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Improving how nurses' sick leave is managed

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Revamping the sick note system is a good way to encourage nurses back to work, says Julian Topping, Head of Workplace Health at NHS Employers

Ensuring an organisation has a healthy workforce is fundamental to success and perhaps never more so than in the NHS where staff costs account for 70 per cent of the total costs.

Not only does a healthy workforce safeguard the investment in staff and provide a better service for patients, it also has a direct impact on the health and wellbeing of the wider population as NHS staff are at the heart of high-quality patient care. And, as the largest staff group within the largest employer in Europe, the welfare of nurses is pivotal – few can doubt that a healthy, happy nursing team results in a better patient experience.

In her review on the health of Britain’s working age population, Dame Carol Black highlights the economic and human cost of ill-health and examines solutions. One recommendation, that NHS Employers fully supports, is the introduction of an electronic fit note to replace the existing paper-based F Med 3.

Studies have shown that working has a positive effect on health and wellbeing, and the new certificates would include details of work that the employee is capable of carrying out, allowing the employer to identify suitable tasks. This would shift the emphasis and concentrate on what someone is able to do rather than enforcing a total ban on work.

We are not endorsing these certificates as a way of forcing people back into the workplace when there is a valid reason why they should be signed off sick. However, many people often want to return early but are unable to perform the tasks they are contracted to do – and this provides an opportunity for them to do so.

For nurses, whose job is often both mentally and physically demanding, the introduction of these certificates would improve the way their sick leave is managed. In many cases it may be that a nurse who is on sick leave is keen to return to work but is unable to undertake their contracted role and so is forced to stay at home. This increases the risk of a person developing more serious illnesses, frequently in the form of minor mental health problems and, in the worse cases, can lead to people never returning to work at all.

One of NHS Employers’ consultation meetings on ill-health described how a nurse with a broken leg was given a medical certificate from her GP stating that she should not work for eight weeks. Although this is clearly reasonable – many of the more physical aspects of nursing would clearly be impossible with a broken leg – following a request by the nurse herself, the trust’s HR department identified duties that she was able to fulfil enabling her to return to work after the first week. This had obvious benefits for everyone – patients, the organisation and the nurse.

While actively encouraging people to return to work is clearly the way forward it can be difficult for an organisation to help an employee back to the workplace if they have little understanding of why someone is signed off sick.

To help resolve this, NHS Employers is working with government to develop a workable new certificate that enables more effective, and earlier rehabilitation while also protecting the confidentiality of employees.

As such a large and diverse employer with specialist health knowledge, the NHS is in an ideal position to push forward good practice and NHS Employers is ideally placed to guide the agenda to ensure that the largest employer in Europe continues to be a place where people want to work.

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