Department of Health to save £555m by absence management

Ruth

There is a difference between illness and disease. Illness is how you feel, disease is what you have got. Most people go off sick because they don't feel well enough to go to work, but of these few have a disease that would prevent them from working. In the NHS most are off because of 'stress' or various aches and pains, often 'back pain', but there is rarely an identifiable pathology causing their symptoms.

The key issue here is to identify why they don't feel well enough to go to work. As Ann has identified, this is all about motivation, about enjoying work. The Boorman review that has identified the potential savings of £500m does not say this can be done simply by absence management, but by addressing 'health and wellbeing'. This is all about helping staff feel good about their work, and also feeling good about themselves because they are leading a healthy lifestyle.

Good management is a fundamental part of this, but employees should also accept some responsibility for their own health, and that is probably the greatest challenge. Changing unhealthy lifestyles cannot be done by political decree without substantial investment, and some unpopular legislation too.

Also, there is a huge difference between someone who has a cold turning out to work in a factory and someone with a cold turning up to an intensive care ward... Ditto mental distress, some routine jobs which get you out of the house have quite a positive effect if you're feeling a bit low, but facing a high pressure life or death situation when you're feeling low is absolutely not on. We should all protest about this - I don't want ill doctors and nurses thanks. Let's get rid of other wastage in the system first...

I believe that focusing on absence management policy and practice will be counter productive as it is dealing with the outcome not the cause. listening to and coaching NHS professionals gives me an insight into :
the dissatisfaction felt,
the perceived lack of support,
the many changes in standards,
sadness and anger at the standards of care,
the lack of honest patient centred activity
increased staffing levels does not equate to improved performance

Staff will be more likely to present themselves for work if they enjoy their job, feel heard and supported by their manager and colleagues, feel they can cope with the demands of the job, have some control over the way they work, feel safe, are clear and happy with their role and kept in the loop when change is required.
In other words, the management Standards for Stress are known, valued and applied by a competent, supportive manager who has the same standards in place for them.

Also appears over the weekend not the only place on the "production line" they are intending to be "saving" something other than perhaps the patients and staffs "quality of experience" that may affect any sense satisfaction of all other than the experience has been survived for another day.

http://news.bbc.co.uk/1/hi/health/8590710.stm

Perhaps it is time to make clear to patients friends and relatives that they will be welcome to provide support care services from cleaning to food & feeding those at risk of malnutrician if their stay is longer than a few days.

Also just maybe time to look at budget based funding that prevents nurses being employed because they have run out of wages yet have plenty left in agency budget to pay double the money for prolonged periods ?

Or, where staff on a cardiac ward are doing charity parachute jumps to raise money for extra de-fib machines whilst watching admin offices being refitted for the second time in eighteen months before budget is lost - madness..

Or, consultants desperately trying to extend their waiting list to qualify for the same budget as last year because over the years funding now solely poorer performance related rather than clinically / patient needs driven....

No wonder the perception of NHS is that funding more administrative than patient services with the urban mythe that probably twelve pen pushers behind the scenes to every needle pusher on the front line.

Aaah -soo, "Compliance" & "Positive Regard for All" delivered by improving quality of relationship management and thereby 'wellbeing' via mindset change management program - think that sums it up ?

Or, is it gonna end up as more of the same compliance driven presenteeism and drip, drip, drip, performance sapping and productivity insidious underminning & sort of standard generic and on-going "approval deprivation" ?

Don't s'pose it matters whether triggered by Budget or Equity Bill or occupational health or trying to replace exclusive with inclusive cultures in a bid to reduce collateral damage to human resources by the friendly fire of omission to impliment more parental than expediently preditory cultures viewing staff as temporary kit and just a question of logistics to get tick-boxes ticked .......

As a recipient of care culture and regular visitor to a number of local hostipals you cannot but admire the level and/or intensity of trauma care however, once out of immediate danger passing from various departments 'ticked ok' alive the transition from critical to out the door is a less than positive experience and fraught with a little anxiety and danger.

Often lucky to see the same nurse twice, often find promises to do something sort of forgotten as constantly redirected to other tasks and risk of shift change over info not being passed on or being misinterpreted quite high as little or no direct contact time or familiarity with patient but shed loads of contact time with "notes".

No wonder NHS staff must feel like machines ocationally idling to catch their breath but the majority of time running flat out like a fast food waitress chasing their tails to ensure maximum number of covers got through in a given service period and table or bed prepared for next customer before it's even cold.

Ben Willmott seams to sum it up well "big contrast in policy and practice"