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["Baseline assessment: Workplace health: long-term sickness absence and capability to work "]
["NG146"]
[]
[]
["Published: November 2019"]

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["Baseline assessment tool for workplace health: long-term sickness absence and capability to work  (NICE guideline NG146)"]
[]
["This baseline assessment tool can be used to evaluate whether practice is in line with the recommendations in Workplace health: long-term sickness absence and capability to work.  It can also help to plan activity to meet the recommendations."]
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["The tool can be used by individual services or organisations. Alternatively, an assessment completed with the involvement of all relevant services or organisations would help to develop a picture of activity in the local area."]
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["It should be used in conjunction with Workplace health: long-term sickness absence and capability to work (NICE guideline NG146)."]
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["In the first instance, consider whether the guideline is relevant and record the conclusion in the box below."]
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["Is the guideline relevant?"]
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["The data sheet contains the recommendations from the guideline. Information can be entered about current activity relevant to the recommendation, actions needed to meet the recommendation, deadlines and the names of the responsible leads.  Useful documents can be added as hyperlinks."]
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["The table can be adapted to include any other local information that is thought to be useful."]
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["If it would be helpful to group the recommendations, for example those that are key priorities for implementation or by deadline, use the filter function in the data menu. "]
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["Tools and resources to help put the guidance into practice are available on the NICE website. "]
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["National Institute for Health and Care Excellence\nLevel 1A, City Tower, Piccadilly Plaza, Manchester M1 4BT; www.nice.org.uk\n\nCopyright\n© NICE 2022. All rights reserved. Subject to Notice of rights.\n"]

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["Baseline assessment tool for workplace health: long-term sickness absence and capability to work  (NICE guideline NG146)"]
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["NICE recommendation",null,"Year of recommendation","Is the recommendation relevant?","Current activity/evidence","Recommendation met?","Actions needed to implement recommendation","Is there a risk associated with not implementing this recommendation?","Is there a cost or saving?","Deadline","Lead"]
["1.1  Workplace culture and policies"]
["Make health and wellbeing a core priority for the top level of management of the organisation. See the section on organisational commitment in NICE’s guideline on workplace health: management practices (this section includes making health and wellbeing a core priority, ensuring the commitment of managers, and the importance of policies and of clear communication). ","1.1.1",2019]
["Foster a caring and supportive culture that encourages a consistent, proactive approach to all employees’ health and wellbeing. ","1.1.2",2019]
["Organisations (for example those with a small number of employees) that do not have formal policies should ensure that clear and accessible procedures for reporting and managing sickness are in place and are explained to all new and existing employees. ","1.1.3",2019]
["Ensure that all employees know the workplace policies or procedures for notifying and managing sickness absence, and for return to work. Make this part of the induction process for new employees and ensure that they know the sickness absence reporting system is confidential. ","1.1.4",2019]
["When developing workplace policies for managing sickness absence and return to work, ensure that these are part of a broader, strategically led approach to promoting employees' health and wellbeing (see recommendation 1.1.1). ","1.1.5",2019]
["Consider using a confidential and accessible employee assistance programme and occupational health provider if the organisation does not already do this. ","1.1.6",2019]
["Monitor and regularly review the impact of sickness absence policies and procedures to ensure that they are being implemented fairly and consistently across the organisation and that they are fit for purpose.","1.1.7",2019]
["Consider collecting non-identifiable data that can enable the sickness absence profile and changing trends to be monitored across the organisation. The data should include information on: \n•\tthe duration and frequency of absence\n•\tthe cause of absence (and whether work related)\n•\tfactors that may be associated with sickness absence such as job role, salary band, department and location of workplace.","1.1.8",2019]
["\tRegularly review the data on trends in sickness absence to identify: \n•\tareas in which intervention may be needed to support employees' health and wellbeing and \n•\tpolicies or procedures that may need to be reviewed or amended. ","1.1.9",2019]
["1.2   Assessing and certifying fitness for work"]
["The statement of fitness for work (‘fit note’) should be completed by the practitioner with the most relevant recent knowledge of the person’s health, reason for absence and prognosis for return to work. This can be a doctor, registered nurse, occupational therapist, pharmacist or physiotherapist. ","1.2.1",2019]
["Encourage people who are assessed as not fit for work to maintain regular contact with their workplace. ","1.2.2",2019]
["If the person is likely to be absent from work for more than 4 weeks, consider:\n•\treferral to health rehabilitation and support services, such as physiotherapy, counselling or occupational therapy\n•\tsignposting them to other possible expert sources of vocational advice and support relevant to their condition. ","1.2.3",2019]
["Take account of the fact that reasons for sickness absence can be complex. Encourage the person to: \n•\treflect on any factors in their work or personal life that may be contributing to their current absence or causing concern about returning to work and \n•\tidentify any additional support they might need. ","1.2.4",2019]
["Be aware that employers need information on how the employee’s health condition or treatment could affect them on their return to work. Use the statement of fitness for work to provide sufficient information in clear, non‑technical language. ","1.2.5",2019]
["1.3  \tStatement of fitness for work "]
["When a statement of fitness for work ('fit note') is received indicating that someone is not fit for work, start and maintain a confidential record. This record should include: \n•\tthe reason for absence, the anticipated length of absence and any recurrence of absence for the same reason and \n•\tany comments from the practitioner about how the person's condition or treatment affects their capacity for work. ","1.3.1",2019]
["To support the person who is currently not fit for work and plan for their return to the workplace, consider: \n•\ttaking into account any additional information provided (for example from an allied health professional's health and work report) about how their condition may affect their ability to do their role \n•\tseeking information and advice on what support they might need, such as from an occupational health service or from other possible expert sources of vocational advice and support relevant to their condition (this may include online resources, or telephone advice from external bodies)\n•\tdiscussing with them what adjustments or other support might be needed if any ongoing health needs are anticipated for when they return to work; if adjustments need approval, discuss these with decision makers to gain sign-off. ","1.3.2",2019]
["When a statement of fitness for work indicates that a person may be fit for work, contact them as soon as possible:\n•\tDiscuss what adjustments (such as flexible working, phased return, reduced hours, changes to workstations or duties) might help them return to work. Use any recommendations in the statement of fitness for work as a starting point.\n•\tInvolve the employee and line managers in these discussions initially, and occupational health services if needed.\n•\tHuman resources, trade unions or occupational health services (if not already participating) may also be involved, especially if the circumstances or adjustments are more complex. ","1.3.3",2019]
["If adjustments in the statement of fitness for work or requested by the employee cannot be made, explain the reasons clearly in writing to the employee. With their informed consent, send a copy to the certifying practitioner. ","1.3.4",2019]
["If a person may be fit to return to work with adjustments but those adjustments cannot be made, the person should continue to be treated as ‘not fit for work’, in line with the Department for Work and Pensions' guidance for employers. In such cases: \n•\tAdvise the person that they should return to work only when they have sufficiently recovered and are able to perform their regular duties. \n•\tDiscuss and jointly agree a plan for keeping in touch during their extended absence. Discuss any actions that may support them in making a full recovery and returning to their regular duties, and agree to regularly review these (see the section on early intervention). ","1.3.5",2019]
["1.4  Making workplace adjustments"]
["When any work adjustments have been agreed with a person returning from sickness absence:\n•\tArrange additional risk assessments if needed. Guidance on these is available on the Health and Safety Executive website.\n•\tDiscuss with the returning person whether colleagues could be informed about the adjustments to help them understand the need for them. Seek the person's informed consent and, if it is given, explain the reasons why the adjustments are being made. Discuss with colleagues any concerns that they may have about the impact of adjustments. ","1.4.1",2019]
["Record any workplace adjustments agreed with the employee, including a timeframe for their implementation and how long they are expected to last, in a written return-to-work plan for the employee and their line manager. ","1.4.2",2019]
["Monitor any workplace adjustments that have been put in place to see if they are meeting the needs of both the employee and employer. Review this regularly, within a timeframe agreed by the employee and line manager in the written return-to-work plan.\n•\tEncourage the employee to raise any issues related to the workplace adjustments and discuss who to raise them with. This may be an independent, impartial person. If necessary, think about making changes to the return-to-work plan. \n•\tEnsure that the employee is aware of other interventions that may be available to support them in their workplace (see the section on early intervention).","1.4.3",2019]
["1.5  Keeping in touch with people on sickness absence"]
["Ensure that the organisation regularly keeps in touch with people who are ‘not fit for work’ during periods of sickness absence, including people with a chronic health condition or a progressive illness or disability covered by the Equality Act 2010. ","1.5.1",2019]
["Make contact as early as possible, and within 4 weeks of them starting sickness absence, depending on the circumstances. ","1.5.2",2019]
["When contacting the employee: \n•\tBe sensitive to their individual needs and circumstances.\n•\tBe aware that communication style and content could affect their wellbeing and decision to return to work. \n•\tEnsure that they are aware that the purpose of keeping in touch is to provide support and help them return to the workplace when they feel ready. \n•\tIf an early referral to support services (for example physiotherapy, counselling or occupational therapy) is available through the organisation’s occupational health provider, discuss if this may be helpful. \n•\tDiscuss how they would like to be contacted in future, how frequently and by whom. If the line manager is not the most appropriate person to keep in touch, offer alternatives. \n•\tProvide reassurance that anything they share about their health will be kept confidential, unless there are serious concerns for their or others’ wellbeing. ","1.5.3",2019]
["Ensure that members of staff responsible for keeping in touch with people on sickness absence: \n•\tare aware of the need for sensitivity and discretion at all times \n•\tunderstand the organisation’s policies or procedures on managing sickness absence and returning to work\n•\tare competent in relevant communication skills and are signposted to and encouraged to use online or other resources and advice to improve these skills. ","1.5.4",2019]
["1.6  Early intervention"]
["In organisations that offer access to early interventions (such as rehabilitation, counselling or an employee assistance programme) ensure that all employees are aware of their availability, remit and confidentiality. ","1.6.1",2019]
["Assure employees that all contact with the employee assistance programme is confidential.","1.6.2",2019]
["For employees whose sickness absence is expected to continue beyond 4 weeks, in organisations with access to an occupational health provider:\n•\tdiscuss the possibility of a referral to occupational health for an assessment of fitness for work or \n•\tdiscuss the suitability for early referral to support services; if referral is appropriate, ensure that this takes place as early as possible. ","1.6.3",2019]
["If occupational health services or an employee assistance programme are not available, encourage employees whose sickness absence is expected to continue beyond 4 weeks to discuss with their GP or secondary care specialist any options for referral to support services such as physiotherapy, counselling or occupational therapy. ","1.6.4",2019]
["1.7  Sustainable return to work and reducing recurrence of absence"]
["Sustainable return to work for people with a musculoskeletal condition"]
["For people who have been absent for 4 or more weeks because of a musculoskeletal condition, consider interventions to help them return to work. For example: \n•\tA programme of graded activity delivered by someone with appropriate training (for example, a physical or occupational therapist).\n•\tProblem-solving therapy.\n•\tA worksite assessment by a suitably qualified professional to review and discuss with the employee, together with a representative of the employer, the suitability of work tasks or any adjustments that could be made. \n•\tA meeting between the employee and their line manager, facilitated by an impartial person, to agree the key barriers to returning to work and what modifications could be made to the work environment to overcome these. ","1.7.1",2019]
["Reducing recurrence of absence for people with a common mental health condition"]
["For people who resume work after an absence of 4 or more weeks for a common mental health condition, consider a 3 month structured support intervention to reduce the likelihood of a recurrence of absence. Involve the line manager in this process, which could be led by an impartial person. The intervention may include: \n•\tMeeting the person to identify any issues encountered since their return to work, and exploring possible solutions and support needs. \n•\tDeveloping an action plan to implement, which is agreed with the person’s line manager.\n•\tRegular follow-up meetings with the person and their line manager to evaluate progress. ","1.7.2",2019]
["1.8   People with a health condition or disability who are not currently employed "]
["Commission an integrated programme to help people receiving benefits who have a health condition or disability to enter or return to work (paid or unpaid). The programme should include a combination of interventions such as:\n•\tan interview with a trained adviser to discuss the help they need to return to work \n•\tvocational training (for example help producing a CV, interview training and help to find a job or a work placement) \n•\ta condition management component run by local health providers to help people manage their health condition\n•\tsupport before and after returning to work that may include 1 or more of the following: mentoring, a job coach, occupational health support or financial advice. ","1.8.1",2009]