Staff at Western General Hospital in Edinburgh receive the Covid-19 vaccine. Before the pandemic, in 2019, an NHS staff survey found 57 per cent had gone to work in the previous three months despite not feeling well enough to perform their duties © Andrew Milligan/Reuters

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The events of 2020 have made us question things we used to take for granted, from why we used to commute daily to the office, to whether it was smart to depend so much on Google. Matt Hancock, the UK’s health secretary, posed one such question last month: “Why in Britain do we think it’s acceptable to soldier on and go into work if you have flu symptoms or a runny nose, thus making your colleagues ill?”

The numbers back him up. The UK has one of the lowest sickness absence rates in the OECD. The proportion of working hours lost to sickness has declined steadily for two decades, while measures of “presenteeism” — working while sick — are on the rise.

Take the NHS, the UK’s biggest employer. The 2019 staff survey, which drew more than 500,000 respondents, found 57 per cent had gone to work in the previous three months despite not feeling well enough to perform their duties. Even before the Covid-19 pandemic, the danger of staff with infectious bugs interacting with vulnerable patients should have been clear.

Mr Hancock’s question may have been rhetorical but it deserves an answer. One reason people “soldier on” is the country’s inadequate statutory sick pay, currently one of the poorest in the OECD. A less visible explanation is the punitive approach that some employers take to managing sickness absence and, underpinning that, a simple mathematical formula with mysterious origins and dangerous consequences: the “Bradford factor”.

No one knows for sure where the Bradford factor came from. HR folklore sources it to a pharmaceutical company in the 1980s whose managers attended a seminar at the Bradford University School of Management (Bradford University didn’t reply to my questions about it). It is based on the assumption that frequent, short-term absences are more problematic for organisations than longer-term ones. The formula is S-squared x D, where S is the number of spells of absence in the last year, and D is the total number of days of absence in that year. If one employee is off for 14 days in a row, and the other is off for seven two-day spells, their Bradford scores would be 14 and 686 respectively.

Use of the Bradford factor is relatively common, especially in the public sector. It has spread as far afield as Dubai and New Zealand. It’s easy to see the appeal of a quasi-scientific metric that treats everyone the same and allows comparisons across teams. Stephen Bevan, head of HR research development at the Institute for Employment Studies, says the scores can be a useful early warning flag for problems such as depression. “But in the wrong hands,” he adds, “it’s toxic.”

Some employers use Bradford scores to rank people for redundancy. Many use them as “trigger points” to manage their absences. The Rotherham, Doncaster and South Humber NHS Foundation Trust, for example, states that employees must keep their Bradford score below 80, or enter a “monitoring stage” where they are reminded that “continued absence” could “potentially put their continuation of employment at risk”. They must then keep their Bradford score below 10 for a certain period. Nicola Hartley, director of people for the trust, told me that adjustments were made for employees with a recognised disability and that managers used flexibility and compassion.

These tools may dissuade shirkers but they can also scare the genuinely sick into going to work. Jean Fisher, an occupational health nurse who runs a consultancy in Wales, has had people tell her they are “frightened to go for their hospital appointments because they’ll get more [Bradford] points and they’ll be disciplined”. These are often older workers with back, heart or lung problems, especially if they’ve had a “heavy life of work” in factories. People with disabilities are protected by law, but she says many don’t dare pick a fight.

David D’Souza, of CIPD, the UK professional association for HR staff, hopes the pandemic has jarred companies out of their old mentality towards sickness. “People haven’t been talking about absence triggers, quite often the opposite, they’ve been talking about making sure people aren’t overly present,” he says.

Infectious diseases aside, punitive sickness policies are not fit for the future. The proportion of the working age population aged between 50 and the state pension age will increase from 26 per cent in 2012 to 34 per cent in 2050. Almost half of people aged between 50 and the state pension age have at least one long-term health condition. Employers need to learn how to adapt and support staff with health problems, not pressure them to work through the pain or push them out of the door.


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