The TUC published a report in July 2002 "rehabilitation
and retention: what works is what matters". This follows
extensive research by the Labour Research Department into the
issue of rehabilitation and UK employers' approach to retaining
their staff in work following sickness or injury.
Workers in Britain today have less chance than
their counterparts in the USA and Europe of remaining at work
in the event of them becoming sick or sustaining an injury at
work. According to the Health & Safety Executive, 27,000
people a year leave work permanently in such circumstances,
facing poverty and disability instead of jobs, health and wages.
At the same time, research by the HSE has found
that only 3% of companies provide comprehensive occupational
health support for their employees. In addition, only 30% of
workers have access to any form of occupational health, compared
with 50% in 1990.
HOW WAS THE RESEARCH CARRIED OUT?
Labour Research started their research in 2001
by surveying approximately 2000 safety representatives throughout
the UK. This provided a snapshot of how employers treated rehabilitation
and sickness absence.
The survey was followed by a series of interviews
carried out with managers, occupational health staff, union
reps and employees at nine companies and organisations, including
Scottish Power, Scottish Courts Service, Sheffield City Council,
Newham NHS Healthcare Trust, Moseley & District Churches
Housing Association, along with four private sector companies.
In depth case studies were also carried out and
formed a separate part of the report.
What is rehabilitation?
Sixty years ago, when planning the Welfare State,
William Beveridge stated that access to rehabilitation was one
of the three pillars of the welfare state. He defined it as
"a continuous process by which disabled persons should
be transferred from the state of being incapable under full
medical care to the state of being producers and earners. Rehabilitation
must be continued from the medical through the post-medical
stage till the maximum of earning capacity is restored."
For the purposes of the research, LRD defined
rehabilitation as "any method by which people with a condition
resulting from sickness or injury which interferes with their
ability to work can be returned to work".
WHAT DID THE RESEARCH FIND?
The study came to the conclusion that Britain
is one of the safest places in the world to work, due to the
work of unions and HSE inspectors.
However, there are still too many accidents in
the workplace and every year 27,000 people leave employment
permanently due to work-related illness and injuries. Many more
have long periods of sickness absence and do not get the support
they need to get back to work. Even in unionised workplaces
with a good network of safety stewards, there is very little
evidence of access to rehabilitation.
The case studies carried out showed that employment
practices aimed at rehabilitating staff provided many benefits
to businesses by:
- improved attendance and retention
- reduced costs from absence and medical retirement
- compliance with the DDA
- demonstrating good practice on health & safety
- promotion of a health "culture"
WHAT AIDS SUCCESSFUL REHABILITATION?
The case studies showed that employees suffering
from a wide range of problems, ranging from injury, chronic
pain, severe depression, ME, have been assisted in returning
to and remaining in work often after years of sickness absence.
Their successful rehabilitation has been achieved
- adaptations to work and working practices , including
tools and equipment
- changes in duties or change of post with same employer
- phased returns to work
- alterations to working hours
- provide additional vocational training
Occupational health is one of the most important
issues to aid retention in work and it is concerning that these
services are being cut back. Employers need to be made to see
OH as a benefit rather than a cost and will need to work out
the figures to prove it.
Back pain and musculo-skeletal disorder (MSD)
which includes RSI count for almost 60% of all health-related
absenteeism at a huge cost to both employers and the NHS. Studies
have shown the early intervention and management of the absence
can have a remarkable reduction on the number of days through
The use of occupational therapists and physiotherapists
by some employers has been very successful in helping people
back to work and assessing jobs to see what steps will achieve
the best outcomes.
The aim is for everyone to receive the same standard
of rehabilitation as David Beckham did, prior to the World Cup
in June 2002, when he broke a bone in his foot.
WHAT SHOULD BRANCHES DO?
The research concluded that formal rehabilitation
policies were essential to bring about the changes necessary.
Branches should therefore:
- establish clear formal rehabilitation and retention policies
or consider amendments to existing policies, such as Health
& Safety, Disability, Equal Opportunities or Management
of Sickness Absence procedures to include rehabilitation
and retention measures.
- place on Health & Safety Committee Agenda
- ensure that Rehabilitation policies are separated from
the Disciplinary Procedure.
- Involve all levels of management as effective management
is seen as a key to successful rehabilitation policies.
- involve the trade unions in managing the process.
- monitor sickness absence records and be aware of the potential
for occupational causes
- negotiate access to good occupational health facilities.
- ensure that interventions are started as early as possible
(within a month of the illness occurring)
- keep in touch with members of staff who are off sick.
- ensure that employers carry out risk assessments and investigate
any work related health problems
Rehabilitation and Retention
Occupational Health: Back in Business 06 Aug 02
Rehabilitation – an LRD Guide Aug 2002
Health Framework – Health & Safety
at Work September 2002 Edition.
Helped Back into Work – Labour Research
September 2002 Edition.