Returning to work after illness: evidence on improving the experience
This week’s guest blog comes from Abasiama Etuknwa, a postgraduate researcher, part of our Work and Learning Evidence programme at the University of East Anglia. Here, Abasiama outlines the results of her recently published systematic review on the effects of personal and social factors on the sustainable return to work after ill-health.
The most commonly reported ill-health among workers in developed countries have consistently been musculoskeletal and common mental health conditions such as depression, stress and anxiety. These conditions are a source of discomfort for the people experiencing them, as well as requiring employers (and the state) to provide in-work sickness benefits. Moreover, as the graph below shows, the trend is that these conditions are persisting.
Summary statistics for Great Britain 2017
Even though there is evidence that workplace-based interventions that make provision for work accommodations, contact with healthcare providers, early contact with workers by workplace, ergonomic worksite visits and presence of a Return To Work Coordinator are effective in helping people recorded as sick within an organisation with musculoskeletal and common mental health conditions return to work, current sickness absence statistics beg the questions:
- How sustainable are the effects of these interventions on return-to-work outcomes?
- Are there other factors that are likely to achieve more sustainable return to work outcomes, not currently taken into account in the implementation of these interventions?
By ‘sustainable’ we mean where stable full- or part-time return to work is achieved, either to the original, or a modified position, for a period of at least three months. This has to be without a relapse or recurrence of the sickness absence.
Included studies of both quantitative and qualitative design presented a varied level of evidence ranging from very strong to very low – indicating that both personal and social factors play a role in facilitating a sustainable return to work.
- High levels of support from leaders and co-workers can improve the self-confidence and optimism of the returning worker, thus making them feel valued, leading to better work attitude and self-efficacy and better outcomes for returning workers.
- Younger workers and workers with a higher education level were more likely to return to work sustainably than older employees and people of lower education level.
- Worker-initiated changes to their work, economic status, length of absence and job contract or security show indications of an impact on sustainable return to work, but there are too few studies exist to draw definite conclusions.
- Results regarding gender were inconsistent – in some instances men showed more sustainable return to work and in others it was women who did.
What does this mean for policy and practice?
Although return to work takes place within a complex system involving employing organisations and the healthcare system, given the consistent evidence on the role of line managers, we recommend that policy-makers consider ways to provide guidance for employers to help equip line managers with relevant skills, knowledge and a repertoire of appropriate actions.
Promoting a culture of support and choice in the workplace is essential, a culture that makes returning workers feel valued, worthy and not necessarily blamed for absence, as the former would improve work attitudes and ease the transition back to work.
The full technical report has now been published in the Journal of Journal of Occupational Rehabilitation. We are currently investigating the inconsistent effects of gender to provide more definitive knowledge on the role of gender related factor on return to work.