Healthy Working Lives Group

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Sickness absence and return to work

The Healthy Working Lives Group has undertaken a sustained programme of research on sickness absence, early intervention, return to work and prevention of job loss.

This work has focused on how occupational health services can support workers earlier, reduce avoidable sickness absence, improve return-to-work outcomes, and help people remain in employment when health problems affect work.

About this work

Sickness absence is a major issue for workers, employers, public services and the wider economy. For individuals, prolonged sickness absence can affect health, income, confidence, work identity and long-term employment. For employers and organisations, it can affect workforce capacity, service delivery and productivity.

Our research has examined how early occupational health support can improve outcomes for workers and employers, and how data can be used to understand absence patterns, identify risk factors and target support more effectively.

The EASY study

The group developed and evaluated the EASY: Early Access to Support for You sickness absence service.

EASY was designed as an early access support model for sickness absence management. It provided structured support from the first day of absence, including early telephone contact, communication between the worker, line manager and occupational health service, and referral to occupational health where needed.

The EASY model was developed to provide earlier support, improve communication, and reduce the risk of short-term absence becoming prolonged absence.

Evaluation of the EASY service showed that it was effective in reducing sickness absence and maintaining that reduction over time.

Early intervention and return to work

The group has also undertaken research on the effectiveness of very early workplace interventions to reduce sickness absence and support return to work.

This work examined whether workplace interventions delivered in the early stages of sickness absence can improve return-to-work outcomes, reduce absence duration and prevent longer-term work loss.

This programme highlights the importance of timely, supportive and work-focused intervention, rather than waiting until sickness absence has become entrenched and then trying to fix it with a policy document and crossed fingers.

Sickness absence duration

Our research has examined sickness absence duration among Scottish healthcare workers, particularly for musculoskeletal and mental health conditions.

This work has helped identify how absence duration varies by health condition, job role and worker characteristics, and how common health problems contribute to working days lost.

Understanding these patterns is essential for designing targeted workplace interventions, supporting return to work and improving workforce planning.

Predicting job loss

The group has also examined predictors of delayed return to work and job loss among people off sick.

This includes research developing tools to identify workers at higher risk of job loss, as well as systematic review evidence on predictors of delayed return to work or job loss in workers with respiratory ill-health.

This work supports earlier identification of workers who may need additional support to remain in employment.

Why this matters

Sickness absence and return to work are not simply administrative issues. They are major occupational health, public health and labour-market issues.

Early, supportive occupational health intervention can help prevent unnecessary work loss, reduce the duration of absence, and support workers to return safely and sustainably.

This work contributes to evidence-informed sickness absence management, return-to-work practice and workplace policy.

Key themes

  • Sickness absence management
  • Early occupational health intervention
  • Return to work
  • EASY: Early Access to Support for You
  • Telephone-based sickness absence support
  • Musculoskeletal conditions and sickness absence
  • Mental health conditions and sickness absence
  • Prediction of job loss
  • Delayed return to work
  • Respiratory ill-health and employment
  • Sustainable work participation
  • Workforce retention

Selected publications

  1. A novel approach to early sickness absence management: The EASY (Early Access to Support for You) way
    Demou, E., Brown, J., Sanati, K., Kennedy, M., Murray, K. and Macdonald, E.B. (2016). Work, 53(3), pp. 597–608.
    https://doi.org/10.3233/WOR-152137
  2. The EASY (Early Access to Support for You) sickness absence service: a four-year evaluation of the impact on absenteeism
    Brown, J., Mackay, D., Demou, E., Craig, J., Frank, J. and Macdonald, E.B. (2015). Scandinavian Journal of Work, Environment & Health, 41(2), pp. 204–215.
    https://eprints.gla.ac.uk/102196/
  3. Effectiveness of very early workplace interventions to reduce sickness absence: a systematic review of the literature and meta-analysis
    Vargas-Prada, S., Demou, E., Lalloo, D., Avila-Palencia, I., Sanati, K.A., Sampere, M., Freer, K., Serra, C. and Macdonald, E.B. (2016). Scandinavian Journal of Work, Environment & Health, 42(4), pp. 261–272.
    https://eprints.gla.ac.uk/119752/
  4. Evaluating sickness absence duration by musculoskeletal and mental health issues: a retrospective cohort study of Scottish healthcare workers
    Demou, E., Smith, S., Bhaskar, A., Mackay, D.F., Brown, J., Hunt, K., Vargas-Prada, S. and Macdonald, E.B. (2018). BMJ Open, 8(1), e018185.
    https://eprints.gla.ac.uk/152295/
  5. Predicting job loss in those off sick
    Wilford, J., McMahon, A.D., Peters, J., Pickvance, S., Jackson, A., Blank, L., Craig, D., O’Rourke, A. and Macdonald, E.B. (2008). Occupational Medicine, 58(2), pp. 99–106.
    https://doi.org/10.1093/occmed/kqm141
  6. Predictors of delayed return to work or job loss with respiratory ill-health: a systematic review
    Peters, J., Pickvance, S., Wilford, J., Macdonald, E. and Blank, L. (2007). Journal of Occupational Rehabilitation, 17(2), pp. 317–326.
    https://eprints.gla.ac.uk/120817/