Case Study - Employing a Case Manager to improve sickness absence management

Buckinghamshire Hospitals NHS Trust

Ged Marsden, Head of Occupational Health and Wellbeing

What we did

Buckinghamshire Hospitals NHS Trust created a new role to better drive an improvement to health and wellbeing in all employees, but with particular focus on those individuals whose sickness absence was problematic. The role in its simplest form knits the various elements of sickness absence management more tightly. There is nothing greatly new about what we are doing but it is borne out of 15 years as an OH manager seeing the shortcomings of the old ways of doing things. 

Background - Why

  • Sickness absence is often seen as inevitable and acceptable, the more you take this view the worse it can become. 
  • SHA requirement to get sickness down to 3% from what has been 4.5+%
  • Lack of co ordination and communication about who was doing what.
  • Lack of clear and accurate understanding of what sickness we had, where it is and its impact on the person concerned, the service in which they work and perhaps most of all at this difficult time, the cost
  • Lack of ownership of the problem by managers.
  • Realisation of the cost of managing it and its effects on other staff still at work. 

The approach

The role works with service managers and managers and employees at all levels, training, directing, supporting and most of all formulating an action plan of what needs to be done, how quickly and by whom. There is an element of performance management, identifying hot spots of unaddressed issues. An initial appointment was made for a 1 year period. 

Click here to see the job description/person specification

The Outcome

We have just completed a 12 month pilot of the role and although sickness absence has not plummeted it is not only on a downward trajectory but is discussed at many meetings and committees I attend across the organisation. It must be borne in mind that the almost complete lack of info prior to the role now shows the following.

  • Much clearer detailed view of absence - down to Ward level and named personnel.
  • Monthly reports to all managers on Bradford scores.
  • Clear and supportive guidance to managers enhancing their confidence in managing the issue.
  • Closer management of all those elements widely acknowledged to be essential in driving down sickness, eg back to work interviews, adherence to policy.

Following the pilot, the service has submitted a Business Case for a permanent post at band 8a. 

Click here to see detailed feedback from the service

The difference - two examples

  1. A nurse had been off sick for over three years out of seven. Her case is a sad one but both her private life and working life could only be describes as chaotic. She had multiple chronic medical issues and an extremely high Bradford score. The organisation calculated that it had spent in excess of £130,000.00 on managing her situation. After offering the person a range of supportive opportunities her contract was terminated earlier this year. The Case Management role was pivotal in driving the process to its ultimate completion.
  2. A qualitative and quantitative assessment of the success or not of our Counselling support was undertaken earlier this year. This assessment was to underpin the business case to access finance to ensure the continuity of the service. By working closely with the counsellors and offering strategic support, the case manager was able to show the clear financial benefits to the Trust gained in terms of reduced sickness, maintenance of individuals in work and earlier return to work. Coupled with the improvement in the wellbeing of valued staff this is a real bonus. Client feedback clearly showed real benefits. Management feedback also supported this.

For additional information please contact Ged Marsden - Head of Service. Occupational Health and Wellbeing, NHS Buckinghamshire Hospitals Trust


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