Pulling a sickie

Pulling a sickie is part of workplace culture. Who hasn’t psyched themself up for the 9am phone call to the boss and explained in your best deathbed croak that you won’t be in today because you’ve suddenly come down with a ‘nasty bug’, which miraculously clears up the following day?

Currently, sick notes, or fit notes, to give them their official name, are issued by GPs, sometimes after a five-minute consultation. According to NHS data, they have increased significantly from 8.7mn in the 12 months to March 2021 to 11mn in the equivalent period to March 2023.

And as every sickie has a cost to the economy, this month (April), the Government announced a crackdown on ‘sick note culture’ with the aim of shifting responsibility away from GPs and onto specialist work and health professionals.

People will sometimes feel the need to take unplanned days off

Generally, it’s accepted in leadership that people will sometimes feel the need to take unplanned days off for such things as hangovers or job interviews and that rather than ‘fess up, they’ll tell a white lie. Everyone is in on the ruse. You’ll be asked with mock sincerity the following morning if you feel better, and gingerly, you’ll reply that yes, you’re still a bit fragile, but like the trooper you are, you’ve managed to drag yourself in.  

This is the largely harmless side of the sick day spectrum. But in its extreme, it has become a huge headache for organisations and for the country as a whole. Last October, the CIPD reported that the average rate of employee absence now stands at 7.8 days per employee per year.

The number of people saying they are inactive due to long-term sickness is now 2.8 million – an increase of more than 200,000 in the past year and of 700,000 since the pandemic started in 2020.  

Are we reaching for sick notes too hastily?

Poor mental health, mental illness and behavioural disorders were the most common causes given by doctors for ordering patients to take time off work, appearing on 1mn notes. More than 60 per cent of all mental health diagnoses last year led to fit notes being issued for more than five weeks, while a quarter extended beyond 12 weeks. A large proportion of the fit notes issued are repeat ones that are provided without any advice, according to the government.

This rising level of mental ill health in the UK’s workforce has been blamed for aggravating labour shortages, increasing the welfare bill and stunting economic growth. The UK is the only country in the G7 where the share of working-age adults who are neither in a job nor looking for one remains higher than it was before the coronavirus pandemic.

Among these one million mental health sufferers, I have no doubt that there will be significant numbers who absolutely require time away from work. But I can’t help feeling that perhaps overstretched clinicians are reaching for the fit notes too hastily without considering that work can benefit mental health. And that if the workplace is not a contributing factor, assigning someone long-term sickness may be doing them more harm.

Work can improve mental wellbeing

Paid work can improve mental well-being (big caveat here—as long as the workplace is psychologically safe and generally safe) because it provides a purpose, a sense of community, and a positive routine. If someone generally enjoys doing a job in a place with a decent workplace culture, signing them off sick for mental health reasons may not help them.

Instead, would it not be a better policy to help them with coping strategies? Whilst I recognise not everyone enjoys their work and undoubtedly there are extremely stressful jobs, we do need to think differently about the quick fix of signing people off.  This can cause further problems down the line. (Read my previous article - 'Being stressed at work is not a mental illness')

And if there is an epidemic of poor workplace culture which is leading to this rise in sick notes, surely a more strategic policy would be to address this rather than inflame the situation by forcing people who are miserable because of their jobs back into them.

Energies would be better spent on investigating why there is such a rise in sick notes

A war on ‘sick note culture’ makes good headlines, but arguably, energies would be better spent investigating the causes and addressing them. Maybe the nation needs more occupational health positions and professionals who are qualified to support people at work.

Work can be a pressured environment, and there is nothing wrong with that if the pressure is managed in the right way. Organisations should take responsibility for providing people with a healthy work-life balance, encouraging them away from their desks, and providing psychologically safe environments so that if they do need to take time off for a short period, they are supported when they return.

Mental health first aid courses, which create awareness and reduce stigma, are all too easily used to tick a box rather than to address cultural issues such as workplace bullying or bad routines. What’s really needed in some organisations is a culture change so people are resilient when the pressure is on and are supported when they need it.

Some people will always take liberties and call in sick because Martha’s leaving ‘do’ unexpectedly ended up in a nightclub at 3am. But a lot more can be done to mitigate the damaging effects of more serious sickies.