Sickness Absence - good practice

Introduction:

Requests for advice regarding sickness absence may come from various sources:

• The worker/patient
• A doctor looking after him/her
• The employer

Requests for advice may be directed to:

• The General Practitioner
• A hospital based doctor
• An occupational physician
• Other health care workers in occupational health, and elsewhere

Problem solving: 

What is the problem?

• This may sound obvious but is not necessarily always the case. Besides explicit concerns, there may be hidden ones...

What information is needed to address the problem?

• Information about the health status of the worker/patient, based from history or other sources
• Information about the workplace and the job: The requirements for fitness, and the possible effects of work on health, since this may be a significant contributor to the sickness absence or a hindrance to successful return to work.
• What about the sickness absence policy, other implications for the worker/patient?
• What about prospects for rehabilitation (this might need to be considered in much more detail later.

Important questions to answer: 

• likely duration of absence, 
• residual disability; 
• implications for future work performance, attendance and safety; 
• need for workplace improvements, 
• rehabilitation and/or redeployment; 
• possible occupational causation of ill-health.

Outcome and audit:

The individual case:

• Make a plan for closing the loop - and checking on outcome: Perhaps getting the patient/worker to 'phone you back. What if s/he does not?

Your overall performance:

• Plan for an audit 

References:

• Practical Occupational Medicine
• Agius RM, Seaton A, Lee RJ. Audit of sickness absence and fitness-for-work referrals. Occup Med 1995; 45: 125-30.