Occupational Health

by Anna Harrington

Management of sickness absence

The management of sickness absence should be a cooperative effort between managers, the employee concerned and appropriate professionals.

The aims are to maintain as high an attendance level as possible and to enable people to return to work as smoothly and easily as possible. An important part of the process is to record and monitor absences and identify patterns that may suggest underlying problems (see Sickness absence recording and monitoring).

It’s important to note that records concerning the individual’s health are legally protected; for more see Health records and data protection.

See also Fit notes and communication with doctors.

Role and responsibilities of line management

The role of line management in the management of attendance will be outlined in the organisation’s absence policy.

Line mangers have responsibility to encourage and ensure good attendance from all employees. This will require the manager to set the standards and expected levels of behaviours, but it is worth noting that the way an organisation works will affect the level of employee engagement and productivity and management behaviours can affect stress levels.

As a line manager, you need to ensure that all employees are aware of their responsibilities as stated in the absence policy. This is likely to state the expected behaviours in relation to attendance, what to do if absence from work is required (who should they contact and with what information) and what processes will be implemented if attendance is a problem. These processes should be developed to apply to health and non-health reasons for absence and could include return-to-work interviews and accessing support from appropriate outside agencies, such as the Citizens Advice Bureau, for debt and housing problems. This may be particularly necessary and helpful if the absence is due to mental ill health (see Helping recovery in the topic on Psychological Health at Work).

Keeping in touch

It is likely that it will be the line manager’s responsibility to keep in touch with an employee who is off sick. If the employee is on long-term sickness absence it may be appropriate and necessary to visit the employee at home. The purpose of remaining in contact is to aid the return of the employee through keeping the psychological bond/contract between the employee and the workplace and to keep the employee aware of changes and progressions within the workplace.

The line manager should be given guidance on how to communicate with sick employees. This should include the reason for remaining in contact and the style of communication, which should be fair, supportive, open, honest and friendly. Agreement needs to be made between the employee and line manager as to the frequency and method of communication. It can be very alarming to an employee to receive unexpected postal or other communication from the employer.


The line manger will have responsibilities to collate sickness absence data and to forward it to the central collecting system, usually controlled by Human Resources.

The line manager should treat all information relating to an individual’s sickness and absence as confidential. They need to understand that sensitive data, as specified under the Data Protection Act, must be treated and processed differently from other data.

Return to work

The line manager will need to be involved in case management meetings. They will be required to give details about the job role and responsibilities of the individual, the individual’s performance, and training undertaken and/or required. In relation to case management, and dependent on the case, they will need to be able to consider appropriate adjustments/temporary changes to enable the individual to return to work safely and as early as appropriate and possible.

The line manager should conduct return-to-work interviews. The purpose of the interview should be to welcome the employee back into the workplace, offer support for the employee to remain at work and explore the reasons for absence (if unknown).

When absence has reached a ‘trigger point’ as outlined in the organisation’s absence policy, the manager will need to undertake formal proceedings with the employee. These could include issuing warnings and conducting formal interviews and might result in dismissing the employee.

Once the employee is back at work, it is necessary, especially after a long period of absence and where the reason relates to mental ill health, that the line manager continues to offer support to the employee (see Returning to work in the topic on Psychological Health at Work). This will help to reduce the likelihood of another period of absence.

If the absence was work related, it would be prudent of the line manager to investigate the causes, with the aim of identifying others who may be affected, so that risks can be eradicated or minimised.

Role and responsibilities of human resources

Human Resources will have organisational responsibility for the management of attendance, which includes the prevention and management of absence.

They will have responsibility for writing, implementing and centrally monitoring the absence policy. They will need to ensure all managers and employees are aware of and able to carry out their responsibilities, which will primarily be covered during the induction. They are likely to be responsible for additional training of line managers to carry out return-to-work interviews.

The Human Resources team is likely to collect absence figures and have responsibility for analysing and reporting the figures. They will need to devise and implement methods for encouraging attendance. This could include assessing employee motivations and engagement levels, job analysis and design, flexible working policies, incentives, occupational sick pay, private health insurance, and categories of special leave. In additional, they will

  • Advise and guide managers on sickness absence and be involved in individual cases, where they may act as a co-ordinator between all parties
  • Have a responsibility to be involved in the development of ‘trigger points’ and actions to be taken
  • Be required, when necessary, to seek medical advice and guidance from doctors, specialist medical practitioners and occupational health.

Sensitive data, such as ‘Fit Notes’ and information which relates to the health status of the individual, will need to be kept securely and confidentially by the Human Resources team.

They will assist line managers through the process of managing a poor attendee. Depending on the reasons for absence, they may need to obtain a report from occupational health on the health of the employee in relation to his/her attendance and job role and any formal disciplinary processes that may be required.

Role and responsibilities of the employees

The employee is expected to maintain a good level of attendance. They are expected to follow procedures set out in the organisation’s absence policy about informing the workplace about any absence.

They are expected to make efforts to return back to work as quickly and swiftly as possible.

Occupational health professionals

Occupational health and other health professionals can provide a professional opinion on an individual’s health in relation to their ability to work, what workplace adjustments may be required and any legislation which may apply. They are only able to do this with the consent of the employee.

Consent should be informed and written. If this is not so, the occupational health professional is avised not to conduct the examination or issue a report. Informed consent occurs

  • Where the employee is able to understand the process and consequences and
  • An explanation has been given and understood by the employee about the process – the reasons, how, who is involved and the methods and broad content of the report.

Employees are entitled to see any medical report that relates to them if a medical practitioner who is or has been responsible for their clinical care has written it (Access to Medical Records Act, 1988). The employee will need to be made aware of actions which may occur if they do not give consent. These actions could result in dismissal.

The role of occupational health is also to provide and interpret medical information so that management is fully informed about the employee’s ability to work. Occupational health will work within the consent limitations given to them by the employee and their professional codes of conduct. The information they are able to disclose to requesting parties will be governed by these limitations, plus considerations about the safety of the employee and others, their work role and responsibilities and who the requesting body is.

The appropriate occupational health professionals will be able to conduct workplace assessments, offering advice on adjustments to facilitate the effectiveness of the workforce as a whole or individuals. They will also be able to co-ordinate and manage the communication between all health professionals, the workplace, and the employee, with the aim of returning the employee back to work safely and as quickly as possible. They are often used as the case manager in cases where the management of long-term absence is required.

Occupational health and all health professionals will keep health records, as detailed in the Data Protection Act, 1998, in a confidential and appropriate manner and for the specified length of time.

Occupational health and other health professionals, such as physiotherapists, occupational therapists, mental health/wellbeing specialists and nurses are able to work with organisations to develop and implement interventions which will reduce the likelihood of sickness absence occurring. They are also able to arrange for reports from other appropriate health professionals and interpret these reports, giving management an informed opinion on an individual’s ability to work.