FfW Bulgarian report (English language) - Fit for Work Europe

Interventions
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This requires employers to think beyond their statutory duty to address health and safety risks,
and to recognise that sickness absence management, effective return to work programmes
and rehabilitation are underlying principles for effective management (Waddell and Burton,
2006b). Much is dependent on raising awareness about how to manage the symptoms of
MSDs amongst employees and their managers, and ensuring that the latter have the skills and
confidence to support employees in work.
4.5.3 Line managers
Fear and anxiety associated with high workload, lack of autonomy and job insecurity can cause
muscle tension – a main cause of MSDs. When accompanied with poor line management
behaviour this association becomes more important (Tzenova and Velkova, 2008). With good
line management these psychosocial factors could be eliminated or at least reduced, thus
diminishing the risks of MSDs. The HSE Management Standards for Stress54 sets out helpful
guidance to line managers on reducing the risk of stress.
As well as the importance of line manager behaviour in preventing MSDs it is clear that the role
of line managers in early intervention is also crucial, both in work retention and rehabilitation.
Yet many line managers feel ill-equipped to manage long-term absence and incapacity. They
may find aspects of mental ill-health or chronic incapacity awkward and embarrassing to talk
about or confront, and are therefore unable to manage disclosure of ill health appropriately.
Additionally, managers may be concerned about challenging or asking for more information
about GP sick notes, making home visits or telephoning staff at home for fear of being accused
of harassment or falling foul of the law and landing themselves and their organisation in a
tribunal. They are also ignorant of, or uncomfortable with, the idea of rehabilitation. Bulgarian
legislation on health and safety at work is explicit about adapting the working conditions to the
individual ‘eliminating and reducing their harmful effects on his/her health.’ By law, employers
must therefore go beyond merely, ‘doing no harm’ to healthy employees and ensure that they
adapt working conditions, through rehabilitation so that they do not exacerbate a pre-existing
the health condition of an employee, regardless of whether it is work-related.
Given that MSDs are the most common work-related health problem, and the importance of
psychosocial factors in determining whether employees remain in work or return to it as soon as
they can, managers need to have the skills to deal with staff who have these health problems.
If managers do not intervene the costs to their organisation may be significant, particularly for
small and medium enterprises where the impact of absence on customer service, productivity
and business performance will be greater.
54 http://www.hse.gov.uk/stress/standards/
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