Oxford Health NHS Foundation Trust. Returning to work: A selfhelp. Healthy Minds Wellbeing Service: Employment support service

Transcription

1 Oxford Health NHS Foundation Trust Healthy Minds Returning to work Returning to work: A selfhelp guide Healthy Minds Wellbeing Service: Employment support service

2 Healthy Minds Returning to Work Introduction This self-help guide offers practical advice to help you return to work after a period of sickness and absence. It gives information regarding the fit note, which replaced the sick note, best practice when off sick and how to manage your return to work successfully. The guide will take you through your journey back to work, offering practical advice about what to do when you first go off sick and the best ways to ensure that you return to work as soon as you feel able to. In some cases working can actually help your recovery, particularly if reasonable adjustments can be made by your employer to help you return to work. This may include working part-time, at home, changing some of your tasks or responsibilities in the short-term. Or perhaps having a buddy or mentor or transferring to another department for a while. With correct planning, preparation, good communication by you and your employer and appropriate support, a return to work can be made easier for both you and your employer so that you can ensure a successful and sustainable return to work. 2 Oxford Health NHS Foundation Trust

3 Information leaflet The fit note The Statement of Fitness for Work ( fit note ) was introduced in April 2010 to replace the sick note. The fit note allows GPs to provide patients with advice on their fitness to work, which can be passed to their employer. Employees may be able to perform some elements of their role (or an alternative role) before they have recovered from illness completely. The fit note is used by GPs to give information on when an employee might be able to return to work and what they can/ can t do as a result of their ill health. What s changing? From early July 2012, GPs started using computer-completed fit notes. The roll-out of the computer-completed fit note is expected to be complete by early The new computercompleted fit note is printed on one side of A4 paper, it includes the same information as hand-written fit notes and is printed out by GPs and given to patients (it cannot not be sent via or any other electronic method). Patients will still get handwritten fit notes from hospital doctors, GPs on home visits and GPs with older IT systems (until their systems are upgraded). Oxford Health NHS Foundation Trust 3

4 Healthy Minds Returning to Work Advantages for employers The electronic fit note: is easier to read allows easier data collection due to a systemgenerated barcode, which can be scanned. (This barcode cannot be altered once it has been printed by the GP and contains key information from the fit note) enables employers to check that the information it contains matches the information on the computercompleted fit note allows employers to feed information into the employee record system Fit notes - what they are The fit note allows your doctor to provide you with more information on how your condition affects your ability to work. It will help your employer to understand how they might be able to help you return to work sooner. Using the fit note your doctor can: advise when you may be fit for work with some support suggest common ways to help you return to work 4 Oxford Health NHS Foundation Trust

5 Information leaflet give information on how your condition will affect what you can do The fit note can be used as evidence of why you cannot work, due to illness or an injury, but you won't need the fit note as evidence until after the seventh calendar day of sickness. Understanding your fit note When your doctor provides you with a fit note they will advise you on one of two options. Either you will be 'not fit for work' or you 'may be fit for work'. 'Not fit for work' Your doctor will choose this option when they believe that your health condition will prevent you from working for a stated period of time. 'May be fit for work' Your doctor will choose this option when they believe that you may be able to return to work while you recover with some help from your employer. If appropriate, they can also suggest one or more common ways to help you return to work by ticking the boxes that are on your fit note. Ticking the boxes will assist your employer with what will support you. (The next time you have been given a fit note look at the categories). Oxford Health NHS Foundation Trust 5

6 Healthy Minds Returning to Work The categories on your fit note are: a phased return to work This is where you may benefit from a gradual increase in your work duties or working hours, for example after an operation, after injury, recovering from stress. altered hours Allowing you the flexibility to start or leave later, for example if you struggle travelling in the 'rush hour' or you get extremely tired while recovering. amended duties To take into account your condition, for example removing heavy lifting if you have had a back injury, reducing workload due to difficulty with concentration from stress. changes to your workplace To take into account your condition, for example allowing you to work on the ground floor if you have problems going up and down stairs, special screens if you suffer from dyslexia or if your eyesight is affected. As well as your GP ticking the above boxes that appear on your fit note, they can also write in the comments section any further recommendations which can also help your employer understand how you are affected by your condition. 6 Oxford Health NHS Foundation Trust

7 Information leaflet Communicating about stress and distress at work Talking to your manager about stress and distress Many people are afraid of revealing their stress or distress and will struggle on until they reach the point of breakdown. However, the earlier the issues are tackled, the more likely it is that you can agree on support or adjustments that enable you to continue in work. When approaching your manager, remember that they may also be fearful of emotional or difficult interviews. The stigma around mental health can easily affect both parties, so explaining the facts about mental health as much as possible will help a manager understand. It may be helpful to consider some or all of the following helpful points: If your manager seems anxious or reluctant to engage with you, you may need to show them a way into discussing the issues. They may be fearful about saying the wrong thing. If that happens, you can gently correct them but show that you value the effort they are making. You will need to produce a fit note in order to obtain sick pay. Think about what you are going to say to the GP. Will it Oxford Health NHS Foundation Trust 7

8 Healthy Minds Returning to Work be helpful to put your employer and GP in touch? You may have to give permission for the employer to contact your GP Check out what you are required to do under the terms of the attendance policy of your employer by checking the policies or procedures, and if the problem involves your home life, how much do you wish to reveal? Might it be helpful for the manager to know of a particular issue? If so, consider your boundaries around this. Are there particular actions that your manager could take which would reduce stress? What, if anything, do you wish colleagues to be told? Decide which colleagues and who will tell them. Do you wish to ask for any company-funded medical care? How do you think your progress / performance should be monitored? It may be that something has triggered distress that has been building up for some time. You may feel angry or frustrated. How will you manage these feelings in the meeting? Are there any ways in which the meeting with your manager could be made easier? For example, held in a neutral location or with a friend, family member, trade union representative or advocate attending? How much are you prepared to disclose about any medical care? If there are problems at work that involve other people, are you going to talk to the manager about this? Do you need to consult others before doing so? For example, there may be a problem with bullying or harassment. 8 Oxford Health NHS Foundation Trust

9 Information leaflet Considerations in the course of Sickness Absence Keeping in touch during sickness absence Early, regular and sensitive contact between the employee and employer can be a major factor in enabling an early return to work. Managers sometimes fear that contact with an employee who is off sick will be seen as harassment. But lack of contact or involvement can actually make an employee isolated and less able to return to work. To alleviate incorrect assumptions and manage expectations, here are some things to consider: Although it can feel difficult, it is advisable to keep in touch with your employer. This is partly so that practical issues around sick leave can be resolved and you can clear up any worries you have that relate to the job. However it s also important for emotional and social reasons. It s easy to feel cut off and isolated and to lose confidence. And, the longer you are away, the more difficult it can be to cross the threshold when you do return. Agree a time that your employer can regularly contact you and the method of communication, such as telephone, text, or face-to-face meetings in a neutral setting. If you meet face-to-face you can arrange for someone to accompany you. Oxford Health NHS Foundation Trust 9

10 Healthy Minds Returning to Work If you are too unwell to be contacted suggest a friend or family member that can keep in touch with work on your behalf. Then as soon as you are well enough you can arrange direct contact yourself. Some issues you might like to consider are: Worries about losing your job or about financial issues. It is best to raise these fears directly so that you can clarify the true position whether there is a half-way house between working and being off sick for example, maybe you could work a couple of hours a day from home? When it is right for you, could you attend work just for a cup of tea so that you are in touch with people and what s happening both at work and socially? Is there a colleague or friend at work who can keep you in touch and let others know how you are? Do you want visits / cards / calls from colleagues? What will you tell them when they visit? What questions are off limits? And how will you handle this? Can your manager refer you to sources of support or treatment? Are there any company schemes that you can draw upon, such as counselling, access to healthcare, access to occupational health professionals (doctors and nurses who specialise in workplace health). 10 Oxford Health NHS Foundation Trust

11 Information leaflet Returning to work: Return to Work plan A Return to Work plan is a written and agreed plan about how you will return to work. It should be developed in discussion with your employer, taking into account any adjustments that have been indicated by the GP on the fit note. The point of the plan is to ease the employee back into work based on a planned structure that both employee and employer can work from. It s about helping the employee be rehabilitated to their working environment and to assist in their recovery until the employee can return to full duties. The Return to Work plan should be regularly reviewed and amended as appropriate. If you have identified any stress factors which you can control, review these regularly and ensure that you have necessary strategies in place. Remember: A timeframe should be agreed and who will review this with you. Be prepared to be flexible as some of the adjustments may not be organisationally practical. Try to negotiate a sensible sustainable plan that is realistic. Communication is the key and has to come from both the employee and the employer. Discuss with your employer any Oxford Health NHS Foundation Trust 11

12 Healthy Minds Returning to Work reasonable adjustments that will help support you and ease your return to work, which could include the following points: How can I prepare for returning to work? Think about any adjustments or support that would be helpful. For example, are there particular aspects of the job that make you feel anxious? You might have some practical suggestions about what can be done about these. Are there any particularly stressful projects / events coming up where support might be helpful or where you can delegate responsibility? Think about how you d like your progress to be monitored. What goals are realistic? How would you like this to be done and at what frequency? You might prefer meetings or informal chats outside work. If your workplace has a system for this, do you know what it is? You might find it useful to talk to a neutral/ independent person who could act as a mentor. You will want to ask that you be allowed to attend therapeutic sessions, treatments and medical appointments. 12 Oxford Health NHS Foundation Trust

13 Colleagues and clients Information leaflet Think again about what you d like colleagues or clients to be told. How will you describe what s been happening? How will you protect yourself against intrusive or tactless questions? Might it be helpful to meet up for a drink / coffee / lunch with a trusted colleague to catch up before you return? Gradual increase in hours When you feel ready to return to work, would you benefit from a gradual phased return to work such as three half days a week, then five half days, then three full days and then a full return to work? Do not contemplate overtime until you feel fully recovered. Managing an on-going illness whilst at work If you have an on-going mental health problem, it is likely that you have developed coping strategies. These may include being aware of the warning signs for a relapse and taking pre-emptive action. For example: no overtime, reduce social events that affect the likelihood of a relapse being careful about drinking alcohol taking exercise and finding time to relax Oxford Health NHS Foundation Trust 13

14 Healthy Minds Returning to Work being able to take breaks not eating at your work station or desk It may be helpful to talk to your manager about this strategy and to ask for support if you spot early signs of a relapse. Again, communication is the key. Advance statements Some people find it useful to draw up an advance statement which explains how they wish to be treated if they become unwell. The statement can cover practical arrangements as well as treatment preferences, including details of the people who should be contacted or provided with information. You should agree what will be said to work colleagues and when this should be done. Including how work colleagues can be supportive and so help them understand how you want to be treated at work. Other factors to consider when compiling a Return to Work plan To agree and arrange an informal chat with your manager or HR to agree your Return to Work plan to find out your responsibilities and duties will be before you start back to work. Before you actually do any work, visit your work premises to re-acquaint yourself to the environment, have a cup of coffee, say hello to people, see if there are any physical 14 Oxford Health NHS Foundation Trust

15 Information leaflet changes at work, if there are new people and to check out your own work space. This could take just half an hour and there will be reduced pressure on the day you do start back to work. Agree to have regular catch-up meetings once a week with your manager and have a backup contact if your manager goes on holiday, is sick or is unavailable. This is not to appraise your work, but to ask about your welfare and wellbeing and how you are getting on. Plus, any further adjustments that need to be made and if the plan is working? To agree on having a buddy or mentor who can help with the day-to-day queries and support, plus they can understand and notice if you are showing signs of stress and ask if you are ok. This will be useful as you may not realise that you are behaving in a stressed manner. If you feel confident enough you may want to share what the triggers are that cause the stress so a buddy can support you in your coping strategies. Be aware that you will become more tired as your mind and body readjust to the routine of work. Try and agree in having regular breaks. Get fresh air at lunch time. Don t eat at your work station. Focus on something else, such as reading a magazine or going for a walk. Return to work interview When you have your return to work interview it would be helpful for the manager to update you on new developments within the organisation, any retraining, Oxford Health NHS Foundation Trust 15

16 Healthy Minds Returning to Work new equipment, new processes and procedures. It could be put in writing, so you don t forget and have something to refer to. Generally this must be a friendly chat on what has been going on at work. The manager must ensure you are well enough to be at work. You may or may not feel able to discuss your medication, but if there are health and safety risks at your work, it is crucial to share what medication you are on in case there are any side effects that you may experience and could put yourself at risk of being hurt. Confirm you and the manager are clear on work duties and look at aspects that you find particularly stressful so the manager is then fully aware. Agree on how to introduce further work duties as hours increase. To confirm how you will be paid during the phased return. This discussion should be honest and open and be careful not to make assumptions that people will know what to do. Be clear on your expectations as well as the employer s expectations, so there is no misunderstanding. What happens if the return to work is not successful? Try to go through the reviewing process and options for making further adjustments and talk sensibly and practically with your employer about the best way forward. 16 Oxford Health NHS Foundation Trust

17 Information leaflet Consider: Did you return to work too quickly? Are there any other reasonable adjustments that could be made to help you? Was the phased return too short or even too long? Did you not feel supported and if so what would support you further? Statutory Sick Pay (SSP) Statutory Sick Pay - telling your employer you are sick and providing evidence Before your employer can decide on your entitlement to Statutory Sick Pay (SSP), you must tell them that you are sick. You will also have to provide your employer with some form of evidence that you are sick. Your employer may have their own rules about when and how you tell them you are sick and should tell you what these are. Your employer may have a self-certification document for the first seven days, so it is always best to check. You must check with your employer if you do not know or check your organisation s policies and procedures. If your employer does not have their own guidelines, you should tell your employer within seven days of the first day that you are sick. Oxford Health NHS Foundation Trust 17

18 Healthy Minds Returning to Work However, your employer cannot insist that you tell them: in person earlier than the first qualifying day or by a set time on a special form on a doctor s statement of fitness for work (fit note), more than once a week during your sickness Delays in telling your employer that you are sick Your employer does not have to pay you Statutory Sick Pay (SSP) for any delay in telling them that you are sick. They will pay from the date that they were told as long as you are still sick and the rules for payment are satisfied. However, you may have to serve 'waiting days' before payment. Who can get Statutory Sick Pay? You may be able to get Statutory Sick Pay (SSP), if you have: been sick for at least four or more days in a row (including weekends, bank holidays and days that you do not normally work) average weekly earnings equal to or more than the Lower Earnings Limit (LEL) 18 Oxford Health NHS Foundation Trust

19 Information leaflet Lower Earnings Limit (LEL) The LEL is the amount you would need to earn before you start paying National Insurance contributions. From 9 April 2012, the LEL is 107 a week. What days you'll be paid SSP for? SSP is paid for qualifying days. These are the days that you would normally work for your employer under a contract of employment. However, it is not payable for the first three qualifying days. These days are known as waiting days. If you work part-time, you must still serve your three waiting days before you can get payment. This means you may not receive a payment at the start of your period of illness. If you have a varied work pattern, your qualifying days may be different in each week that you work. Please speak to your employer about this. Examples If you work Monday to Friday and become sick on a Friday. Your waiting days will be Friday, Monday and Tuesday. If you continue to be sick, SSP will be paid from Wednesday. If you work Thursday and Friday and become sick on a Friday. Your waiting days will be the Friday of the week that you are first sick and the Thursday and Friday of the next week. If you continue to be sick, SSP will only be paid from the Thursday of Oxford Health NHS Foundation Trust 19

20 Healthy Minds Returning to Work the following week. Types of sick pay If you take time off from work due to illness, you might be entitled to sick pay. There are two types of sick pay: Company sick pay (also called contractual or occupational sick pay) Statutory Sick Pay If your employer runs their own sick pay scheme it is a 'company sick pay scheme' and you should be paid what you are due under that. This will depend on what is included in your employment contract. If you aren't entitled to anything under a company scheme, your employer should still pay you Statutory Sick Pay (SSP) if you are eligible. Company sick pay (or company contractual sick pay) Your employer may offer a sick pay scheme that is more generous than SSP. Your employer can offer any scheme that does not fall below the legal minimum. Details of your company sick pay entitlement should be included in your written statement of employment particulars, which you should be given within two months of starting work. 20 Oxford Health NHS Foundation Trust

21 Information leaflet If your company doesn't offer a scheme, the written statement should say so. It may also be in your company s policies and procedures. Company sick pay schemes vary from employer to employer. A typical sick pay scheme usually starts after a minimum period of service (e.g. a three month probationary period). You would then receive your normal pay during any period that you are off work due to illness, up to a specified number of weeks. After this, you are likely to receive half-pay for a further period before any sick leave you take becomes unpaid. Proof of sickness required by your employer Your employer may set out how you should tell them that you are sick (e.g. ring in before a certain time of the day). Usually you will be able to self-certify for a week of illness, beyond that a fit note (doctor's note) is normally needed. Oxford Health NHS Foundation Trust 21

22 Healthy Minds Returning to Work The Benefits of working Good mental health at work The workplace has an impact on people s health and wellbeing. It has been evidenced that, in general, being in work is good for our health. However, poor conditions in the workplace can have a detrimental effect on our wellbeing and limit the benefits of working. It is important not to underestimate the positive psychological benefits of returning to work after illness, although it is imperative that the benefits are weighed up against the disadvantages. Many people feel that returning to work after illness gives them a sense of their old self and helps them to not feel defined by their illness. However, this can mean that some people go back to work sooner than perhaps they ought to, or overdo it when they return. Do be aware that while the positive impact of feeling a little bit like you used to is certainly a good thing, you do not want to risk getting ill again by pushing yourself too hard. Confidence Returning to work after illness can be a real boost to your confidence. This is often due to the fact that you are doing something that you are good at and are getting financially rewarded for. 22 Oxford Health NHS Foundation Trust

23 Information leaflet Earning money Aside from the practical benefit of earning money, it also is a real psychological boost, especially if you have been on long term sick pay or receiving benefits. Being rewarded for a job well done is important for your mental wellbeing and enables you to feel the power of having some control over your life back. Your mental wellbeing is a key part of getting over an illness and returning to work, so it is important to appreciate that you will perhaps feel both exhausted and proud at going back to work. It is vital to have a Return to Work plan in place before returning to work so you can feel confident that your return is successful and sustainable. The Return to Work plan will give you and your employer a structure and basis to work from which will support you while you rehabilitate yourself back into the work environment. Recognising work-related stress The definition of work-related stress by the Health and Safety Executive is the adverse reaction people have to excessive pressure or other type of demands placed on them at work. A certain amount of pressure in a working business environment is appropriate. Pressure helps to motivate people and will boost their energy and production levels. But when the pressure people face exceeds their ability to cope with it and stops people being able to function, it becomes a negative Oxford Health NHS Foundation Trust 23

24 Healthy Minds Returning to Work rather than a positive force in other words: stress. Employees can also feel stressed when they are bored, undervalued or under stimulated. Stress is not a medical condition, but research shows that prolonged exposure to stress is linked to psychological conditions such as anxiety and depression. With this guide as a supportive tool you will be able to recognise the symptoms of stress at work and how to manage it appropriately, whether through your own coping strategies or with the help of your employer. Remember that recognising, communicating and planning can be key in maintaining your wellbeing at work. Good luck on your recovery journey and returning to work. PLEASE SEE OTHER SELF HELP GUIDES FOR FURTHER INFORMATION AND ADVICE e.g. Finding work, preparing for an interview and returning to work. 24 Oxford Health NHS Foundation Trust

25 Information leaflet Notes Oxford Health NHS Foundation Trust 25

26 Healthy Minds Returning to Work Notes 26 Oxford Health NHS Foundation Trust

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28 Healthy Minds Returning to Work Oxford Health NHS Foundation Trust Trust Headquarters 4000 John Smith Drive Oxford Business Park South Oxford OX4 2GX Switchboard Website CF Oxford Health NHS Foundation Trust