Agenda item

To consider the SBC Sickness Management documents and interview witnesses for the review

Following presentations from SBC Senior Human Resources Manager, SBC officers and FirstCare Business Development Manager, the Overview and Scrutiny Committee formulated the following recommendations:

1.         That a further meeting to consider other aspects of the review be arranged

2.         That management officers from Customer Services and Housing Investment be invited to the next SBC Sickness Management review meeting

3.         That union representatives be invited to a future Sickness Management review meeting

4.         That data collected for FirstCare’s East of England clients be shared with the Committee

5.         That officers clarify the projections for reduction in sickness absence after the engagement of the third-party sickness absence provider (FirstCare)

6.         That the “Time to Change” pledge be circulated to Members

7.         That the SBC Volunteering Policy be submitted to the Committee

8.         That the current (and when available) the revised Sickness Policy be submitted to the Committee

9.         That details of the employee assistance programme be submitted to the Committee

The Chair welcomed Matthew Scrimshire, the FirstCare Business Development Manager to the meeting. The Business Development Manager had been invited to provide an update on the proposed Absence Management Contract.

FirstCare is an Absence Management Solutions provider that was established in 2004.  The company has a staff compliment of about 180 and it operates from a base in Watford. FirstCare has another office in Waterloo and it also has remote working arrangements. FirstCare provides a specialised phone triage service for 120 clients including 15 local authorities. 60% of the company’s clients are public sector organisations. FC works with 15 local authorities. The provider employs one doctor and nurses of Band 6 grade and above. The service provider also works with 12 NHS Trusts. The robust service had been signed off by Chelsea and Westminster NHS Foundation Trust.

The service was procured via the Watford Borough Council Procurement Framework Agreement. The Framework Agreement enables local authorities to procure the Absence Management Service without going to tender. The Agreement sets the cost of the service to £3.30 per employee per month.

The objectives of FirstCare Absence Management Solutions are to support employees, minimise absence and promote safe return to work. All initial calls to the service are handled by administration (non-clinical) staff who will direct callers/employees to relevant nurses for clinical advice. 

FirstCare received about 1 million calls in 2017. One in 436 of calls received involve life-threatening conditions. The provider has handled 215 urgent calls so far this year including seven (7) unintentional overdoses, 28 suicidal ideation calls and 44 cardiac/chest pain calls. It is worth noting that 56% of red flag calls were received between 6.00pm and 9.00am. Statistics from FirstCare clients indicate that early intervention significantly contributes to reduction in sickness levels.  A bus operator had reduced sickness absence following advice from FirstCare to adjust shift patterns for drivers. Data analysis had revealed a link between musculoskeletal disorders and the operator’s working patterns.

The Business Development Manager informed the Committee that:

•           FirstCare would be the first point of contact for officers. FirstCare non-clinical staff would record employee details and then transfer the call to a nurse. The provider’s call centres operate the entire 24 hours of the day and seven days of the week (24/7).

•           An email or text notification would be sent to the employee’s line manager or other nominated Council officer within five minutes of the employee’s first call to FirstCare.

•           FirstCare would provide regular updates regarding estimated duration of absence

•           Medical details will be shared only in cases of positive consent by the employee

The Committee also considered the Sickness Absence Report for the period 1 October 2017 to 30 September 2018. The report highlighted the overall trend, organisational changes, comparison with national and local absence trends, long and short term absence, cost of sickness absence, reasons for sickness absence and the support available to employees. It was reported that on average 50% of staff did not take time off for sickness.

Members were informed that:

•           The Executive had been monitoring sickness levels for a long time. The introduction of the FirstCare service was part of the Council’s sickness absence management strategy. SBC will still maintain control over sickness management

•           The FirstCare service was aimed at delivering safe and speedy recovery

•           FirstCare will facilitate holistic analysis of sickness absence and improve sickness management

•           The benefits of the service will be assessed via contract monitoring procedures. Regular feedback from managers will be used for data analysis. Absence levels will be tracked at quarterly meetings of the Executive and at SLT

•           SBC had opted for a one year contract with an option to extend if contract performance was satisfactory

•           Management culture at SBC supports safe return to work. Even with the introduction of FirstCare service, managers and officers would still be expected to discuss health and safety issues during regular scheduled appraisal meetings.

•           Return to Work interviews were the perfect forum for constructive discussions about health and safety issues

•           The introduction of FirstCare service will not stop managers from contacting employees who are off sick

•           Line Managers will still be able to use the medical suspension option

•           The service was scheduled to be introduced during the final quarter of the current financial year

It was confirmed that elective procedures such as routine dental and eye checks were not included in the scope of the SBC Contract with FirstCare. However, if requested, FirstCare would provide advice on routine procedures.

With regard to mental health, Members were informed that statistics showed that 50% of employees were not comfortable discussing mental Health issues with their managers. Even though there was an increase in mental health issues, employees were not fully utilising available resources. FirstCare had specialist nurses who provided unbiased mental health support. Following the intervention of FirstCare, Nuneaton and Bedworth Borough Council recorded a 64% mental health absence reduction. The Chief Executive confirmed that SBC had a genuine commitment to act on mental health issues. The Council had signed the “Time to Change” pledge. By signing the “Time to Change” pledge, the Council was demonstrating a commitment to changing how staff think and act about mental health in the workplace and supporting employees who are facing these problems. Mental health champions are part of the Council’s mental health support structure. A list of trained mental health counsellors was available on request.

The Waste Operations Manager provided an updated on sickness management for one of the Stevenage Direct Services teams. Stevenage Direct Services had performed below target between October 2017 and September 2018. Members were informed that the Waste Operations team holds regular absence workshops. It was reported that 39 absence cases had been reviewed in the past year with the aim of supporting staff and identify any underlying issues. The impact of staff absence on team cohesion was highlighted at team meetings. Managers followed up on long-term absence cases. Staff returning from long-term absence were offered alternative duties and flexible working. Peak absence was recorded in the summer. During this period, operatives were supplied with extra bottles of water and shift patterns were adjusted so as to minimise exposure to extreme heat conditions.

Corporate Services and Transformation was one of the Business Units that had performed above target during the period under review. The Business Improvement Manager informed the Committee that low sickness absence levels were partly due to the management practice of giving officers as much autonomy as is possible to deliver projects. In some cases, officers opted to work from home or have a shorter working day so as to aid recovery. The Business Improvement Manager confirmed that officers were not under pressure to substitute annual leave days for sickness absence. It was also indicated that risk assessments and reasonable adjustments were made for employees with chronic conditions and those returning from long-term absence.

Members questioned whether the introduction of a third-party absence management service could potentially put pressure on employees to return to work before full recovery or discourage employees from reporting sickness. In response to a question about raising awareness about the service, the Senior HR Officer informed the Committee that there were plans to use promotional videos and other publicity materials. There were plans to enlist the assistance of current SBC employees who had used the service at Stevenage Homes. The Executive Portfolio Holder for Resources confirmed that unions had been consulted on the engagement of a third-party absence management provider. Members sought clarification on projections for reduction in sickness absence after the engagement of FirstCare. Members were reassured that the Council had put in place a number of measures to reduce sickness absence levels over the past ten years. It was highlighted that cuts to local government funding, the salary freeze and restructuring of Council Business Units had a bearing on sickness absence figures. Members agreed that staff should be told how much they are valued. The Committee requested more details about current FirstCare clients, employee assistance programme, current SBC sickness and volunteering policies. Members also sought to interview union representatives and management officers from Customer Services and Housing Investment at a further Sickness Management review meeting.

The Overview and Scrutiny Committee formulated the following recommendations:

1.         That a further meeting to consider other aspects of the review be arranged

2.         That management officers from Customer Services and Housing Investment be invited to the next SBC Sickness Management review meeting

3.         That union representatives be invited to the further Sickness Management review meeting

4.         That data collected for FirstCare’s East of England clients be shared

with the Committee

5.         That officers clarify the projections for reduction in sickness absence

after the engagement of the third-party sickness absence provider (FirstCare)

6.         That the “Time to Change” pledge be circulated to Members

7.         That the SBC Volunteering Policy be submitted to the Committee

8.         That the current and revised Sickness Policy (when available) be submitted to the Committee

9.         That details of the employee assistance programme be submitted to the Committee