Attendance Management / Sickness Absence Management Practice Guidance Note Managers Guidelines - Attendance / Sickness Management V02

Transcription

1 Attendance Management / Sickness Absence Management Practice Guidance Note Managers Guidelines - Attendance / Sickness Management V02 Date Issued Planned Review PGN No: Issue 1 May 2014 May 2017 ASM-PGN-01 Author / Designation Responsible Officer / Designation Part of NTW(HR)10- Attendance Management / Sickness Absence Management Policy Elaine Kelly Case Management Officer Jacqueline Tate Case Management Advisor Contents Section Description Page No. 1 Introduction 1 2 Aim 1 3 Why do Managers have to Monitor and Manage Sickness Absence 1 4 Manager s Role 1 5 Sickness and Annual Leave entitlements and Bank Holidays 3 6 The role of Workforce Department 4 7 Preventing Absence 4 8 Reporting Absence 4 9 Keeping in Touch 5 10 Submitting Medical Certificates / Fit Notes 5 11 Short Term / Sporadic Absence 6 12 Attendance at Meetings 6 13 Time off for Appointments 7 14 Overtime and Attendance 8 15 Who is Responsible? 8 16 Equality Act 9 17 Dismissal due to Capability Final Review Meeting Temporary Injury Allowance (TIA) Permanent Injury Benefit (PIB) Further Information 15

2 1 Introduction 1.1 These guidelines have been written to be used in accordance with (the Trust) Policy, NTW(HR)10 - Attendance Management / Sickness Absence Management. They are designed to positively manage and promote good attendance within the organisation creating a workplace that is healthy and productive. 2 Aim 2.1 The aim of these notes and the accompanying policy is to maintain wellbeing in the organisation, reducing levels of absenteeism caused through illness. They are designed to promote the services that the Trust have in place to support staff when they encounter problems attending work, including domestic and childcare problems. 2.2 The guidelines have also been developed to promote a culture of attendance across the organisation and for those staff who may abuse the policy the guidelines will assist managers in being able to quickly and effectively manage those employees, therefore freeing capacity to continue with proactive management as opposed to reactive. 3 Why do Managers have to Monitor and Manage Sickness Absence? 3.1 The NHS has a high sickness absence rate. This is very expensive and also puts extra pressures on those that are left to provide cover and impacts on the level of service that we can provide to our community. 3.2 In recent years health and healthy living have become increasingly important issues both in society and the workplace. It is also widely recognised that where staff have difficulty in finding a balance between their work and home responsibilities this will have an adverse effect not only on their ability at work but also their general health and well being. 3.3 You are best placed to manage any sickness absence in your ward / department / team. You should ensure your staff is not placed at undue risk from stress, accidents or violence at work and that they have a healthy work / life balance. You should also take action to reduce any abuse of the sickness system. 4 Manager s Role To report staff absent on the day absence begins via Workforce Sickness Reporting System and to report them back at work on the day sickness ends; To maintain contact with the absent member of staff and to establish the reason for sickness and likely duration of absence. 1

3 4.1 As a manager it is your responsibility to proactively manage the sickness absence of your team ensuring the timescales outlined in the Sickness policy are adhered to. For example; referral to Occupational Health after 14 days, whilst ensuring that accurate records relating to sickness absence are maintained. 4.2 To promote the services that are available across the Trust that can help employees when they have problems; you should familiarise yourself with the Occupational Health service provided by Team Prevent and counselling and information services provided by Care First as well as childcare services and improving working lives initiatives. 4.3 To be aware of the Trust s NTW(HR)11 - Flexible Working Policy and what options are available to staff should the need arise for flexible working. 4.4 To familiarise yourself with the Trust s NTW(HR)12 - Stress at Work Policy and ensure that you are being proactive in your application of it in your own areas. 4.5 To ensure full compliance with the Trust s NTW(HR)10 Attendance Management / Sickness Absence Management and that it is adhered to at all times by all staff within your area of responsibility. 4.6 To develop robust systems for recording absence in your area and holding return to work meetings after every occasion of absence in a timely manner i.e. on first day back at work. 4.7 Return to work documentation must be retained by the manager this documentation is not to be sent to Workforce and should not be used in place of absence return forms. 4.8 To regularly communicate with staff through team meetings the levels of absenteeism in your area in a statistical format and the impact this has on the Trust s ability to meet targets and standards of patient care. 4.9 To raise and explain the problems caused to the service unplanned / sporadic absence has To praise those staff with good attendance records To attend relevant training programmes i.e. Workforce Policy Training To meet the targets set out in the Workforce Strategy (see below) To be mindful of confidentiality when accessing reports in relation to employees absence within the Trust Complete short term sickness pro forma each month Meet with staff who hit the three in twelve rolling sickness target, set targets as appropriate, issue warnings as appropriate when target not met. 2

4 4.16 Act on guidance in fit notes. 5 Sickness and Annual leave entitlements and Bank Holidays 5.1 Bank Holidays If an employee is on sick when a bank holiday falls, they are not entitled to claim the bank holiday back. Paragraph 14.8 Agenda for Change Handbook. 5.2 Contractual Leave If an employee has a number of episodes of absence in a twelve month period, they will accrue the amount of contractual leave for that leave year as specified in their Contract of Employment if they return before the leave year ends. They may carry forward a maximum of five days into the next leave year with the agreement of their manager. 5.3 Statutory Leave Employees are entitled to accrue, and take, statutory leave i.e. 28 days, during periods of sick leave Untaken statutory leave can be carried over from one leave year to the next in line with current case law. An employee wishing to carry over statutory leave from one leave year to the next must request this in writing no later than the 31st March An employee on half pay or no pay wishing to take statutory leave during a period of absence must make a written request to their manager and stipulate that this part of their absence should count as holiday. Employees should note that if in receipt of Temporary Injury Allowance, payment will be a maximum of 85% of earnings Managers must complete a Change of Circumstances Form which confirms the period of paid leave being requested from start to end and confirmation that the period of sick pay entitlements are not extended by this process Similarly employees should give notice of their intention to defer taking their statutory leave until a later date Please note, this is a complex area of employment law which is subject to regular changes. Please contact the Case Management Team in each case for the most up to date advice. 3

5 6 The Role of the Workforce Department 6.1 The Workforce Department is there to provide advice and best practice when managing absence cases ensuring that the Trust complies with legislation. 6.2 For more complex cases the Workforce Department s Case Management Team will assist with any cases that are: Linked to a disciplinary matter; Four months or less from sick pay entitlement ceasing; Short term sickness cases where a warning may be issued or an appeal against a warning is received. 7 Preventing Absence 7.1 There are a number of different ways that you as a manager can prevent absence within your team. The most effective way of prevention is to ensure that you know your staff. If you have a good relationship with your staff and you understand what responsibilities they have in their lives you will be able to plan for these problems before they become an issue. 7.2 You should also know the policies and procedures that are in place within the Trust to provide support to your staff such as stress, flexible working and the various types of leave that can be taken to assist staff with domestic, childcare or personal situations such as bereavement. 7.3 Special leave is there for a reason and should be used accordingly where there is a requirement for it. In some cases where you as managers do not use the provisions available to support a member of staff this can lead to unnecessary sickness absence. 8 Reporting Absence 8.1 All of your staff should be aware of the process for reporting absent for work, for new starters this process should be explained as part of their local induction. It is not acceptable for staff to leave messages for the manager / nurse in charge or to be using communication methods such as text. Staff should be informed that they need to speak to the manager / deputy before the start of their shift. They should explain their reason for absence and an expected date of return. Staff should be aware that they should ensure you are regularly communicated with so that you can plan for their absence and the running of an effective service. 8.2 As a manager you should therefore develop your own local protocol for reporting absence and ensure all members of staff within your ward / department are familiar with it and adhering to it. 4

6 8.3 For those staff that attend for work and are deemed unfit to remain at work this will not be recorded as absence unless the nonattendance runs beyond the first day. Staff who go home or are sent home due to sickness should still be met with upon their return for a return to work interview, and managers should raise any concerns if this happens on a number of occasions with the member of staff. 8.4 If a trend or pattern starts to appear the sickness policy can be invoked using the short term / sporadic absence procedure. 9 Keeping in Touch 9.1 If any member of staff does not keep in touch as they are required you should contact them. It is important that you are kept up-to-date with a member of staff s absence and staff should be reminded that their compliance with the policy is important. For those staff absent longer term the manager should agree with the employee the frequency and method of communication. 9.2 In some circumstances where the member of staff has failed to make contact for a period of time you should make every effort to get in touch with them to offer support, if you are not able to do this you may need to write to the employee at their home address asking them to make contact. Failure to make contact may result in the member of staff being recorded as unauthorised absence and in some cases disciplinary action may be taken. Workforce advice must be taken in these situations. 10 Submitting Medical Certificates / Fit Notes 10.1 It should be noted that self certification is not required until day four of the absence and medical certificates / fit notes from day eight. Submitting medical certificates / fit notes to cover absence of more than seven days is essential to a member of staff receiving their sick pay. Staff should be reminded of the importance of submitting certificates timely and the possible consequences of not doing so. As above every effort and opportunity should be given to staff to submit their certificate on time, however if the member of staff fails to comply with this it may result in their pay being withheld and possible disciplinary action. Staff are responsible for making managers aware if they are having problems accessing their GP Fit notes with recommendations and / or adjustments should be seriously considered and where appropriate put into place. On occasions where a member of staff is able to return to work albeit with adjustments every effort should be made to accommodate this. Where the adjustments cannot be facilitated in the normal workplace / team then managers should inform their line manager who can liaise with colleagues from across the group / Trust to accommodate the member of staff in alternative workplaces. 5

7 10.2 In circumstances where a fit note / medical certificate is not received on time the member of staff should be written to with a date of no more than five days time for the medical certificate / fit notes to be received. If the certificate is not received by this date sick pay will cease and the employee will be notified of this in writing If following the cessation of sick pay the certificate is subsequently received sick pay will be reinstated but will not be backdated and will only commence from the date the certificate was received. In cases where a member of staff is required to provide continuous cover of medical certificates, any gaps will result in pay being withheld until the certificate is received. 11 Short Term / Sporadic Absence 11.1 You should not allow a culture of short term / casual absence to develop in your area. This type of absence causes huge problems to be able to deliver effective services and has a huge impact on those staff required to provide cover for the absent person After every occasion of absence regardless of whether it was for one or seven days the employee should be met with upon their return to work. These meetings are known as return to work interviews. The aim of these interviews is to quickly determine if there is an underlying problem, and if so seek the right support for the member of staff to try and prevent the absence from requiring formal intervention in accordance with the policy. Where there is not an underlying reason the interview should be used as an opportunity to reiterate the standards of attendance that is expected from the individual. These meetings should be treated as a confidential meeting and held in an appropriate room where there will not be interruptions. In most cases the meeting will be conducted by the manager but in cases where they are not available the deputy should conduct the meeting. Managers should be mindful of male / female issues and that it may be appropriate in some cases for an alternative person to meet with the member of staff Employees will not be given the opportunity to be accompanied at these meetings by staff side or a colleague Return to work forms should be completed at every interview with the employee and retained by the manager. 12 Attendance at Meetings 12.1 Staff are obliged under their terms and conditions of employment to attend meetings that have been arranged for them by the Trust, this includes meetings to discuss absence and occupational health appointments. Staff that fail to attend such meetings should be reminded of their obligation. 6

8 In some circumstances, however, the member of staff may not be able to attend due to their health, in these cases alternative methods of communication should be identified and alternative venues should also be considered such as meeting at their home Occupational Health appointments are also covered under an employee s terms and conditions and it is not acceptable for employees to fail to attend appointments or re-arrange on numerous occasions. As managers you should ensure time is given to attend appointments or telephone consultations and address issues of re-arranged appointments of more than one occasion. It should also be noted that staff are not entitled to be accompanied at Occupational Health appointments by staff side representatives Employees who do not attend for meetings or Occupational Health appointments arranged for them by the Trust or make contact to advise why they are unable to attend will be written to twice giving them the opportunity to attend the arranged meeting. If after the second letter the employee still fails to attend then disciplinary action will commence and the employee will be written to advising them of this decision Case Management advice should be taken in these circumstances As a Line Manager you should be monitoring and taking action to reduce any excessive stress on your staff. The Stress at Work Policy gives you more information on how to assess and tackle work related stress. 13 Time off for Appointments 13.1 There are occasions where staff will require time off to attend GP and Dentist appointments. As a general rule those staff that work a flexi or time owing system should use flexi leave to attend these appointments. In all other cases staff should try to make the appointments as close to the start or the end of their working day to minimise disruption. Staff will be required to make the time back for these appointments In the situation where a member of staff is required to attend for a hospital appointment, this should be discussed with the line manager. For appointments that relate to the employee themselves pertaining to treatment or investigation managers should try to accommodate the release of the member of staff. In these circumstances staff will not be required to make time back, however, must produce evidence of appointments. For appointments that are not compulsory to attend such as volunteered cosmetic procedures leave should be used or an arrangement to make the time back should be agreed. Special leave would not apply for appointments for dependents other than in an emergency situation. 7

9 There are some instances where following a period of absence i.e. after surgery attendance at hospital is still required. Employees should discuss these circumstances with their line manager and where possible and within reason staff will be able to attend for these appointments without using annual leave. However, should the time required for the appointments be deemed unreasonable arrangements to use annual leave or make the time back should be put in place. 14 Overtime and Attendance 14.1 There have been situations where a member of staff s attendance is cause for concern but yet the staff member continues to work overtime shifts and / or bank shifts In this case it may be that overtime and bank shifts should be ceased until the member of staff can improve their level of attendance. This course of action should be discussed with the member of staff before any action is taken and an agreed timescale should be put in place to review progress Managers must remember that where this course of action is implemented then they should ensure communication with the Bank Co-ordinators and colleagues who book the member of staff concerned for shifts. 15 Who is Responsible? 15.1 There is no longer a requirement for different levels of management to carry out different parts of the procedure. For example, the Ward Manager who deals with stage one of the sickness procedure can see it all the way through to stage three where dismissal may be the outcome. Managers should keep senior managers appraised throughout all stages of the process and have case management involvement at stage three of the process The only time the level of management will change will be when a member of staff has failed to comply with the sickness policy and this results in the case being heard at a disciplinary hearing in which case the manager will present to a panel with the chair being of the appropriate level to apply the relevant sanction in accordance with the trust s disciplinary policy Managers are responsible for the arrangements of meetings under the sickness policy and for any correspondence to Occupational Health and the employee. Case Management will provide advice on the content of any documentation produced. In supporting managers with long term sickness cases in which employees are approaching a no pay situation in the following four months, Case Management, will produce letters to employees in conjunction with Managers. Managers should ensure that they obtain information on full and half pay expiry dates where appropriate before the meeting. 8

10 15.4 Managing sickness includes helping an employee who may need support either to prevent them from having to take sickness absence in the first place or easing them back into work when they have been away. 16 Equality Act 16.1 The Equality Act is the most relevant piece of legislation when dealing with cases related to ill health. The Act is there to protect staff from being discriminated against on grounds of disability and the definition of a disability is an illness or impairment that affects the individual on a day to day basis. This includes hearing / visual problems, cancer, MS and some mental health conditions As a first step it is important that staff are asked what adjustments they think would help them in the workplace Serious consideration must be given to suggested adjustments. Occupational Health advice should be sought when dealing with members of staff who potentially fall under this definition and reasonable adjustments, including redeployment, should always be considered before reaching a decision about the person s employment with the Trust. See Trust s NTW(HR)10 Attendance Management / Sickness Absence Management Appendix 5 Equality Act 2010 Check List for Reasonable Adjustments Examples of reasonable adjustments could be changing the place of work; modifying equipment such as telephones for those with hearing problems; specialised computer monitors for those with visual impairments etc In cases where modifications need to be made to a person s role to enable them to continue in employment help and financial assistance can be obtained from the Trust s Equality and Diversity Manager and the Disability Employment Adviser who can be contacted via Job Centre plus. Managers dealing with staff under this process should always seek the advice from the Workforce Department Should there be a reason why certain adjustments cannot be made, managers must ensure that their rationale for not agreeing to these suggested adjustments is well documented If, after full consideration of all possible options, redeployment to a suitable alternative role is not possible within the home service, then managers must consider and discuss with Service Managers across the Trust, the possibility of identifying a suitable post in other service areas Absence for reasons of disability should also be dealt with differently in terms of the short term process, this should also be applied to women who are pregnant and cannot prevent being absent due to their condition Case Management should be contacted in these situations. 9

11 17 Dismissal due to Capability 17.1 Unfortunately there will be cases where a member of staff will not ever be well enough to return to the organisation. In these cases Occupational Health advice will have been sought and all avenues explored in terms of trying to find the member of staff alternative work and making reasonable adjustments to the person s role When this has been exhausted and there is no alternative than to dismiss the member of staff on grounds of capability due to ill health the manager terminating the employee s employment should ensure that the employee is fully aware of the Ill Health Retirement Scheme and any other provisions the Trust / pensions agency offer people in this position The termination itself will not be delayed whilst waiting for a decision as to whether or not the employee has been granted ill health retirement as the Trust has no influence over this decision at all. This decision lies with the NHS Pensions Agency and the Case Management Officer supporting the manager will request the appropriate forms on behalf of the employee. The Trust s obligation in this situation is to make the employee aware of the scheme and to try and facilitate the smooth application for the employee, assisting where required Employees have a responsibility to keep as healthy as possible through maintaining a healthy lifestyle and assisting with the promotion of a healthy working environment. 18 Final Review Meeting 18.1 Under Agenda for Change terms and conditions employees are entitled to a final review meeting before they go into a no pay situation. If this meeting is not arranged before their pay ceases the employee may be entitled to have their half pay reinstated, provided the employee can demonstrate that attempts to hold a final review meeting have not been made by the Trust. Reinstatement of half pay will continue until the meeting has taken place and a decision about how to proceed has been made i.e. whether the employee will return to work or not. The outcome of the final review meeting should be to reach a decision about whether the employee will return to work. See Annex Z of Agenda for Change Handbook Managers should be aware that staff are entitlement to different amounts of sick pay dependent upon the number of years service they have and should therefore familiarise themselves with the dates in which their staff s pay will be affected. 10

12 19 Temporary Injury Allowance (TIA) /Permanent Injury Benefit (PIB) Temporary Injury Allowance 19.1 TIA is payable to staff who are or have been absent from work on reduced pay or no pay as a result of being injured which is wholly or mainly attributable to their employment. Such examples of situations when TIA may be paid include: An injury sustained on duty due to a specific incident (e.g. falling off a ladder, attacked by a patient); An injury sustained on duty due to a series of incidents; An injury sustained whilst travelling on official duty (e.g. RTA whilst travelling in a car from one hospital to another). This does not include sick leave as a result of an RTA on a normal journey to and from work; A disease contracted on duty; A psychiatric injury (for example stress) as a result of being attacked at work or through overwork or employers negligence. This does not include stress related sick leave wholly or mainly attributable due to investigation or disciplinary action TIA tops up the employee s income to 85% of the average earning they were receiving prior to their pay being reduced as a result of the injury. This is subject to Tax deductions, but not NI and Pension Entitlement to TIA for staff employed by Northumberland, Tyne and Wear NHS Foundation Trust will decided by the Trust. This decision must be made by someone of a Service Manager level (or equivalent) or higher Should an employee wish to apply for the payment of TIA, then Form TIA1 within the Trust s NTW(HR)10 Attendance Management / Sickness Absence Management (Appendix 8) should be used. The employee will complete part A, which sets out their reasons for claiming TIA, before sending this an appropriate officer of the Trust (as stipulated above) who will complete part B. Form TIA1 can be obtained from the Workforce Department or Trust intranet page Before signing part B the Service Manager (or appropriate officer) should then complete an investigation into the incident within 30 days of receiving the TIA1 form, and obtain copies of incident form, any witness statements and Occupational Health opinion etc when making decision. The Workforce Directorate will be able to provide advice and guidance on request. 11

13 19.6 Should the appropriate officer take the decision that it is appropriate for TIA to be paid, they must sign the declaration at the bottom of part B which states they support that application, and forward this to the Workforce Directorate, who will countersign and forward to Payroll Services for action. By signing the declaration at the bottom of form TIA1 to say you support the claim for TIA, you are agreeing that TIA can be paid to the employee in question and that the evidence you have found supports the claim by the employee that they were injured in a way that is wholly or mainly attributable to their employment. The appropriate officer must then write to the employee using the template letter attached, TIALet1, informing them that that application for TIA has been successful. A copy of this letter should also be sent to the Directorate Support Team for the employee s personal file. Workforce will then add this person to a central log which can also be accessed by Health and Safety and the Incident and Claims Department Should the appropriate officer, following an investigation into the incident which must be completed within 30 days of receiving the TIA1 form, take the decision that it is not appropriate for TIA to be paid, they must sign the declaration at the bottom of part C which states they do not support that application. By signing the declaration to say that you do not support the claim for TIA you are indicating that there is insufficient evidence to support the claim that the employee was injured in a way that was not wholly or mainly attributable to their employment. The appropriate officer must then write to the employee using the template letter attached, TIALet2, informing them that their application for TIA has been unsuccessful. This letter will detail the appeal process to the employee. A copy of this letter should also be sent to Workforce for the employee s personal file Following receipt of TIALet2, should the employee wish to appeal this decision they must write to the NHS Pension Agency, enclosing the original claim form and associate documentation (i.e. TIA1, copies of Occupation Health forms etc from the original investigation, to the NHS Pensions Agency. A copy of this letter must be sent to the Directorate Support Team in the Department of Workforce and Organisational Development for the employee s personal file. 20 Permanent Injury Benefit (PIB) 20.1 Permanent Injury Benefit is available to NHS staff who suffer a permanent reduction in their earning ability from employment of more than 10%. It can be paid if the number of hours the employee can work is permanently reduced; if they have to change to a lower paid job; or if they have to leave their NHS employment. It is not payable if the permanent reduction in the employee s earning ability is 10% or less. The allowance is intended to top up the employee s income to a percentage of their average pay, dependent on length or service and the permanent reduction in earning ability. 12

14 20.2 The NHS Pensions Division administer and make decisions about an applicant s entitlement to PIB, in conjunction with its Occupational Health Advisers. Assessment of earning ability since the illness / injury is based on evaluation by the Scheme s Occupational Health Advisers of the applicant s capability for work in the general field of employment To have a successful claim for PIB, the NHS Pensions Division must satisfy themselves that two criteria have been met by the applicant: They must be suffering from an injury or disease whose cause is wholly or mainly attributable to their NHS employment; They must have suffered a permanent loss of earning ability of more than 10% Applicants need to make their application on form AW13, which is available from employers. Part of the form is completed by the employer and part of it by the applicant. Applications can be completed whilst an employee is still employed, but the outcome cannot normally be decided until they have left their NHS employment or moved to a lower paid job In calculating the annual PIB allowance due to a successful claimant, the NHS Pensions Division are required deduct annual income applicants may be getting from pensions (NHS, SERPS or any other public or private sector pension scheme), from a range of specific social security benefits and from compensation claims As a result, there are some people who may have a successful claim for PIB but, because of income received from other sources, they will receive no actual payment from the Scheme. This does not mean PIB will never be payable in these cases: if the applicant s condition deteriorates and with it their earning ability, or their income from a pension or social security payment stops, they can contact the scheme administrators for a review of the claim For more details on how this is calculated please visit the website payable/index.htm 20.8 Whilst employers can express an opinion as to an individual s entitlement to PIB they cannot deny an individual s right to apply for PIB In the course of a PIB claim the employer must provide the scheme administrators with the following information: The injuries sustained or the disease contracted (i.e. the condition) by the applicant, its treatment and prognosis; How it is connected to their NHS duties (i.e. what caused it); 13

15 How or whether the condition has caused a permanent reduction in earning ability Employers must include with the PIB application form copies of: All accident reports; All Occupational Health Department notes and records; Reports of any internal investigation connected with the claim; A full job description; Sick leave records. A full statement of events explaining what injury / disease the applicant is claiming for and the circumstances leading to the claim. Employers who do not support the claim must still provide a statement, and whatever information other information the scheme administrators require to process the claim Applicants are required to provide, on the application form, a statement explaining what happened, details of the illness / injury sustained and its effect on their ability to work and carry out daily activities. They are asked to check the information provided on the form by their employer and any other accompanying documentation, and to provide copies of all documents or reports in their possession that relate to their claim. These might include things like accident book records, DWP accident declarations or medical assessment papers, witness statements, GP or hospital records, compensation claims and any other evidence they think might be useful in supporting their claim The application form and supporting material will be passed to the Scheme s Medical Advisers who will assess the existence and effect of the injury or disease in the applicant s work. During this process the applicant may be asked for additional information / evidence which may include examination by an independent medical expert or functional analyst. The NHS Pensions Division, advised by their Medical Advisers will then decide whether the injury or disease claimed for is wholly or mainly attributable to the duties of the applicant s NHS employment and they will then be told if they have a successful claim for PIB Any payments awarded will usually be backdated to the start of the reduction in earnings or earnings ability. For those who remain in NHS employment on lower pay it will usually be from the start of the lower pay. For those who terminate their employment, it will be from the day after the termination of employment. 14

16 21 Further Information 21.1 For more information on the Attendance Management policy please contact: Case Management Team on Tel: