Practices tend to be small businesses and staff absences can have considerable impact.
Absences tend to group into one of the following: occasional absences, persistent short-term absences and long-term absences. This article concentrates on how to manage the first two of these.
Short-term absence can be difficult to manage because it is unpredictable. However, poor absence management can lead to a destructive cycle. If staff perceive that regular absence is ignored or even accepted by the practice manager and GPs, resentment can build.
Staff who willingly cover for colleagues during a short-term crisis become less willing when it appears that the crisis is allowed to drag on or recurs frequently. Staff who tend rarely to be absent themselves may decide that they, too, will have a sick day and a culture of acceptance of absenteeism grows.
So what can practices do to manage absence better?
The first step is to have a written absence policy. Outline policies are available from various sources and additional help can be found on the ACAS website. Once the policy is established, adhere to it. It can include the following elements:
- Sickness reporting policy. Clarify in the policy the specific details of how sickness should be reported. In person or can someone telephone on behalf of the employee? By telephone or by text? To whom? Within what timescale? What information will be required? When is the employee expected to call back if the absence continues? The policy should clarify that failure to adhere to the reporting procedure may result in the absence being treated as unauthorised.
- Unauthorised absence policy. Clarify the definition of unauthorised absence and how it will be managed. Who will attempt to contact the employee? A failed telephone call should be followed up by a letter asking the employee to get in touch with the practice. Continued failure by the employee to get in touch should trigger a further letter, clarifying that this could result in disciplinary action.
- Use of self-certification and fit notes. Design a self-certification form to use for absences of less than seven days.
Make sure you receive a fit note for longer absences.
- Back-to-work interviews. This is an ideal opportunity to explore the absence and check whether the employee is well. Complete the self-certificate face-to-face with the employee. Check that the employee is feeling well and agree any short-term adjustments if any are suggested, for example in a fit note.
- Recording and monitoring absence patterns. It is possible to monitor patterns of absence for the whole staff and also for individuals. This is dependent on good absence records. Your sickness absence policy should specify how you will monitor absence patterns and what will trigger informal and formal absence review procedures.
All of the above signal to the team that attendance is important and that the practice takes absence seriously. Ensure that you are fair, reasonable and consistent at all times.
Underpinning these formal arrangements is a raft of good management practices.
First, know your staff. Someone in the practice, usually the practice manager or equivalent, should know generally how people are. This can be achieved by regular one-to-one meetings with staff, chatting at coffee time and other informal networks.
Staff who feel looked after are more likely to raise a problem with the expectation that someone will pay attention and take action. Staff who feel undervalued and ignored are more likely to feel disengaged, feel less team loyalty, and tend to take more single sick days.
Of course, a member of staff with a usually good attendance record who suddenly starts to take frequent sick days will then trigger a supportive chat, the consequence of which may be a temporary adjustment in working arrangements or other action.
Ensure good team management. It is possible that management in the practice, or lack of it, is contributing to staff absences. If there is a problem with absence, ask yourself the following questions. Are absent staff all supervised by the same person? Are there other team issues (bullying/cliques etc)? Is variety built into the working day? Is induction training effectively delivered? Are working conditions effectively managed?
It is a good idea to introduce a policy on other absences, such as hospital appointments and procedures, doctor's and dentist's appointments, adverse weather/travel conditions, bereavement, sporting/special events and dependant leave.
Make sure staff are clear on how to use time in lieu and overtime. All pregnant employees have a right to reasonable and paid time off for antenatal care.
It is also important to have a 'staff as patients' policy. If you are in a rural area, work out a fair and consistent way of separating out how you function as a GP and how you function as an employer. If at all possible, avoid having staff as patients.
It is not always helpful to use occupational health for unrelated, short-term absences. However, if you are going to move forward with a formal procedure and there is a continuing absence problem, advice from occupational health will become important.
Staff should receive reasonable warnings that continued absence could put their job at risk. Set attendance standards and put in support if necessary.
Your absence policy should state how continuing problems and formal meetings will be handled. Your disciplinary procedure will form a basis for this and this should comply with the ACAS Code of Practice: Discipline and Grievance at Work.
Remember to take advice from ACAS and/or your employment law adviser if embarking on a formal procedure, as this article offers guidance only.
- Fiona Dalziel is a practice management consultant, www.dlpracticemanagement.co.uk