are unable to get to the office for whatever reason. Arguably there is a debate to be had here concerning whether this ability to work at any time and at any place may indeed be a stressor in itself, making it difficult for people to know when to switch off from work.

Employers can be actively involved in trying to ensure that their staff are aware of the notion of ‘work/life balance’. They could provide information about mental health and wellbeing, including work-related stress, and make sources of further information readily available to staff at all levels. They could also try to provide opportunities for physical activity linked to the workplace by, for example, offering discounted gym membership as an employee benefit. Keeping lines of communication open with employees is also vital so that employers can spot if somebody appears to be stressed, anxious or overworked and see whether there is something they can do to lighten their load and address their issues.

The Health for Work Adviceline (0800 0 77 88 44) offers support and guidance for all small business owners wanting to boost wellbeing in the workplace. Employee wellbeing can have a significant impact on organisational performance, including:

-          Reduced absenteeism and lateness.

-          Improved staff retention, particularly of experienced staff.

-          Increased productivity.

-          Improved customer service.

-          Greater employee commitment.

-          Increased willingness on the part of employees to be flexible and accommodating in times of business need or change.

The Adviceline can also offer practical tips, resources and expertise in employee health. In particular we can help you stay up-to-date with the ever-changing and jargon-heavy employee health legislation, leaving you to get on with the important job of running your small business. Call 0800 0 77 88 44 or find more information on the website www.health4work.nhs.uk.

The standards are split into three levels because the charter recognises that smaller employers may find it hard to achieve the same level of activity as larger employers:

-          Commitment: this demonstrates a real commitment by small organisations.

-          Achievement: good achievement for medium-sized organisations.

-          Excellence: the level that large organisations should strive for.

The assessment is grouped into eight areas of activity offering suggestions under each of the three levels:

-          Leadership: e.g. is equality guidance and legislation in place; are effective policies in place to manage disciplinary and grievance procedures; is work-life balance embedded within the organisation’s conditions of employment?

-          Attendance management: e.g. are absence rates and causes collected and monitored, are documented return-to-work procedures in place and followed?

-          Health and safety requirements: e.g. are all staff informed of workplace risks and controls in place to minimise them; are relevant policies and procedures in place to demonstrate compliance with health and safety legislation; have all managers received appropriate health and safety training?

-          Mental health and wellbeing: e.g. do employers provide information to employees about mental health and wellbeing and make sources of further information readily available to staff at all levels; are bullying, harassment and whistle-blowing policies and systems in place and are staff at all levels made aware of them?

-          Smoking and tobacco control: e.g. are all staff aware of the smoke-free and tobacco control laws and how they are applied in their workplace?

-          Physical activity: e.g. is information made available on the benefits of physical exercise; are staff encouraged to take regular breaks?

-          Healthy eating: e.g. does the organisation actively promote healthy food options; do all staff have access to fresh drinking water?

-          Alcohol and substance misuse: e.g. are employees supported in seeking help to treat alcohol or substance misuse issues; are employees made aware of the link between alcohol/substance misuse and stress in the workplace?

Do you need help managing health and wellbeing in the workplace? The Health for Work Adviceline (0800 0 77 88 44 – www.health4work.nhs.uk) can give you professional advice from qualified occupational health nurses on health and work-related issues. By taking simple steps, organisations can reduce levels of sickness and absenteeism, retain staff more effectively, attract better staff, and maintain the health of staff as they grow older (an issue that is becoming increasingly important with our ageing population). Healthier employees will be happier, and organisations that look after their employees will experience less sickness absence, increased productivity and staff loyalty, and, ultimately, a healthier bottom line.

The original ‘Get Well Soon’ series was produced in 2008 covering a number of common surgical procedures, and an additional nine were published on 24th March 2011. The leaflets fill a current information gap that many patients experience following an operation and aim to give sound advice on what to expect from their recovery. The guidance is available on the RCS website (www.rcseng.ac.uk/patient_information/get-well-soon).

The guidance advises individuals to seek advice about possibly doing lighter duties in the initial stages of the return to work. It also gives advice on driving and general wellbeing, and includes a ‘recovery tracker’ so individuals can chart their expected recovery from post-op through to their return to work.

Clearly employers will need to be involved in this process. A fully-fledged occupational health department may be something only enjoyed by larger companies, but the Health for Work Adviceline (www.health4work.nhs.uk – 0800 0 77 88 44) is a free service for companies employing fewer than 250 staff. It connects managers to fully qualified occupational health nurses and advisers who will outline a clear plan of action with employers detailing how to best address issues. The Adviceline advisers can also signpost you to support networks and other sources of information available to you and your business.

Employers taking a proactive approach to helping employees back to work after a period of absence will reduce any risk of complications.

The Management of Health & Safety at Work Regulations (MHSW) includes regulations that protect the health and safety of new and expectant mothers who work. Under the Sex Discrimination Act 1975, if an employer fails to protect the health and safety of their pregnant workers, it is automatically considered sex discrimination.

Every employer has a duty to make a suitable and sufficient general written assessment of the health and safety risks its employees are exposed to whilst at work, including those who, in future, could become expectant mothers. This means that any significant risks to unborn children and expectant mothers even at the early stages should be identified.

Pregnancy risk assessment

On receiving written notification of a pregnancy, however, employers should not delay in undertaking a specific assessment as workplace conditions that may have been acceptable may no longer be suitable during pregnancy and whilst breastfeeding. What is covered in this assessment will vary greatly depending on the type of workplace, the kind of work the employee is doing, etc. Employers will then be required to regularly monitor and review any assessment made to take into account possible risks that may occur at different stages of pregnancy.

The Health for Work Adviceline has developed a policy which can be adapted for your business, including a template risk assessment form to aid undertaking these assessments. Find out more by phoning 0800 0 77 88 44.

Removing or reducing risks found

Employers are then obliged to try to remove any risks that have been highlighted by the risk assessment, including possibly reducing hours to reduce stress, agreeing more frequent rest breaks, excluding heavy lifting or long periods of standing up, etc.

Employers must give information on the risks found and the protective measures to be taken. If the risks still remain, employers will need to alter working conditions or hours of work, if it is reasonable to do so and would avoid the risk. If this is not possible, or the risk cannot be avoided, employees should be offered a suitable alternative job. And, if this is not possible, the employee should be suspended on full pay for as long as is necessary to avoid the risks. Employees who have unreasonably refused alternative work would lose the right to full pay during their suspension.

The Health for Work Adviceline can guide employers through the process of risk assessments. Calls are free and completely confidential. Our advisers can help you ascertain any hazards within the workplace, and the risk that these hazards could harm employees, together with an indication of how serious the harm could be. They can also clarify your obligations as an employer. Call 0800 0 77 88 44 to find out more.

NICE quality standards enable:

• health and social care professionals to make decisions about care based on the latest evidence and best practice;
• patients to understand what service they can expect from their health and social care providers;
• NHS Trusts to quickly and easily examine the clinical performance of their organisation and assess the standards of care they provide;
• commissioners to be confident that the services they are providing are high quality and cost effective.

According to NICE, depression currently affects about one in six people in the UK at some stage in their lives, and is more common in women (Office of National Statistics). It may have no obvious cause, or it can be triggered by physical illness or difficult things that have happened in the past or may be happening now, like bereavement, family problems or unemployment.

The quality standard on depression identifies 13 statements that define high quality care. These include:

• ensuring that people who may have depression receive an assessment that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode;

• reviewing treatment plans for people with depression who haven’t responded adequately to initial treatment within six to eight weeks;

• ensuring that practitioners delivering pharmacological, psychological or psychosocial interventions for people with depression receive regular supervision that ensures they are competent in delivering interventions of appropriate content and duration in accordance with NICE guidance.

Employers also need to be educated about depression in the workplace so they are aware of what depression is and how it can be treated. Understanding and knowledge of mental health issues will help employers to respond confidently to staff who come to them in distress. Employers will need to consider making workplace adjustments to support employees with depression in the workplace or returning to work, and staff need to know that flexibility exists within the workplace. The Adviceline advisers can offer guidance on practicable workplace adjustments, and help for employers who are supporting employees who want to balance depression and work. Lines are open during normal office hours (0800 0 77 88 44). A call-back form can be found on the Health for Work Adviceline website (www.health4work.nhs.uk).

The report identifies certain work stressors such as job insecurity, work intensity and inter-personal conflict at work, all of which it says have increased since the 2008-09 recession. This relates particularly to the public sector, where levels of work-related stress are expected, according to the report, to rise.

Stress isn’t an illness in itself but rather something that has become a normal part of daily life for many, but which can lead to physical or mental illness if it becomes excessive. Extended periods of stress can cause depression and a suppressed immune system, which can eventually lead to physical illness.

Interestingly, sickness absence rates have fallen slightly since the 2008-09 recession, perhaps, according to the report, due to increased pressure during times of economic instability to turn up for work. Presenteeism (namely turning up for work because of a pressure to do so, regardless of one’s state of health) has its own implications for businesses and individuals.

The report identifies two main approaches to reducing work stress: stress management training (which focuses on increasing a person’s ability to deal with stress) and workplace organisational interventions. One of these workplace interventions might be to develop an employee engagement strategy. For example, employers could:

-    hold regular reviews with staff giving them the opportunity to discuss any ongoing concerns;
-    introduce an ‘open door policy’ so staff feel they can discuss any issues whenever they feel they need to;
-    encourage a two-way or open dialogue to actively involve staff and promote engagement and communication.

It is very difficult for employers to be clear about how their employees are feeling. What are acceptable levels of stress? How do you detect when stress is becoming excessive? How would you recognise the difference between anxiety, stress and depression, and how would you intervene?

The Health for Work Adviceline (0800 0 77 88 44) allows small business managers to speak to a qualified occupational health professional in the strictest confidence who will offer guidance and advice over the phone and will send a breakdown down of the issues discussed and an action plan. They will also provide signposts or recommendations to specialist providers, if required. There is a callback form on the website should you call outside normal office hours (www.health4work.nhs.uk).

1.      Demands:

-          Quantitative demands (workload, working hours, quantity and intensity of work). Workload is a persistent factor that contributes to work-related stress, and is one that organisations find difficult to resolve as it implies increased financial resources, such as extra staffing. Long hours will inevitably also lead to stress.

-          Qualitative demands (emotional and cognitive demands at work including work-life balance issues, complexity of work, dealing with angry clients and suffering patients, feeling afraid, having to hide emotions, etc.)

2.      Control^:

-          Autonomy (deciding when to take a break, flexible working time, deciding how to work, etc).

-          Decision latitude and room for manoeuvre.

-          Control over work, including control over pace of work and over job content and decision-making power.

-          Predictability of work.

-          Use and possibility to develop skills.

3.      Support:

-          Encouragement and resources offered by the organisation, management and colleagues.

4.      Relationships^:

-          Social support from colleagues or supervisor.

-          Management style and relationships with colleagues/managers/the organisation.

-          Violence and harassment at work.

5.      Role:

-          The perception of the role the employee holds in the organisation.

-          Whether employees are clear about what is expected of them.

-          Employer ensuring employees have no confliction roles.

6.      Change:

-          How organisational change is managed and communicated in the organisation.  Change is considered to be a key stress factor for workers in the UK. The recent economic crisis has meant that increased numbers of organisations are undergoing change, which has increased the potential to cause stress among employees.

Even employers who do all they can to work with employees to manage these six risk factors may find employees succumbing to stress. Whilst stress isn’t an illness in itself, mental or physical illness can develop if stress is prolonged and/or excessive. Employers have a general duty to ensure the health of their employees at work, which includes taking steps to ensure they don’t suffer stress in the workplace. Call the Health for Work Adviceline on 0800 0 77 88 44 to find out whether you have sufficient measures in place to prevent employee stress. Lines open from 9am to 5pm Monday to Friday. An online callback form is available for out-of-office hours.

Her public announcement may help remove some of the stigma attached to the illness, and to depression in general, and raise awareness of bipolarity. It’s interesting that she apparently only went public with the news because an American magazine had threatened to sensationally spread the information that she had been to rehab. This shows the stigma that’s still attached to mental illness – I wonder whether the news that she were suffering from a physical illness would have caused such a sensation…?

This week is Depression Awareness Week (see www.depressionalliance.org) so this announcement is timely. Perhaps it will make us question the extent to which we understand depressive illnesses. Would we really be able to pick up on the signs of depression in our employees? What would we be looking for in the way of symptoms? How would we distinguish between low level stress and more significant signs of deep-set anxiety and depression?

If you are a small business manager you can call the Health for Work Adviceline advisers (0800 0 77 88 44) who can give you advice on detecting the signs of depression early on, monitoring and assisting the recovery of staff diagnosed with depression, and promoting team morale and good communication in the workplace.

Then, in the autumn of 2010, research was carried out with 4,185 GPs in England, Scotland and Wales to find out data on GPs’ attitudes towards health and work issues amongst their patients and their views on whether the fit note has changed their clinical practice in the six months since its implementation.

The findings show that the majority of GPs perceive the fit note to have had a positive impact on the quality of consultations, the advice they give on fitness for work and, importantly, outcomes for patients.

Some key findings:

-          Almost universal agreement amongst GPs that work is beneficial for people’s health.

-          96% of GPs agreed that worklessness is generally detrimental to people’s health.

-          77% agreed that staying in or returning to work is an important indicator of success in the clinical management of people of working age.

-          81% completely or somewhat disagreed that patients had to be fully recovered before returning to work.

-          48% agreed that the fit note had increased the frequency with which they recommend a return to work as an aid to patient recovery.

-          70% of GPs agreed that the fit note had helped their patients make a phased return to work.

A longer report will be published in summer 2011 outlining more detailed findings from the research.

If you want to discuss occupational health issues with a healthcare professional, call the Health for Work Adviceline on 0800 0 77 88 44 for free, confidential advice.

This brought to mind a call I’d taken recently taken from a customer who wanted reassurance that an employee with cancer could return to work. The first thing to consider is, of course, whether their treating specialist or GP feels that they are well enough to be at work. They may prefer them to work reduced hours, or have some restrictions in the duties of their role for a period of time, but as an employer your mind needs to be open to the fact that staff don’t need to be 100% to be at work.

Obviously, if someone is operating heavy machinery, driving for long periods or working in a highly demanding environment, you will need to consider these occupational factors when making a decision. But being at work can, in itself, be beneficial to a person’s health, and it’s obviously of benefit to employers too so long as the return to work is handled sensitively and carefully.

If you need advice about managing an employee’s return to work, or about any other Occupational Health issues, call the Health for Work Adviceline on 0800 0 77 88 44 for completely confidential, free guidance.

New Starters Screening health-related checks

During the interview process, you can only ask health-related questions to help you to:

• decide whether you need to make any reasonable adjustments for the person to the selection process

• decide whether an applicant can carry out a function that is essential (‘intrinsic’) to the job

• monitor diversity among people making applications for jobs

• take positive action to assist disabled people

Once a person has passed the interview and you have offered them a job (whether this is an unconditional or conditional job offer) you are then permitted to ask appropriate health-related questions.

If you would like to know more about how to support an employee in the workplace who has a disability, please contact www.health4work.nhs.uk or call 0800 077 88 44 for free confidential advice.

The office for National Statistics (ONS) has revealed that the rate of sickness absence is back up to normal levels with having a cough or cold, followed by accidents and musculo-skeletal problems such as back pain cited as the top reasons for calling in sick.  Have you noticed this within your own company?  Are staff with minor illnesses becoming more confident about taking time off without worrying that doing so might earmark them for future job cuts?   The ONS report said that 613,000 employees were absent from work with sickness in the three months to December last year, resulting in 2m lost working days.  During this same time health experts warned workers were forcing themselves to work while genuinely ill, leading to the phenomenon of ‘presenteeism’.

If you are a small business MD, or the person responsible for HR, concerned about a rise in sickness absence, or presenteeism our free Adviceline is here for support and guidance.

Some examples of reasons why employers call us are listed below.  Our advisers can confidentially answer any questions you might have, or help you with the next steps:

1. A team member is off on long-term sick.

One of your team has been off work for just over a month. It has put extra pressure on the rest of the team, sales are down and customer complaints are up. You are unsure what to do next, but want to be supportive while protecting your business.

2. You suspect you are experiencing staff truancy

A member of your workforce is frequently off sick. They give you a variety of reasons, all seemingly plausible but you can’t help but wonder if they are always authentic. You’ve noticed increased absence in general and you concerned that it may be influencing others.

3.       You are unsure about termination of employment due to chronic sickness.

A staff member has a serious health problem which means they will be off work for the foreseeable future. It has created mounting pressure on your workforce and has begun to affect your business’ efficiency. You are now considering terminating their employment to protect your business.

4. You are worried about a staff injury at work.

Your team say they are happy lifting heavy equipment but you know some suffer from backache from time to time. You’d like to know if you would be liable if one of them sustained an injury, and how you can make it easier for them to raise a concern, or follow a procedure that is already in place.

5. You are unsure if you can contact an employee’s G.P.

You’d like to talk to an employee’s GP about a complicated health issue that is now affecting the rest of the team. You are not sure if you can to do this or if you should raise it with the employee.

6. A staff member has just been diagnosed with a serious health condition.

You’ve just been told that an employee has a chronic health condition. You are naturally concerned and want to do what you can to help as an employer and to support the rest of team that are worried about their colleague.

7. You want to check an applicant’s health before appointing them.

You are about to begin a major recruitment drive and having had issues in the past with absenteeism You would like to protect your business by checking if anyone you take on is fit to do the job.

8. You want to learn about dealing with staff anxiety during this challenging time of recession.

As a small business you are vulnerable during the financial downturn and your team is feeling increasingly stressed with financial worries at home, as well as being concerned about their own job security. You want to help your staff to cope with this difficult time and ensure they stay motivated.

9. You think someone is not well enough to work.

You suspect someone in your team is unwell but they continue to struggle on and come in to work. You have heard presenteeism can be as much of a problem as absenteeism but don’t know how to bring this up with them without causing offence.

10. You want to manage staff stress levels through a big change at work, but are unsure what is the best approach.

Your small business is about to go through a major restructure of roles. Understandably everyone is worried about their jobs and how this change will affect them. Motivation and productivity is down as a result. You would like to support them and to help keep morale up at this stressful time.

Health4Work experts can help you manage staff absence yourself or to gain access to qualified nurses, doctors and occupational health specialists. These professionals can help you for free to create wellness programmes for your workforce, or advise on a specific issue. In time this could reduce or even prevent absenteeism, and help get people suffering from long-term sickness back to work faster. It can also help employers support their staff while at work and still receiving medication.

0800 0 77 88 44 (Lines open 9-5pm. Online Callback Form available for out-of-office hours contact).

Stopping smoking is one behaviour which will have far reaching affects on you health & wellbeing. Experts say stopping smoking is the very best thing you can do to improve your health. Other benefits include being wealthier, smelling sweeter, improved fitness, less risk of ill health now or later in life.

As an employer having staff who do not smoke is a real benefit for your business. Non smokers have less time off sick, less opportunistic infections and less long-term health conditions. Smokers often take breaks from the workplace which makes them less productive than their colleagues. Smokers are often more stressed than their colleagues, they are often thinking about their next nicotine fix which can distract them from the task in hand.

Helping Small and Medium businesses manage health and wellbeing in the workplace, the Health4work advice line 0800 077 88 44 or http://www.health4work.nhs.uk/ The advice line can give you professional advice from qualified Occupational Health nurses on health and work related issues.

Encouraging your workforce to quit on No Smoking Day 9^th March 2011, using the support of local and national smoking cessation services will benefit you and your business. For more information contact: www.nosmokingday.org.uk or www.smokefree.nhs.uk to find local services.

The Government has today called for a major review of the sickness absence system in Great Britain in order to help combat the staggering £100 billion that working age ill health costs the economy every year.

The independent review, jointly chaired by David Frost, Director General of the British Chambers of Commerce and Dame Carol Black, National Director for Health and Work, will explore radical new ways on how the current system can be changed to help more people stay in work and reduce costs.

Under the current system employers bear the costs of short term sickness with the State, and ultimately the taxpayer, absorbing the cost of longer-term ill-health, with over 300,000 people leaving work to claim sickness-related benefits each year – making up around half the total flow on to Employment and Support Allowance (ESA).

Once out of work these people face an even greater risk of their health deteriorating even further, and the potential of themselves and their families falling into poverty.

Ministers are determined to end this vicious cycle and are clear that in these difficult economic times, the country cannot afford to continue to bear these costs.

The review, which is jointly sponsored by the Department for Work and Pensions and the Department for Business Innovation and Skills, will include a panel of experts from business, trade unions and health representatives and will be conducted in the context of the Growth Agenda.

It will also feed into the wider Employment Law Review, which is looking at measures to reduce red tape and remove the burdens on business, encourage growth and maximise flexibility for employers and employees.

Also announced today is an additional £12 million of funding for health and work programmes, including the Fit for Work Service and Occupational Health Advice lines. Both have already proved highly successful in providing support for both employers and individuals in the early stages of sickness absence.

Lord Freud, Minister for Welfare Reform said:

“Too many people, through no fault of their own, have fallen on to a life on benefits because of the failures in the sickness absence system. This isn’t fair to the taxpayer but most of all it isn’t fair to the individual.

“We all have a stake in reducing sickness absence, but it’s not clear who is best placed to take responsibility for this change.

“I am delighted that Dame Carol Black and David Frost have agreed to lead this review which will answer these questions and inform Government thinking on how the current system can be changed.”

Employment Relations Minister Edward Davey said:

“This is an important review which will help tackle the problems faced by business and individuals. Managing sickness absence more effectively will be a win-win situation for all – businesses, individuals, the taxpayer and crucially, the economy. It could improve productivity, boost growth and mean that many more people no longer have to rely on taxpayer handouts.”

Dame Carol Black, National Director for Health and Work said:

“From my work as a doctor and now as National Director for Health and Work, I’ve seen the damaging effects of prolonged sickness absence on individuals and their families, and on the wider community, besides the costs to business and the economy.

“I’m also delighted with today’s announcement that a number of initiatives, including the Fit for Work Service and the National Occupational Health Advice Lines, are to receive further funding, to maintain their efforts to help people return to and stay in work.”

David Frost, Director General of the British Chambers of Commerce said:

“Sickness absence undoubtedly has a huge impact on businesses – particularly on smaller firms that struggle with the processes and procedures required, not to mention the direct costs involved. The private sector must focus on growth if we are to sustain the recovery, so it is right that the Government has chosen to look at ways to reduce sickness absence in the workplace and get people back into employment.

“I look forward to working with Dame Carol Black to reduce the unsustainable bill on both employers and the state caused by sickness absence, and making radical recommendations to achieve this.”

This includes the following:

• The employer has to make a suitable and sufficient assessment of risks to his employees
• This assessment must be recorded if there are more than 5 employees
• The assessment must be reviewed
• Workers who are not his employees must be provided with information on the risks to their health and safety providing them with essential health and safety information
• The employer must provide adequate health and safety training when employees are first recruited or when they are exposed to increased risks
• Health and training should be provided periodically during working hours
• The employer must provide health surveillance if appropriate

More information can be obtained on the Health and Safety Executive web site on http://www.hse.gov.uk