Why RM's commitment to addressing absence is delivering

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Profile: Why Royal Mail's commitment to addressing absence is delivering results

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Royal Mail’s introduction of early intervention and case management may reduce its absences by more than a month. Owain Thomas discovers how the organisation is making its mark

Business case

With two-thirds of absence being long-term it was clear that the situation had to be addressed

Diagnostic testing can be accelerated and individuals are case-managed throughout their absence

Two trial periods have shown very positive results and Royal Mail is now expanding the service nationally

Royal Mail is one of the country’s biggest employers and 18 months ago it underwent a high-profile privatisation. The industry in which it operates is a rapidly evolving one and, as such, the business has many challenges to ensure it is fit for the 21st century.

One of those is to tackle its sickness absence issue – something it started doing a couple of years ago, but the process has come to full fruition in the past six months. Following two successful smaller-scale trials, Royal Mail is now in the midst of rolling out an early-intervention and case-management service to its employees nationwide.

Speaking at Health and Wellbeing at Work 2015, group director of safety, health, wellbeing and sustainability Shaun Davis explained that Royal Mail’s 88% male employee population had been creating significant concerns regarding absence.

“Through some research we’ve done quite recently, we have identified specific issues regarding our ageing population and the length of service that we’ve got,” he said. “In terms of a forensic analysis of our absence issues, we know that we’ve got issues in the mental health arena, the musculoskeletal one and injury, and those are the areas that we pay particular attention to and that case management has been particularly effective in addressing.”

As with many employers across the country, Royal Mail has seen an increase in musculoskeletal and mental health absence over recent years. Its long-term absence is higher than industry norms and accounts for nearly two-thirds of all absence – by and large the opposite of what would be expected.

This trend alerted the organisation that it needed to focus on this area and form a far more integrated partnership with its occupational health (OH) provider; something that is trickier than it would normally be because of the heritage and size of the company. When targeting the key areas of musculoskeletal and mental health, the organisation found that managers were very uncomfortable having conversations with people who had been on long-term sick leave.

“They really didn’t know how or, in some cases, didn’t want to have that conversation. So working in partnership with an occupational health provider meant that we could say we were putting a mechanism in place that they can operate within to get the support that they need. And it broke down some of the mystery and the barriers to the occupational health provider by saying that they are part of our solution and they work alongside us to help get our people back to work,” continued Davis.

Taking a deep dive

The first thing to do in tackling the problem was begin a deep dive into the personnel system database, which the HR team and OH Assist conducted together. They established a group of 959 individuals who had all been off for more than three months.

“We wanted to know who they were, where they were, what they look like, what jobs they do, how old they are, how long they have been in the business ... what all the characteristics of this subset were,” explained OH Assist consultant occupational physician Dr Noel McElearney.

“And we wanted to know whether there were any characteristics that we could identify that made them highly at risk of going long-term. If you lose these people and the locus of control goes elsewhere, then it’s difficult to get that locus of control back in terms of managing their attendance.”

The team found that in the large bulk of cases people had mental health issues, musculoskeletal issues, or a combination of the two.

“So when we looked at the cases, it appeared at one point in time to be leading on musculoskeletal and when you looked into the detail of the case underlying that, there were some mental health problems. So very often these complicated cases have more than one thing going on at a time,” McElearney continued.

Taking back control

To make the next step possible, buy-in was needed from all across the business, including teams from HR, advice and support, the service centre, disability, line managers and IT. The new plan was designed to take control away from the NHS appointment clerk – which could mean a 14-week wait – and give it back to the business and helping people.

And it targeted an endpoint of people coming back to do their whole jobs, as far as that was possible.

“If it means putting someone in rehabilitation to do that, then we’re happy to do that because that’s what we want as the employer,” McElearney added. “If they can’t do that, then we want them properly redeployed. And if they can’t do that, then they exit the business because the business can’t support somebody who cannot fit into the business, but we want them to exit with dignity.”

The policy and action maps were put together to ensure that employees reported illnesses early, that managers stayed in touch, and that there were formal points of action. A four-week intervention period was introduced for people with musculoskeletal and mental health conditions, at which point a full bio-psycho-social “unpack” could be done to discover all of the issues for each employee.

This would allow the Royal Mail to understand that person’s health journey so far, identify things that the organisation could do as an employer that would shorten their journey, and augment what the GP might be doing.

“So once the person gets enrolled into the case management, we write to the GP and say, ‘We’re enrolling this person and we may do some things to your patient – have you got any objection and do you want to input?’ To date, no GP has written back and said, ‘No, don’t do anything for my patient, because we’re always stuck with the same thing: waiting, waiting, waiting’,” continued McElearney.

The clinical protocols are all based on the National Institute for Health and Care Excellence (NICE) evidence base and guidelines, with OH Assist potentially looking to accelerate the process by making referrals and funding other diagnostic interventions.

Consistency is key

Consistency is also key: the case manager is the single point of contact and stays with the person right through to the end – be that back to their normal duty, back to an alternative position, or to an exit from the business. There will also be contact after an employee has come back to work.
“The line manager is engaged. Nobody goes back to work on a return-to-work plan for modified duty or for adjusted duty unless the line manager has been spoken to, is fully agreed, and is going to fully support that person’s rehabilitation,” he said.

“Quite often, we will have had the experience of giving advice to somebody that, ‘This is my recommendation for rehab’, and you’re hoping that’s what happens, and it doesn’t. In this case, it’s followed all the way through because the endpoint – the point at which we bill – is when this person is fixed. And that’s important because that’s very different to other models.”

An initial small-scale pilot was carried out with remarkable results. Compared to a control group, absences were 22 days shorter for mental health and 12 days for musculoskeletal problems.

But with complicated data protection issues adding about ten days to this, the team felt the figures could be improved further. So a larger-scale pilot was funded and conducted involving 312 cases, again at the 28-day trigger point. This also included the logistics staff who move mail around the country.

Spectacular results

Results for the second study, again compared to a control group, were even more spectacular – this time mental health cases were cut by 37 days and musculoskeletal cases by 28.

“So we have put those results back to the operations executive and gone for a national rollout which began in January and is rolling out across the whole of the UK – that’s Land’s End to John o’ Groats – which is a big challenge,” McElearney continued. “It’s up, it’s running, and the early indications are that the long-term sick absence headline rates are starting to come down already.”

An additional bonus has been that even if employees do not see their absence significantly reduced, they have now been identified and are no longer able to fly under the radar for extended periods of time. The secret of the project’s success, according to Royal Mail’s Davis, is to use the pilots, rather than just going all in and hoping it works.

“The approach of having a pilot and then fine-tuning it and having a further pilot helps you to start and to be able to qualify what you say, particularly when you are looking for investment or looking for support,” he says.

“It also gets the organisation warmed up to the idea, so you can get people taking interest. It created a bit of its own momentum because once people started seeing the benefits of the pilot, they wanted a piece of that themselves. So they were saying, ‘Can we have it sooner?’ And it moved from us pushing it to the business, to being a pull because the business wanted it, which was a key change in terms of getting people on that journey with us.”
At present, the business does not fund private surgery and other major treatments, but nothing is off the table. Consideration of the benefits to the individual and Royal Mail is the next phase of the process.

And, as McElearney concluded, the benefits have been felt by the staff as well as the business: “The spirit of what we have been doing is very much one of helping the individual employee as much as treating the numbers. There is a serendipitous benefit to doing your best for the employee because the business gets the gain from that.”

[IloveMYredTROLLEY!]

Or perhaps they could look at the daily physical and mental assault many OPGs get due to the workload and the tools they give us to do the job, while many of us do the job to the best of our ability. We are not automatons.

Computer looks at management, computer says no.

[Judgee]

It would also probably be in RMs best interest to sort out some private health plan for the workforce. Privately people could be treated much quicker than waiting for NHS appointments. The health plan would pay for itself as time off sick would be greatly reduced!

[teesdale]

Bit like their selling to Royal Mail an absence policy which it already has. Identifying those for exit after 3 months could result in unfair dismissal claims which may be more expensive than VR. Bit sinister the muscular skeletal is caused by mental health problems?, trying to be too clever there. And then it pushes a commission producing private health care on Royal Mail which could be used to embarrass them.

[mudmonster]

It would deliver a lot quicker if they took a look at the bullying & harassment that goes on in the offices.When Royal Mail put in to practice their own policies,then we might see a reduction in mental health issues & people with various muscoskeletal problems but that probably will never happen,

[Puppetmaster]

On the basis of this study and others and Managers input into reducing absence ,what exactly does Management due to help work force on the front line.
Answer make the rounds constantly larger and introduce lapsing/absorption, and now talk of emptying Post Boxes.


You tell you line manger before you go out you will not e able to complete, standard reply "why?"
You say" round is to big and you have too much mail and packets"
He replies "the traffic figures are average for this day and the walk was agreed with the Planner and CWU, so their should be no reason cannot complete today !"

Then when you return to the office ,they ask lots of stupid questions ,pull faces etc, funny the CWU reps are never around when you return mail !

If any one was actualy serious about the being of the walking staff.
A, they could do Park and loop for a week and see it effects ,especially CWU officials the larger walks not easy ones
B. Commission a study on the long term effects upon the Human body of walking, several miles a day constantly, including going up and down stairs and across all types of terrain.
This is what our union fees should be spent on ,not propaganda and supporting political parties !
I say the CWU are too scared of their Masters at Royal Mail head office to even think about such a thing!