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Sick leave down by 40 percent after focus on attendance

| Text: Gunhild Wallin

The Norwegian municipality of Songdalen went against the grain in order to cut the level of sick leave. They concentrated on attendance instead of absence, and used the staff’s own knowledge about their working environment with great success.

“When you focus on attendance rather than sick leave you give employees themselves the chance to improve the factors that lead to better attendance,” says researcher Trond Stalsberg Mydland at the research institute Agderforskning. He has been research observer for the four years the project has been running.

Songdalen municipality in Vest Agder county in the south of Norway has a population of some 6,400. 2012 saw the introduction of ‘The value project – better attendance’ at three preschools and one provider of home visits to the elderly. Two years later the project expanded to include five preschools. The Norwegian Association of Local and Regional Authorities, KS, launched the initiative which has been carried out together with Songdalen and Arendal municipalities.

The project is also part of a more comprehensive development programme called ‘Together for a better municipality’, initiated by Norway’s Ministry of Local Government and Modernisation. It aims to deal with the challenges around sick leave, skills and recruitment, full-time culture and reputation. A total of 104 municipalities have taken part and have run their own local programmes dealing with one or more of the focus areas. ‘Together for a better municipality’ builds on the cooperation between the social partners, the state and researchers.

Factors for improving workplace health

The FAFO research institute recently published a final report on the four year long development programme, summing up the results from the different focus areas. The report shows that fewer people go off sick in 85 percent of the municipalities which work with either sick leave or attendance. They highlight several reasons for why reducing levels of sick leave is important. Municipalities will save money, but it also improves continuity and leads to a better service for citizens. Reduced absenteeism also has a positive impact on the working environment and people’s well-being. Earlier research has also shown that employees who are happy with the quality of the services they provide are more likely to stay healthy for longer periods of time.

The interviewees in the different municipalities mention a range of crucial factors for reducing the levels of sick leave – a feeling of belonging, cross-party cooperation, organisation and project leadership, knowledge and the sharing of knowledge, systems and routines, leadership, employees’ culture and involvement. The final report also highlights the importance of analysing how local conditions impact on the levels of sick leave before introducing any measures. There is no single solution for solving the challenge. There are differences in culture and attitude, skills developments differ and so do leadership roles.

“Skills improvement both for leaders and employees and not least attention from the top leadership in the municipality, including the politicians, can change the culture in an organisation” sums up the FAFO report.

Municipalities which have worked with sick leave and attendance have also noticed a change in how sick leave is perceived. “There has been a move from focusing solely on the rights of those on sick leave to also looking at their duties to the workplace.” Sick leave is no longer just something which concerns the person who is ill and their doctor, but also employers, colleagues and users.

A change from the bottom up

Rather than looking at what causes sick leave, Songdalen chose to try to understand what creates attendance in a workplace. After four years they see that sick leave is down by 40 percent in the working places that took part in the project. Health promoting measures, leadership development through coaching and skills development for employees have improved the working environment and levels of sick leave have fallen. 

Trond Stalsberg Mydland sees many reasons for this progress, but wants to highlight that the change was from the bottom up – it worked because of the employees themselves.

“When employees are given the chance to influence their working environment, they see causes, solutions and attitudes and realise their own importance in it all. They know something about their job and their health, and they often know their colleagues’ situation too.

“They know how they can help each other and which solutions will work both for each individual worker and for the workplace as a whole when someone is ill. They also see that there are pros and cons of being in work when you are ill,” he says.

Takes time and courage

Another success factor is the support from management and good cooperation between union representatives, political leadership and company leadership. The three-partite cooperation is the key to progress, according to Trond Stalsberg Mydland.

“It is a way of approaching the problem together,” he says.

Experience shows that there is no quick fix for improving attendance and reducing levels of sick leave. It takes time and courage. Employers are investing in preventative measures rather than having to deal with the consequences of sick leave. And real efforts are needed, even though in this instance it did not take more than around one working week per employee a year. The important thing is to allow time for reflection.

“In everyday life there is no time to think about your working situation. For this you need your ‘own space’ so that improving the working environment is not limited by not having the time to do it. But if you get that and management is on board, you will see results after a few years,” he says.

Trond Stalsberg Mydland believes the project has become more sustainable because its starting point has been the employees’ own engagement and their proposals for how to improve things, rather than running it as a top down exercise. The resulting knowledge belongs to everyone and does not disappear if there is a change of leadership.

A high level of participation is also a way of taking pressure off the person who is ill. Sometimes sick leave is strictly only a matter for the patient and their doctor, other times sick leave is a result of a range of not always very clear-cut factors. This is where Songdal municipality has wanted to create what Trond Stalsberg Mydland calls a room of opportunity, a way of finding solutions to work-related ill health which benefit the individual worker as well as the workplace as a whole.

“This is knowledge which is relevant to us all – how can you find ways of managing work and health in the most efficient way for me, my colleagues and for the workplace,” says Trond Stalsberg Mydland.

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Norwegian women working in the health and care sector are more likely to take doctor prescribed sick leave (over more than 21 days), compared to other groups of working people.

The numbers can be explained by the working environment according to a fresh report from the Norwegian National Institute of Occupational Health, STAMI.

Results show that the risk of going on sick leave for more than 21 days is 42 percent higher for women in the health and care sector compared to women in other parts of the labour market. 70 percent of this increased risk stems from factors to do with the working environment, especially those of a psychosocial nature. It could be the threat of violence, emotional demands at work, but also heavy lifting in uncomfortable positions.

Compared to the total labour market, workers in the health and care sector face high demands combined with a low degree of control. STAMI’s ‘Fact book on the working environment and health’ is published every three years, and describes developments in Norway’s working environments.

‘Together for a better municipality’/ FAFO (in Norwegian)

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