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SHIC Case: Botkyrka and Örnsköldsvik

During the fall of 2017, a pre-study was conducted in seven municipalities of Sweden. The purpose was to identify models for investing in preventive and early actions for better health and working environment for employees. The pre-study was conducted in collaboration with the Swedish Association of Local Authorities and Regions (SALAR), Lumell Associates, The European Investment Bank, Impact Invest Scandinavia, and Kommuninvest. Seven analyses were conducted in total.

In the analysis, a particularly vulnerable group was identified, with a large number of current and expected future sick-absence days. Additionally, the study identified large differences in the number of short-term sick-absence days between workplaces.

Figure 1: Sickness absence is equivalent to 54 700 full-time positions in areas such as school and home care


Figure 2: The risk group reemerges from year to year


Sick absence implies not only ill-health for the individual, but also challenges in terms of competence provision at the workplace, with large financial expenses as a consequence. Thus, there is substantial potential for decreasing sick absences and reducing costs in the municipalities by shifting the focus to preventive action.

Botkyrka and Örnsköldsvik are taking a holistic approach to develop a course of action to prevent sickness absences and to ensure health-enhancing workplaces. The actions are based on an extensive analysis of municipality sick-leave data, a thorough desktop analysis of current research on the subject, “good examples”, and interviews with employers, employees, and union representatives. The output is a model for a more proactive approach to decreasing sick absences caused by problematic working environments. RISE supports the work in collaboration with SALAR.

The project is carried out within the framework of social outcome contracts, including monitoring and measuring social and economic outcomes. The model tested in Botkyrka and Örnsköldsvik is unique as the municipalities themselves are financers of the project, with the finance department and the project owner in the municipalities as contract parties. The service providers, Aino Health in Botkyrka and Previa in Örnsköldsvik, are commissioned with outcome-based contracts in which the compensation depends on the outcome. RISE and SALAR act as intermediaries and support the implementation of the project.