Sickness absence due to stress

A practice manager receives a text message to say that the lead receptionist has a cold and will not be coming into work. The practice manager notes this in her files, and works out that it is the ninth sick day the employee has had in the last three months.

The employee has taken off more and more sick days recently. Four months ago, the receptionist had less responsibility and was a different person – she left work on time, and seemed chirpy and approachable in her manner. Since being put in charge of the practice's procedures and operations, she has complained about the amount of work she now has to do. As well as organising the rest of the receptionists in the large practice, she is also in charge of the practice's infection control measures, complaints, and is undertaking a project with the practice manager to improve patient confidentiality and privacy.

The receptionist has mentioned that she feels stressed with the weight of her new responsibilities, and the practice manager suspects that the employee is taking a day off to recuperate from her busy workload.

So far, the practice manager has allowed for the receptionist to take some days off but the work carries on mounting, and with the possibility of a looming CQC inspection, he now needs to confront the problem.

Advice from Peninsula Business Services

Nine single days' absence within three months is certainly a trigger for alarm bells. The practice manager now realises that he must confront the issue, although action should have been taken from the day of the first absence. Employee issues can often be time-consuming and difficult, but the earlier you deal with them, the more control you will have over how they affect the practice.

It might initially be prudent to assume that stress is actually the cause of the employee's absence. There may be separate illnesses that have occurred at the same time. The key to identifying the cause is good communication. You must set up channels of communication with the employee and ensure that the employee feels comfortable using these channels.

Return to work interview

When the employee returns to work, you should set some time aside to speak to her. A return to work interview is a good opportunity for you to question the employee about their absence. Not only does this help you understand the cause, but also shows staff that you take absence seriously and that they will have to explain each occasion.

Although termed an 'interview', this meeting is an informal chat between you and the employee. However, you should keep a record of the date of the absence in question and the reasons. Make enquiries as to the cause of the absence and be intuitive with the responses you get. Some employees will relish the opportunity to offload about their problems but some won't. Avoiding direct questions and instead asking general wellbeing questions may elicit more truthful responses.

In this scenario, the employee's responses may tell you that her absence is not stress-related but down to other ailments such as migraines, colds or possibly backache. You should explain to the employee that the practice cannot accept such high levels of absence.

Disciplinary action

Disciplinary action at this stage would be difficult to justify as you will be imposing a sanction in relation to a time when the employee did not know she was being monitored. For disciplinary action, you will need further instances to build a case.

Work-related stress

If the employee's responses do lead you to believe that work-related stress is the cause of the absences, your response will need to be different. You have a duty to take reasonable care of the health and safety of your staff. Tribunals expect employers to support and assist employees who are suffering from workplace stress and to try to find ways of helping the employee overcome their problem.

Work together with the employee to look at which aspects of the job cause the stress. You could ask her to identify real examples and consider ways to reduce the impact on her. You may want to reduce some of her responsibilities, with her agreement.

You should endeavour to keep the employee informed at all times of the actions you are taking.

Your role as manager

Think about your role in this situation. In particular, consider whether:

• you could have done anything to prevent the employee from being overwhelmed by her responsibilities
• you gave full consideration to whether she would be able to cope with the extra responsibility
• you could have supported the employee with training
• you could have arranged for regular meetings with the employee to determine how she was dealing with the extra responsibilities
• you provided an opportunity to raise any concerns.

Prolonged periods of absence would ultimately require the intervention of an occupational health report, which will provide an opinion on the likelihood of the employee returning to work.

Nicola Mullineux
Research co-ordinator at Peninsula Business Services

This is a fictional case compiled from Peninsula's actual cases from their files.

Learning points

• Implement a sickness absence policy. This will set expectations of what is required from the employee. It also reduces the likelihood of an allegation of discriminatory treatment in comparison with other staff.
• Don't ignore the first signs of a problem – if an employee tells you they feel stressed, ask them if they want to speak to you further about it.
• Monitor every occasion of sickness absence and record the reason. Look for patterns that may arise, for example, if absences always fall on days that important meetings are due to be held. You are within your rights to question the absence and ask for an explanation as to the pattern.
• If an employee mentions work-related stress or dissatisfaction, you should consider whether you can provide extra support and training.
• Communicate with the employee by involving them in decisions and providing an action plan.
• Consider external help such as an employee assistance programme. As an employer, you are not the employee's counsellor and therefore must take help from professionals if needed.