Analysis of sickness

Report: 14
Date: 25 July 2002
By: Commissioner

Summary

This is the first detailed six-monthly report and provides an analysis of sickness data covering the period from April 2001 to March 2002. The paper builds upon that provided on 1 November 2001. The paper looks at underlying trends, variations between short and long-term sickness, the impact of 11 September, gender variations, reasons for sickness, and identifies actions being taken to reduce sickness absence.

A. Recommendations

That Members note the contents of this report

B. Supporting information

Service targets and rates of sickness

1. The Service target for 2001/2 for sickness absence was 9 days per officer for police, 10 for civil staff and 20 for Traffic wardens. Sickness rates as at 31 March 2002 were 10.5, 11 and 19.4 days for police, civil staff and traffic wardens respectively.

The total number of days lost in 2001/2 was 401,182 compared to 394,039 in 2000/1, an increase of 1.78%. During 2001/2, the nature of sickness altered insofar that long-term sickness showed a marginal downward trend while short-term absenteeism rose considerably. Further analysis and details are provided in appendices 1 and 2A (see Supporting material).

Impact of 11 September 2001

3. Short-term sickness shows a significant increase with effect from October 2001, compared to September's figures (16.72% for police; 16.45% for civil staff). Fuller details covering the number of days lost to short and long-term sickness, over a 12-month period, are provided at appendix 2B (see Supporting material).

Reasons for sickness

4. Reasons for sickness are split into 15 main categories. 57.8% of police sickness falls within the categories musculoskeletal and mental health disorders. 51.9% of all civil staff sickness are musculoskeletal, mental health disorders and infectious and parasitic diseases. Reasons for traffic warden sickness follow closely the civil staff pattern.

5. Full details of the causes of sickness (by gender) are shown at appendix 2C (see Supporting material).

6. There is some disproportionality in sickness between male and female officers, with female staff (both police and civil staff) incurring more sickness. The only female specific sickness category is "gynaecological and obstetrics" but further work is required in this area, as not many absences in fact are attributed to these reasons.

Regulation 46

7. The figures for April 2002 across the three categories – full pay, half pay and off pay reflect a continuing downward trend since November 2001, albeit recent figures are beginning to plateau out. It has been proposed that future decisions in respect of Regulation 46 are centralised to ensure uniformity of decision-making. Work on this is being undertaken within the HR Directorate and proposals will be made shortly.

8. A monthly breakdown of officers on full, half or off pay for the period January 2001 to May 2002 is attached at appendix 2D (see Supporting material).

Action to address sickness

9. The management of sickness absence policy is the framework within which interventions are undertaken to reduce sickness and progress officers back to full duties from recuperative duty. In addition to the traditional activities undertaken in Occupational Health (OH) such as access to medical officers (including specialist practitioners), occupational health advisors, physiotherapists, chiropractors and rehabilitation services, OH also undertakes a "hotspotting" process which provides for a detailed and focussed review of sickness through team visits to boroughs/business units. Since the start of the process in late November 2001, over 28 units have been visited, excluding some shorter follow-up meetings requested by local managers. Areas covered during the visit include (not an exhaustive list):

• A review of all sickness cases with agreed action plans
• Pro-active health promotion advice
• Assistance with analysis of sickness within local units
• Health and Safety advice
• Review of local attendance management processes, including validation of data
• Advice on alternative interventions available through OH
• Additional recuperative clinics
• Additional case conferences for difficult or non-progressing cases
• Provide access for review of difficult cases by Senior OH Physician
• Provision of support to personnel managers inexperienced in the management of sickness
• Advice on the use and benefits of Disability Discrimination Act (DDA) interventions (civil staff only)

10. Since the start of the process in late November 2001, a number of issues have been identified following the visits including:

• Problems with flow of information between units and OH staff
• Problems with local reporting of sickness and reporting of resumption of duties
• Sickness has a low profile on some boroughs/business units
• Personnel managers and not line managers taking responsibility for sickness absence
• Need for training of staff inexperienced in attendance management processes
• Lack of understanding of role of OH within attendance management – who advises, who decides?
• Need to highlight importance of pro-active return to work interviews and sickness monitoring (not a tick box approach)
• Lack of appropriate response by medical officers to local managers
• Lack of appropriate questions by personnel/line managers to medical officers
• Number and length of time officers are on recuperative duty
• Confusion between recuperative and restricted duty
• Individuals being allowed to reside hundreds of miles away while off sick with little contact made during their absence with consequential impact on future return to work.
• Medical appointments missed with no sanctions imposed by local management.

11. These issues (and more) are not common across all boroughs/business units. Where good practice is identified, it is promulgated to a wider audience. The "hotspotting" process has identified weaknesses in both local and OH processes, which are now being addressed. The most common being the lack of appropriate questions to OH practitioners by local managers and lack of appropriate feedback from OH to local managers, to enable the latter to make informed decisions about their staff.

12. The issues listed above are being addressed and have resulted, for example, in additional reviews of difficult cases; greater one to one contact between the medical officers and senior line managers; an amended and more robust recuperative duties process which incorporates a "shared care" approach between occupational health advisors and medical officers; visits by personnel managers to the clinic office to see how the system works and the limitations of the process; and some one to one training of personnel managers by OH staff. Our approach to "hotspotting" is being developed through the involvement of TPHQ staff and OH medical retirement staff in the borough visits. A similar process is being developed for SO and other business groups, as necessary.

13. There is evidence that the "hotspotting" process has had some impact, in that local senior managers are inviting OH teams to assist them with sickness problems. In terms of traffic warden sickness, the process has clearly worked as evidenced by the continuous fall in sickness and the achievement of the traffic warden sickness performance indicator.

14. A series of follow-up reviews (in addition to more initial visits) are taking place to assess progress with the previously agreed borough/business unit action plans. The results of one of the first borough reviews have shown a reduction in 8 officers from the original long term sick list (as at January 2002) – seven back to full duties with one resuming to recuperative duties. Six different officers have however joined the long-term list.

15. Other initiatives to reduce sickness have included the provision of an additional physiotherapist on six month contract (to support musculoskeletal illness), continuation of the Spend to Save scheme to speed up the diagnosis of illness and the funding of knee surgery (within specific criteria). Budget provision has also been made in 2002/3 to provide additional psychiatric care in support of mental health issues.

C. Financial implications

There are no financial implications arising from this report. Achieving a reduction in sickness absence will however increase the resources available for daily deployment, particularly within the operational environment.

D. Background papers

None.

E. Contact details

Report author: Robert Crawley, OH Practice Manager, MPS.

For information contact:

MPA general: 020 7202 0202
Media enquiries: 020 7202 0217/18

Appendix 1: Analysis of sickness

A. Service targets and rates of sickness

1. The Service target for sickness for 2002/3 is 9 days per officer for police, 10 for civil staff (excluding traffic wardens) and 16 for Traffic wardens. 2001/2 targets were 9, 10 and 20 days respectively.

2. The rate of police sickness per officer for March 2002 was 10.5. This has remained fairly static over the past 12 months; the April 2002 figure was also 10.5.

3. The rate of civil staff sickness [excluding Traffic Wardens] for March 2002 was 11.0 days per officer. This figure has shown a gradual increase since April 2001 when it was 10.4.

4. The rate of sickness for traffic wardens for March 2002 was 19.4 days per officer. This figure reflects a steady decrease from 22.1 days recorded in April 2001.

5. Fuller details covering a 12-month period for all three groups are provided at appendix 2A.

B. All staff – long term sickness [more than 28 days]

6. The number of working days lost has decreased from 20,212 in April 2001 to 19,965 in March 2002. (A decrease of 1.22%.)

C. All staff – short term sickness [less than 28 days]

7. The number of working days lost has increased from 10,302 in April 2001 to 13,348 in March 2002, an increase of 29.57%.

8. In April 2001 long-term sickness was nearly double that for short-term sickness. The total number of days lost has increased over the 12-month period to April 2002 by 2,799 days (an increase of 9.17%). Within this, the nature of sickness has altered insofar that long-term sickness has decreased but, at the same time, short term absenteeism has risen considerably.

D. Police sickness

9. Long-term sickness has reduced from 14,358 days in April 2001 to 14,306 in March, a reduction of 0.36%.

10. Short-term sickness has increased from 6,666 days in April 2001 to 8,634 days in March 2002, an increase from 29.52%. An analysis of this change has been commissioned.

11. The total number of working days lost in March was 22,939 against an average for the previous 11 months of 22,860.

E. Civil staff (including traffic wardens (TWs))

12. Long term sickness has reduced from 5,854 days in April 2001 to 5,659 days in March 2002, a reduction of 3.33%. Short-term sickness has increased from 3,636 days in April 2001 to 4,714 days in March 2002, an increase of 29.64%. An analysis of this change is required. The total number of days lost in March was 10,374 against an average for the previous 11 months of 10,582 days.

F. 11 September 2001 impact

13. There is no indication that long-term sickness has been influenced by 11 September activity. Short-term sickness, however, did increase with effect from October 2001 but is now showing a downward trend.

14. Fuller details covering the number of days lost to short and long term sickness, over a 12-month period, are provided at appendix 2B.

G. MPS strength

15. The changes in the number of days lost to sickness for both police and civil staff need to be looked at in the context of strengths. Police numbers increased by 1,295 from April 2001 to March 2002 [5%], while civil staff numbers increased by 315 [2.89%] over the same period.

H. Reasons for sickness (based on March 2002 figures)

16. Reasons for sickness are split in to 15 main categories. 58.7% of police sickness falls within the categories musculoskeletal (36.0%) and mental health disorders (22.7%).

17. Civil staff sickness (excluding TWs) is more evenly spread with three main categories: musculoskeletal (21.4%), mental health disorders (17.4%) and infectious and parasitic diseases (13.3%) being accountable for 52.1% of sickness.

18. Reasons for traffic warden follow closely the civil staff pattern with musculoskeletal, mental health disorders and infectious diseases taking 37.4%, 16.5% and 19.0% respectively.

19. Full details of the causes of sickness (by gender) are shown at Annex B. Musculoskeletal illness is prominent in both short and long-term sickness, with mental health disorders being a major category within long term sickness, reflecting the inherent difficulties in dealing with illnesses of this type.

I. Sickness by gender (based on March 2002 figures)

20. Police - females represented 16.08% of the service but incurred 24.4% of sickness. 59.12% of civil staff (excluding TWs) were female who incurred 71.0% of sickness. The TW service comprised 58.7% female staff who incurred 67.4% of sickness. Fuller details are provided at appendix 2C.

21. The above indicates disproportionality in sickness between male and female officers. The only female specific sickness category is "gynaecological and obstetrics": the figure for police officers under this category is 1.46% of all illnesses for March. Civil staff and TW figures are 3.94% and 2.68% respectively. These figures are insufficient to explain the variances that occur and may point to a non-medical reason for absence. Further work in this area is required.

J. Regulation 46

22. The figures for April 2002 across the three categories – full pay, half pay and off pay reflect a continuing downward trend since November 2001, albeit recent figures are beginning to plateau out. A review of the consistency of decision making around Regulation 46 has been undertaken which has identified potential anomalies in outcomes. It has been proposed that future decisions in respect of Regulation 46 are centralised to ensure uniformity of decision making. Work on this is being undertaken within the HR Directorate and proposals will be made shortly.

23. A monthly breakdown of officers on full, half or off pay for the period January 2001 to May 2002 is attached at appendix 2D.

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