Management of Ill Health Policy and Procedure

Transcription

1 Management of Ill Health Policy and Procedure This Policy describes the process for Managing Ill Health Key Words: Sickness, Ill health, Fit Note, Long term, Short term, return to work, triggers, occupational health, targets, underlying condition, phased return, reasonable adjustments, stress, permitted hours, medical appointments, sick pay, industrial Injury Version: 11 Adopted by: Date adopted: Name of originator/author: Name of responsible committee: Date issued for publication: Workforce and OD Development Committee 18 th April 2012 Human Resources Workforce and OD Development Committee 1 st May 2014 Review date: May 2016 Expiry date: May 2017 Target audience: All Staff Type of Policy Clinical (tick appropriate box) NHSLA Risk Management Standards if applicable: n/a Relevant CQC Standards: 14 Non Clinical

2 CONTRIBUTION LIST Key individuals involved in developing the document Name Kshama Srivastava Vyv Wilkins Vanda Walker Designation Senior HR Business Partner Equalities and Human Rights Officer HR Business Partner Circulated to the following individuals for comments Name Kathryn Burt Human Resources Operational Team Antony Upton Richard Holmes Designation Head of HR (CHS) Senior HR Business Partners/ HR Business Partners/ Senior HR Advisors Local Counter Fraud Specialist Support Local Counter Fraud Manager HOG members LPT senior managers band 8a and above Workforce & OD Development Committee Members Policy Group Members Integrated Equality & Diversity Service Joint Staff Consultation and Negotiating Committee (JSCNC) Listening into Action focus group. 2 of 74

3 Contents POLICY Section Area Page No. Equality Statement 11 1 Summary 11 2 Introduction 11 3 Purpose, Scope and Key Principles, Training 12 PROCEDURE 4 Duties within the organisation 14 5 Certification, Monitoring & Recording Absence 18 6 Return to work 21 7 Absence triggers 22 8 Referral to Occupational Health 22 9 Procedure for dealing with short term & unrelated sickness absence Procedure for dealing with absence due to a chronic underlying medical condition or long term or permanent incapacity whether or not absence has occurred. 11 Absence due to stress or anxiety Other areas 12.1 Postponement of ill health review meetings Phased return to work - Staff returning to work due to underlying medical after condition long term sickness Permitted Work Staff still on certified sick leave 12.3 Self Elected or Cosmetic Surgery 12.4 Sickness and Annual Leave/Public Holidays 12.5 Medical appointments 12.6 Pregnancy-related sickness 12.7 Sick Pay 12.8 Industrial Injury 12.9 Absence due to IVF treatment Gender Reassignment Absence due to D&V 13 Sickness Absence Data Monitoring for Compliance and Effectiveness of 74

4 Contents continue. Section Area Page No. 15 Link to Standard/Key Performance Indicators Due Regard References Dissemination and Implementation Training 43 1 Absence from Work - First Contact Sheet 44 1a Self Certification of Sickness Absence 45 1b A Sample Statement of Fitness for Work (fit note) 46 2a Health Monitoring Form 47 2b Return to Work form 48 3a Weekly absence return form with guidance to complete 49 3b Guidance for inputting sickness on ESR using self service 49 4 Occupational Health Referral Form 50 5 Template for ill health review meeting letter 54 6 Redeployment on ill health grounds 57 7 Levels of Authority for Dismissal, Reviews and Appeal 59 8 Flowchart showing how a sickness hearing will be run 60 9 Procedure and flowchart for conducting an appeal hearing Trust s guidance on carryover of annual leave accrued during sick leave Due Regard Initial screening template NHS Constitution checklist Policy Monitoring 71 4 of 74

5 Version Control and Summary of Changes Version No 1 Date March 2012 Comments (description change and amendments) Adopted the LCCHS Managing Sickness Absence Policy and Procedure and updated accordingly /05/12 Deleted the following wording in Para Staff working in catering sections or handling food must be excluded from coming to work for a period of 48 hours after they have been symptom free and excluded from handling food for a period of further 24 hours. This has been replaced with the following; Any employee who is off sick due to D&V must be excluded from coming to work for a period of 48 hours after they have been symptom free. 17/05/12 Added clarification on Chronic underlying medical condition to be recognised under section 10 of the Procedure. The foot note states: For a Chronic underlying medical condition to be recognised under this section, it should have been diagnosed by a clinician (GP, Nurse or a hospital doctor) and the person should be under the care of their GP or another clinician 17/05/12 Additional text added to the first bullet point of Shown in red and italics: Discussions regarding how long the employee is likely to be incapacitated. Discussions regarding the level of future absences particularly in cases of short term sickness absence due to a chronic underlying condition. 17/05/12 Appendix 1a self-certificate: Deleted the following option from the reason for absences: S99 Unknown causes (not specified) 17/05/ addition of the following text in point 4 Shown in red and italics Ill health retirement will be considered if in the opinion of the Occupational Health service the employee meets the criteria for applying for ill health retirement and where the employee meets the NHS Pension Scheme length of service criteria. Where ill health retirement is an option, the application process for ill health retirement will l run concurrently with the notice period to terminate an employee s contract of employment unless the employment has been terminated with pay in lieu of notice 06/09/12 In cases of employees with special class status who are aged 55-60, termination of employment may be deferred following the result of their ill health retirement application. If their ill health retirement application is unsuccessful this deferral ill enable them to apply for special class status retirement whilst still in 5 of 74

6 employment. 17/05/12 Appendix 10 updated as follows; 6 of Where an employee has been unable to take their annual leave entitlement in the leave year due to being on sick leave for the entire leave year or because there is insufficient time left to take leave on their return from sick leave, they will be entitled to carry forward outstanding leave into the next leave year. The amount to carry forward will be calculated as specified in point 4 below. 4. Where a decision has been made to allow an employee to carry over outstanding annual leave (more than 1 week) to the next leave year, the total of the number of days leave taken during the leave year and number of days leave to be carried over cannot exceed statutory leave entitlement including any bank holidays which have been taken in the leave year. 4 22/05/12 Final version 5 31/05/12 First contact sheet amended 6 06/12/12 Under 12.5 medical appointments added the text in red and italics: Employees are expected to arrange medical appointments outside their work hours. Where this is not possible, the employees will be allowed to take time off to attend these appointments taking into account any reasonable adjustments such as adjustments of hours etc. for regular appointments. The line manager, however will need to see the proof of appointment before granting time off with pay. 7-8 Amendment to para 9.1 as follows: Where a manager has identified a problem of short term and unrelated sickness absence (patterned or sporadic) and they have established that the absences are not due to a chronic underlying condition, the manager will act in accordance with the following procedure, unless there are exceptional reasons not to do so. Where a manager is unsure whether there is an underlying medical condition they should refer the employee to Occupational Health to seek advice on this. 9 23/05/13 Paragraph and have been amended in light of the changes in national NHS terms and conditions regarding calculation of sick pay /01/14 Throughout the policy, reference has been made to the Reasonable Adjustments (RA) Policy which is now implemented (Dec14). This policy should be implemented in conjunction with the RA policy is new to account for e-rostering process Line managers are responsible for ensuring the accurate

7 7 of 74 submission of absence data to payroll. Submission can be through: 1. Where areas are rostered absence should be recorded through the E-rostering system. 2. Where managers have access to ESR supervisor self-service functionality they must ensure that absences are recorded on ESR in a timely manner. 3. Where managers have no access to electronic systems they should complete the weekly absence return form (Appendix 3) for all their employees and ensure timely submission to payroll for the previous week so SBS will input by 12 noon on the Tuesday. Managers should only submit the data using one method If an employee becomes ill whilst at work and feels too unwell to continue working, their absence from work for part of a working day will not be recorded as sickness absence for sick pay purposes. This absence however will be recorded on their health monitoring form and will be taken into account when monitoring patterns and levels of sickness absence. 9.5 There are a number of stages of formal reviews that can be held. Each stage is attached to an action. These increase in severity to reflect the size of the absence issue, but will generally start from the lowest level and progress to more serious levels if the problem is not resolved. There may be circumstances where it necessary to move straight to a formal stage of the procedure e.g. where a significant history of poor sickness absence has been identified And In stage 2 and 3 of formal review meeting, we have added that A member of the HR Operational Team will usually be present at this meeting have been separated out for clarity. We now have managing long term absence where redeployment is an option and a separate section where redeployment is not an option. Where redeployment is an option, appendix 6 provided detail and should be read in conjunction with this section added additional information to take account of the NEST pension scheme Employees undergoing self-elected surgery/procedures will normally need to use their annual leave or request unpaid special leave to cover for their absence. We have added: N.B Gender reassignment procedures are exempt please refer to Gender Re-assignment Policy. Added Employees who are required to attend Amica counselling appointments will not be required to make up the time lost.

8 Added Where the employee's absence is as a result of an injury at work, or may be attributable to their employment they should be made aware of the amended NHS Injury Benefit Scheme regulations (2013) and the Trust Guidance on NHS Injury Allowance. Please refer to section 12.8 for further details. Added Any employee who is off sick due to D&V must be excluded from coming to work for a period of 48 hours after they have been symptom free. This applies if you are off with one of the symptoms i.e. D and/or V New due regard screening template appendix 12 completed Appendix 2a added guidance on triggers Appendix 2b added prompt regarding professional registration Appendix 6 provides clearer guidance on the timing of giving notice on the redeployment process. Regardless of contractual notice, all employees will be issued with 12 weeks notice of termination at the beginning of the 12 week re-deployment period. Added Included new stage where the employee will be offered the right to a formal dismissal panel hearing. This is also included in appendix 7. Titled changed to Management of Ill Health policy and procedure and include a new section Section 10 now makes reference to procedure for dealing with chronic underlying medical condition or long term or permanent incapacity whether or not absence has occurred. Legal advice sought and they confirmed that redeployed due to disability related ill- health redeployment will attract pay protection in accordance with the Trusts pay protection provisions /04/14 Feedback from policy group comments incorporated, which include; Training paragraph and NHS Constitution checklist 08/05/ Employees must not work under any other employment arrangement (directly employed bank, agency or self-employed) with the Trust or any other employer during this time). 28/05/14 Appendix 5 amended to reflect prompt of annual leave discussion and half pay/no pay discussion /10/14 Appendix 2b amended to include prompt for discussion about support which could have been offered which would have negated the need for absence. 02/10/14 The number of days an employee has to appeal against a formal 8 of 74

9 9 of 74 warning or dismissal on grounds of ill health has been amended from 7 calendar days to 10 working days to ensure consistency with other Trust policies.

10 All LPT Policies can be provided in large print or Braille formats, if requested, and an interpreting service is available to individuals of different nationalities who require them. For further information contact: Vanda Walker, HR Business Partner, on (0116) or 10 of 74

11 Definitions that apply to this Policy Long term sickness Short term sickness Trigger points Due Regard Sickness absence will be classified as long term if the employee has been absent for a continuous period of 4 weeks or more. Sickness absence will be classified as short term if the employee has been absent for a continuous period of less than four weeks. 6 working days or 4 episodes in any rolling 12-month period (pro rata to the number of days worked per week for staff working less than 5 days per week) Having due regard for advancing equality involves: Removing or minimising disadvantages suffered by people due to their protected characteristics. Taking steps to meet the needs of people from protected groups where these are different from the needs of other people. Encouraging people from protected groups to participate in public life or in other activities where their participation is disproportionately low. 11 of 74

12 Equality Statement Leicestershire Partnership NHS Trust (LPT) aims to design and implement policy documents that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. It takes into account the provisions of the Equality Act 2010 and advances equal opportunities for all. This document has been assessed to ensure that no one receives less favourable treatment on the protected characteristics of their age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex (gender) or sexual orientation. In carrying out its functions, LPT must have due regard to the different needs of different protected equality groups in their area. This applies to all the activities for which LPT is responsible, including policy development, review and implementation. 1.0 SUMMARY 1.1 The exists to provide a fair and consistent and compassionate approach to the management of sickness absence in the work place. 1.2 The Trust values the health and well being of its employees and aims to enable the attendance of all employees throughout the working week and provide a supportive framework on which ill Health may be managed appropriately. This proactive approach aims to support employees to remain at work. 1.3 Whilst is accepted that ill health is a part of life. The Trust acknowledges that high levels of ill health may have a detrimental effect on the level of service provided and can place an added burden on other employees. 1.4 This policy should be read in conjunction with the Trusts Reasonable Adjustment Policy. 2.0 INTRODUCTION 2.1 Leicestershire Partnership NHS Trust (LPT) recognises the valuable contribution made by every member of staff to the delivery of its services and is committed to the promotion of their health, safety and well-being. 2.2 LPT is committed to supporting employees who suffer ill health or incapacity either of a temporary or permanent nature. 2.3 Every employee has a duty to attend work regularly and report any sickness absence in accordance with their local procedure. 12 of 74

13 2.4 Managers have responsibility for monitoring and managing ill health in their area. They will be supported to do this by receiving appropriate training and advice from Human Resources. 3.0 PURPOSE, SCOPE, KEY PRINCIPLES AND TRAINING Purpose 3.1 This policy and procedure is intended to facilitate a fair and consistent approach to handling staff sickness absences. It is inevitable that staff will experience periods of ill health and require sick leave from time to time, it is important therefore that managers deal sensitively and effectively with employee absence in a sympathetic, supportive and consistent manner. 3.2 The aim of this policy and procedure is also to ensure that the Trust is aware of and records the levels of and reasons for staff sickness absence, helping to minimise the negative impact on services due to employees ill health whilst ensuring staff absence is dealt with fairly and equitably given the individual circumstances of each case. Scope 3.3 This policy applies to all employees of LPT for matters relating to incapacity through mental or physical ill health. 'Incapacity' can involve periods of prolonged absence or short term absences of an unrelated nature or caused by an identified chronic underlying condition with or without absence s. 3.4 For medical and dental staff this policy should be applied in conjunction with Maintaining High Professional Standards in the Modern NHS framework. This document can be found on the Department of Health website or accessed using the following link: DH_ Other policies might also need to be taken into account in the management of sickness absence including: Flexible working/work life balance Policies, Special Leave policy, Alcohol, Drugs and/or Other Substance Misuse, Health and Safety, Infection Control and the Reasonable Adjustment Policy. Key Principles LPT S approach to managing attendance is underpinned by the following principles and standards: 3.6 Regular attendance at work is a fundamental element contained in all contracts of employment. All staff has a duty to attend work and where they are prevented from doing so due to ill health they should report their absence as soon as possible in line with their local reporting arrangements. 13 of 74

14 3.7 All ill health will be regarded as genuine unless LPT receives evidence to the contrary. 3.8 Line Managers are responsible for managing attendance and identifying and addressing issues which impact on employees attending work. 3.9 A Return to Work meeting will be held after each period of sickness absence. The purpose of this meeting will be to provide support, to ascertain well-being of the employee, to discuss the employee s overall attendance Staff will have the right to be accompanied in formal ill health review meetings by their Staff Side Representative or a work colleague Communication between Line managers and staff is key to maintaining a positive working relationship during periods of absence. Line managers will keep in contact with staff on a regular basis. Similarly staff will ensure they keep their line manager updated regarding their sickness absence Advice and support will be sought from the Occupational Health Service to help manage ill health and improve attendance All staff will be provided with information, help and support to enable them to attend work regularly Staff will be entitled to receive statutory and occupational sick pay in line with their contract of employment and terms and conditions of service. This entitlement can however be suspended if staff do not comply with the requirements of this procedure. Training 3.15 In accordance with the classification of training outlined in the Trust Learning and Development Strategy this training has been identified as role development training Training on sickness absence management under this policy and procedure will be provided to all managers by Human Resources and/or Staff Side representatives The Training Administration Team will annotate the record of all staff for whom sickness absence management training is indicated, according to the Training Needs Analysis, with a requirement to have training in Sickness Management on the Organisation s Training database Attendance on the sickness absence management training will automatically assign competence to the individual s record once confirmation of attendance has been received. 14 of 74

15 3.19 Cases of non-compliance with the requirement to book on and attend courses to maintain competence will be reported to the Head of Service The OLM database can be utilised to provide efficient and accurate data for the monitoring of training and education activity, ensuring quality assurance mechanisms are in place. 4.0 DUTIES WITHIN THE ORGANISATION All staff are expected to accept personal responsibility for the practical implementation of this policy. Lead responsibility for the implementation of this policy will rest with each Trust Director/Divisional Director. To ensure the policy is consistently applied, co-ordinating responsibility is assigned to the Director of Workforce and OD who will have responsibility for monitoring the implementation and operation of this procedure across the Trust 4.1 Trust Board The Trust Board has a strategic responsibility to ensure that appropriate conditions at work exist to ensure the health, safety and wellbeing of Trust employees and to ensure that employees are able to maintain regular attendance The Trust Board will set the Key Performance Indicators (KPI) for sickness absence for the Trust and will review the overall sickness absence data and performance of the organisation. They will provide the strategic direction for the Trust on managing employee health and well being and sickness absence 4.2 Management responsibilities Line managers are responsible for: Supporting staff with health problems at the earliest opportunity in accordance with this policy ensuring appropriate Occupational Health advice and support is sought Maintaining accurate sickness absence records which include information such as: date/s of absence, reason, working time lost and time off due to disability leave It is essential that managers complete the health monitoring form, ensuring that all appropriate information is recorded This will enable line managers to access accurate information regarding 15 of 74

16 their staff sickness and allow them to identify absence trends and manage absence effectively Monitoring attendance and sickness absence of their employees; Putting in place locally agreed reporting procedures which include procedures for notifying absence, completion of first contact form etc; Ensuring all new employees are made aware of all locally agreed procedures as part of an employee s workplace orientation Conducting a return to work interview following each episode of absence so that advice and support can be given at an early stage (see section 6); Taking appropriate action to manage ill health effectively and in a timely manner in accordance with this policy and procedure; Obtaining advice from the Trust s Occupational Health Service where work may be impacting on an employee's health, or where health problems may be affecting an employee's attendance or work performance; Ensuring contact is maintained with employees who are absent due to ill health in order to offer appropriate advice, support and to keep them up to date with the organisational changes.; Ensuring that where ill health is attributable to an accident at work, the appropriate documentation is completed and requirements of LPT s accident reporting procedure are adhered to Ensuring that employees are treated fairly and compassionately when managing ill health; Ensuring that consideration is given to reasonable adjustments for those members of staff that require them Ensure confidentiality is maintained. 4.3 Employee Responsibilities Employees are expected to achieve acceptable levels of attendance in the workplace and to take personal responsibility for their own health and wellbeing Employees should also ensure that Health and Safety standards in their 16 of 74

17 working environment are maintained at all times and report any risks they may identify in relation to their own physical and/or mental health at work to their line manager All employees must comply with the requirements of their locally agreed reporting procedures. Employees must make themselves aware of the contents of their locally agreed reporting procedure for their area/team; In the absence of a local procedure, notification of absence should be made to the line manager as soon as possible before the commencement of duty to allow any arrangements to be made for cover; When contacting their line manager the employee will be required to provide the following information to complete the first contact form (appendix 1). Reason for absence (nature of illness/symptoms) Estimated duration of absence (where possible) Contact details Details of any urgent commitments/urgent work which needs to be covered whilst the employee is absent. Any support required It is the employee s responsibility to inform their manager (or a nominated alternative if absent) of their inability to attend for work due to illness. It is not the responsibility of a friend, family member or work colleagues to contact the manager. However it is acknowledged that in exceptional circumstances a staff member may be unable to contact the line manager themselves and therefore only in those circumstances will it be acceptable for someone else to contact the manager on their behalf. The person who contacts will need to provide the information detailed in paragraph above Employees are responsible for maintaining daily contact with their line manager whilst absent and for keeping their manager updated regarding their health, unless if there is an expected date of return. In this case, as a minimum, employees will be required to maintain weekly contact with their line manager Employees are responsible for informing their line manager of any health concerns that are affecting their ability to carry out the full duties of their role or may affect their ability to attend work on a regular basis. Employees also have a duty to discuss any reasonable adjustments that may be required for example in relation to any disability Employees are obliged to liaise with Occupational Health when required by their Line Manager. Where an employee fails to liaise with the Occupational Health service when required it may result in suspension of sick pay and disciplinary action. 17 of 74

18 Employees are required to share as much information as possible with their line manager where a period of long term absence is anticipated, e.g. for a planned operation. This should be shared prior to the absence and ideally should include the reason for absence, the anticipated duration of absence and any anticipated recovery period and any anticipated changes in capability, whether short or long term. This is to allow the Line Manager to plan for the absence and anticipate any adjustments that may be required following the absence. Appropriate confidentiality will be maintained Employees are required to attend ill health review meetings arranged under this policy. If the employee or their representatives are unable to attend a review meeting it will be rearranged once and will where ever practicable take place within one week of the original meeting. If an employee fails to attend a sickness review meeting despite repeatedly being requested to by management, this may result in suspension of sick pay and disciplinary action Employees must conduct themselves in a manner which aids their recovery An employee who fails to follow the requirements of this policy may be subject to disciplinary action LPT reserves the right to withhold occupational sick pay if an employee fails to comply with the requirements of this policy. 4.4 Human Resources/ Medical Staffing Team Human Resources Department or Medical Staffing will be responsible for: Updating this policy in light of changes e.g. changes in legislation, changes in Department of Health guidance, changes in service requirements etc Providing training, advice, assistance and support to ensure robust, consistent and fair implementation of this policy Facilitating a proactive approach to the management of sickness and improvement in attendance Providing regular sickness absence and disability leave information to the operational management, senior management team, Board etc. 4.5 Staff Side Representatives 18 of 74

19 4.5.1 Staff Side Representatives are required to provide advice and support to their members throughout the application of this policy Staff Side and management will work in partnership to reduce sickness absence, improve attendance and improve employee health and well being When accompanying their members at ill health review meetings/ hearings, staff side representative/work colleague can do the following: put the employee s case sum up the employee s case respond on behalf of the employee to any views expressed at the hearing confer with the employee during the meeting/hearing ask questions The staff side representative/work colleague can not however answer any questions on the employee s behalf. 4.6 Occupational Health The role of Occupational Health Service is to provide specialist, impartial advice on health issues in the context of the working environment. Any referrals must be undertaken in line with this procedure 5 CERTIFICATION, RECORDING & MONITORING SICKNESS ABSENCE 5.1 Certification of Absence For sickness absence of 1-7 calendar days (inclusive), including non working days, employees are required to provide a self-certification form (Appendix 1a) upon their return to work For sickness absence of 8 or more calendar days (inclusive), including non working days employees are required to obtain a Statement of Fitness for Work or Fit Note 1 from their doctor. Statement of Fitness for Work must be 1 With effect from 6 April 2010, medical certificates (Med 3 and Med 5) have been replaced with a single revised Statement of Fitness for Work (fit note). The fit note system will mean that doctors can advise that the employee is either: unfit for work; or may be fit for work. A doctor will give a may be fit for work Statement if they think that their patient s health condition may allow them to work if they get suitable support from their employer. If an employee is not fit to work the statement of fitness for work will state this. A sample Statement of Fitness for Work is included in Appendix 1b. For further information please visit 19 of 74

20 provided to the line manager within 7 calendar days of the expiry of the self certificate or last fit note In exceptional circumstances the Trust may suspend the facility for an employee to self certify sickness absence and may require a medical certificate from day one. The line manager will pick up the cost of early certification where this applies Failure to provide medical certificates in a timely manner may result in the suspension of sick pay If an employee falls sick whilst travelling abroad they must report their sickness to their line manager in the normal way and submit a medical certificate or other acceptable evidence in the country of travel (where possible in English language). Failure to provide such certification will result in non payment of sick pay and non-return of annual leave. Advice from the local consulate may be sought if applicable. 5.2 Recording If staff are unable to attend work due to sickness they must inform their line manager as soon as possible in line with local reporting procedures. Line managers will ensure that their absence is recorded accurately and in a timely manner. This will include completion of the First contact form (appendix 1) Line managers will hold a return to work interview and will complete a Health monitoring form every time an employee returns to work following a period of sickness absence Line managers are responsible for ensuring the accurate submission of absence data to payroll. Submission can be through: 2. Where areas are rostered absence should be recorded through the E-rostering system. 2. Where managers have access to ESR supervisor self-service functionality they must ensure that absences are recorded on ESR within 3 working days. 3. Where managers have no access to electronic systems they should complete the weekly absence return form (Appendix 3) for all their employees and ensure timely submission to payroll for the previous week so SBS will input by 12 noon on the Tuesday. Managers should only submit the data using one method If an employee becomes ill whilst at work and feels too unwell to continue working, their absence from work for part of a working day will not be recorded as sickness absence for sick pay purposes.. This absence however will be recorded on their health monitoring form and will be taken into account when monitoring patterns and levels of sickness absence. 20 of 74

21 5.2.5 An essential part of sickness recording is to ensure the full and correct coding of reasons for sickness absence for all days lost to sickness. This provides line managers and the Trust with information to highlight the main causes of sickness, helps to identify where patterns are emerging and enables the Trust to target and action any areas of concern. The codes for other and unknown should not be used. In exceptional circumstances advice should be sought from HR where this is being considered. 5.3 Monitoring Line managers are responsible for monitoring sickness absence levels for their teams and are responsible for periodically reviewing records to identify any trends and patterns When reviewing sickness absence line managers should determine if the absence is:- Long Term Sickness absence will be classified as long term if the employee has been absent for a continuous period of 4 weeks or more or is expected to absent a continuous period of four weeks or more. Short Term Sickness absence will be classified as short term if the employee has been absent for a continuous period of less than four weeks. Sickness absence can also be classified as: Patterned: Where patterns in sickness absence are identified e.g. sickness absence precedes or follows annual leave, non rostered days, bank holidays, weekends, particular shift patterns, or periods of night duty, etc. Sporadic: irregular or intermittent sickness absence. Planned: Where sickness absence is for a planned surgery and/or hospital admission Ill Health attributable to an industrial injury must be recorded as such and monitored When monitoring sickness absence for their area, line managers should compare the levels in their area with overall levels of sickness absence for the Trust and with other comparable areas. Appropriate action should be taken if sickness absence levels exceed targets If line managers feel that an individual s sickness absence is not genuine, they should seek advice from the Human Resources Team. If evidence is established that an employee has provided false information about their 21 of 74

22 sickness absence the disciplinary procedure will be invoked and the Trusts LCFS (Local Counter Fraud Specialist) should also be directly informed to consider a possible criminal investigation. 6 RETURN TO WORK MEETING 6.1 A return to work meeting must be conducted after each period of sickness absence regardless of duration. Where possible the line manager should meet with the employee to conduct this meeting. However where line mangers and their teams are not sited in the same location it will be acceptable to conduct this meeting by telephone. 6.2 This meeting will provide an opportunity to discuss the reason/s for sickness absence. The line manager should also use this meeting to: confirm the date when the employee was fit (this may be a non working day i.e. Saturday, Sunday etc) confirm if the employee has fully recovered and is fit to perform their duties; Where it transpires that the employee may have suffered from a condition causing memory loss or inability to remember all aspects of their work correctly, a full assessment of their ability to carry out the role in conjunction with Occupational Health and other appropriate professionals should be instigated. Where the employee s absence period is over 7 days and they have submitted a Statement of Fitness to Work (fit note), discuss with the employee their doctor s advice, in terms of the support to be provided to facilitate their return to work. If it is not possible to provide the support for the employee to return to work, the Statement should be read as if the doctor had advised not fit for work. In this case the manager should inform the employee s doctor of reasons why they were unable to accommodate their advice regarding support and what support they are able to provide instead. review any links to earlier absences; Establish if the employee has worked with another employer whilst on sick leave with the NHS establish whether it is necessary to seek occupational health advice* or seek support from other agencies; review the employees sickness absence against agreed triggers and update the employee re triggers for a formal review; update the individual on any work issues that have occurred since their absence; The return to work meeting, should be handled sensitively and take into account the employees right to medical confidentiality. Intrusive questioning should be avoided if possible. Record the meeting on a health monitoring form (Appendix 2a and 2b). *In cases of anxiety or stress-related illness, or where there appear to be links 22 of 74

23 to earlier absences line managers should refer the employee to Occupational Health service. 6.3 Line managers should take into consideration that the health of employees may be affected by a number of factors e.g. their work, personal or domestic circumstances, relationships with other team members etc. 6.4 In some instances employees may find it difficult to discuss certain problems with a manager of the opposite sex. In these cases the employee may request for these discussions to take place with someone other than the individual s own line manager with an understanding that any work related implications of the discussions will be shared with the employee s line manager. 7 ABSENCE TRIGGERS 7.1 In order to facilitate effective management of short term sickness absence an ill health review will be required if an employee has been absent from work due to sickness for 6 working days or 4 episodes in any rolling 12-month period (pro rata to the number of days worked per week for staff working less than 5 days per week). Please refer to Reasonable Adjustments Policy in respect of disability leave which is not counted as sickness leave. Formula to calculate pro rata triggers: No of days worked by the employee x 6/5 = pro rata trigger (fractions should be rounded up to the nearest whole number) 7.2 This does not preclude managers from initiating a review of absences prior to these 'trigger points' being reached where there is sufficient concern to make such action necessary. 7.3 Where an employee has triggered it may be necessary to seek Occupational Health advice prior to convening an ill health review. A referral to the Occupational Health service should be made following the return to work meeting to avoid unnecessary delays. This does not preclude managers from initiating an Occupational Health referral prior to employees reaching the triggers if necessary. Equally, when looking at short term absences managers will not as a matter of routine need to make a referral before proceeding to stage 1 i.e. setting targets if it is clear there is no underlying condition. 7.4 Long-term sickness absence will be reviewed after 4 weeks or before if Occupational Health advice is available. 8 REFERRAL TO OCCUPATIONAL HEALTH 8.1 The role of the Occupational Health Service is to provide advice to line managers on the medical condition of their staff and any impact their condition may have on their ability to attend work or perform the duties of their role. 23 of 74

24 8.2 Where advice from Occupational Health on the employees medical condition is received, this must be followed. Non medical advice received from Occupational Health should be considered on a case by case basis. 8.3 The Occupational Health Service provide advice in relation to long term health problems where prognosis for recovery is important for managers to arrange cover. The Occupational Health Service also provides advice where there are limitations on an individual s capability to perform their duties due to a disability. 8.4 The Occupational Health Service also provide advice in cases of short term persistent sickness absence and line managers require medical opinion on an employee s ability to attend work regularly. 8.5 In cases of recurrent sickness absence, the manager is able to ask the employee directly if they have a medical condition that impacts on their ability to attend work. If the answer is no, then a referral may not be needed even if they have breached the trigger as outlined within this policy and managers can proceed directly to formal stage 1 i.e. setting targets. 8.6 Breaching the trigger is an indication that management action is needed to try to reduce the employee s absence, not necessarily that a referral to OH is required. This will speed up the process in managing short term absence as line managers will not be waiting for OH advice where it is not required. 8.5 An employee can be referred to the Occupational Health by their line manager at any time when a medical assessment is required; this should be done by completing the Occupational Health Referral Form (Appendix 4). The reason for the referral should be clearly stated and specific questions should be asked. The reason for and contents of the referral must be shared with the employee who is being referred at the time of making the referral. Where it is not practical, the line manager should, as a minimum share this information with the employee at the earliest opportunity and as a must before their Occupational Health appointment. 8.6 If line managers are unsure whether a referral is appropriate they should discuss the case with the Occupational Health Service prior to implementing the referral. 8.7 An example of circumstances where Occupational Health advice may be sought is given below, it must be noted that the list is not exhaustive: Advice on sporadic absence and confirmation if it is due to chronic underlying medical condition The impact of a health problem on the employee s ability to work; Timescales for expected improvement/return to work; An opinion on the employee s ability to perform the duties of their role; Temporary or permanent reasonable adjustments to the work place or tasks that would assist in maintaining an employee s health and improve attendance; An opinion on suitability for redeployment; 24 of 74

25 An opinion on phased return to work where appropriate; An opinion if ill health retirement should be pursued; Specific questions should be asked as required 8.8 Employees can refer themselves to the Occupational Health Service at any time for advice. In these circumstances the line manager will not receive any assessment report from Occupational Health unless if the employee request the Occupational Health to share their report to the line manager or where the Occupational Health decides that failure to share the report may pose a risk to the employee or the organisation. 8.9 It is a requirement of this policy and an express term of the employees contract of employment that an employee will submit to an occupational referral and medical examination if requested to do so Where an employee fails to attend an occupational health appointment or cancels an appointment, Occupational Health will inform the relevant line manager and rearrange the appointment. Failure to attend a third appointment may lead to disciplinary action taking into account any reasonable adjustments on an individual basis. If an employee is unable to go to the Occupational Health Unit for health reasons a home visit can be arranged. Employees should be aware that if a manager, having made all reasonable attempts to obtain Occupational Health advice, is unable to do so, they will make decisions and take action without occupational health advice and on the information that is available. 9 PROCEDURE FOR DEALING WITH SHORT TERM AND UNRELATED SICKNESS ABSENCES 9.1 Where a manager has identified a problem of short term and unrelated sickness absence (patterned or sporadic) and they have established that the absences are not due to a chronic underlying condition, the manager will act in accordance with the following procedure, unless there are exceptional reasons not to do so. Where a manager is unsure whether there is an underlying medical condition they should refer the employee to Occupational Health to seek advice on this. 9.2 At all stages, managers will ensure that all relevant facts and aspects of the case are considered as far as possible and whether at any stage it is appropriate to re-categorise the absences within the policy. 9.3 There is a separate procedure for dealing with short term absence due to a chronic underlying cause and due to permanent incapacity which is outlined in section 10 below. Rights to be accompanied 9.4 At all stages of the procedure under section 9, the employee will have a right to be accompanied by either their staff side representative or by a work 25 of 74

26 colleague. In exceptional circumstances and where agreed by the Trust, the employee can be accompanied by a family member or friend. There is no right to legal representation in these meetings/hearings. Stages of formal reviews 9.5 There are a number of stages of formal reviews that can be held. Each stage is attached to an action. These increase in severity to reflect the size of the absence issue, but will generally start from the lowest level and progress to more serious levels if the problem is not resolved. There may be circumstances where it necessary to move straight to a formal stage of the procedure e.g. where a significant history of poor sickness absence has been identified. 9.6 It is also possible for a review meeting under this procedure to conclude that no formal action needs to be taken. 9.7 The stages of formal review and the range of formal action is as follows: Stage 1 Formal review meeting: Initial improvement target set Stage 2 Formal review meeting: First Written Warning Stage 3 Formal review meeting: Final Written Warning Stage 4 Final Formal review : Termination of employment (panel hearing) Stage 1 Formal Review Meeting 9.8 Where an employee s level of sickness absence has hit the trigger, and persistent absences are not due to a chronic underlying medical condition, unless reasonable justified, a stage 1 formal ill health review meeting should take place, to formally review the employee s sickness absence. 9.9 At this meeting the employee will have a right to be accompanied by their Staff Side Representative or a work colleague. A member of the Human Resources Operational Team may also attend the meeting where requested by the manager/employee 9.10 If the employee is unable to attend the review meeting, it can be rescheduled once in accordance with paragraph 12.1 of this procedure The purpose of this review meeting will be as follows: To review the member of staff's attendance record during the relevant period; 26 of 74

27 To ensure the employee is aware of their attendance record, the number of absences and the periods of good attendance in between To give the member of staff the opportunity to discuss any problems or raise any concerns; To remind the employee of the standards of attendance which are required To set a target for improvement and a period over which attendance levels will be monitored 2 To arrange for support or work adjustments if recommended by Occupational Health; To obtain the commitment of the employee to achieve the required attendance level. To inform the member of staff that If he/she fails to demonstrate agreed improvement in the levels of sickness, stage 2 review will be instigated 9.12 If, at the end of the review period, the required attendance level has been met, the employee will be informed of this and they will be encouraged to maintain this level of attendance If, however, the required improvement target has not been met, a meeting will be held under the stage two of this procedure Where it is apparent, that the employee has exceeded the improvement targets set before the end of the review period, the date of the next review and any subsequent meeting will be brought forward Notes of all ill health review meetings will be kept in the employee s personal file as an accurate record of these meetings and shared with both parties. Stage 2 Formal review meeting First Written Warning 9.16 Where the employee has not met the improvement targets set at stage 1 review meeting, stage 2 review meeting will be convened. A member of the HR Operational Team will usually be present at this meeting The employee will be given the right to be accompanied together with a minimum of 7 calendar days written notice of the date and time of the meeting. 2 Setting Targets for Improvement in Sickness Absence Levels When considering whether it is appropriate to set targets for improvement and what targets to set, it is important to ensure that individual circumstances of the employee are taken into account. The factors to consider are: Does the employee have an underlying medical condition or disability? Has any advice been received from the Occupational Health Service which needs to be implemented? Are there any reasonable workplace adjustments which need to be put in place before improvements in attendance can be expected? Is the absence related to an injury or accident at work? and Is the absence related to pregnancy? 27 of 74