Bolton NHS Foundation Trust Attendance Management Policy Page 1

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1 ATTENDANCE MANAGEMENT POLICY Document type: Policy Version: 5 Author (name and designation) Janet Healey/Gillian Childs HR Business Manager Ratified by: Executives Date ratified: 24/9/2014 Name of responsible committee/individual JNCC Name of Executive Lead Mark Wilkinson Master Document Controller Sandra Drysdale Date uploaded to intranet 24/09/14 Review date: 24/9/2016 Equality Impact strives to ensure equality of opportunity for all service users, local people and the workforce. As an employer and a provider of healthcare Bolton NHS FT aims to ensure that none are placed at a disadvantage as a result of its policies and procedures. This document has therefore been equality impact assessed to ensure fairness and consistency for all those covered by it regardless of their individuality. The results are shown in the Equality Impact Assessment (EIA) (Appendix 18). Attendance Management Policy Page 1

2 Version Control Schedule Version Type of Change Date Revisions from previous issues V.1 Full review March 2014 Major revision and replaces Attendance Management policy December 2009 Sickness Absence policy NHS Bolton December 2004 Attendance Management and Sickness and Absence policy Pennine Acute Hospitals NHS Trust March 2005 Capability policy and procedure : Managing frequent short term sickness absence Salford Royal NHS Foundation Trust May 2011 Policy on the management of long term sickness Salford Royal NHS Foundation Trust May 2011 Attendance Management Policy Page 2

3 Contents 1 Introduction 2 Purpose of the Policy 3 Responsibilities 4 Sick Pay 5 Reporting Procedure 6 Return to Work Interviews 7 Trigger Points 8 Managing Short Term Absence 9 Long Term Absence 10 Rehabilitation Programme 11 Long Term Absence and Ill Health Retirement 12 Medical Suspension 13 The Equality Act Disability Provisions 14 Pregnancy 15 Pay Progression/Medical Staff Pay Thresholds 16 Temporary Injury Benefit Scheme 17 Sickness Absence as a Result of an Accident at Work 18 Accidents Outside Work 19 Staff who Become Ill During Annual Leave 20 Absence for Non-Medical Reasons 21 Sickness Absence as a Result of an Outbreak of Communicable Disease 22 Time off for Personal/Family Reasons 23 Annual Leave Accrual 24 Disciplinary Issues 25 Training and Communication Attendance Management Policy Page 3

4 1. INTRODUCTION The aim of this policy is to both engender and support a culture of 100% attendance amongst staff within the Trust and to outline the support and action that will be taken where an individual s level of attendance falls significantly short of that which is expected in this regard. This Policy should be implemented with due regard to the Infection Control Policy where appropriate. 2. PURPOSE OF THE POLICY The purpose of this policy is to ensure a consistent and fair approach to managing attendance and to assist managers/clinicians responsible for attendance management in their areas to identify appropriate support and/or corrective action. This policy offers a progressive approach, structured to assist employees achieve an early return to acceptable attendance levels. However, where problems continue, either as the result of long term sickness, or persistent poor attendance, this will be managed and may result in formal action being taken with termination of employment potentially the ultimate outcome. 3. RESPONSIBILITIES 3.1 Trust Board The Trust Board is responsible for the provision of a policy on attendance management. The Trust Board has a strategic responsibility to ensure that the appropriate conditions at work exist to ensure that employees are able to attend work regularly. The Trust Board will monitor attendance rates through divisional performance reviews. 3.2 Workforce Directorate The Workforce Directorate will ensure the development of an appropriate policy for managing attendance and are responsible for training managers on the consistent application of the policy. HR Business Managers/HR Advisors have a role in providing advice and support on the application of the Attendance Management policy and guidance on making appropriate and timely referrals to the Workplace Health and Wellbeing department. HR Business Managers/HR Advisors will produce monthly sickness absence level reports to Divisional Boards and monthly trigger reports to managers. Audits will be undertaken in areas where absence levels are of concern within each Division, on a monthly basis or as required. The audits will include evidence that Attendance Management Policy Page 4

5 return to work interviews are undertaken for every episode of sickness, that timely referrals are made to the Workplace Health and Wellbeing department and that an informal stage 1 meeting is carried out once an employee reaches a short term trigger point or where absence extends or is expected to extend beyond 3 weeks. 3.3 Managers Managers must ensure that the physical and psychological working conditions are as good as it is reasonably practical to provide, and that all appropriate health and safety standards are adhered to. If an absence is due to an accident or injury at work, managers have a responsibility to record and report this accordingly. Managers are responsible for ensuring that the management of attendance is applied fairly and consistently. There are many reasons why staff feel unable to come into work and sickness is not always the real reason, although often given as the cause. Managers should explore with employees if there are alternative courses of action available to them rather than being off sick. This may include, but is not restricted to, flexible working options, carers leave, special leave or bereavement leave. Any alternative options should be considered within the limits available. The successful management of absence requires absences to be accurately recorded and monitored. This is the responsibility of all managers and allows for early indication of possible problems. Managers, or a named deputy, are expected to conduct return to work interviews with employees on the day of return to work for every absence. Line managers can help to ensure that employees feel supported and valued by the organisation by taking a proactive role managing sickness absence. This involves keeping in touch with employees who are away from the workplace due to sickness through to planning adjustments to enable a quicker return. Managers must ensure all sickness absence and reasons for absence for all groups of staff (including medical staff) are accurately recorded on the relevant reports in accordance with the current deadlines so that it can be updated onto the Electronic Staff Record System (ESR). Managers have a responsibility to ensure that regular contact is maintained with staff who are absent due to sickness and ensure they arrange to meet with staff at appropriate intervals. Managers must ensure they keep staff informed of their individual pay situation. Managers are encouraged to identify and acknowledge members of staff who achieve one hundred per cent attendance within a financial year. Attendance Management Policy Page 5

6 3.4 Payroll Department The Payroll department is responsible for the recording of sickness absence for pay purposes; ensuring staff receive appropriate sick pay entitlements in accordance with Occupational Sick Pay and Statutory Sick Pay regulations; providing information on pensions and particularly for early retirement on ill-health grounds; and the notification of employees on-going full and half pay entitlements to managers. The Payroll department will ensure that an employee who meets the criteria for payment of Temporary Injury Allowance (TIA) is paid this allowance during their period of absence. 3.5 Employees All staff have a responsibility to take all reasonable steps to keep themselves in a good state of general health and to comply with the Trust s policy on Health & Safety. All staff have a responsibility to ensure that they follow the local reporting procedure for sickness. This includes ensuring their manager is informed as soon as possible when they are unable to work due to sickness and to keep their manager informed as to the length of time they expect to be absent. Staff have a responsibility to maintain contact with their managers and inform them in advance when they are due to return to work. If an employee becomes unwell during the working day they must speak to their manager before leaving work. During sickness absence all employees are expected to aid their own recovery and should not undertake any activity during sickness that could impair their recovery. This may also include work for another employer dependent on the requirements. If an absence is due to an injury/incident at work staff must notify their manager immediately and should ensure an accident form is completed without delay. All staff should meet with their manager, or a named deputy, on the day of their return to work to have a return to work interview. As a condition of employment staff must attend the Workplace Health and Wellbeing department when requested to do so. Staff should not undertake bank/agency work/overtime in this Trust or any other organisation until such time as they have completed a full time 37.5 hour week following an episode of sickness absence, having been declared fit to return with no conditions, or whilst on formal sickness absence monitoring. 3.6 Trade Union/Professional Organisation The role of Trade Union/professional organisation representatives is to represent the best interests of their members. This will often involve attending any formal Attendance Management Policy Page 6

7 meetings to address concerns about attendance but does not extend to attending informal or routine return to work interview meetings. They can also offer help, support and advice on a whole variety of issues i.e. general welfare, referral to self-help groups, counselling and external agencies and individual benefits such as accident and sickness benefit which may be available to their members. 3.7 Workplace Health and Wellbeing Department The Workplace Health and Wellbeing department is able to give practical advice and assistance to managers and staff, on issues relating to health in the context of employment. The Workplace Health and Wellbeing department will provide, as required, a referral and reporting service for Managers in respect of staff with short and longterm absence problems. An objective assessment will be carried out on the reasons for absence and a report provided of that assessment, including advice on measures to facilitate rehabilitation to work and future attendance. The purpose of seeking advice is to aid management decision making. In some cases it may be appropriate to convene a case conference with the manager, HR Business Manager/HR Advisor, and a representative from Workplace Health and Wellbeing. The purpose of this would be to review the employee s situation and determine a way forward. This may be helpful in cases where there is no clear prognosis or conflicting medical opinion, for example between Workplace Health and Wellbeing and the employee s General Practitioner. Advice, appropriate help and support will be offered to staff to improve their attendance levels, their general health and to secure a return to work where possible. At all times medical confidentiality will apply. A standard referral form should be completed and sent to the Workplace Health and Wellbeing department (Appendix 1). An up to date job description and person specification should be attached to the referral. Any further information which the manager feels may assist the Workplace Health and Wellbeing consultation can be attached in a covering letter. Employees may self-refer to Workplace Health and Wellbeing for any health related matter, particularly if it relates to, or is affecting their work, or their attendance at work. Where an employee self-refers, and with their permission, the Workplace Health and Wellbeing department may also contact the manager to consider all aspects of the issue before completing their report. The Workplace Health and Wellbeing department will advise on the need to exclude staff from duty due to contact with a communicable disease. Attendance Management Policy Page 7

8 The Staff Counselling Service will be available to all members of staff for support with work related problems or personal problems affecting their ability to perform at work. Employees may self-refer or be referred by their manager. Employees will have two opportunities to make an appointment with the Workplace Health and Wellbeing department. Failure to attend two appointments will result in the employee not continuing to receive sick pay until they either attend for assessment, return to work or provide a reasonable explanation for their nonattendance. Under the Data Protection Act 1998, individuals are entitled to see their Workplace Health and Wellbeing records, including the management referral forms and any other communication from their managers to Workplace Health and Wellbeing e.g. s, records of telephone calls and letters. Access to these records will be given in accordance with the Act by written application to the Data Controller/Senior Nurse in the Workplace Health and Wellbeing department and may require payment of an administration fee in accordance with Data Protection legislation. Reports from Workplace Health and Wellbeing to an employee s manager will be copied routinely to the employee concerned. If an employee submits a fit note which states stress or musculo-skeletal reasons they should immediately be referred to the Workplace Health and Wellbeing department for additional support, advice and if necessary support Rapid Referrals Early intervention such as occupational therapy, physiotherapy or counselling is important for preventing acute conditions becoming chronic and securing successful rehabilitation. Increasingly, evidence suggests that earlier interventions in a period of sickness absence are more effective than waiting for an indicator to trigger action. For example, in cases where it is appropriate, referral to physiotherapy in the first week of sickness can have the employee rehabilitated back into work by the time they would normally have been having the first review of their case. Such early intervention will reassure the member of staff that they are valued by the Trust and will, in all probability, recover more quickly when back in the working environment, than at home. The Trust has identified the two most common reasons for sickness absence as being stress and musculoskeletal problems; this is consistent with the top two reasons for sickness absence nationally. The Trust has developed Specialist Staff Support Services with a view to supporting staff who may be suffering from these conditions Mental Health and Wellbeing Service The Trust has developed a nurse-led mental health service to support any employees who may be suffering from stress, anxiety, depression, alcohol or drug Attendance Management Policy Page 8

9 issues or obsessive compulsive disorder. The aim of the service is to promote mental well-being at work as recommended by the Boorman Report 1. It is expected that each Department would have a Stress Risk Assessment in place for each role/band within the department where any potential issues have been raised. The Mental Health and Wellbeing Service will work in line with the Health & Safety Executive Management Standards for the control of work-related stress and will deliver a range of approaches which may include:- full mental health assessment including depression screening and assessment of risk Cognitive Behavioural Therapy healthy life style (management of stress) problem solving symptom management solution-focused intervention self-help signposting to other services advice and information relapse prevention The service will ensure appropriate communications with the employee s linemanager, Human Resources and if appropriate the employee s GP. Access to the service can be obtained either by employees choosing to self-refer through the Mental Wellbeing drop-in clinics or managers may choose to refer staff to the service Staff Physiotherapy Service The Staff Physiotherapy Service is provided by the Trust s Physiotherapy team and is available for the benefit of staff who are experiencing musculoskeletal problems which is affecting their ability to work. Employees may access this service by contacting the Workplace Health and Wellbeing department to request a referral. The Physiotherapy department will offer a range of support, as required, including:- a full clinical assessment a course of treatment specialist advice regarding the condition and any support regarding returning to work exercises in the physiotherapy gym exercises to undertake at home workplace assessment 1 NHS Health and Well-Being report Nov 2009 Attendance Management Policy Page 9

10 4. SICK PAY Employees are entitled to sick pay as set out in the Agenda for Change NHS Terms and Conditions of Employment or current Medical and Dental Terms and Conditions. Statutory Sick Pay (SSP) is paid from the 4 th day of absence for up to 28 weeks dependent on meeting the qualifying conditions as per SSP regulations. Payment of SSP is notional during the period of full sick pay; therefore individuals who are off sick will notice no difference in their pay. Where an individual has exhausted his/her entitlement to full sick pay and has entered a period of half pay or no pay, SSP may be paid as an additional sum to the half pay or no pay. This will be paid by the Trust on behalf of the DSS and no claims will be necessary. This is subject to individual entitlement. Further details can be obtained from Payroll Services. As a condition of contractual sick pay the Trust may at any time require an employee absent from work due to illness to attend a Workplace Health and Wellbeing appointment/examination by a medical practitioner. Where an employee has failed to attend a Workplace Health and Wellbeing appointment and/or sickness referral meeting with their manager without reasonable explanation, the employee s sick pay will cease until attendance at Workplace Health and Wellbeing or a return to work has taken place. This decision will be made in conjunction with HR Business Managers who are responsible for notifying Payroll of the cessation of pay. Where there is good reason to believe that an employee is abusing his/her sick leave entitlement, the matter should be dealt with under the disciplinary procedure as misconduct. Counter fraud advice will be sought. 5. REPORTING PROCEDURE All staff are required to notify their sickness absence to the person in charge of the ward/department in accordance with the local procedure for the area. As a minimum this must be within the first hour of the expected starting time or in relation to locally agreed departmental reporting procedures. It is not appropriate for staff to send text messages to the person in charge or colleagues to notify absence nor is it acceptable to do this via social media. Please see Appendix 2 for a sample procedure for reporting sickness absence which may be modified to meet individual departmental requirements. Employees will be requested to give an indication of their return date and the nature of their illness. If the absence is medically certified, or they have previously indicated a date of return to work, they will not be expected to ring in every day unless their expected date of return to work changes, in which case they should notify their manager. Those staff who are absent on uncertified sick leave and have not given a date of return, are required to telephone their manager each day, unless an alternative frequency of communication is agreed. Attendance Management Policy Page 10

11 In the case of a serious illness involving the employee a relative or friend should notify the ward/department at the earliest opportunity. Failure to follow local absence reporting procedures and failure to produce selfcertification or GP Fit notes on time may result in sick pay being withdrawn and potential disciplinary action as it will be considered unauthorised absence. Pay may not retrospectively be reinstated. 6. RETURN TO WORK INTERVIEWS It is considered good management practice and is central to this policy that managers/clinicians discuss an employee s sickness absence on the first day of their return to work following each absence. This includes leaving work due to illness which will be classed as an episode of sickness if an employee does not feel well enough to complete more than half of their full shift/full working day, or after planned absence such as surgery. If the employee is able to complete more than half of their full shift/working day, but is not able to complete the full shift due to ill health, they will be classed as having attended work and as such an episode of absence will not be triggered. In such circumstances, upon the employee s return, a return to work interview must still be completed and as such the part absence will be recorded. If patterns emerge where an employee repeatedly uses this reason to not work a full shift, this will be classed as misconduct and disciplinary action may be taken against the employee. The return to work interview discussion should include:- a) reason for absence b) reference to previous periods of absence c) concerns about levels or patterns of previous sickness absence. d) the offer of appropriate help and support, an agreed course of action to improve attendance and any changes whether temporary or permanent e.g. referral to Workplace Health and Wellbeing department, adjustments to working patterns, overtime restrictions, flexible working, completion of a stress risk assessment etc. e) completion of the return to work form with the employee A template of the return to work interview form can be found at Appendix THRESHOLDS FOR ATTENTION One of the main uses of sickness absence data is to highlight those staff on whom managers should focus attention. An increasingly common way of doing this is to set parameters or thresholds which can help determine where and when action is needed. The attendance record of individual employees will then be monitored against these criteria. Specified thresholds can be used to identify when managers should introduce an informal review. In this Trust the thresholds to be consistently used in all areas are:- Attendance Management Policy Page 11

12 3 occasions in 6 month period; or 4 occasions in 12 month period; or 90 working hours absence within a 12 month period (pro-rata for part time staff); or absent on a particular day for a number of months over a one year period absent at a particular time of year over a two year period regularly taking sickness attached to annual leave, bank holidays, weekends or a particular shift system where there is a pattern of return to work immediately prior to going onto half pay status 8. MANAGING SHORT TERM ABSENCE Short term absence is defined as occasional absences which may or may not suggest a problem. This may often be the result of a number of unrelated minor ailments that may or may not require a medical certificate. Managers should monitor absence and threshold reports to identify patterns and frequency of absence and attendance problems at an early stage. 8.1 INFORMAL PROCEDURE When an employee reaches one of the thresholds in section 7, the manager/clinician should instigate the informal stage of this policy. An informal discussion with the employee will take place at the return to work interview to discuss the absences and ascertain if support and assistance is required. A review period not exceeding 3 months (with an option to extend for a further 3 month period where the absence forms a pattern under the above thresholds) from the return to work date will be set and the employee advised that any further absence in this period will result in a formal stage 1 meeting being convened. The employee should also be made aware of the consequences of continued poor attendance at work. If after the review period the employee has achieved 100% attendance they will be informed that they will be removed from the informal review process. The manager/clinician must summarise the content of the discussion and agreed actions on the return to work interview form and the discussion must also be documented in a letter to the employee (Appendix 4). Further absence in the review period will usually result in the formal procedure being instigated. 8.2 FORMAL PROCEDURE STAGE 1 Where there has been further absence the formal stages of the procedure should be followed and a letter sent to the employee to invite them to a formal stage 1 hearing (Appendix 5). Attendance Management Policy Page 12

13 At the meeting an HR Advisor/HR Business Manager will accompany the manager and the employee will have the right to be accompanied by their Trade Union, Staff Association Representative, work colleague or friend if they wish. It will be for the manager to establish all the circumstances surrounding further absences before deciding the next steps. Any underlying medical problems should be explored and advice sought from the Workplace Health and Wellbeing department. Where the medical opinion confirms the employee has an underlying medical condition, the manager should ensure that medical advice is followed and facilitate sufficient support for the employee. The employee should be informed that their attendance will continue to be monitored. A review period not exceeding 3 months (with an option to extend for a further 3 month period where the absence forms a pattern as stated in the thresholds) will be set and the employee advised that their attendance will be expected to improve. A first written warning will be issued which records the substance of the meeting (Appendix 6). If an employee does not attend a scheduled sickness referral meeting due to sickness and their level of attendance has not improved significantly then a first written warning will be issued on their return to work. If after the review period the employee has achieved 100% attendance they will be informed that they will be removed from the formal review process. If the employee is absent for more than 25% of the review period or has shown intermittent interim improvements previously the employees review period may be extended at this stage. If subsequently within a 12 month period the employee s attendance deteriorates once again they will re-commence at this stage of the review process Equally, if they have been on a review at this stage on more than one occasion within the last 2 years then action may commence at formal absence review stage 2. The employee will have a restriction/removal of overtime, bank and agency working in this Trust or any other organisation whilst they are in the process of formal sickness monitoring. 8.3 FORMAL PROCEDURE STAGE 2 At the stage 2 meeting the attendance record since the previous meeting will be reviewed and any relevant circumstances discussed. The employee should be advised that if they are not able to demonstrate an improvement in their attendance then their future employment will be at risk. Again, any underlying medical problems should be considered and Workplace Health and Wellbeing advice sought. Consideration should be given to any suggestions put forward by the employee which may improve their attendance e.g. flexible working, unpaid leave, or possible re-deployment if they are unable to maintain consistent attendance in their current post for a health related reason. Attendance Management Policy Page 13

14 A review period of 3 months (with an option to extend for a further 3 month period where the absence forms a pattern as stated in the thresholds) will be set and the employee advised that no further absence is expected during this time. A final written warning will be issued which records the substance of the meeting (Appendix 7). If after the review period the employee has achieved 100% attendance they will be informed that they will be removed from the formal review process. If the employee is absent for more than 25% of the review period or has shown intermittent interim improvements previously the employees review period may be extended at this stage. If subsequently within a 12 month period the employee s attendance meets a threshold once again they will re-commence at this stage of the review process. Equally, if they have been on a review at this stage on more than one occasion within the last 2 years then action may commence at stage 3. The employee will have a restriction/removal of overtime, bank and agency working in this Trust or any other organisation whilst they are in the process of formal sickness monitoring. 8.4 FORMAL PROCEDURE STAGE 3 (MEETING TO CONSIDER POTENTIAL DISMISSAL) Where there has been further absence the third stage of the formal procedure should be followed. The manager, in conjunction with the Divisional HR Business Manager will set up a third formal meeting. A manager who has the authority to dismiss must be present at the meeting. The employee should be informed that they are entitled to be accompanied by a Trade Union representative or workplace colleague. If they fail to attend the meeting, the hearing manager will make a decision based on the information available. The manager should present the facts of the case to the hearing manager and the employee will have the opportunity to put their case forward. If, having considered all the circumstances and any help the Trust has been able to offer, the employee has been unable to maintain a satisfactory level of attendance; their contract of employment will be terminated, with full notice, on the grounds of their inability to attend work on a regular basis. No decision to dismiss should be taken without up to date written medical advice from the Workplace Health and Wellbeing department and the involvement of the Divisional HR Business Manager. The decision to dismiss is an employment, not medical decision. However, it must be taken in the light of available medical evidence. The employee should be given the opportunity to discuss any information received from the Workplace Health and Wellbeing department. It is important to remember that the objective in managing attendance is, wherever possible, to assist the employee to remain in or return to work, or to improve their Attendance Management Policy Page 14

15 attendance. At all stages the manager/clinician should give consideration to the employee s continued employment using all the facts available. However if all options have been exhausted and there is no indication that improvement in attendance is likely, dismissal will take place at that point. The outcome from the meeting should be confirmed in writing within seven days and include the right of appeal if dismissal was the outcome (Appendix 8). 9. LONG TERM ABSENCE Long term sickness absence is defined as continued absence in excess of three weeks. Whilst a medical certificate provides an indication of the likely timescale for absence, it is reasonable to expect employees to contact their manager to provide an update on their current condition and progress on a regular basis. Employees must be referred to the Workplace Health and Wellbeing department via the management referral form (Appendix 1), in order to obtain a report on their fitness to perform the duties of the post no later than 3 weeks after the absence commenced. In the case of absence due to stress, whether work related or personal or musculoskeletal injuries a referral should be made as soon as the manager is aware that this is the reason for absence. It is essential to establish a reasonable time frame in which to manage long term sickness absence and there are potentially five stages. At every stage the manager should outline what the steps are and the overall time scale in which the sickness absence should be managed. At each stage the action, timescale and next stage will be decided and confirmed in writing. It is important to establish, as early as possible, whether an employee will be:- able to return to their current role; or potentially redeployed into an alternative role; or eligible to apply for Ill health Retirement through the NHS Pension Scheme; or prevented from any of the above on the grounds of incapacity (ill health), when consideration would need to be given to termination of their contract of employment. It is normal practice to attempt to reach a conclusion during the employee s receipt of sick pay entitlement with a decision prior to the expiry of pay. Therefore the timescales for meeting stages may vary according to sick pay entitlement. It may be appropriate to hold further meetings with the employee in addition to the formal review meetings and managers should work within the formal stages whilst ensuring that the needs of the individual are met, bearing in mind greater contact may facilitate an earlier return. If an employee is not well enough to attend a sickness referral meeting at the normal workplace then alternative arrangements should be discussed such as meeting elsewhere or at the employee s home, with their permission. In all instances, the discussion will be confirmed in writing. Attendance Management Policy Page 15

16 In some cases it might be possible for the employee to return to work in a different capacity to their substantive role, on an interim basis, whilst they are awaiting diagnosis, prognosis, further information, treatment and/or operation. This will only be on the advice of the Workplace Health and Wellbeing department and will be subject to suitable work being found which the employee is capable of undertaking. In these circumstances the employee should receive their normal pay and it is expected that this should only be for a short period. 9.1 INFORMAL REVIEW MEETING (FOR ABSENCES OF 3 WEEKS) It is the manager s responsibility to maintain appropriate and agreed contact with an employee who is on long term sickness absence. Throughout the period an employee is off on long term sickness regular contact will be maintained by the individual s manager, at least when submitting each fit note. The purpose of this contact will be to provide the employee with early interventions and support. This contact may be made via telephone, letter or home visit by agreement and managers will be sensitive to the circumstances that the employee is off sick and act accordingly. Where absence extends or is expected to extend beyond 3 weeks the manager will invite the employee for a stage 1, informal review meeting and confirm this by letter (Appendix 9). It is well researched and documented that the longer people are away from work, due to illness or injury, the more difficult it is for them to make a successful return. The purpose of the regular contact is to ensure that the individual feels supported and encouraged to return as soon as possible. The manager/clinician must summarise the content of the discussion and agreed actions and the discussion must also be documented in a letter to the employee. Following an informal review meeting managers have a responsibility to ensure that regular contact is maintained with the employee who is on long term absence. 9.2 FORMAL REVIEW MEETING (FOR ABSENCES OF 6 WEEKS) A formal review meeting will be held when the employee has been absent from work for 6 weeks. At this stage and at all subsequent meetings a Human Resources Advisor/Business Manager would normally be present with the line manager, and employees should be advised of their right to be accompanied by a trade union representative or colleague in writing prior to the meeting. A letter should be sent to the employee to invite them to the formal meeting (Appendix 10). The purpose of the meeting is to provide continued support to the staff member and the meeting should be conducted sensitively. A copy of this policy should be made available to the employee as soon as possible prior to this meeting taking place. Potential outcomes from a formal review meeting may include one or more of the following:- Attendance Management Policy Page 16

17 further referral to the Workplace Health and Wellbeing department for assessment review all of the information available, including Workplace Health and Wellbeing advice facilitate a return to work Following the formal review meeting a letter should be sent to the employee outlining the details of the meeting and any actions agreed (Appendix 11). It will be expected that managers will meet with the employee at least every 4 weeks during their absence from work. Managers have a responsibility to ensure that regular contact is maintained with staff who are on long term absence. 9.3 FORMAL REVIEW MEETING (FOR ABSENCES OF 3 MONTHS) A formal meeting will take place for absences of 3 months in the following circumstances:- when the employee remains unable to return to work. medical opinion or clarification has been received in relation to the employee s health the employee plans to return to work with adjustments or to consider redeployment Workplace Health and Wellbeing have advised that due to the employee s health condition, a return to work is unlikely in the foreseeable future. Advice from the Workplace Health and Wellbeing department must be obtained for employees who have been absent for 3 months. If the employee is unlikely to return to work a final formal review meeting should be arranged. A letter should be sent to the employee to invite them to the final formal review meeting (Appendix 12). Following the final formal review meeting the manager/clinician must summarise the content of the discussion and agreed actions and the discussion must also be documented in a letter to the employee (Appendix 13). 9.4 FORMAL REVIEW MEETING (FOR ABSENCES OF 6 MONTHS) A formal meeting will take place for absences of 6 months in the following circumstances:- when the employee remains unable to return to work following the 3 month formal review meeting medical opinion or clarification has been received in relation to the employee s health the employee plans to return to work with adjustments or to consider redeployment Attendance Management Policy Page 17

18 Workplace Health and Wellbeing have advised that due to the employee s health condition, a return to work is unlikely in the foreseeable future. Advice from the Workplace Health and Wellbeing department must be obtained for employees who have been absent for 6 months. If the medical advice indicates that the employee is unlikely to return to work in the foreseeable future, a final formal review meeting should be arranged. The manager/clinician must summarise the content of the discussion and agreed actions and the discussion must also be documented in a letter to the employee (Appendix 14). 9.5 FINAL FORMAL REVIEW MEETING TO CONSIDER DISMISSAL A manager who has the authority to dismiss must be present at the meeting. The employee should be informed that if they fail to attend the hearing, the hearing manager will make a decision in their absence, based on the information available. The meeting will be held if any of the following circumstances occur:- the employee is unable to return to work following formal review meetings. medical opinion has confirmed that a return to work is unlikely in the foreseeable future there are likely to be continued absences from work on a regular basis and the service is unable to sustain this level of sickness absence no suitable alternative employment has been found the employee has attempted to return to work but has been unable to do so. The employee has returned to work but even with a phased return and/or reasonable adjustments cannot fulfil the requirements of the job role and no suitable alternative employment has been found. The outcomes from a final formal review meeting will consider one of the following options:- where for medical reasons Workplace Health and Wellbeing has determined that the member of staff is likely to return to work by a specified date, there may be a recommendation to return to work either via a rehabilitation programme or in an alternative role within the Trust. It may be appropriate to utilise the support of Access to Work; where Workplace Health and Wellbeing have determined that medically, the employee is unlikely to return to work in the foreseeable future; there may be a recommendation for termination of contract. The employee will have the right of appeal against any decision made to terminate their contract of employment; retirement on the grounds of ill health, should the employee wish to apply for this benefit and is eligible to do so. It is expected that, if applicable, this option will already have been discussed with the employee and the Trust will support them to pursue this option. However, the decision to approve an ill health retirement rests solely with the NHS Pension Agency and the Trust is not able to influence that decision in any way. Attendance Management Policy Page 18

19 The dismissed employee should be advised that they are entitled to notice paid in lieu together with payment for any outstanding annual leave. The manager should confirm the details of the meeting in writing to the employee. The dismissal letter (Appendix 15) should inform the employee of the right to appeal, in writing, within 21 days of the date of the letter to the Head of Human Resources stating their grounds of appeal. The appeals procedure is at Appendix REHABILITATION PROGRAMME If rehabilitation is considered appropriate by the Workplace Health and Wellbeing department, a range of options may be considered by the manager, employee, Workplace Health and Wellbeing and the Divisional HR Business Manager/HR Advisor. The rehabilitation period is to allow an effective, sustained return to work and may include the following:- phased return to work adjustment to work activity reduced working hours temporary placement in an alternative role with the option to return to normal duties within the short term future permanent re-deployment. Where annual leave has accrued, the manager, together with the member of staff should discuss how this would be best used to support a return to work. Where an individual who has had a period of long-term sickness makes an effort to return to work on reduced hours it may be possible for them to make up the hours not worked with outstanding annual leave, and so receive full salary. If an employee has no annual leave remaining then by agreement the Trust will make up the hours worked in accordance with Agenda for Change Terms and Conditions of employment. Phased return to work programmes will last for no more than 4 weeks unless there are exceptional circumstances. The number of hours or appropriate adjusted duties may be recommended by the Workplace Health and Wellbeing department although ultimately the working pattern will be determined by the line manager, in consultation with the individual, and based on service needs. The use of an employee s outstanding annual leave as part of the rehabilitation plan will be considered on a case by case basis with advice from the HR Business Manager/HR Advisor in order to ensure consistency. At the end of the agreed rehabilitation period, the individual will revert to their contracted working arrangements. During this period the individual will be classed as returned from sickness. Staff who are on long term absence and who refuse to attend absence meetings with no justifiable reason will not continue to receive occupational sick pay. Attendance Management Policy Page 19

20 11. LONG TERM ABSENCE AND ILL HEALTH RETIREMENT Employees who are members of the NHS pension scheme may decide to apply for ill health retirement and associated benefits. Whilst the Trust can support an employee in completing the appropriate documentation, the decision as to whether or not the application is accepted rests solely with the NHS Pensions Agency, and the Trust is not able to influence that decision in any way. A decision to dismiss on the grounds of capability should therefore be made irrespective of any application for ill health retirement. Decisions concerning potential termination in these circumstances will be taken on a case by case basis. A letter to send to an employee who wishes to proceed with an ill health retirement application can be found at Appendix MEDICAL SUSPENSION Where an employee attends work and the Manager has genuine concern about the state of their health, the employee may be medically suspended from duty. The decision to suspend should only be taken as a last resort and after the Manager (who must have authority to suspend) has advised the employee of their concerns and requested that the employee seeks medical advice and obtains a medical certificate. If the employee refuses, the Manager may take the decision to suspend on medical grounds. Where possible this should only occur after discussion with the Divisional HR Business Manager/HR Advisor and Workplace Health and Wellbeing. The decision to suspend on medical grounds will only be taken after the following issues have been considered:- the severity of the employee s health problem. the possible effects on the employee s own work. the possible effects on patients and/or other employees. re-deployment as an alternative to medical suspension. The employee will receive normal pay during medical suspension. The Manager must refer the employee immediately to the Workplace Health and Wellbeing department to obtain a medical assessment. In cases where a GP recommends that an individual is fit to return to work but the Workplace Health and Wellbeing department does not, discussions will take place between the GP and the Workplace Health and Wellbeing department to agree a way forward. All options will be explored to find an acceptable solution for all parties i.e. lighter/adjusted duties, if appropriate. Whilst discussions take place the individual will be placed on special leave with full pay (as defined in current Agenda for Change terms and conditions). The same process will apply where the Workplace Health and Wellbeing department recommends that an individual should return to work but is not supported by the GP. However, in this case the individual will remain on sick pay. Attendance Management Policy Page 20

21 13. THE EQUALITY ACT 2010 DISABILITY PROVISIONS The Equality Act lays a duty upon employers to consider what changes or reasonable adjustments they could make to the workplace or the way work is done which would overcome the effects of disability. In the operation of this policy, managers must ensure that anyone who has a disability, as defined by the Act, is not subject to unjustified discrimination. This applies whether the disability was present when the employee was appointed, or whether they became disabled during the course of their employment. Where the Trust engages an employee in the knowledge that the employee has a condition that meets the definition of disability under the Act 2, it accepts the particular disability as an implied term of the Contract of Employment. The disability (or absence associated with that disability) cannot normally be used as grounds for later dismissing the employee unless the same condition had deteriorated since the commencement of employment. It is the responsibility of the employee to bring to the attention of the Workplace Health and Wellbeing department, at the time of their pre-employment medical screening, any medical condition that may impact upon their ability to attend work regularly. It is the responsibility of the Trust to make adaptations or adjustments to the role or seek reasonable alternative employment in the event of an employee becoming disabled whilst in employment. Advice should be sought from the Human Resources department and the Workplace Health and Wellbeing department. 14. PREGNANCY Any dismissal or detrimental action in relation to pregnancy related absence is automatically unfair. Monthly risk assessments should take place and lighter or alternative duties be considered in order to enable the employee to continue working until the start of her planned maternity leave. For the purposes of short term thresholds, pregnancy related occurrences will be discounted. If an employee is off work ill, or becomes ill, with a pregnancy related illness during the last four weeks before the expected week of childbirth (EWC), maternity leave will normally commence at the beginning of the fourth week before the EWC or the beginning of the next week after the employee last worked, whichever is the later. Absence prior to the last four weeks before the EWC, supported by appropriate certification, shall be treated as sick leave in accordance with normal leave provisions. 15. PAY PROGRESSION/MEDICAL STAFF PAY THRESHOLDS 2 A disability is defined as a physical or mental impairment which has a substantial and long-term adverse effect on the individual s ability to carry out normal day-to-day activities Attendance Management Policy Page 21

22 Whilst absence from work will not automatically trigger withholding an increment, managers should take this into account in assessing an individual s overall performance during the review. Managers should refer to the Trust s Pay Progression policy for further information. 16. TEMPORARY INJURY BENEFIT SCHEME Where a member of staff suffers either a temporary or permanent reduction in pay as a result of an injury or illness sustained in the course of their work, they may be entitled to benefits under the NHS Injury Benefits Scheme. This applies whether or not they are a member of the NHS Pension Scheme. 17. SICKNESS ABSENCE AS A RESULT OF AN ACCIDENT AT WORK Where a member of staff sustains a major injury as a result of work, for example a fracture (other than to fingers, thumbs and toes), amputation, loss of sight; suffers an over three day injury or suffers from a reportable work-place disease, the reporting requirements under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995, (RIDDOR), must be complied with. Details of the regulations are contained within Health and Safety procedures. Where an absence occurs following an accident at work, managers are advised to seek Workplace Health and Wellbeing advice to ensure that an employee is fit to resume work, and to prevent future accidents to any other employees. Where an absence occurs that can be clearly evidenced as a result of workplace stress (but not in relation to an on-going disciplinary investigation or case), managers are advised to seek advice from the Mental Health & Wellbeing Service. Where an accident at work, or illness caused by work, is not due to an employee s negligence this should be taken into account when reviewing sickness absence thresholds and should not result in escalation based on one single episode. In the event of more than one episode linked to the same accident, this will also be taken into account. 18. ACCIDENTS OUTSIDE WORK Sick pay is not normally payable for an absence caused by an accident due to active participation in sport as a profession, semi-professional or where contributable negligence is proved. An employee who is absent as a result of an accident is not entitled to sick pay if damages are received from a third party. The Trust will advance to the employee a sum not exceeding the amount of sick pay payable under the scheme providing the employee repays the full amount of sickness allowance to the Trust when damages are received. 19. STAFF WHO BECOME ILL DURING ANNUAL LEAVE If an employee becomes ill during a period of annual leave, the employee must Attendance Management Policy Page 22