Quality standard

Quality statement 2: Support during sickness absence

Quality statement

Employees who are assessed as 'not fit for work' are contacted by their employer as soon as possible to provide support and discuss arrangements for keeping in touch during sickness absence.

Rationale

Making contact with employees who are assessed as 'not fit for work' in their statement of fitness to work ('fit note') and offering support and reassurance can help people return to work, and prevent a short-term absence becoming a long-term absence. The first contact should happen as soon as appropriate after the employee's 7‑day self-certification period, and within 4 weeks of the start of the sickness absence. After considering the personal circumstances of the employee, their reason for and anticipated length of absence, as well as their communication needs and preferences, the first contact can be used to make it clear to the employee that the purpose of keeping in touch is to provide support, and help them return to the workplace when they feel ready. The person making contact can discuss with the employee how they would like to be contacted in the future, how frequently, and by whom. This will help to provide a supportive link between the employee and their workplace.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of policies or procedures to ensure that employees who are assessed as 'not fit for work' in their 'fit note' during periods of sickness absence are contacted by their employer as soon as possible during their sickness absence, and within 4 weeks of the start of the sickness absence.

Data source: Local data collection, for example review of organisation sickness absence and return-to-work policies, and HR management systems.

Process

a) Proportion of employees assessed as 'not fit for work' in their 'fit note' during periods of sickness absence who are contacted by their employer.

Numerator – the number in the denominator who are contacted by their employer.

Denominator – the number of employees who are assessed as 'not fit for work' in their 'fit note'.

Data source: Local data collection, for example employee HR records.

b) Proportion of employees assessed as 'not fit for work' in their 'fit note' who were contacted by their employer within 4 weeks of the start of their sickness absence.

Numerator – the number in the denominator who were contacted by their employer within 4 weeks of the start of their sickness absence.

Denominator – the number of employees assessed as 'not fit for work' in their 'fit note' during periods of sickness absence.

Data source: Local data collection, for example employee HR records.

Outcome

a) Rates of long-term sickness absence.

Data source: Local data collection, for example HR management systems.

b) Employee satisfaction with the support from their employer during their sickness absence.

Data source: Local data collection, for example employee surveys.

What the quality statement means for different audiences

Organisations (senior management teams, including the chief executive, and departmental managers) ensure that systems are in place to consider the earliest appropriate opportunity to contact employees who are assessed as 'not fit for work' in their 'fit note' during periods of sickness absence. They have systems in place to ensure that this happens within 4 weeks of the start of the sickness absence, that a meaningful and supportive discussion takes place, and that the employee is contacted by the most suitable person, which may not be their line manager.

The person making contact ensures that they contact the employee who is assessed as 'not fit for work' in their 'fit note' during periods of sickness absence, at the earliest appropriate opportunity, and within 4 weeks of the start of the sickness absence. They consider the individual circumstances and communication needs and preferences of the employee before making contact. They ensure that a meaningful discussion with the employee takes place that is supportive and does not pressure them about returning to work.

Employees who are advised that they are 'not fit for work' by a GP or hospital doctor are contacted by their employer as soon as it is appropriate for them, and within 4 weeks of the start of the sickness absence. They are contacted in a way that suits their communication needs and preferences and the personal circumstances of their absence. They feel supported and valued by this contact and are offered help to return to work when they are ready, without pressure from their employer. They understand that anything shared about their health will be confidential (unless there is serious concern for their or others' wellbeing). They have the opportunity to discuss how they would like to be contacted in the future, how frequently, and by whom, including alternative options to their line manager if this contact is not appropriate.

Source guidance

Workplace health: long-term sickness absence and capability to work. NICE guideline NG146 (2019), recommendations 1.2.2, 1.5.1, 1.5.2, and 1.5.3

Definitions of terms used in this quality statement

Evidence of sickness absence

Employees can be asked to produce evidence of their reason for sickness absence if they are ill for more than 7 days in a row. Employers have flexibility over what evidence they accept. If the employee has been assessed by their GP or doctor, they may have been provided with a statement of fitness for work ('fit note') advising whether they are 'not fit for work' or 'may be fit for work'.

[Adapted from HMRC's guidance on Statutory Sick Pay: employee fitness to work]

Short-term sickness absence

An absence lasting up to (but less than) 4 weeks. Recurring short-term sickness absence is defined as more than 1 episode of short-term sickness absence, each lasting less than 4 weeks.

[NICE's guideline on workplace health: long-term sickness absence and capability to work]

Long-term sickness absence

An absence lasting 4 or more weeks. Recurring long-term sickness absence has been defined as more than 1 episode of long-term sickness absence, with each episode lasting more than 4 weeks.

[NICE's guideline on workplace health: long-term sickness absence and capability to work]