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Supporting employees back to work

In the Northern Ireland Civil Service, over 70% of absence days are due to staff on long-term sick (absences lasting 20 working days or more). Using behavioural insights, the Lab designed a new suite of letters to support employees when they go off sick. The letters reject traditional formal approaches of absence management in favour of empathy, clarity, and empowerment. Both line managers and staff feel the letters are a huge help in providing the support they need when off sick.

Innovation Summary

Innovation Overview

How can organisations support employees to return to work after illness or injury?

In the Northern Ireland Civil Service, over 70% of absence days are due to staff on long-term sick (absences lasting 20 working days or more). In addition, over 40% of those long-terms absences are due to Mental Health Illnesses. If each person on long-term sick came back to work only 4.3 working days sooner, the Northern Ireland Innovation Lab worked out that they could reduce the overall average working days lost by 5%, generating a paybill savings of £1.6m. The Innovation Lab worked with Human Resources (HR) to redesign the letters sent to staff off sick in order to better support them and to remove any bureaucratic barriers to a timely return-to-work.

Traditionally, the language used in HR letters is often frightening, anxiety-provoking, and not empathetic to the person recovering from illness. There is a focus on ‘policy triggers’, dismissal, and legal language designed to intimidate and scare the employee back to work. The Innovation Lab heard stories from HR staff that on several occasions they have had to spend the first 20 minutes of a conversation calming down the member of staff, reassuring them they were not going to lose their job, and trying to explain the letter in a more empathetic way. We also heard stories from employees who received the letters while off sick about the impact the letters had on their mental health. The employee may have spent days worrying about the letter before they are even able to speak to HR, thus delaying even further a prospect of a timely return to work. There was an urgent need to revise the HR letters, and the Innovation Lab thought a behavioural science perspective could bring fresh and innovative thinking to their approach.

For each letter reviewed, organisers asked a few questions to start:
• Is this letter necessary? Is it the best form of communication?
• If so, what do they want people to do when the get this letter?
• How can the Innovation Lab make it as easy and clear for people to do what it is they want them to do?
• What do they want or need them to know? What is vital to know and what can they remove to an information sheet at the back of the letter?
• How will the member of staff feel when they receive the letter? Can they incorporate the empathetic language you use in a face-to-face meeting into the letter?

To design the letters, they used the Behavioural Insights Team’s EAST and MINDSPACE frameworks, a recent trial of an intervention designed to increase employee return to work, and CIPD guidance on the role of line management in the return to work.

Our main guiding value was compassion and empathy for the staff member off work. A return to work can be daunting for staff who have been off sick for a period of time. It’s vital to foster positive relationships, both to encourage a return to work, but also to create a safe, productive work environment.
The letters also focused on the following principles:
• Simplifying the content and messages
• Personalisation – removing references to case number in the “To” field and replacing the surname with first name
• Minimizing ‘legal speak’ and using plain language
• Framing all content in terms of “return to work” and “recovery” rather than “inefficiency” and “sickness”
• Making the design attractive and professional
• Adding structure with the use of headings, colour coordination, bullet points, chunking, and white space
• Consider the messenger: for each letter, we considered who was signing off the letter and what impact that may have. Where possible the messenger was a person, not just “HR”
• Removing potentially anxiety-provoking but important information from the main body of the letter, carefully making the wording as empathetic as possible, and incorporating the information into a separate “Information Sheet”.

The letters also emphasized themes of:
• Recovery, recovery plans and encouraging visualizing the steps needed to return to work
• Accountability of employee – clear emphasis on the steps, if any, that the employee needed to take to be sure they were complying with the policy
• Line manager as primary support mechanism
• Effective signposting of support services – putting all forms of support, including the option of phased-return, in a separate leaflet that could be attached to any letter. We removed hyperlinks to webpages (because all letters are printed and posted) and included phone numbers or email addresses to the services
• Encouraging staff member to seek social support on day one of return to work

The Lab also considered the impact of anchors and avoided the use of language that would anchor a member of staff in the identity of “someone on long-term sick.”

The letters were rolled out in June 2019 to one Department and, because of excellent feedback, will be expanded to all 9 Departments by the end of 2019. The Lab will be analysing sickness absence data to look at impact on return to work data in 2020.

Innovation Description

What Makes Your Project Innovative?

Traditionally, the language used in HR letters is often frightening, anxiety-provoking, and not empathetic to the person recovering from illness. There is a focus on ‘policy triggers’, dismissal, and legal language implicitly designed to scare the employee back to work. The Innovation Lab’s approach was human-centered and put the employee experience of illness and recovery at the heart of the letters. In addition, HR had not used a behavioural science approach to absence management before, and this approach allowed a concrete understanding of the behaviours required of the employee in order to return to work as well as all of the factors that could influence that behaviour. Behavioural Insights had also never been used in the HR letters. The Lab made use a many insights in the new letters (as described above).

What is the current status of your innovation?

The programme is in Implementation and Evaluation stages. The letters are being used in a couple of Departments so far and will be rolled out to all Departments by the end of 2019. Line managers have already given great feedback during workshops with HR – they have said that the letters set the tone that they try to achieve with staff which makes it easier to have those conversations with them. In addition, we are planning on analysing the sickness absence data over the course of the next few years to see if there has been any impact on return to work times. It will be difficult to isolate direct effects about the impact of the letters alone, however, because there have been other small changes to the absence management process like increased line management responsibility. But hopefully it will be possible to draw some conclusions when there is further data.

Innovation Development

Collaborations & Partnerships

The Lab worked very closely with Human Resource Professionals in the Civil Service who have expert knowledge of the absence policies and procedures which was vital to the success of the project. They also got feedback staff and staff who have line management responsibility in order to get feedback on the letters. The Lab also worked with Solicitors, Trade Union Staff and Employee Relations Staff to get feedback on the legalities of the process.

Users, Stakeholders & Beneficiaries

With clear, concise, and empathetic communications, employees better understand what is asked of them and feel supported in taking those actions. Line managers can feel confident that the letters sent to their staff better represent their views and their relationship with their staff will be less likely to be adversely affected. The organisation as a whole benefits from reduced absenteeism if staff face fewer barriers when returning to work and are able to return when they are ready.

Innovation Reflections

Results, Outcomes & Impacts

To evaluate the impact of the letters before sickness absence data was available, the Lab ran a “lab experiment” with staff in the NICS in order to understand the clarity of the letters as well as to try to gauge the emotional response to the letter. During the experiment, organisers asked staff to read a scenario and imagine themselves in it. The Lab then gave some staff the standard letter, some the revised letter, and asked everyone to complete some surveys. They found that staff who read the new letter felt significantly more empowered and supported and less guilty than staff who read the standard letters (t-test; p<0.5). Though not all differences in emotions were statistically significant, all negative emotions were rated lower and positive emotions were rated higher for the new letter compared to the standard letter. Also staff found the new letters clearer to understand and felt more empathy from HR about their 'situation'.

Challenges and Failures

1. Initial acceptability: the Innovation Lab pushed the project onto HR staff, trying to convince them there were things we could improve to create a better experience for employees when they were off sick. The initial pitches did not go well and we struggled to get buy-in. Only after they did a prototype of a brand-new letter, and found someone who was willing and keen to work with them, did they start to gain traction. Now the head of HR loves the work they have done.
2. Complexity of policy: the absence management policies in the civil service are complex and the wording had to be exactly right. The Lab were reliant on policy experts to help with the intricacies.
3. Needs of different groups: Trade Unions, Solicitors, and Employee Relations staff all had different priorities that we had to account for. The Lab had to make compromises between, for example, wanting to reduce the length and complexity of letters and including enough legal/policy info to satisfy everyone.

Conditions for Success

1. Existing structures: the infrastructure allowed us to modify the letters without too much hassle
2. Leadership buy-in: Senior-level support is vital and means the innovation won’t be shut down at a later stage.
3. Right level of control: It is crucial to work closely with the project manager who can make decisions and is responsible for rolling out the new approach.
4. Good working relationships: as above, so much is about the people you are working with and the positive working relationships that are developed.
5. Excellent policy knowledge: you need to have someone on board who knows the subject area inside and out.
6. Personal values: The project team had a deep desire to improve the experience for staff who go off sick. They had years of experience under the previous system and wanted to do as much as possible to bring a fresh, empathetic approach to the absence management process.


The format and thinking behind the letters has been replicated into other HR forms, done by HR themselves. In the Innovation Lab, we have used the same principles and the same behavioural science approach to redesign other letters for other agencies for different purposes: for example, we redesigned a letter to prompt people who had gone into arrears to make a payment. The letter generated over 1.2m in recovered arrears payments.

Lessons Learned

A ‘behavioural’ approach allows complex problems to be broken down into manageable chunks – in other words, by focusing on an individual’s behaviour (“What do you want them to do next?”), the communications you use with that person become more straightforward.

Finding the right people to work with is critical. You need people who have direct responsibility for the work area and who can make the required changes.

There is a significant amount of work required in redesigning a suite of letters. Almost every single line in each letter had to be considered from the legal and policy perspective. Do not underestimate the time required in a ‘simple’ letter!

It’s vital to speak to the people directly affected by the letter or policy that you are trying to improve. Put yourself in their shoes and try to understand their pain points and barriers to action.

Changing letters is a step towards changing culture. By changing the tone and messaging your company delivers, you change how people engage with you and how your staff engage with each other. Letters are also a physical artefact of a policy – and because it may be the only physical representation of that process it’s important to get it right.

Year: 2019
Level of Government: National/Federal government


  • Implementation - making the innovation happen

Innovation provided by:

Date Published:

4 January 2021

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