The ‘Sick Note Culture’

June 17, 2024

The ‘Sick Note Culture’

What That Means For Workplaces

While the 4^th July might be demanding a heap of attention as the nation decides who will shape the future of our country, Rishi Sunak’s recent plan for signing people off work remains a hot topic.

Of course, the future is uncertain until we know who takes victory in the General Election. But one thing we know for sure is that there are many people who are unhappy about the welfare plan that will see more people back in work.

Why is that?

Surely people being in work is a good thing?

The simple answer is ‘yes’, but as with all things political and involving humans, the solution is never that straight forward.

Here, Lisa LLoyd, Psychologist and founder of It’s Time for Change, and Chris Chamberlain, Operations Manager at Guernsey Mind, share their views about some important questions that individual employees, managers and leaders need to be considering. Although people in Guernsey cannot vote in the general election, the ramifications of the result will have a huge influence on the island. We include helpful resources for you to use too.

The response to Sunak’s “sick note culture” speech has been heated. Why has it been so controversial?

Chris:

The word sicknote has been used for years, and not always in a way that is supportive to someone who is absent from work due to ill health. The political rhetoric has not helped this situation. ‘Sicknote’ has been used to describe colleagues in a negative light without really understanding the reasons why a person is not in work. The negative connotations can create discord in teams as well as psychological stress that can cloud judgement when managing a situation.

It can also support presenteeism – this is lost productivity that occurs when employees are not fully functioning in the workplace because of an illness, injury, or other condition. Even though the employee may be physically at work, they may not be able to fully perform their duties and are more likely to make mistakes on the job. Rather than be labelled ‘sicknote’, people may still come into work and struggle rather than talking to somebody about a situation or illness that is impacting them.

The use of the term ‘sicknote’ can also create stigma, particularly for those with mental health challenges. With ever increasing waiting lists to get specialist mental health support, this adds to a person’s distress.

There does need to be more done regarding the use of a “fit note” or “light duties”. This would help individuals start conversations around what a return to work might look like. A coordinated approach between employers and employees, with advice from any professional mental health support they may be receiving, is the best way to plan a productive return back into the workplace.

There are many layers to what good looks like. Will the government provide resources to support any plans, or will they place unrealistic demands on the employer and the employee?

There is also the wider challenge of the political landscape and challenges within the NHS. What will the UK’s leadership say about culture in the workplace and will they lead by example?

Lisa:

‘Sick notes’ remind me of school, when students would present them in an attempt to dodge a PE lesson. So, Sunak’s terminology conjures up an image of petty attempts from adults trying to bunk off work. Now imagine you’re one of these individuals wanting the necessary support to get on with your life and finding that it’s not available? Being signed off is not an enjoyable option for most; work provides us with meaning and purpose, a sense of status and achievement, a place for connection. Sunak’s choice of words undermines the very real challenge that so many people experience with their mental health.

I agree that issuing repeat notes stating individuals are ‘not fit for work’, without any advice or support, is a major issue. However, without adequate resources in the form of adequate mental health provision, the emphasis remains on workplaces to step in and meet mental health needs, or employees previously deemed ‘unfit’ to ‘get on with it’.

It is a positive step to move towards identifying what people can do, but that can sound rather simplistic too, unless the debilitating effects of mental health are properly understood. I might be able to physically do something but having the confidence and being able to manage what’s going on in my head are very different abilities.

Of course, if the government provides enough specialist work and health professionals, of the right calibre, motivated by doing what is right for the individual and not by meeting political targets, that is ideal. Imagine the difference that skilled, accessible people with dedicated time and expertise would make, providing objective assessments and specific advice about tailored arrangements and support required. But that needs to be available for every individual going through this process, and allow for conversations with employers who may have questions. That feels like a big ask when mental health services are already stretched to the point of feeling inaccessible to many.

What does Sunak’s plan mean for individuals?

Chris:

I think the plan makes an already difficult situation for employees even more challenging and will apply more pressure on individuals to return to work or stay in work when they shouldn’t. Presenteeism isn’t new and costs organisations more than absenteeism, so there is a balance that needs to be carefully managed. Finding mental health support is difficult enough – individuals can be pushed around which can make them feel undervalued and add to any mental health challenges. A greater awareness of conditions and a considered approach by managers to support employees back into the workplace through reasonable adjustments is required – this can generally be overlooked.

These challenges aren’t new and have always been present but may not have been brought to front and centre of how to improve culture and organisational performance. So, I prefer to look at this in a more proactive light and shine a light back on what employers can do to support individuals and create a culture that supports people well in the workplace. Are employees aware of their responsibilities when employees are unable to work? Does the employee feel safe enough to talk to their line manager? Are they aware of the fact that their employer still has a duty of care when they are off work? Organisations that do this well often perform at a higher level.

Lisa:

I think many are experiencing fear. They find themselves in a void, unable to be at work where their needs are not yet understood or supported well enough, and yet unable to access mental health services. A shift in expectation for people to leap from one unhealthy situation (being out of work) to another (returning to a workplace that is ill-equipped to meet the employee’s needs) is likely to exasperate mental health symptoms.

There is the added complication that returning to work after a period of absence can feel really challenging and it requires special care and consideration by the employer. Without this, we are setting employees up to fail.

What can I do as an individual?

Be proactive, don’t let things build up, talk to your employer/colleague if you are having challenges in the workplace.
Find support, check to see if your company has an EAP or if your insurance covers you to see a therapist/specialist. Mind have a great Supportive Self Help Programme which is easily accessible.
Learn more about the condition.

Individuals are going to need to find ways to support themselves, without relying on specialist help or pinning all hopes on their employer. Here are some resources that could be helpful:

What does the plan mean for managers and their teams?

Chris:

Ultimately it may cause more stress. We know getting people back to work is beneficial but it has to be done in the right way for it to effective, However, managers are quite often the ones stuck in the middle. They may have been promoted to a mangement postion based on the length of time they have been in the job or due to their technical ability, and then asked to manage people with little or no training. Throw in their own workloads and pressure from senior leadership and you end up with a melting pot of stress. So, I feel this is going to cause additional worry and potential mis-management as well as increased pressure on personnel or HR departments.

When there is long term illness, the team can quite often be forgotten in terms of communicating effectively. They may have heard that a colleague has been off with an illness and rumours can easily start swirling – they can feel aggrieved for having to pick up the slack when a colleague is absent. This plan can add to that stigma – “oh sick note is off again, and I’m already stretched” – which causes friction.

This can create an unhealthy culture that can cause wider issues when trying to manage a colleague’s return to work on a phased return. However, if managed well, we start to see more open dialogue, proactive management, trust and equality through fairness and consistency.

I always worry about consistency for organisations with multiple teams working in different departments. I often hear one team is managed well and supported in a way that another might not be, which causes unintentional animosity.

Lisa:

I think, like individual employees returning to work, also fear. We know many managers lack the knowledge, skills, confidence and support to deal with the current demands made of them in terms of meeting people-needs (i.e. the whole-person and not just that within the work role).

Add to that an expectation that managers will ‘pick-up’ additional needs that employees returning to work may have, without adequate support themselves; we are setting up managers to fail.

What can I do as a manager?

Find the space and learn more about managing/leading people and teams with compassion and empathy. What are the processes that support people in and out of work in your organisation. Learn about your companies’ policies and ask if they support people or does it unintentionally undermine it and what support is available so you can signpost and guide when necessary.
Think about workloads and stressors. Do you discuss these in 121 and team meetings? Is the team aligned and supporting each other?
Have an interest in the people you manage, learn a bit about them, their skill sets, motivators, and drivers and how you can build that into you’re their workstreams.
Learn about mental health conditions, how to spot the signs and support somebody who might be experiencing poor mental health.

Successful managers are those who are compassionate and who create psychological safety for their teams, regardless of Sunak’s plan. But knowing how to create that and how to have the conversations that matter can be really tough. After all, the majority of managers end up in their role without any adequate development support.

The resources found here Resources | It’s Time for Change (itstimeforchange.co.uk) provide information that you need to know and practical solutions. These are designed to help the workplace better support employees with experience of mental health challenges, including:

Depression & Anxiety
Addiction
Self-Harm, Disorders & Phobias

Other resources for managers include:

What is the impact for leaders at a whole-organisation level?

Chris:

The challenges are the questions, expectations and stressors that are going to be placed on leaders and organisations, when many are already feeling the pressures of the last 5 years.

The challenge for leaders is to look beneath the rhetoric, prioritise the space and time to look at it proactively and ask ‘Is our organisation promoting good working culture that supports our people?’. This means looking at all aspects of the organisation, including the leadership level.

Guernsey Mind’s Workplace Partnership is based on the core fact that leaders must consider promoting mental health and wellbeing within their workplaces, and look at every aspect of the business starting with leadership first. What is the culture? Are you measuring the indicators that support people and drives performance? Are employees heard? Is there fairness and equality? Are policies and procedures supporting wellbeing? Do our managers have the skills to manage people effectively? Have we provided our employees with awareness and safety to communicate upwards?

Of course, these are all good and well, but bring another set of challenges and questions areas performance. Is your business willing to address poor performance and begin to promote the right performance?

Lisa:

This is a great question, and the answer really depends on the leaders! For some companies, they will be able to embrace the shift in employee needs because they’ve taken the time to develop their people-practice.

It is really important that organisations are shaping a culture where people are not required to be experts in mental health but are able to take a human approach to business. That means prioritising people by creating practices that equip, allow and normalise check-ins, adjustments and other acts of care to happen across the board. Where managers aren’t providing this, that barrier to good employee experience (and engagement, and thus performance) must be addressed (without blame or shame).

It’s all about your culture. That can feel daunting as an area of business to develop, but it’s not as hard as you think when broken down to a human level. Most of us can relate to that! It’s about shaping an experience around what feels most relevant and meaningful to your people.

What can I do as a leader?

Look at this proactively and ask if you as leaders have the time and space for themselves and each other to understand this space and where to find it if not.
Find external partners that aren’t connected to your organisation. Measure workplace wellbeing and action on results, talk to Guernsey Mind about our workplace partnership or our workplace culture partners at time for change.
Ensure HR are at the top table.

Your leaders need time, space and intention to develop a culture that equips everyone to take responsibility for themselves and to support each other. This has to come from the top. But it’s a big ask with everything else you’re dealing with in your role, so here are some approaches that can help:

The best advice we can give is to reach out to us for a chat. There is never any expectation for you to sign up to work with us. But it might just feel a relief knowing that you know you are supported and that you have a plan for addressing the increasing needs that are coming.

We help companies be the best places for people to thrive and perform well.

Find out more about how Lisa helps: My work with companies | It’s time for Change (itstimeforchange.co.uk)