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Return to work following long term sickness absence: a comparative analysis of stakeholders’ views and experiences in six European countries

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Abstract

Purpose Return to work is a complex and challenging process which takes various forms in different contexts. The aim of this study is to explore and compare cross-country differences in stakeholders’ experiences and views on actors, policies and practices relevant for return to work after long-term sickness absence. The comparative exploration is done in six countries with various legislative backgrounds, welfare and social dialogue systems. Methods Using a purposive sample, six multidisciplinary stakeholders group discussions were conducted in six countries: Belgium, Estonia, Ireland, Italy, Romania and Slovakia. A total of 51 individuals comprised of social partners, policymakers or representatives of public bodies and patient associations participated. An interpretative phenomenological analysis was employed to derive the most important themes in the discussions. Results Five major themes emerged from the group discussions. A graphic model is proposed to emphasize the variety of frameworks and processes across countries. Conclusions The core part of the return to work process is the dynamic relation between legislation, stakeholders and practices, which is influenced by broader national and societal factors. The cross-country variation in legislations, stakeholders and practices can be understood as a continuum, from low to high structuring, development and comprehensiveness. Although social dialogue appears to have a role in return to work process with variation across countries, it is not always on top of the agenda of social partners.

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Data Availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

Notes

  1. The project ‘Negotiating return to work in the age of demographic change through industrial relations (REWIR)’ received funding from the European Commission during 2018–2020. For more details, see the project website: https://www.celsi.sk/en/projects/detail/64/.

  2. Developed framework, early intervention possible, but no emphasis on gradual RTW and limited coordination between actors. Return to work issues approached towards the end of sick leave.

  3. Less-developed framework, limited or missing coordination between actors, limited institutional support for RTW, no possibility for progressive return. Ad-hoc initiatives from employers when dealing with such employees, also ad-hoc initiatives from governmental and non-governmental agencies and organisations.

  4. Very limited framework for RTW, rehabilitation conditional on the disability status, no formal measures to facilitate RTW. Support offered to employers only targets the hiring of people with disabilities.

  5. At the time of writing this paper, there has been an ongoing process in the Irish system that would change the provisions on sickness leave allowance and the source of payment, which will likely have an impact on RTW (see Table 1 for details).

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Acknowledgements

This paper has benefited from the information collected from the roundtable discussions held during the REWIR project ‘Negotiating Return to Work in the Age of Demographic Change through Industrial Relations’ funded by the European Commission between 2019–2021 (REWIR project No. VS/2019/0075). Author Adela Elena Popa has also received research support through the project ‘The challenges of returning to work after chronic illness in Romania: barriers, facilitators and collaboration of stakeholders’ (RTW-CI), project code PN-III-P4-ID-PCE-2020-1384, delivered by Lucian Blaga University of Sibiu, with funding from Consiliul National al Cercetarii Stiintifice - Unitatea Executivă pentru Finanțarea Învățământului Superior, a Cercetării, Dezvoltării și Inovării (CNCS-UEFISCDI).

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Authors and Affiliations

  1. Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Bdul Victoriei, 10, 550024, Sibiu, Romania

    Adela Elena Popa

  2. European Trade Union Institute (ETUI), Boulevard Roi Albert II 5, 1210, Brussels, Belgium

    Mehtap Akgüç

  3. Beth Johnson Foundation, 64 Princes Road Parkfield House Hartshill, Stoke-on-Trent Staffordshire, ST4 7JL, Stoke-on-Trent, England

    Ziv Amir

  4. Institute for Labor Economics (IZA), Schaumburg-Lippe-Stra?e 5-9, 53113, Bonn, Germany

    Mehtap Akgüç

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  1. Adela Elena Popa
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Contributions

All authors contributed to the study conception and design. Data was collected as part of a larger study funded by the European Commission (REWIR project No. VS/2019/0075). Data analysis was performed by Adela Elena Popa, Mehtap Akgüç and Ziv Amir. All authors contributed to drafting sections of the paper. All authors read and approved the final manuscript.

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Correspondence to Adela Elena Popa.

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Popa, A.E., Akgüç, M. & Amir, Z. Return to work following long term sickness absence: a comparative analysis of stakeholders’ views and experiences in six European countries. J Occup Rehabil 33, 213–225 (2023). https://doi.org/10.1007/s10926-022-10066-3

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