Managing Sickness Absence

Transcription

1 Managing Sickness Absence Human Resources Policy No. HR31 Additionally refer to HR01 Equality and Diversity Policy HR06 Maintaining High Standards of Performance HR07 Disciplinary Policy for Doctors and Dentists HR09 Alcohol and Substance Misuse HR21 NHS Injury Benefits HR24 Maternity Leave HR29 Special Leave HR30 Annual Leave & Public Holidays HR32 Ill Health Retirement HR36 Disciplinary Procedure HR40 Employment of People with Disabilities HR47 Managing Exposure to Blood Borne Viruses HR48 Managing Staff with MRSA HR65 Occupational Health Service HR66 Staff Counselling Service HS01 Health and Safety policy HS03 Accident & Incident Reporting Policy HS13 Stress Management Policy and Risk Assessment Procedure NHS Employers Mental Health and Employment in the NHS This policy should be read in conjunction with Managing Sickness Absence Guidance Notes for Managers Version: V2.10 Originally issued August 2010 Approved by TNCC Date approved June 2012 Ratified by: Date ratified: Document lead Lead Director Date issued: Date of Next Review Target audience: Trust Board Deputy Head of HR - Workforce Workforce Director TBC All Staff, managers Page 0

2 Version Control Sheet Author/Contact: Keith Hudson, Deputy Head of HR - Workforce Document ID HR31 Version 2.9 Status DRAFT Date Equality Impact Assessment completed Issue Date Review Date Distribution Key Words Dissemination Please refer to the intranet version for the latest version of this policy. Any printed copies may not necessarily be the most up to date Staff Quarterly Update; HR pages on intranet; HR Centre reports Version history Version Date Author Status Comment 1 Aug 10 Liz Walton Final 2.0 Sept 10 Keith Hudson Draft Revision of policy following establishment of absence targets by Strategic Health Authority 2.1 Nov 10 Keith Hudson Draft Further amendments following TNCC Working Party 2.2 Dec 10 Keith Hudson Draft Further amendments following TNCC Working Party 2.3 Feb 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.4 March 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.5 April 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.6 Dec 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.7 March 12 Keith Hudson Draft Further amendments following TNCC Working Party 2.8 April 12 Keith Hudson Draft Further amendments following TNCC Working Party 2.9 May 12 Keith Hudson Draft Further amendments following TNCC Working Party 2.10 June 12 Keith Hudson Draft Further amendments following TNCC Policies meeting Page 1

3 Section Contents Title Page Number Section 1 Policy Statement 4 Section 2 Introduction 4 Section 3 Scope 4-5 Section 4 General Principles 5-7 Section 5 Reporting Sickness Absence 7-8 Section 6 Recording, Monitoring and Review 9 Section 7 Return to Work Interviews 9-11 Section 8 Special Circumstances 11 Section 9 Managing Frequent Short-Term Sickness Absence Section 10 Managing Long-Term Sickness Absence Section 11 Managing Patterns of Absence 13 Section 12 The Procedure Section 13 Review Meetings/Postponements 17 Section 14 Disability Discrimination Section 15 Graduated Return to Work 18 Section 16 Extended Paid Sick Leave Section 17 Termination of Employment on the Grounds of Incapability due to Ill Health 19 Section 18 Appeals Against Termination of Employment 19 Section 19 Applications for Ill Health Retirement 20 Section 20 Occupational Health Section 21 Work Related Injury/Absence 21 Section 22 Sickness and Annual Leave/Bank Holidays Section 23 Training 22 Section 24 Review Process 22 Section 25 Equality Impact Assessment 22 Page 2

4 Section 26 Process for Monitoring Compliance 23 Section 27 References Appendix A Return to Work form Appendix B Assessment of Fitness to Return to Work 28 Appendix C Leave Accrued During Periods of Sickness Absence 29 Appendix D Appendix E Short Term/Frequent Absence Flow Chart Long Term sickness Absence Flow Chart Page 3

5 1. POLICY STATEMENT The health and well-being of our staff is crucial to the delivery of high quality patient care. As a Trust we are committed to developing a strategy to support the health and well-being of our staff. This policy details the processes in place for staff affected by sickness absence issues, and describes the necessary processes to follow in the management of such issues. 2. INTRODUCTION 2.1 This policy sets out how the Trust manages issues concerning sickness absence. It provides guidance on how to encourage good health and good attendance at work and how to manage individuals whose attendance is unsatisfactory due to ill health or physical/psychological injury. It should also be read in conjunction with Managing Sickness Absence Guidance Notes for Managers. 2.2 The Trust is committed to encouraging and supporting staff in sustaining good health and attendance at work and, as far as is reasonably possible, to retaining staff in employment should they become disabled. Therefore, in managing unsatisfactory attendance, the emphasis must be on supporting the individual; however, consideration must be given at all times to ensuring high standards of service are maintained. 2.3 Where poor or deteriorating performance is identified as possibly being the result of ill or declining health, the manager should refer the matter to HR for guidance. The matter should then be handled in accordance with the appropriate HR policy. In such cases an Occupational Health assessment will be sought ahead of any decision, and alternatives may include making reasonable adjustments to the current role or redeployment into a suitable alternative position. 2.4 It should be noted that there is no entitlement to sick leave and therefore individuals do not have a right to take any number of days of sickness absence in a year. Rather, it is inevitable that employees will be absent from work from time to time due to sickness and this policy sets out standards detailing how managers should manage sickness absence and how individuals may expect to be treated following a period of ill-health. 2.5 This policy is not designed to be used to manage poor performance unless the underlying cause of the poor performance is related to an individual s health condition, in accordance with HR06, Maintaining High Standards of Performance and HR07, Disciplinary Policy for Doctors and Dentists. 3. SCOPE 3.1 This policy applies to all staff who are directly employed by the Trust, whether full time or part time, permanent or temporary including those employed by the Trust via the Temporary Staffing Department. 3.2 The policy does not apply to individuals employed by agencies or other contractors. Issues relating to sickness absence for these individuals should be referred to the appropriate employer. 3.3 In implementing this policy, managers must ensure that all staff are treated fairly and within the provisions and spirit of the Trust s Equality & Diversity Policy, (HR01). Page 4

6 Special attention should be paid to ensure the policy is understood when using it for staff new to the NHS or Trust, by staff whose literacy or use of english is weak, or for persons with little experience of working life. 4. GENERAL PRINCIPLES 4.1 Managers will handle sickness absence issues for all staff in their area in a positive, supportive, fair and consistent way, taking account of relevant circumstances in each individual case. They, and other authorised individuals, will also ensure they are fully trained in the use of this policy and conversant with the document Managing Sickness Guidance Notes for Managers. 4.2 The need for confidentiality must be respected in all cases. Information regarding the health of an individual will be made available only on a need to know basis. 4.3 The following factors will be taken into account in deciding how a sickness absence matter should be managed: The continuing length of absence Frequency of absences and reason The individual s previous attendance record Occupational Health or other medical reports Prognosis on a return to work The impact of making reasonable adjustments Impact on service provision 4.4 Where guidance is given in this policy for progressing the management of sickness absence, only days/shifts designated as work days/shifts should be counted for monitoring purposes (although calendar days are used for certification purposes ((see Section 5.13)). The period during which sick pay should be paid, and the rate of sick pay for any period of absence, is calculated by deducting from the employee s entitlement on the first day of sickness, the aggregate periods of paid sickness absence during the 12 months immediately preceeding that day. (Agenda for Change, Terms & Conditions Handbook, Section 14.6). 4.5 Where a number of days are given as guidance for trigger points in the process, these should be applied consistently across all staff groups. Examples of where pro-rating should be applied include: for part time employees based on number of days worked per week; for full time staff working fewer than 5 shifts per week; and for employees with under one year of service, based on number of months service. 4.6 All employees of the Trust are expected to observe this policy and comply with all reasonable management requests to attend meetings, including Occupational Health appointments, to ensure relevant information can be obtained. Failure to do so, without justifiable reasons, may result in action being taken in accordance with the Trust s Disciplinary Procedure (HR36). 4.7 At all stages of the procedure, staff have the right to be accompanied by an accredited representative of a Trade Union / Professional Organisation or work colleague. 4.8 At Stage 3 Short-Term and Stage 3, Part 2 Long-Term of the procedure, the employee has the right of appeal. Page 5

7 4.9 All staff are eligible for sick pay in accordance with NHS Terms and Conditions of Service Handbook or National Conditions of Service for Medical Staff except in the following circumstances: where a member of staff fails to adhere to Trust policy and/or departmental procedures, or where the absence is found not to be due to the sickness of the individual receiving sick pay, or where the absence is caused by an accident due to active participation in sport as a profession, or where contributory negligence is proven, or where, following an accident, damages are received from a third party. Where any of the above circumstances occur please liaise with the HR Advisory Team for further advice Sickness absence is not a disciplinary matter, although in managing sickness absence, employees may be issued with a series of formal warnings. These warnings are to inform the individual of the potential consequences of further or continued periods of sickness absence Any abuse of this procedure or regulations for sickness absence may lead to the individual losing their entitlement to NHS sick pay and Statutory Sick Pay and disciplinary action being taken in accordance with the Trust s Disciplinary Procedure (HR 36) Where management has evidence that an individual is not sick as reported or has lied in any aspect of the management of their absence, action may be taken in accordance with the Trust s Disciplinary Procedure (HR 36) Where management has evidence that an individual has provided misleading information to management or the Occupational Health Department, either during preemployment checks or during the course of their employment, (for example by failing to declare a long standing health problem), disciplinary action may be considered in accordance with the Trust s Disciplinary Procedure, (HR 36) Where it is suspected that an individual s health problems may be attributable to alcohol or substance misuse, reference will be made to the Alcohol and Substance Misuse Policy (HR09) Where it is suspected that an individual s sickness absence may be attributable to domestic violence, support may be available through the Occupational Health Service, details of which can be found on the Trust s intranet Where a member of staff is away from the Trust due to sickness absence, no secondary employment should be undertaken during the period of sickness, unless the secondary employment is specified and allowed on the GP Fit note covering that particular absence. Where secondary employment is to be undertaken during a period of sickness, the staff member must inform their line manager that they are working elsewhere and the GP Fit Note must be provided immediately to confirm that they are fit to carry out their secondary role Where a member of staff is found to be working elsewhere whilst in receipt of contractual sick pay and a GP Fit Note cannot be provided to confirm there eligibility to work, the Trust Counter Fraud Officer may be notified to carry out further investigation into the matter. Page 6

8 4.18 Dishonestly working elsewhere whilst in receipt of sick pay may be treated as gross misconduct and/or a fraud by false representation and may result in disciplinary action or criminal prosecution. 5. REPORTING SICKNESS ABSENCE 5.1 Managers must ensure that each department has in place procedures to ensure that sickness absence is properly reported, recorded and monitored and that these procedures are consistent with this policy, and are accessible to all relevant staff. 5.2 Managers must report sickness absence for pay purposes, using the relevant paper or electronic system as soon as possible at the start and end of each episode of absence. If a member of staff reports for duty but is not fit to stay at work, this day/shift will be counted as a normal working day for pay purposes. However, the period away from work should be recorded for sickness absence management monitoring purposes only. However, a pattern of absence (see Section 6.2) may be taken into account in the management of the case. A Return to Work Interview must still be completed where absence of this nature is recorded. 5.3 Where sickness absence is a result of an accident or physical/psychological injury at work, please refer to Section 21 of this policy. 5.4 Any individual who is unable to attend work due to illness is required to personally notify their manager (or other authorised person as specified in departmental procedures) before the start of their duty or as soon as is reasonably possible. If they are not able to notify their manager personally, clear reasons for this should be given by the individual reporting the absence. Notification by text message or is not acceptable. The individual should inform the manager, or authorised person, of the nature of the illness and if possible, give some indication of the likely period of absence to assist the manager in planning for any cover that may be required. 5.5 Where reasonably possible: in areas such as wards which operate a 24 hour service, employees must report sick no later than 1 hour before the start of their shift; for staff on night duty, the notification should be no later than 4 hours before the start of their shift, bearing in mind that it will be necessary to find cover for the absence; in areas staffed during usual office hours, (eg 9am 5pm), the notification should normally coincide with the normal start time, and in any case, no later than 30 minutes after. 5.6 If an individual fails to report sickness absence in accordance with departmental and Trust procedures, the leave will be counted as unauthorised absence and will be unpaid for the entire shift/duty, unless exceptional circumstances prevail. In this situation the manager must notify Pay Services. Reference should also be made to the Annual Leave and Public Holiday policy (HR30). 5.7 If an individual finds they are able to return to work sooner than indicated, they should inform their department as soon as possible so that any cover that has been arranged can be cancelled. Where absence is being covered by a Statement of Fitness for Work, (Fit Note), the individual must obtain written confirmation of their fitness to return to work earlier than expected from their GP or the Occupational Health Department. Page 7

9 5.8 If an individual is unable to return to work as expected, they are required to inform their manager as soon as possible. 5.9 Where an individual is able to return to work but is rostered for off-duty on that day, it is important that they telephone their manager to confirm that they are fit to return to work Where an individual falls ill during a period of annual leave, reference should be made to Section 22 of this policy Where an individual falls ill during a period of Maternity, Adoption, Maternity Support Leave, Parental or Special Leave, the leave will continue as planned and will not be treated as sick leave If an individual is sick immediately following a period of Maternity Leave, this will be treated as sickness absence. The manager must notify Pay Services that the individual has returned to work from Maternity Leave as normal and has commenced sickness absence (using the appropriate paper or electronic recording system.) Absence will then be managed in accordance with this Policy Certification Return to Work Form A Return to Work Form (Appendix A) must be completed by the immediate line manager in a timely manner and countersigned by the member of staff following EVERY episode of sickness absence. Where required, this form serves as the self-certification of sickness absence for Statutory Sick Pay purposes, and confirms that an individual is fit to return to work Assessment of Fitness A Fitness to Return to Work form (Appendix B), if To Return to Work applicable, must also be completed BEFORE an individual returns to their work area Medical Certification For absences longer than 7 calendar days, the employee is required to obtain a Statement of Fitness for Work, (Fit Note), to cover the absence from day 8 onwards. It is the responsibility of the individual to ensure that the medical certificate is received by the manager within three days of it being issued. Any subsequent continuous absence must also be covered by a medical certificate which must be received within three days of the expiry of the previous certificate. Failure to submit a medical certificate within the specified time may result in payment of NHS sick pay and Statutory Sick Pay being withheld. Copies of Statements of Fitness for Work, (Fit Notes) still need to be provided even when an employee has entered a period of nil pay All certificates should be treated as confidential and retained on the individual s personal file. 6. RECORDING, MONITORING AND REVIEW Page 8

10 6.1 Individual attendance records will be maintained in each department and these should be reviewed regularly by the manager. Information held should include dates and reasons for absences (e.g. sickness absence, special leave, study leave). For sickness absence, information should also include the nature of the illness, the total number of days/shifts absence and details of any occurrences where the individual has left work before the end of their working day/shift. This will enable the manager to accurately monitor attendance and deal consistently with all staff, (see Section 5.2). 6.2 When looking for patterns or trends, the following should be considered: regular Monday or Friday absence, or absence before or after rostered days off; regular absence on a certain shift pattern (e.g. earlies, lates, nights or weekend shifts); absences immediately before or after a period of annual leave; regular absence during school holidays; regular absence on an annual basis (e.g around public holidays such as New Years Day, or during major sporting events such as major national/local football matches, the Olympics); regular absence at a specific time each year; regulularly reporting for duty but not fit to stay at work; a regular pattern of almost reaching the threshold for formal action to be taken 6.3 In order to manage sickness absence effectively and fairly, managers should review absence records regularly and deal with any issues as soon as they arise. Sections 9 and 10 below give guidance on the management of individuals whose attendance is unsatisfactory due to sickness absence. Section 11 provides guidance on how to manage an individual who has demonstrated a pattern of absence. It should be noted, however, that each case is different and must be handled appropriately, depending upon the particular circumstances of the individual, their health condition, their attendance record, their role and the department in which they work. 6.4 Where an individual is on secondment either within or outside the organisation, the manager employing them in their permanent post is responsible for monitoring and managing sickness absence during the period of secondment to ensure continuity. However, this should be in consultation with the manager accepting the seconded employee and therefore, systems must be put in place to ensure any absence is reported to the substantive manager. 7. RETURN TO WORK INTERVIEWS 7.1 Return to Work interviews are considered to be highly effective in reducing the absence of employees. Their purpose is to welcome the employee back to work and identify what, if any, support is necessary to integrate the employee back into the workplace. The tone of the meeting should be positive, providing an opportunity to make an employee aware of how valued they are. 7.2 It is important for managers, or authorised person, to meet with all employees after each absence episode, ideally on the first day of return, but must be within a timely manner, as this will assist in identifying if the employee is fit to resume duty and whether reasonable adjustments should be made. If managers do not talk to every employee upon their return, this becomes inconsistent and may lead to accusations of unfair treatment. It is also useful to establish whether further advice is needed e.g. Page 9

11 Occupational Health. It is anticipated these meetings should take no longer than a few minutes however they should be tailored to individual needs. 7.3 Before commencing work, staff who have been off sick MUST report to the most senior person on duty in their work area, to confirm their fitness for work. 7.4 A Return to Work Form (Appendix A) must be completed in ALL instances. According to circumstances, the nature of the discussion may include: to confirm that the individual is fit to return to work; to confirm the nature of the ill health; to establish whether the sickness absence is related to a disability as defined by the Equality Act 2010 (Section 14); to establish whether the sickness absence is related to an on-going health matter; to assess the likelihood of any recurrence; to establish whether support from the Occupational Health Department or any other support (e.g. counselling) may be appropriate; to review the attendance record of the individual to establish whether formal management action is required and, if appropriate inform the individual of what action will be taken either immediately or if unsatisfactory attendance continues; to advise the individual of any work issues that may have arisen during the absence. to confirm that if the individual is in receipt of damages from a third party following an accident, that they are entitled to receive sick pay whilst absent from work, but that any sick pay maybe recovered from any subsequent award and that pay services have been advised accordingly. It is the individual s responsibility to inform the Trust. 7.5 In reaching a decision as to whether further action, if any, should be taken, consideration should be given to the following factors: working environment; managerial issues such as organisational change; work patterns such as long shifts; extra work being undertaken by the individual, such as external employment, excessive overtime or work on the nursing/other bank; whether any absence is as a result of a physical/psychological work-related injury (see Section 21) whether any absence is due to inability to return to work for health and safety reasons (e.g. diarrhoea and vomiting); domestic circumstances; patterns of absence for example where episodes tend to precede or follow long shifts, periods of night duty, days off or holidays; absence levels of colleagues which may increase the workload of the individual; hospital-wide or department-wide infection or illness causing higher than usual absence amongst the workforce; whether the individual has a disability as defined by the Equality Act 2010, (see Section 14); what support has been provided in order to improve attendance; if Special Circumstances apply (see Section 8) 7.6 No absence should be discounted because of any of the above factors, but these factors should be taken into consideration in deciding how to manage the situation. Page 10

12 7.7 Should a formal warning be issued, the effective start date will be the date of the individual s return to work. 8. SPECIAL CIRCUMSTANCES 8.1 The Trust recognises that there are occasions when absence should not be counted towards triggers, for example, medical exclusion, or when an individual is fit to attend work but unable to do so due to Health & Safety or infection control reasons. Periods of absence resulting from work-related accident or injury, whether physical or psychological, should be discounted when calculating whether a trigger point has been reached. However, such factors must be taken into account in deciding how to manage the individuals case. The following are examples of such special circumstances; Accepted hospital acquired illness, physical or psychological injury sustained during and in the course of employment; (see HR48 Managing Staff with MRSA); Medical exclusion, where an individual is fit to attend work, but unable to do so due to Health & Safety or infection control reasons; Terminal illness; Pregnancy related illness, (see HR24 Maternity Leave) ; A medical condition that comes under the remit of the Equality Act 2010 (Section 14); Delays caused by access to assessment/treatment 8.2 Advice must be sought by the manager from HR Advisory Team, who will monitor consistency across the Trust. 9. MANAGING SHORT-TERM SICKNESS ABSENCE 9.1 In taking any action on short-term absences, the manager must demonstrate that they have attempted to find out whether there is an underlying medical cause for the absences, both through discussion with the employee (at the Return to Work interview) and where applicable, by referral to Occupational Health. 9.2 When dealing with short-term absence, the following information needs to be considered at the Return to Work Interview:- Previous Return to Work documentation. The employee s attendance record over the past 12 months. Any other information that may be relevant, e.g. Occupational Health reports 9.3 Where Special Circumstances exist, (Section 8) it may not be appropriate to move the employee to the next stage in the procedure. However, any decision based on Special Circumstances must be reviewed at each stage. 9.4 Depending upon the information provided about the cause of the absence (and the conclusions drawn), further action may include one or more of the following:- A decision to take no further action. Page 11

13 Referral to Occupational Health if not already done so or to gain more up-todate information, to establish if there is an underlying medical condition causing the absence. If the employee refuses to attend, without reasonable justification, and he/she is on sick leave, sick pay may be withheld. The Manager must inform the employee prior to this action being taken. The Manager may consider a temporary or permanent change in working hours, role, or discuss with the employee possible re-deployment to a different job. In these circumstances a referral should be made to Occupational Health for advice on whether redeployment is appropriate on medical grounds and advice should also be sought from the HR Advisory Team. Managers should refer to Section 21 where they suspect work related factors maybe affecting the employee s attendance. A decision to take formal action (see Section 12). The employee must be warned in writing as to the potential consequences of continued poor attendance. 9.5 Triggers have been broadly set in order to achieve the Trust s annual targets, and are based on number of days absent and/or number of occasions. 9.6 Stages and Triggers of absence are (pro-rata see Section 4.5): Stage Trigger 1 A total of 10 working days or 4 episodes in a rolling 12 month period. 2 A further 5 working days or 2 episodes in the following 6 months. 3 A further 5 working days or 2 episodes in the following 6 months. 10. MANAGING LONG-TERM SICKNESS ABSENCE 10.1 Long-term absence is defined as a continuous period of 4 calendar weeks or as soon as it becomes apparent that the period of absence is likely to extend to this period. The aim in managing long-term absence is to provide support to an employee through a period of ill health, or physical/psychological injury, and to effect a return to work as soon as is reasonably possible The first trigger during long-term absence is 4 calendar weeks, when a Stage 1 meeting will be convened. The triggers following the issue of a Stage 1 warning for Stages 2 and 3 are detailed below:- Stage Trigger 1 After 4 weeks absence 2 After 12 weeks absence 3 After 20 weeks absence 10.3 During a period of long-term sickness absence, it is the responsibility of the employee to maintain contact with their manager, to advise of progress with regard to any treatment, anticipated return to work and provide a Statement of Fitness for Work (Fit Note) from their GP. However, managers also have an obligation to maintain regular contact with the employee, usually on a fortnightly basis, initially via a telephone call or letter if deemed to be appropriate. This timescale may be extended depending on the sensitivities and circumstances of the case. Employees are also required to advise their manager if they are not available for regular contact, e.g. in-patient attendance at hospital or long periods away from home. Page 12

14 10.4 As soon as it becomes apparent that a period of absence is likely to extend to 4 weeks or more, the manager should discuss the matter with the employee, in accordance with Stage 1 of the procedure, (Section 12). The meeting may take place at the workplace, or if they are not fit to attend at work, the individual s home, subject to their agreement. In the absence of not being able to meet with the employee in either of the aforementioned settings, it may take place by telephone. The discussion should be conducted in a positive and supportive manner, and it s purpose is to:- Identify the employee s current state of health. Ascertain their progress with regard to any treatment, and anticipated return to work. Clarify whether the individual could undertake any work to prevent the sickness absence continuing, providing that the individual has been declared medically fit to carry out identified tasks. For example, where the individual is unable to drive but is able to carry out some tasks from home, or is unable to carry out their full range of duties, but could do other work. Establish whether it would be appropriate to seek advice from Occupational Health. Inform the employee of their current Trust sick pay position If appropriate, the discussion will also enable the manager and the employee to plan their return to work In cases where a specific date of return to work is anticipated, the manager and the employee should continue to maintain contact to monitor progress and plan for their return to work Where there is no prospect of a return to work within a reasonable and predictable recovery period, or where the employee does not return to work as planned within the 8 week timeframe following the Stage 1 meeting, (i.e. after a total of 12 weeks absence), the manager should move to Stage 2 of the procedure in accordance with the long-term absence trigger points The manager should keep notes of all discussions, and these should be made available to the employee on request Staff who return to work from a long-term absence, but then report absent due to a reoccurrence of the same condition within a month of returning to work will be managed at the same stage of the procedure as they were being managed at previously. 11. MANAGING PATTERNS OF ABSENCE 11.1 When patterns or trends of absence have been identified, (see Section 6.2), the manager will meet with the individual to discuss their concerns and understand the reasons for the pattern of absence If appropriate, the individual will be referred to Occupational health Depending on the outcome of the above, the manager may take the decision to agree an action plan to support the individual to attend work, or take action in accordance with the Trust s Disciplinary Procedure (HR36). Page 13

15 12. THE PROCEDURE 12.1 This section details the various stages to be followed in the management of both short-term and long term absence. At all stages, the employee may be referred to Occupational Health, and where a disability exists, as defined by the Equality Act 2010, it is management s responsibility to explore whether reasonable adjustments can be made, in conjunction with advice from Occupational Health to working conditions or workplace. A copy of the Occupational Health report will be forwarded to the individual in advance of the review meeting. The outcome of any review meeting must be confirmed in writing to the employee SHORT-TERM SICKNESS ABSENCE Stage When an employee breaches a trigger point for short-term sickness absence, (i.e. after a total of 10 working days or 4 episodes in a rolling 12 month period), the manager will arrange a meeting with the employee, on returning to work. If the manager accepts that absence is due to special circumstances, (see Section 8), consideration will be given as to whether a Stage 1 warning will be issued, or if no action is to be taken on this occasion. If no special circumstances exist, the manager will issue a Stage 1 warning. The warning will include details of the standard of attendance required during its life (the standard Trust triggers as defined, unless special circumstances apply). The warning will be live for 6 months and if the employee does not breach a further trigger during this period, (i.e. pro-rata of 5 working days or 2 episodes, whichever figure is exceeded first), the warning will expire. If the specific triggers are breached, a Stage 2 meeting will be convened. Stage Should the employee breach a further trigger (i.e. after a further 5 working days or 2 episodes) in the following 6 months, the manager will arrange a Stage 2 meeting with the employee (a member of the HR Advisory Team may also be invited). This should be done within 10 working days of the breach, and not left until the end of the warning period. If the manager accepts that absence is due to special circumstances, (see Section 8), it is at management s discretion whether to extend the warning for a maximum of a further 6 months, or allow it to run its course. If no special circumstances exist, the manager will issue a Stage 2 warning. The warning will include details of the standard Trust triggers as defined but consideration can be given to specific circumstances. The warning will be live for 6 months, and if the employee does not breach a further trigger during this period (i.e. short-term pro-rata of 5 working days or 2 episodes, whichever figure is exceeded first), the warning will be replaced by a Stage 1 warning as above. If the specific triggers are breached, a Stage 3 hearing will be convened and the employee made aware that failure to improve their attendance in-line with Trust trigger points may result in their dismissal from the Trust. Stage Should the employee breach a further trigger (i.e. after a further 5 working days or 2 episodes) in the following 6 months, following a Stage 2 warning, and unless special circumstances apply (see Section 8), a hearing will be convened, the arrangements for which will be confirmed in writing. At this hearing a decision will be made regarding the continued employment of the individual and will be chaired by a Senior Manager not previously involved in the case, who has the authority to dismiss. A member of the HR Advisory team will also be present at the hearing, as well as the individual and their representative, plus the individuals line manager and HR support. The decision taken will be one, or a combination of, the following: Page 14

16 To be retained in employment under alternative arrangements as specified in Early retirement on the grounds of incapability due to ill health (Section 19) Termination of employment on the grounds of incapability due to ill health (Section 17) The manager will then confirm the course of action to be taken and the individual will be advised that if they are unable to return to work, their employment will be terminated Alternative arrangements to be considered include: The individual continuing in their existing post but with defined restricted duties; The individual continuing in their existing post but with permanently reduced hours and/or alternative shift patterns; The individual continuing in their existing post with agreed permanent adaptations to the workplace; The individual re-locating to an alternative workplace on a permanent basis; The individual being permanently re-deployed to an alternative post; Where appropriate, to enlist the assistance of support agencies Where an individual is retained in employment under alternative arrangements specified above, he/she will be employed on the terms and conditions applicable to the new role. The Protection of Pay policy does not apply in such circumstances Where the individual is retained in employment under alternative arrangements, he/she should be advised that it is expected that these arrangements will result in good attendance being resumed. The individual should also be advised that if there is a further 5 days or 2 episodes of absence in the following 6 months, (unless special circumstances apply (see Section 8)), their employment may be terminated with due notice. Should no further absence occur within this period, the matter will be considered closed The decision will be confirmed in writing to the individual within 7 working days, with a copy of the letter retained on the personal file. If the decision is to dismiss the employee with notice, (in accordance with the individual s contract of employment), the individual has the right of appeal against the decision (Section 18) In certain circumstances and normally with the consent of the individual, it may be appropriate to conduct this meeting in their absence. Such circumstances may include, when the individual is not well enough to attend the meeting and is aware that the consequence is that their employment may be terminated or where the individual has failed to attend without good reason LONG-TERM SICKNESS ABSENCE Stage When an employee breaches the trigger point for long-term absence, (ie after 4 weeks continuous absence), the manager will arrange a meeting with the employee, either at home or in the workplace. If the absence is due to special circumstances, (see Section 8), consideration will be given as to whether a Stage 1 warning will be issued, or if no action is to be taken on this occasion. If no special circumstances exist, the manager will issue a Stage 1 warning. Page 15

17 Stage Should the employee breach the trigger point for Stage 2, (ie after 12 weeks continuous absence), the manager will arrange a Stage 2 meeting with the employee, (a member of the HR Advisory Team may also be invited). This should be done within 10 working days of the breach and if no special circumstances exist (see Section 8), the manager will issue a Stage 2 warning. Stage 3 - Part Should the employee breach the trigger point for Stage 3, (ie after 20 weeks continuous absence), the manager will arrange a Stage 3 Part 1 meeting with the individual, (a member of the HR Advisory Team will also be in attendance). This should be done within 10 working days of the breach. At this point it is also recommended that a medical report is obtained from Occupational Health The purpose of the meeting is: To inform the employee of their current sick pay position To review the Occupational Health report To review any special circumstances To discuss the individual continuing in their existing post but with defined restricted duties To discuss the individual continuing in their existing post but with permanently reduced hours and/or alternative shift patterns To discuss the individual continuing in their existing post with agreed permanent adaptations to the workplace To discuss the individual re-locating to an alternative workplace on a permanent basis To discuss the individual being permanently re-deployed to an alternative post Where appropriate, to enlist the assistance of support agencies To discuss the possibility of termination of employment on the grounds of incapability and when relevant an application by the individual for ill health retirement (for those individual s who are members of the NHS Pension Scheme) To make arrangements for a further meeting under Stage 3 Part 1 if required, and confirm the course of action to be taken To advise the individual that if they are unable to return to work, their employment may be terminated under Stage 3 Part 2 of the procedure If appropriate, the discussion will also enable the manager and the individual to plan the individual s return to work In cases where a specific date of return to work is anticipated, the manager and the individual should continue to maintain contact to monitor progress and plan for the individual s return to work The outcome of the meeting will be confirmed in writing to the employee. Stage 3 - Part As soon as is practicably possible a hearing will be convened, the arrangements for which will be confirmed in writing. At this hearing a decision will be made regarding the continued employment of the individual and will be chaired by a Senior Manager, not previously involved in the case, who has the authority to dismiss. A member of the HR Advisory team will also be present at the hearing, as well as the individual and their representative, plus the individuals line manager and HR support. Page 16

18 The decision taken will be one, or a combination of, the following: To be retained in employment under alternative arrangements as specified in Early retirement on the grounds of incapability due to ill health (Section 19) Termination of employment on the grounds of incapability due to ill health (Section 17) Where an individual is retained in employment under alternative arrangements specified above, he/she will be employed on the terms and conditions applicable to the new role. The Protection of Pay policy does not apply in such circumstances Where the individual is retained in employment under alternative arrangements, he/she should be advised that it is expected that these arrangements will result in good attendance being resumed and that, if this is not the case, the individual s employment may be terminated with due notice The decision will be confirmed in writing to the individual within 7 working days, with a copy of the letter retained on the personal file. If the decision is to dismiss the employee with notice, (in accordance with the individual s contract of employment), the individual has the right of appeal against the decision, (see Section 18) In certain circumstances and normally with the consent of the individual, it may be appropriate to conduct this meeting in their absence. Such circumstances may include, when the individual is not well enough to attend the meeting and is aware that the consequence is that their employment may be terminated or where the individual has failed to attend without good reason. 13. REVIEW MEETINGS AND POSTPONEMENTS 13.1 At all stages in the procedure, the employee will be given 1 week s calendar notice of a review meeting/hearing/appeal. In the event that representation cannot be arranged for the appointed time/date or the employee is unavailable to attend, a re-scheduled hearing will be arranged as quickly as possible, but not later than 7 days after the original hearing date. In the event that either the employee or their representative fails to attend the re-scheduled hearing, a decision will be made in their absence, based upon the evidence available and the individual notified of the outcome in writing When an individual is not fit enough to attend meetings at the workplace, it may be appropriate to conduct a sickness meeting at an individual s home, or a mutually agreed location if the individual s home is not suitable. This will be done with prior agreement and consent of the employee. 14. DISABILITY DISCRIMINATION 14.1 Consideration must be given in all cases to whether or not an individual may fall within the scope of Equality legislation. This may apply to any employee who has a physical or mental impairment which has a substantial and long-term adverse effect on his/her ability to carry out normal day to day activities. The condition must: Be one which affects an individual s everyday living activities and may or may not affect their ability to perform their work duties. Such activities include washing, dressing, eating, walking, catching a bus etc and Have lasted for, or be likely to last for, at least twelve months or be terminal. Page 17

19 14.2 An individual may still be considered to have an impairment if the condition goes into remission but is likely to recur. Additionally, a condition which is controlled or treated by drugs or physical aids, is still considered to be on-going if the absence of measures is likely to lead to a recurrence of symptoms Individuals falling within the scope of Equality Act 2010 are protected against discrimination on the grounds of their disability and the Trust has a legal obligation to accommodate their disability as far as is reasonable Reference should be made to Trust Policy HR40 Employment of People with Disabilities. 15. GRADUATED RETURN TO WORK 15.1 Following a period of long term sickness absence, it is important that an individual is properly supported in their return to work. In some circumstances, it may be possible to put in place arrangements for the individual to return to work on a graduated basis in order to help them to acclimatise back into the workplace. Such arrangements may be made at the discretion of the line manager and will require medical certification or approval from Occupational Health The same principles will apply whether the individual is returning to their current role or to alternative working arrangements on a temporary or permanent basis Where arrangements are made to enable an individual to return to work initially on reduced hours, they should receive their normal contractual pay (including any unsocial hours payments) during the phased return, for the first 4 weeks In developing a graduated return to work programme, it is important that a realistic timetable is agreed (which would normally be between one to four weeks and in exceptional circumstances may extend beyond this timescale, subject to Occupational Health advice), so that both the manager and the individual are clear as to the expected date for return to full duties. Progress against this timetable should then be regularly reviewed and adapted if necessary In order to further extend the period of the graduated return, it may be agreed by the manager and the individual that annual leave may be used If, at any stage, it becomes apparent that the individual will not be able to return to full duties within a reasonable period of time (for example if the time is anticipated to be more than double the time allowed in the agreed graduated return to work programme), then action will be taken in accordance with Section 12 of this policy. 16. EXTENDED PAID SICK LEAVE 16.1 In exceptional circumstances the Trust may use its discretion to extend the period of paid sick leave beyond the standard period An application for extended paid sick leave must be made in writing to the Workforce Director and relevant Senior Manager. The individual making the request will be expected to demonstrate that they have made all efforts to obtain State benefits before any such request will be considered. The Workforce Director will consider the application and their decision will be final, and will inform both the employee and Senior Manager, and employee representative (if relevant). Page 18

20 16.3 The authority to extend paid sick leave rests with the Workforce Director. 17. TERMINATION OF EMPLOYMENT ON THE GROUNDS OF INCAPABILITY DUE TO ILL HEALTH 17.1 The authority to terminate employment rests with the Senior Manager. Advice must be sought from a member of the HR Advisory Team prior to any decision being made Termination of employment will be regarded as a last resort in cases of short term and long term absence and considered only after the following criteria have been satisfied: the employee has been fully consulted and advised of the consequences of their continued inability to attend work regularly a medical opinion has been considered all options to retain the individual in employment have been considered Termination of employment may take place before occupational sick pay has expired where there is no prospect of a return to work in the foreseeable future Where an individual s employment is to be terminated, notice with full pay will be given in accordance with their contract of employment If an individual s employment is terminated under this policy, any annual leave accrued in the leave year but not taken prior to the commencement of long term sickness absence or accrued during sickness absence will be paid in lieu. 18. APPEALS AGAINST TERMINATION OF EMPLOYMENT 18.1 Employees have a right of appeal against termination of employment. Any appeal must be made in writing within 14 calendar days of receipt of written notice of such action to the line manager of the Senior Manager who effected the termination, stating the grounds for the appeal The lodging of an appeal will not suspend the notice of dismissal The Manager hearing the appeal will arrange a hearing at which the employee may be accompanied by an accredited representative of a Trade Union/Professional Organisation or work colleague Appellants are required to attend the appeal hearing. If it is necessary to postpone the meeting, another will be arranged by the Trust, normally within 14 calendar days of the original date. Where an appellant fails to attend a meeting without giving prior notice or without good reason, the meeting will proceed in their absence The purpose of the appeal panel is not to re-hear the case. It is to review the decision to dismiss, and to assess whether this was appropriate on the evidence presented at the hearing. The appeal hearing will consider: Why the employee considers the decision unfair or unreasonable and The rationale and justification of the decision to dismiss 19. APPLICATIONS FOR ILL HEALTH RETIREMENT Page 19