UHL PROMOTING WELLBEING AND MANAGEMENT OF SICKNESS ABSENCE POLICY AND PROCEDURE

Transcription

1 UHL PROMOTING WELLBEING AND MANAGEMENT OF SICKNESS ABSENCE POLICY AND PROCEDURE Trust Ref: B29/2006 Approved by: Policy & Guideline Committee Date approved: 10 July 2006 Most recent review: 13 March 2007 Policy & Guideline Committee 10 July 2006 Policy & Guideline Committee 16 February 2009 Policy & Guidelines Committee 28 May 2010 Policy & Guideline Committee Next review: May 2013 Lead Officer: Director of Human Resources

2 UHL PROMOTING WELLBEING AND MANAGEMENT OF SICKNESS ABSENCE POLICY AND PROCEDURE CONTENTS SECTION CONTENT PAGE 1 Policy 3 2 Scope 3 3. Procedure Preamble Notification of Absence Certification Records Monitoring Return to Work Excessive Absence Referral to Occupational Health Industrial Injury Unrelated Absences Episodic Absence due to a Chronic Underlying Cause Permanent Incapacity Termination of Contract and Sick Pay Entitlements Appeals Substantial absence during the lifetime of a sickness absence 13 warning Appendices Appendix 1 Further Clarification/Guidance to all Managers 15 Appendix 1a Fit Note Employee and Management Guidance 20 Appendix 1b Sickness Absence Action Plan 25 Appendix 2 Sickness Policy Allowances Agenda for Change 26 Appendix 3 Procedure for Handling: Persistent, Frequent and Unrelated Absence due to Sickness and where Employees Sickness is due to an Underlying Condition and Unrelated 29 Appendix 4 Levels of Authority Within Sickness Absence (Unrelated Absences) 36 Procedure Appendix 5 Levels of Authority for Reviews and Appeals within Sickness 37 Absence (Unrelated Absences) Procedures Appendix 6 Guidance on Format of Sickness Absence Hearing 38 Appendix 7 Appeals Procedure for Appeals Against Level III (Final Written 39 Warning and Level IV (Dismissal) of the Sickness Absence Procedure 2

3 1. Policy 2. Scope UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST UHL PROMOTING WELLBEING AND MANAGEMENT OF SICKNESS ABSENCE POLICY AND PROCEDURE 1.1 It is the duty of employees to attend regularly for work in accordance with their contract of employment and to report any sickness absence in accordance with departmental procedures. 1.2 Managers will take responsibility for monitoring sickness absence levels in their area. They will be supported to do this by receiving appropriate training, including training in how to deal with individuals with levels of sickness absence, that are a cause for concern. 1.3 The Trust aims to maximise the attendance of all employees throughout the working week. However, it recognises that a certain level of absence may be unavoidable due to sickness, or other reasons. In case of absence due to sickness or injury it is the Trust's policy to ensure provision of appropriate paid leave (i.e. Statutory Sick Pay and Occupational Sick Pay, where applicable) and offer security of employment during such periods, subject to operational requirements and the regular review thereof. 1.4 This Policy applies equally to all staff employed by the Trust. There are specific references to Section 14 of the Agenda for Change Handbook, this will apply only to staff contracted onto these pay, terms and conditions. 2.1 This policy and procedure applies to all employees of the Trust for matters relating to incapacity through mental or physical ill health. For Medical and Dental staff reference should also be made to the Trust s Conduct, Capability, Ill Health and Appeals Policies and Procedures for Medical Practitioners. Incapacity can involve periods of prolonged absence or intermittent absences of unrelated nature or caused by an identified chronic underlying condition; but it may also arise where an employee's performance at work is seriously impaired for the same reasons. 2.2 Other policies might also need to be taken into account in the management of sickness absence, including: Alcohol, Drug and Other Substance Abuse in Employment (DMS ref 12481), Health and Safety (DMS ref 11780), Risk Management, [Protection from Blood Borne Diseases], the NHS Injury Benefits Scheme and Stress Management Policy, Procedure and Management Guidance (DMS ref 20232). The Fit Note Guidance aimed at supporting more people to get back to work is included as Appendix 1a. 2.3 The Trust aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at an unreasonable or unfair disadvantage compared to others. In the review of this policy, the Trust has considered its impact with regard to equalities legislation. 2.4 The Trust recognizes it s responsibilities as a signatory to the Mindful Employer Charter which aims to increase awareness of mental ill health. The Charter is a demonstration of the Trust s commitment to being positive about mental health in the recruitment and retention of staff. 3

4 3. Procedure 3.1 Preamble Department staffing in all areas is normally organised so as to ensure the most effective and efficient staff availability required for service delivery. Therefore, if staff are unable to attend for duty, for whatever reason, it is important that the Department/Ward Manager is informed as soon as possible so that alternative arrangements might be made Furthermore, it is the aim of this procedure to ensure that, in cases of ill-health, termination of employment will be a last resort and only follow a progressive and thorough review of the employee's circumstances and with due regard given to the organisational needs of the Trust To avoid uncertainty and to ensure that staff comply with the conditions of paid sick leave provisions, the following standards and guidance for reporting and monitoring sickness and other absences have been jointly agreed with UHL staff side organisations 3.2 Notification of Absence When an employee is unable to attend for duty due to illness, or for other reasons, he or she must ensure their manager (or whoever else is designated responsible for coordinating the department/ward's staffing) is contacted as indicated below or at the earliest opportunity. This will enable the department/ward to organise alternative cover arrangements or take other actions appropriate to ward intake Nursing staff, wherever possible, should notify their ward as follows:- early/day shift - please telephone the day before, or before 6.30 am the day of duty late shift - before 10 am night shift - before 4.00 pm or such arrangements as may already be operating or agreed locally Non-nursing staff should notify their department at the earliest opportunity and normally before their start time, but in no event any later than 2 hours after their scheduled start time In exceptional operational circumstances, particular arrangements may be agreed locally between management and staff for calling in absent prior to the shift time When notifying the department/ward that they are unable to attend for duty, staff should also give an indication of the length of time they are likely to be absent. This will assist the manager in planning for any cover that may be required. It is understood, however, that this can only be the employee s best guess about when he or she expects to be fit to return to work and that it is not binding If staff then find they are able to return to work sooner than previously indicated, they should inform their department/ward so that any cover that has been arranged can be cancelled. 4

5 Conversely, when staff are unable to return to work as expected, then they are required to inform their manager as above Where staff are able to return to work after sick leave but are rostered for off duty days, it is important that they telephone their manager to confirm that they are fit to return to work, otherwise, the off-duty day will be counted as part of the sick leave period If a member of staff goes home from work sick or comes in late due to sick leave, this day will not be counted as sick leave provided the staff member attends work for greater than 50% of their working day/shift. 3.3 Certification Self-Certification - For absence of 7 calendar days or less, the employee is required to complete a self-certification form upon their return to duty, which must be counter-signed by their immediate manager. This form should be retained on the employee s personal file, Payroll do not require a copy Medical Certification - For absence longer than 7 calendar days, the employee is required to obtain a Medical Certificate issued by a Doctor. Where absence is prolonged, further Medical Certificates must be sent to the manager at regular intervals, as appropriate.. This form should be retained on the employee s personal file. Payroll do not require a copy Fit Note - To help people get the support they need to get back to work. Employees are often keen to return to work as soon as they can, and the new fit note system enables doctors to advise if employees are: Unfit for work This is just like the old sick note where the doctor advises an employee to refrain from work for the stated period of time. May be fit for work - this means the doctor s assessment of an employee is that their condition does not necessarily stop them from returning to work. For example, they could return to work but may not be able to complete all of their normal duties, or they could benefit from amended working hours. A doctor will be able to suggest ways of helping an employee back to work. This might mean discussing with your employee: a phased return to work; altered hours; amended duties; and/or workplace adaptations The Trust will make every effort to support employees who are fit to undertake aspects of their role, including statutory and mandatory training where supported by medical advice, in order to facilitate a return to work. Appendix 1a outlines employee and line management responsibilities, the timescales, documentation and payment for a phased return to work All certificates should be treated as confidential and stored accordingly. Payroll do not require a copy of self or medical certifications. 5

6 3.4 Records Individual attendance record cards will be maintained in each department/ward in respect of all absences, as a point of reference, and should be reviewed regularly for compliance with standards. They will be made available for staff's own personal inspection upon request Directorates must ensure that sickness absence returns are completed weekly for their staff and sent to Payroll unless the Directorate has an agreed alternative inputting arrangement. 3.5 Monitoring Managers are responsible for the review of sickness absence levels in their area. Monthly absence figures will be provided for management information, as part of regular workforce and Sickness Monitoring and Reporting Team (SMART) information reports for those areas using SMART. Managers will, in addition receive quarterly trigger report to review trends over a twelve month period, and longer where appropriate. Trends should be reviewed by area and also by individual employees In the case of individual employees, the manager should identify if the absence is:- a) Long Term Although each person s sickness absence will need to be looked at on an individual basis, taking account of the known circumstances, generally speaking sickness absence should be classified as long term after a period of four weeks duration or more. b) Short Term For periods of absence of less than four weeks duration. c) Patterned For example, where sickness absence precedes or follows days off, holidays, bank holidays, week ends, or periods of night duty, etc. d) Spasmodic For example, where the absence is persistently one or two (or more) days a month, or a week every few months. e) Planned For example, where the absence is for planned surgery and/or hospital admission. See Appendix 1, section 4 link Absence which is known to be attributable to an industrial injury shall not be excluded from monitoring, but will need to be considered in its context in relation to the employee s overall attendance record When monitoring absence by area, managers should compare overall levels of sickness absence with that of the Trust as a whole and with other comparable areas. When absence levels for an area are higher than these, the manager for the area should consider:- a) whether this is due to particular individuals and how they should be managed appropriately; and/or 6

7 b) whether the absence levels are due to other factors (e.g. environmental, managerial) and what action might be taken to address these To ensure that sickness absence levels are properly managed, managers should focus on those individuals with the highest levels of absence compared to the average for their area. 3.6 Return to Work Discussion On return to work, following a period of absence due to sickness, the manager should confirm with the employee the reason for absence and their fitness to resume duty. This is also an opportunity to discuss whether or not it would be helpful to invoke the assistance of Occupational Health (or any other support agencies that are available). The reason for sickness absence will be recorded on the Self Certification of Sickness absence form. This form should be retained on the individual s personal file. Payroll do not require a copy Managers should be aware that the health of a member of staff may be affected by a number of extraneous factors (e.g. their work, personal or domestic circumstances, relationships with other members of staff, etc.) In addition, the individual may find it difficult to discuss some problems with a manager of the opposite sex. Any discussions will therefore need to be conducted with sensitivity and in confidence. There may even be exceptional occasions when it is more appropriate for the discussion to take place with someone other than the individual s own line manager, although the line manager will still be required to sign the self-certification form and countersigned by the manager undertaking the return to work. This should be agreed by all parties. 3.7 Excessive Absence In addition to the monitoring arrangements described in 3.5 above, managers are expected to review on an individual basis every case where a member of staff is absent for 4 episodes or more than 10 days or the equivalent of 2 working weeks for staff on flexible working patterns or part time hours during any rolling 12-month period. Where absence in an area or staff group is lower than average Managers should ensure, through return to work discussions, that expectations for improving attendance are clearly communicated. In addition, where the 4 episode trigger is being consistently hit annually over a period of time, but targets are met, Managers may give consideration to discussing this formally with staff at a Hearing in line with Appendix When a manager identifies a sickness absence problem with an individual, the following action should be taken: a) The absence record should be discussed with the member of staff, initially on a one-toone basis. An expected level of improvement with some target setting may be appropriate and a review date should be agreed between the manager and the member of staff. This discussion should be recorded by the manager in the form of a letter to the employee, recording what has been agreed. A copy will be kept for the employee s personal file. b) At this discussion staff should be advised that, if the appropriate improvement in attendance has not taken place by the review date, and if, subject to Occupational Health advice it appears that the reason for sickness absence is due to unrelated absences, it is possible that the Review meeting becomes a hearing under the processes described in Appendix 3 of this policy and could result in the issue of a warning (see section 3.10 Unrelated absences). In these circumstances, such a hearing would be appropriately set up under the process described in Appendix 3. 7

8 c) If prior to or at the review date, the sickness absence level has not improved, and/or a recurrence of the pattern is apparent, the member of staff should be referred to the Occupational Health Department if that has not yet been done and is appropriate. d) Where the absence record review discussion raises reasonable doubt that the sickness absence was in fact because of illness or injury, this should be followed by a subsequent interview as part of an investigation into the matter. At this interview the reasons for doubting the accuracy of the explanation should be put to the employee, with any explanation on the part of the employee duly noted. If grounds for disciplinary action are revealed, either at this stage or after further investigation, the disciplinary procedure should be invoked. e) At any stage, if it is alleged that an employee s absence is not genuinely for reason of sickness absence (for example an allegation that they are working for another employer while on sick leave from UHL), this will be investigated and if necessary, the disciplinary procedure invoked. 3.8 Referral to Occupational Health Department All managers should have ready access to a copy of the Occupational Health Guidance Notes for Managers and Senior Medical Staff Staff may always refer themselves to the Occupational Health Department at any time in relation to sickness absence or other health problems, which may affect their work, and this should be encouraged An employee may be referred to the Trust s Occupational Health Physician at any time when a medical assessment is required to make judgments on grounds of capability necessitating possible redeployment, job redesign, or continuation of employment If a manager is unsure about the appropriateness of making a referral, this should be discussed with Occupational Health beforehand In all events, staff should be referred for medical assessment if their absence exceeds 4 weeks. Managers should ensure that regular contact is maintained with employees on extended absence for reasons of ill health. Staff who have been absent due to illness for periods of 1 month or more will normally be required to attend the Occupational Health Department prior to return to work. To assist the individual to make a successful return to full duty, it may also be necessary for Occupational Health, the manager, employee and his/her representative to mutually agree a work development plan in writing prior to resuming duty, to assist in the transition back to work It is an express term in the 'Contract of Employment' that staff will co-operate with requests to attend, at any reasonable time, for a medical assessment by Occupational Health, but this course of action should also be discussed with the employee before referral is made Where an employee fails to attend two Occupational Health appointments without prior notification or an acceptable reason, Occupational Health will advise the relevant manager of this. Occupational Health will only arrange another, appointment if the manager advises that they have contacted the individual and that this remains appropriate. Failure to attend a third appointment may result in disciplinary action being taken. If an employee is unable to attend occupational health appointments for exceptional reasons a home visit can be arranged. Staff need to be aware that if managers, having made these reasonable attempts 8

9 to get appropriate Occupational Health advice are not able to do so, then managers will have to act on the information that is available to them. 3.9 Industrial Injury Industrial Injury is an accident which occurs in the course of an employee s work and causes personal injury. In addition, industrial injury may be due to an environmental issue (e.g. chemical reaction) that causes a period of absence due solely or mainly due to the performance of the employee s duties The details of the accident should be reported by the employee, in line with the Trust s policy for the management of Patient and Staff Safety. UHL has a procedure relating to injuries at work and this should be followed The procedure for injuries at work (Policy for the Management of Patient and Staff Safety) should be followed, that specifically requires reporting of the incident, investigation, Occupational Health support / advice as appropriate, notification of the incident as required to the Health and Safety and Manual Handling Advisers Attention should be given to Section 14.6 of the Agenda for Change Handbook, see Appendix 2. Directorate managers will need to consider HR advice regarding sick pay if absence has been due to a specific reason e.g. industrial injury. Section 14.6 does not alter sick pay entitlement once the sickness absence period has commenced but may discount certain absences for subsequent sick pay purposes Where the employee's incapacity is a result of an injury at work, or may be attributable to their employment, and if because of their absence they are likely to suffer a financial disadvantage, then they should be made aware of the availability of Injury Benefit under the NHS (Injury Benefits) regulations. The website link is Unrelated absences If the Occupational Health Department s advice is that the employee's problems (including persistent and frequent absences) are not related to any chronic underlying condition, the matter should be pursued in accordance with the procedure at Appendix 3 This procedure mirrors the Trust s Disciplinary Procedure in giving formal warnings at increasing levels, with dismissal on grounds of capability ultimately possible. Appendix 3 would also be used when considering an employee s overall level of sickness absence if this is both related to an underlying health condition and due to unrelated sickness absences Where the provision of 'occupational sick pay' is regarded as being abused and actions are instituted against the individual employee under the Disciplinary Procedure, then the facility for self-certification may be withdrawn with the employee required to produce a Doctor s Medical Certificate for all periods of sickness absence and in order to qualify for Occupational Sick Pay. Withdrawal would only occur in exceptional circumstances and only after due consultation Episodic absence due to a chronic underlying cause Where an employee is experiencing episodic absence which is due to a chronic underlying condition and where their continued absence is detrimental to the operational efficiency of the department, the following procedure should be adopted: 9

10 a) Consideration should be given to the period over which the employee is likely to be incapacitated. If the duties of the post can be covered for the period, then arrangements should be made to provide such cover, as appropriate. b) Consideration should also be given to the provision of light duties and/or reorganisation of the duties of the post, where this is compatible with both the employee's condition and the operational efficiency of the department. c) Consideration should be given to suitable alternative employment. In certain cases this may involve some retraining in order to accommodate the employee, but the Trust is not under any obligation to provide such retraining in every instance. d) Points a)-c) above must be given serious consideration, since they form part of the employer s obligations under the terms of the Disability Discrimination Act The definition of what constitutes a disability can be split into three parts: The employee must be suffering from a physical or mental impairment The impairment must have a substantial adverse effect on the ability to carry out normal day to day activities The effect must be long term, in other words have already lasted for at least 12 months or be likely to last that long Employees and line managers are also advised of the Access to Work Scheme that provides practical advice and support to disabled people and their employers to help identify and remove disabling barriers in the workplace. Access to work can also pay a grant, through Job Centre Plus, toward any extra employment costs which result from disability. Access to Work applications are employee led and should be appropriately supported by the line manager. East Midlands Access to Work can be contacted on: Telephone enquiries: , Textphone: e) Where none of these options is appropriate the employee's employment may be terminated. Where applicable, this may be achieved through the procedure for 'Premature Retirement on grounds of ill health' and the employee should usually receive contractual notice whilst remaining on the Trust s payroll. In exceptional circumstances pay in lieu of notice will be paid. Where, however, the employee does not satisfy the relevant conditions, the employee should be dismissed on grounds of capability and receive notice or pay in lieu of notice. Managers should refer to Appendix 4 regarding levels of authority to terminate employment. f) Employees have a right of appeal against termination of employment on health grounds and must be advised of that right. g) In accordance with good management practice, any decisions made in relation to b), c) or e) above will be made in consultation with the employee and his or her representative Permanent Incapacity With the advice of the Occupational Health Physician that the employee is permanently unfit to do the job for which the employee was employed, the following procedure should be adopted: 10

11 a) The Manager should consider (with advice from Occupational Health) whether or not it is possible to redesign or re-organise the job to enable the employee to continue in employment. It may also be appropriate to consider with the employee, retirement on the grounds of incapacity at this stage taking into account advice from Occupational Health. b) Where this is not possible, the Manager, in conjunction with the H.R. Department and advice from the Occupational Health Department, should look for suitable alternative employment, taking account of any restriction on employment imposed by the medical report. Redeployment both with or without reasonable adjustments should be considered. The employee and his/her representative will also need to be involved with and consulted about any proposals. It is expected that this search for alternative employment (if supported by Occupational Health, Manager and employee) should, as a usual standard, be for 4 weeks before formal steps are taken towards possible dismissal. This search commencing could be classed as a final review meeting as outlined in c) Where suitable alternative employment is identified, it should be offered to the employee. Consideration should be given to posts at the same, lower or a higher grade. If it is acceptable to service needs, the employee should be retrained If this is reasonably possible. Pay protection will not apply if the employee s redeployment attracts reduced remuneration. d) Points a)-c) above must be followed carefully, since they form part of the employer s obligations under the terms of the Disability Discrimination Act 1995 as outlined in (d) above. e) Where it is not possible to redesign the job and suitable alternative employment does not exist, steps may be taken to terminate the employee's employment as per paragraph e), above. f) Managers, in conjunction with HR and Occupational Health, will support staff that are diagnosed with a terminal illness in a compassionate and pragmatic way Termination of contract and sick pay entitlements In cases of termination of employment with notice or payment in lieu of notice the following shall apply: a) Where the exigencies of the service render it unavoidable, employee s service may be terminated at any time with due notice for which the employee would remain on the Trust s payroll. In exceptional circumstances, payment in lieu of notice may be given. Termination of an individual s contract can occur prior to their reaching the end of their contractual sick pay entitlement. (nb. Managers should consider individual circumstances most carefully when determining the timing of the dismissal). b) Staff on Trust Contracts will be paid according to individual terms and conditions In cases of premature retirement on the grounds of ill-health, notice should be worked or contractual notice paid and the notice extended. Only in exceptional circumstances should pay in lieu of notice be given. It is usually advisable that if the employee remains within pay that the premature retirement application is made whilst the individual remains in employment. However, it is acknowledged that there will be occasions where the 11

12 employee is in a no pay situation or the contract is being/or has been terminated when the application is made For staff on Agenda for Change Terms and Conditions, in line with 14.9 of Appendix 2: sick pay for those who have exhausted sick pay entitlements should be reinstated at half pay, after 12 months of continuous sickness absence, in the following circumstances:- Staff with more than 5 years reckonable service sick pay will be reinstated if sick pay entitlement is exhausted before a final review meeting for long term absence has taken place. Staff with less than 5 years reckonable service sick pay will be reinstated if sick pay entitlement is exhausted and a final review does not take place within 12 months of the start of their sickness absence. Reinstatement of sick pay should continue until the final review meeting has taken place. Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence Paragraph above is taken directly from Section 14.9 of the Agenda for Change Terms and Conditions Handbook (Appendix 2) to clarify interpretation of this section for staff on Agenda for change Terms and Conditions:- If a final review meeting has not occurred then sick pay (at half pay) will be reinstated after 12 months continuous absence regardless of the pay status of the employee at that time. The Divisional Manager/Director will need to be aware that half pay requires reinstatement and the appropriate payroll documentation will need completion for the employee by the Division. The agreement states that those provisions will not apply where a review is delayed due to reasons other than those caused by the employer. Basically, this means that only those delays which are directly caused by the employer, e.g. by not following their own locally agreed sickness absence policies and procedures (delayed OH referrals/review meetings etc.) can be taken into account when considering whether there is a case for reinstatement of sick pay. Delays which can be attributed to the employee, i.e. not adhering to the local arrangements (attending review/oh meetings etc) are beyond the influence of the employer and therefore should not be taken into account For the purposes of applying section 14.9 of Appendix 2 for appropriate staff contracted on Agenda for Change, a final review meeting will have occurred if there is a letter to the employee documenting the decision on the direction of future employment in relation to the specific post. This could include one of the following:- A meeting at which it is agreed by the employee and manager that an application for ill health retirement should be made. A dismissal is confirmed and formal period of notice is given A decision to commence a period of search for an alternative employment option (e.g point b) A decision is made to convene a formal panel which could lead to termination of contract 12

13 Managers may consider, by exception, the possibility of extending sick pay entitlement on full or half pay in accordance with Agenda for Change Conditions and where individual circumstances dictate. (See Appendix 2) Appeals Employees have a right of appeal against dismissal, which takes place as detailed above and where they believe they have substantial grounds for appeal. The table at Appendix 5 shows the composition of the appeal panel for different staff groups Any appeal should be made in writing within 7 working days of receipt of written notice of such action, to the Trust's Director of HR, University Hospitals of Leicester NHS Trust, Gwendolen House, Gwendolen Road, Leicester, stating the grounds on which the individual is appealing The lodging of an appeal will not suspend the notice of dismissal. The employee will be compensated for any loss of earnings incurred from the date of the dismissal to the date of reinstatement/re-engagement if this subsequently occurs as a result of an appeal hearing. 4. Substantial absence of Employee during the lifetime of a sickness absence warning If a member of staff is absent from work e.g. for reasons of maternity leave, career break, for an extensive period during the period when a sickness warning has been given and before the date on which it is discounted, consideration will be given to suspending the warning during the absence or extending the period of the warning period. This will be discussed with the relevant Trade Union/Professional Organisation representative and a letter of confirmation given. Signatories to Agreement Signed on behalf of University Hospitals of Leicester NHS Trust Director of Human Resources Date Signed on behalf of University Hospitals of Leicester NHS Trust Chair of Staff Side Date 13

14 Table of Appendices: Appendix 1 Further Clarification / Guidance to all managers 1a 1b Fit Note Employee and Management Guidance Sickness Absence Action Plan 2 Sickness Policy Allowances 3. Procedure for handling persistent, frequent and unrelated absence due to sickness and where employees sickness is both due to an underlying condition and related absence 4. Levels of Authority within Sickness Absence Procedure 5. Levels of Authority for Reviews and Appeals within Sickness Absence Procedure 6. Guidance on Format of Sickness Absence Hearings 7. Appeal Procedure for Appeals Against Level III (Final Written) and Level IV (Dismissal) of the Sickness Absence Procedure 14

15 MANAGEMENT OF SICKNESS ABSENCE POLICY FURTHER CLARIFICATION/GUIDANCE TO ALL MANAGERS. Appendix 1 1. Contacting staff at home There may be legitimate reasons why managers need to contact staff who are absent on sick leave. For example, to confirm the intended date of return when this has previously been advised, or possibly to clarify any uncertainty regarding messages left by the employee, perhaps even to discuss with the employee urgent or important work related matters about which they have specific or particular knowledge or information. Furthermore, the policy itself states that Managers should ensure that regular contact is maintained with employees on extended absence for reasons of ill-health. The intention behind this is to ensure that staff do not feel that the Trust/their management have forgotten them, or are not concerned about their welfare. In addition, research has shown that staff who are on long term sick leave are more likely ultimately to return to work, if contact with work has been maintained. At the same time, however, managers obviously need to be sensitive to the fact that staff on sick leave may be self-conscious and even anxious about the fact they are absent from work. In particular, managers are advised that if for any reason they wish to discuss with staff matters related to their history of sickness absence, or the future management of their attendance, this should not be done by telephone but on their return to work. In extreme circumstances, it might even be appropriate to arrange a home visit for this purpose. 2. Past absence/attendance records The rolling 12 months reference period in the policy is intended as a yardstick for managers who suspect there might be an attendance problem. The suggested test is whether or not someone has had 4 episodes or more than 10 days of absence in the last 12 months. This does not mean that when reviewing someone s absence/attendance record that managers cannot refer to earlier records. Indeed, if there are absence/attendance problems, then records from two or three years ago (or even earlier in some cases) may be quite relevant. 3. Monitoring absence levels Item states that Managers are responsible for the review of sickness absence levels in their area. Monthly absence figures will be provided for management information, as part of regular workforce information reports. It is agreed that these monthly absence reports (where they are aggregated reports and do not identify individuals) should also be made available to staff representatives, as required. Item states that When monitoring absence by area, managers should compare overall levels of sickness absence with that of the Trust as a whole and with other comparable areas. The aim is that managers should critically compare attendance in their area with attendance/absence performance elsewhere. Item states that To ensure that sickness absence levels are properly managed, managers should focus on those individuals with the highest levels of absence compared to the average for their area. The following points should be kept in mind: where absence in an area is high compared to the Trust as a whole and to other comparable areas, this could be due to environmental or managerial factors which need to be addressed (it is sometimes also the case that absence levels do vary by area because of the nature of the work being performed); 14

16 in areas with a relatively small number of staff overall absence levels may appear to be high compared to the Trust as a whole and to other comparable areas because of the disproportionate effect of the absence of one or two individuals; the fact that an individual s absence record is higher than the average for his or her area does not necessarily mean there is a problem (and the fact that an individual s absence is lower than the average for the Trust and in other comparable areas does not mean there may not be a problem ); if an individual s absence/attendance record in the short-term does give cause for concern, managers should also consider this in relation to their previous absence record. 3.1 Monitoring Compliance The criteria for monitoring compliance with the procedure will include the minimum requirements as set out in the NHSLA Safe Environment (Sickness Aspects) Standards for Acute Trusts, criterion These are: Minimum Requirements Evidence Duties outlining employee and line management Section 3, Appendix 1, 1a and 3 responsibilities Process for maintaining contact Appendix 1 Planning and facilitating return to work plans Section 3 and Appendix 1 Planning and undertaking workplace controls or Section 3.11 and 3.12 adjustments Process for analysing sickness absence data and Arrangements for the organisational overview of sickness absence The following table outlines the sickness absence data that will be providing and the analysis and action required: Report Recipient Analysis Action Monthly sickness absence report on Trust, Division/CBU, Cost Centre and Employee sickness absence Trust Board, Divisional and CBU lead Clinicians, Managers, Sickness Absence leads and Human Resources Review individual and ward / department sickness absence Monthly Score Card Trust Board, Divisional and CBU lead Clinicians, Managers, Sickness Absence leads and Human Resources Review Directorate performance in relation to sickness absence and RIDDOR incidents Forward to line managers to ensure appropriate support / action in line with the Trust Policy Appropriate support / action in line with the Trust Policy and guidance Workforce Absence Data / Trust Executive Summary Trust Board, Divisional and CBU lead Clinicians, Managers, Sickness Absence leads and Human Resources Review Directorate sickness absence %, average per employee, calendar days lost, short to long term ratio and % triggered. Follow up with line managers any wards/departments with excessive sickness absence 16

17 Monthly SMART Return to Work discussion report Divisional and CBU lead Clinicians, Managers, Sickness Absence leads and Human Resources Review Return to Work report Follow up with line managers any return to work discussion not undertaken within 48 hours of an individual s return to work. 8 month sickness report Human Resources Human Resources with Line Manager Ensure appropriate management of sickness absence and final review is scheduled prior to 12 months sickness absence Sickness absence trigger reports produced in January, April, July and October Divisional and CBU lead Clinicians, Managers, Sickness Absence leads and Human Resources Divisional and CBU lead Clinicians, Managers, Sickness Absence leads to review individual and ward / department sickness absence Divisional and CBU lead Clinicians, Managers, Sickness Absence leads to formally review all sickness absence triggers with line managers (April and October) To ensure consistency and sustainability of the management of sickness absence, management actions must be recorded. A suggested template that could be used is attached as Appendix 1b. The action plans should be saved electronically and reviewed by the Divisional / CBU Manager/s and sickness absence leads (or equivalent) on a three monthly basis, and as a minimum reviewed with the line manager CBU Manager and/or Nurse (or equivalent) annually. Where monitoring has identified deficiencies, there must be evidence that recommendations and action plans have been developed and changes implemented accordingly. Managers must be able to provide detailed documentation of the recommendations and action plans as requested. Appendix 1b may be used to document these actions and a copy held by the Divisional / CBU Sickness Absence Leads. 4. Setting of Targets for Review. While the ideal is for the member of staff to attain full attendance, the aim should at least be to ensure that the member of staff attains a level of attendance that brings them below the trigger points (which the policy identifies as 4 episodes or more than 10 days or the equivalent of 2 working weeks for staff on flexible working patterns or part time hours in any rolling 12 month period). Planned sick leave in the case of operations and/or hospital admissions should be excluded in any consideration by managers when setting targets. In cases of on-going disability, it may be that there is a level of attendance that is operationally acceptable, but is nevertheless above the target set by the policy. The decision to accept this higher than normal absence rate would be exceptional and considered carefully by the division as one of the reasonable adjustments that they might be able to make. Staff who trigger under the UHL Sickness Absence Policy should be set a twelve month target which is 'not to trigger with regards to sickness absence over the next 12 months be that 4 episodes or over 10 days or the equivalent of 2 working weeks for staff on flexible working patterns or part time hours'. Staff would be monitored appropriately during this target period. If the staff member then breaches the trigger again then they are to be formally 17

18 managed and, as appropriate, invited to a hearing where a warning up to and including a Final Written Warning maybe given. 3 month targets should then commence:- after the second trigger until an individual attends for a year without triggering during the life of any warning and until an individual attends for a year without triggering If the member of staff has already broken the target within say 1-2 months of the review period, the manager should take action to bring the review forward at that point. 5. Calculation of time lost When counting the number of days of absence for monitoring purposes (as in the case of the 10 days or the equivalent of 2 working weeks for staff on flexible working patterns or part time hours trigger mentioned above), only scheduled or rostered work days/shifts should be included. Rostered days off or unscheduled days (e.g. weekends for staff who normally work Monday to Friday) during an episode should not be counted. This is different from the calculation of qualifying days under the SSP rules. 6. Payment of Staff returning to work part-time under a rehabilitation/ reorientation programme Item states that To assist the individual to make a successful return to full duty, it may also be necessary for Occupational Health, the manager, employee and his/her representative to mutually agree a work development plan in writing prior to resuming duty, to assist in the transition back to work. Staff on a rehabilitation/reorientation programme are not certified as sick and have been deemed fit to return to work by their medical practitioner. It is understood that this may also mean returning to work initially on reduced hours. It is anticipated that a phased return would normally last no more than four weeks and the following arrangements will apply: i) Staff who are on a full or half sick pay entitlement immediately prior to their return to work will receive full pay. The days/hours not worked as part of the phased return will be covered by special leave with pay. ii) Staff who have reached a no pay situation prior to their return to work will be asked to use the annual leave accrued during their period of sick leave to cover any days/hours not worked as part of the phased return. 7. Payment of Staff undertaking a Therapeutic Return to Work A therapeutic return is undertaken while an individual is still certified as sick. Any such return must not exceed hours per week in line with the Department of Social Security Regulations on incapacity. An Occupational Health Physician must prescribe a therapeutic return. It is normally used for staff who have been absent for a long period of time (usually several months) and are not certain of their ability to undertake tasks in their normal working environment. This type of return plays an important part in assessing an individual s fitness to return to work, through observing them in the workplace. Individuals undertaking a therapeutic return are supernumerary and have a mutually agreed, defined role and duties, stipulating exactly what they should do. The nature of the 18

19 return will depend on individual circumstances and could simply involve a visit to the workplace. Payment for staff undertaking a therapeutic return will be in line with their current sick pay/temporary injury allowance rate. 8. Temporary Injury Benefit Section 3.9 refers to the possibility that, if an employee is incapacitated as the result of an injury at work (or for other reasons attributable to their employment) and if because of their absence they are likely to suffer a financial disadvantage, then they may be eligible to receive assistance under the NHS (injury benefits) regulations. Managers who are not familiar with these provisions should refer to the HR department for further information. 9. Overtime after Sickness Following periods of sickness, flexibility should be considered as to whether an employee should be asked / allowed to work overtime. 19

20 University Hospitals of Leicester NHS Trust May be fit for work? Appendix 1a A Doctor may give a Fit Note if an employee s health condition may allow them to work if they get suitable support from their employer. If an employee is too ill to work the doctor will advise this just like the sick note This flow chart explains what to do when you receive a may be fit for work Statement / Fit Note: Discuss the advice on the Statement with your employee ideally within 24 hours of the date it was issued Consider the advice on the Statement and how it affects the job and the workplace Consider the functional comments, any of the return to work tick boxes, and any other action that could help a return to work Agree next review date or return to work date. Pay sick pay as per contractual terms and/or Statutory Sick Pay rules NO Is a return to work possible in the current role, Department, Business Unit, Division or Trust? Discuss the options with your employee YES Agree return to work date Agree any workplace amendments and seek Occupational Health advice if required (refer to the Management of Sickness Absence Policy to check entitlement to 4 weeks special leave during phased return) Agree a date to review and confirm the discussion by completing Record of Discussion Form Monitor and review as agreed 20

21 University Hospitals of Leicester NHS Trust Sick Note to Fit Note Statement of Fitness for Work Frequently Asked Questions When does the Fit Note come into effect? From 6 April 2010 the Sick Note is changing to become a Fit Note. Why has the Sick Note changed? To help more people get the support they need to get back to work. The new fit note system will mean that doctors can advise if employees are: Unfit for work This is just like the old sick note where the doctor advises an employee to refrain from work for the stated period of time. May be fit for work - this means the doctor s assessment of an employee is that their condition does not necessarily stop them from returning to work. For example, they could return to work but may not be able to complete all of their normal duties, or they could benefit from amended working hours. A doctor will be able to suggest ways of helping an employee back to work. This might mean discussing with your employee: a phased return to work; altered hours; amended duties; and/or workplace adaptations What are my responsibilities as an employee? As previously, you must report your absence to your line manager and forward your certification. If you doctor advises you may be fit for work, then you must inform your line manager within 24 hours to discuss the medical advice. What are my responsibilities as a line manager? You must discuss the Fit Note with the employee within 24 hours of notification. This discussion is normally between the line manager and employee and should not be delayed. You would consider: 1. In the first instance if the suggested amendments can be met in the employees existing ward/department? If not, 2. If the suggested amendments can be met within their Business Unit? If not, 3. If the suggested amendments can be met within their Division? If not, 4. Contact your Human Resources Advisor who will review opportunities Trustwide. 5. Identify any potential risks and how they could be managed? Regularly review the risks? 21

22 6. Occupational Health advice may be sought at any of the above stages and must always be sought for sickness absence of 4 weeks or more (or likely to be so). 7. Seek the advice of the Health and Safety team as appropriate Can discussions be deferred to seek HR, Occupational Health or union input? The discussion would take the form of a return to work discussion, between the line manager and employee. The initial discussion should take place within 24 hours and it may be appropriate to seek HR, Occupational Health or union input, prior to confirming the return to work plan. What if the fits note states needs Occupational Health assessment? Occupational Health are happy to discuss issues over the phone with HR and Managers and then a formal referral can be made if appropriate. Please note that Occupational Health must always be sought for sickness absence of 4 weeks or more (or likely to be so). How long can an employee undertake amended / restricted duties? On the Fit Note (Statement of Fitness to Work) a doctor will state the period of time their advice is for. When agreeing a return to work plan the manager/employee should always be clear on the length of time any amended duties or support is for. If the employee cannot then return to their normal duties within 4 weeks, Occupational Health and HR advice should be sought by the line manager in accordance with the Management of Sickness Absence Policy. Line managers must clearly document on Record of Discussion Form the agreed amendments and a review date of 4 weeks agreed with the employee. The Record of Discussion Form must be retained by the line manager on the employees personal file, and a copy of the form must also be handed to the employee. What if the doctor s suggested adjustments cannot be met? If it is not possible to support the employee s to return to work, you and your employee should use the Fit Note as if the doctor had advised not fit for work. i.e. like the traditional sick note. How will I be paid if I am able to return to work on reduced hours? A phased return to work must be recommended by your Doctor or Occupational Health: i) Staff who are on a full or half sick pay entitlement immediately prior to their return to work will receive full pay. The days/hours not worked as part of the phased return will be covered by special leave with pay. ii) Staff who have reached a no pay situation prior to their return to work will be asked to use the annual leave accrued during their period of sick leave to cover any days/hours not worked as part of the phased return. A phased return to work would be supported by special leave for a maximum of 4 weeks, and thereafter unpaid leave or annual leave may be considered. 22

23 University Hospitals of Leicester NHS Trust Statement of Fitness to Work Sick Note to Fit Note Employee Details: Surname: Forename/s: Employee No: Record of Discussion Job Title: Department: Directorate: Date of Statement of Fitness to Work: Date of Discussion (within 24 hours): GP advice: a phased return to work altered hours Comments, including functional effects e.g. Occupational Health assessment : Amendments recommended for (timeframe): amended duties workplace adaptations To (date) From (date) to (date) Amendments agreed: Ward/Department: Phased Return to Work* (days and hours to be worked) Week 1: Week 2: Week 3: Week 4: Duties to be undertaken: Other workplace adaptations: Additional support offered: Any potential risks and how they will be managed: Further advice sought (for example from Occupational Health, Health and Safety or Human Resources): Pay and Annual leave for Phased Return to Work: Up to 4 weeks phased return will be supported by paid special leave where employees are on full or half sick pay immediately prior to their return to work. 23

24 Review Date: Employees who have reached a no pay situation prior to their return to work will be asked to use the annual leave accrued during their period of sick leave to cover any days/hours not worked as part of the phased return. Signature of Employee: Signature of Manager Managers Name: Date: Date Managers Job Title: Original to be retained by line manager in the employee s file, and a copy to the employee A Return to Work Discussion Form must also be completed 24

25 APPENDIX 1b SICKNESS ABSENCE ACTION PLAN Name of Responsible Manager / Supervisor: Job Title: Department / Directorate: Date: Lead Manager: At Work for Patients sickness Training attended Yes / No (If no, confirm date booked to attend ) Deputy Manager: At Work for Patients Sickness Training attended Yes / No (If no, confirm date booked to attend ) Name Assignment Number Total number of episodes From To Reason Total working days / hrs Support / Action taken to date (with dates) Targets Date of Formal Verbal Warning Date of First Written Warning Date of Final Written Warning Further Support / Action (and dates)

26 UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST Appendix 2 SICKNESS POLICY ALLOWANCES/Agenda for Change Contract Holders Only EXTRACT SECTION 14 SICKNESS ABSENCE Agenda for Change Terms and Conditions Handbook 14.1 These arrangements are intended to supplement statutory sick pay to provide additional payment during absence due to illness, injury or other disability. This section is supplemented by Annex Z which sets out a framework to support employers and staff in the management of sickness absence and manage the risk of premature and unnecessary ill health retirements. Scale of Allowances 14.2 Employees absent from work owing to illness will be entitled, subject to the conditions of this agreement, to receive sick pay in accordance with the scale below (see Section 12 for the provisions governing reckonable service):- During the first year of service one month s full pay and two months half pay. During the second year of service two months full pay and two months half pay During the third year of service four months full pay and four months half pay During the fourth and fifth years of service five months full pay and five months half pay After completing five years of service six months full pay and six months half pay In the event of employment coming to an end, entitlement to sick pay ceases from the last day of employment The definition of full pay will include regularly paid supplements, including any recruitment and retention premia, payments for work outside normal hours and high cost area supplements. Sick pay is calculated on the basis of what the individual would have received had he/she been at work. This would be based on the previous three months at work or any other reference period that may be locally agreed. Local partnerships can use virtual rotas showing what hours the employee would have worked in a reference period had he or she been at work Full pay needs to be inclusive of any statutory benefits (so as not to make sick pay greater than normal working pay). The combined addition of statutory sick pay to half pay must not exceed full pay.

27 Calculation of Allowances 14.6 The period during which sick pay should be paid and the rate of sick pay for any period of absence is calculated by deducting from the employee s entitlement on the first day of sickness the aggregate period of paid sickness absence during the 12 months immediately preceding that day. In aggregating periods of absence due to illness no account will be taken of:- Unpaid sick absence Injuries or diseases sustained to members of staff in the actual discharge of their duties through no fault of their own. Injury resulting from a crime of violence not sustained on duty but connected with or arising from the employee s employment where the injury has been the subject of payment by the Criminal Injuries Compensation Board (England and Wales), the Criminal Injuries Compensation Authority (Scotland) and the Compensation Agency (Northern Ireland). As above, but an injury which has not been the subject of payment by the Board on grounds that it has not given rise to more than three weeks loss of earnings or was not one for which compensation above the minimum would arise Sick pay paid to an employee under this scheme when added to an statutory sickness, injuries or compensation benefits, including any allowances for adult or child dependants, must not exceed full pay (see paragraph 14.4 above). Conditions for Contractual Sick Pay 14.8 Employees will not be entitled to an additional day off if sick on a statutory holiday Sick pay for those who have exhausted sick pay entitlements should be reinstated at half pay, after 12 months of continuous sickness absence, in the following circumstances:- Staff with more than 5 years reckonable service sick pay will be reinstated if sick pay entitlement is exhausted before a final review meeting for long term absence has taken place. Staff with less than 5 years reckonable service sick pay will be reinstated if sick pay entitlement is exhausted and a final review does not take place within 12 months of the start of their sickness absence. Reinstatement of sick pay should continue until the final review meeting has taken place. Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence. These arrangements will be in accordance with local sickness absence procedures established in accordance with Annex Z and will only apply where the failure to undertake the final review meeting is due to delay by the employer. This provision will 27

28 not apply where a review is delayed due to reasons other than those caused by the employer Employers will also have discretion to extend the period of sick pay on full or half pay beyond the scale set out in Where there is the expectation of return to work in the short term and an extension would materially support a return and or assist recovery. Particular consideration should be given to those staff without full sick pay entitlements. In any other circumstance that the employer deems reasonable During the rehabilitation period employers should allow employees to return to work on reduced hours or, where possible, be encouraged to work from home without loss of pay. Any such arrangements need to be consistent with statutory sick pay rules Sick pay is not normally payable for an absence caused by an accident due to active participation in sport as a profession, 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. Employers will advance to an employee a sum not exceeding the amount of sick pay payable under this scheme providing the employee repays the full amount of sickness allowance to the employer when damages are received. Once received the absence shall not be taken into account for the purposes of the scale set out in paragraph 14.2 above Employers may at any time require an employee absent from work due to illness to attend an examination by a medical practitioner. Furthermore, staff do not need to be off sick to be referred by their employer for a medical. The employer will meet the cost of any medical examination After investigation, consultation and consideration of other alternative posts, and where there is no reasonable prospect of the employee returning to work, employers will have the option to terminate employment before the employee has reached the end of the contractual paid sick absence period, subject to the employer s agreed sickness absence policies and procedures Notification procedures and payment of sick absence pay when injuries are connected with other insured employment will be for local determination Payment of NHS Temporary Injury Allowance for workplace injuries or disease should be in accordance with the NHS Injury Benefit Scheme regulations. To note: Annex Z of the Agenda for Change Terms and Conditions Handbook refers to Managing Sickness Absences developing local policies and procedures. The section outlines the responsibilities of both staff and employers in the management of ill health together with minimum standards for local sickness absence procedures. Annex Z has been considered in the production of this policy. 28

29 PROCEDURE FOR HANDLING OVERALL LEVEL OF SICKNESS ABSENCE DUE TO: Persistent, Frequent and Unrelated sickness absence; and An underlying condition and unrelated reasons 1 INTRODUCTION 29 Appendix 3 This procedure is intended for use within the Sickness Absence Policy, where Occupational Health reports have shown that the employee has: No chronic underlying condition, but is experiencing unrelated episodic absence at a continued level that affects the operational efficiency of the department and is therefore unacceptable to management. Sickness absence is both due to a chronic underlying health condition and the employee absences due to no chronic underlying condition. The procedures for dealing with episodic absence due solely to a chronic underlying cause and due to permanent incapacity are dealt with in sections 3.11 and 3.12 of the Management of Sickness Absence policy. 2 SCOPE OF THE PROCEDURE 2.1 This procedure applies to all employees of the University Hospitals of Leicester NHS Trust, with the exception of Medical and Dental staff, for whom reference should be made to the Trust s Conduct, Capability, Ill Health and Appeals Policies and Procedures for Medical Practitioners. 2.2 If in exceptional circumstances, an individual is not a member of a recognised Trade Union or Professional Organisation and is unable to be represented by an appropriate fellow worker, consideration will be given to requests by them to be accompanied by an appropriate friend not acting in a legal capacity. Such requests will not be unreasonably refused, but consideration will be given to the reasonableness of the request. 3 RIGHTS TO REPRESENTATION 3.1 The employee will be advised of his/her right to representation by either an accredited Trade Union /Professional organisation (TU/PO), or by a work colleague at any formal hearing within the procedure. Employees will be encouraged to seek advice and support from an accredited Trade Union/ Professional organisation representative at any stage. If the employee declines representation this must be recorded. 4 PROCEDURE 4.1 Where a manager has identified a problem of episodic absence at an unacceptable level, and an Occupational Health report/s has shown that the absences are unrelated and 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. 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. 4.2 FORMAL WARNINGS UNDER THE PROCEDURE There are various levels of action that can be taken. These increase in severity to reflect

30 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, unless the problem is exceptional. It is also possible for a Sickness Absence Hearing under this procedure to conclude that no formal action needs to be taken. The range of formal action is: Level I Level II Level III Level IV Formal Verbal Warning First Written Warning. Final Written Warning Dismissal 5 ARRANGEMENTS FOR THE SICKNESS ABSENCE HEARING 5.1 If the decision is taken to proceed to a formal hearing, the following will take place: The appropriate panel will be identified, with reference to the table of levels of authority given at Appendix 4. The employee will be advised in writing that a sickness absence hearing is to be convened and will be given a written statement of the record of sickness absence and any other relevant information such as Occupational Health reports. A mutually agreeable date should be set with all parties, normally a minimum of seven working days notice will be given, but a longer or shorter time limit may be appropriate in some circumstances. In arranging the venue of the hearing, consideration will be given wherever possible to the wishes of the employee. However the availability of suitable rooms on the different sites may need to be an overriding factor. 5.2 The letter to the employee will be copied to their representative and will contain the following information. : - A written statement of the extent of continuing sickness absence. The documentary evidence to be used at the hearing, copies of which will be sent with the letter. The names of the witnesses to be called at the hearing. A reminder of their right to be represented at the hearing. If dismissal is a possible outcome of the hearing. The names and post titles of the sickness absence panel. The requirement that the employee or their representative advise management prior to the date of the hearing of any other supporting documentation or information that they wish to submit. It will not usually be necessary for witnesses to be called in sickness absence hearings, though this is possible especially at the more serious stages for example if a manager needs to be called to explain to the panel why the continuing level of sickness absence is unacceptable. If management witnesses are to be called, the member of staff needs to be notified of this within the letter. If the member of staff wishes to call witnesses to the hearing, the panel must be notified of this prior to the hearing. 5.3 If the employee declines to attend the first date of the hearing, a second date will be offered. If the employee declines to attend the second date without good cause, the hearing may be heard in his/her absence and they will be informed of this in writing. 6. THE SICKNESS ABSENCE HEARING 30

31 6.1 The aim of sickness absence hearings is to enable the panel to hear and understand the full extent of the evidence, and to enable the member of staff to have a full and fair hearing. It is therefore important for the hearing to enable not only the facts of the case to be presented, but also for the member of staff and their representative to have a full opportunity to present evidence in support of their case, including any mitigating circumstances. To enable this to happen, guidance is given in the attached format of the hearing, (Appendix 6) although it is recognised that the structure will depend on the particular case. 7 Outcomes of Sickness Absence Hearings. 7.1 No Formal Action When as an outcome of a formal sickness absence hearing it is decided that no formal warning will be given, the employee will be notified of this decision in writing. Where appropriate, a further period of review and target may be set for the member of staff. Depending on attendance during this further period (and the rolling retrospective 12 month period), it may be appropriate to reconvene a formal hearing, or to continue to monitor the situation. 7.2 Level I - Formal Verbal Warning This level may be appropriate where: - Sickness absence is unacceptably high and has not improved acceptably since the manager first met with the individual to discuss this and set a target and review period. Appropriate advice and support must be considered in accordance with Paragraph 3.11 Episodic absence due to a chronic underlying cause The employee will be warned that any further failure to achieve the required level of attendance while the warning is in existence may result in further formal warnings being given at a higher level The formal verbal warning will not be confirmed by letter, but the fact that it has been given, reasons for its issue and the response from his/her representative will be noted on the employee s personal file. The improvements required in attendance and the period over which they are expected to take place will also be noted Provided there has been sustained, significant and acceptable improvements in attendance, a level 1 warning will be discounted after a period of six calendar months from the date of the sickness absence hearing at which it was given. Any file notes relating to this warning will be removed from the employee s personal file at this time There is a right of review against a level 1 warning (see Section 8). 7.3 Level II - First Written Warning This level may be appropriate where: - A previously issued formal verbal warning is still valid and further formal sickness absence warning is now warranted, sickness absence having remained unacceptably high and having not improved acceptably since the verbal warning was issued. 31

32 The level of sickness absence is sufficiently serious to warrant taking action at this level as at a first formal sickness absence hearing The warning will be confirmed in writing within seven clear working days of the date of the sickness absence hearing There is a right of review against a Level II warning (see Section 8) The letter will: - Be signed by the appropriate officer. Contain a summary of the facts as presented at the hearing. State the reasons for the issue of the warning. Refer to any previous warnings that have not been discounted State the likely consequences of further unsatisfactory sickness absence. Give details of the improvements required in attendance and the period over which they are expected to take place. State the employee s right of review of this decision A copy of the letter will be sent to the employee s representative, if there is one Provided there has been sustained, significant and acceptable improvements in attendance, a level II warning will be discounted after a period of twelve calendar months from the date of the disciplinary hearing when it was given. 7.4 Level III Final Written Warning This level may be appropriate where :- - A previously issued level First Written warning is still valid and further formal sickness absence warning is now warranted, sickness absence having remained unacceptably high and having not improved acceptably since the verbal warning was issued. - The level of sickness absence is sufficiently serious to warrant taking action at this level as at a first formal sickness absence hearing The warning will be confirmed in writing within seven clear working days from the date of the disciplinary hearing There is a right of Appeal against a Level III Warning The letter will :- - Be signed by the appropriate officer. - Contain a summary of the facts presented at the hearing. - State the reasons for the issue of the warning. - Refer to any previous warnings that have not been discounted. - State that any further unsatisfactory sickness absence record is likely to lead to dismissal. - Give details of the improvements required in attendance and the period over which they are expected to take place. - State the employee s right of appeal against the decision A copy of the letter will be sent to the employee s representative if there is one. 32

33 7.4.6 A copy of the warning letter will be retained in the employee s personal file Provided there has been sustained, significant and acceptable improvements in attendance, a level III warning will be discounted after a period of twenty four calendar months from the date of the disciplinary hearing when it was given. 7.5 Level IV Dismissal This level may be appropriate where: - - A previously issued level Final Written warning is still valid and further formal action is now warranted, sickness absence having remained unacceptably high and having not improved acceptably since the verbal warning was issued. - The level of sickness absence is sufficiently serious to warrant taking action at this level as at a first formal sickness absence hearing. - A lesser warning is still valid and the level of sickness absence is sufficiently serious to warrant taking action at this level as a next step Where all other options have been considered, but there is no alternative but dismissal, the employee will be advised that their employment will be terminated The appropriate notice period or payment in lieu of notice will be given There is a right of Appeal against dismissal (See Section 8) In certain situations, the Trust is obliged to advise certain bodies of the dismissal of individuals for reasons of ill health. This can be, for example the appropriate registering body, if it is considered that the level of sickness absence makes them unsuitable for work within the registered profession. If it is appropriate for the Trust to refer a case to such bodies in addition to any action taken by the Trust, then the individual concerned will be informed of this The employee will be informed of the decision in writing, within seven clear working days of the hearing The letter will: - - Be signed by the appropriate dismissing officer. - Contain a summary of the facts presented at the hearing. - State the reasons for the dismissal (ill health) - Refer to any previously unspent warnings. - State the employee s right of appeal against the decision. - Confirm the effective date of the dismissal. - Confirm the notice provision. 8. RIGHTS OF REVIEW / APPEAL Employees are advised that the outcome of a review or appeal could be a lesser, same or higher sanction. 8.1 Right of Review 33

34 8.1.1 There is a right of Review against a level I (Formal Verbal) warning and level II (First Written) Warning. Should the member of staff consider that they have substantial reason to request this, they should put their request for Review in writing to the Director of Human Resources, University Hospitals of Leicester NHS Trust, Gwendolen House, Gwendolen Road, Leicester. The request must be received within 7 working days of the date of the disciplinary hearing The Review will be undertaken by the appropriate officer indicated in Appendix 5 attached. The depth and format of the review will be at the discretion of the reviewing officer, but will as a minimum include the following points:- A thorough review of the evidence considered by the panel which issued the warning and An opportunity for the member of staff or their representative to explain the reasons for dissatisfaction with the decision. There is no need for witnesses to be recalled unless the reviewing manager feels that it is necessary to clarify matters in dispute and this cannot be achieved from the information already available The review will be complete when the reviewing manager is satisfied that all of the relevant information has been considered The decision of the reviewing manager will be advised in writing to the employee, his or her representative (where appropriate), and copied to the Director of Human Resources as soon as reasonably possible after the completion of the review. 8.2 Right of Appeal There is a right to appeal against a level III (Final Written) warning and against Dismissal. Should the member of staff consider that they have substantial reason to request this, they should put their request for Appeal in writing to the Director of Human Resources, University Hospitals of Leicester NHS Trust, Gwendolen House, Gwendolen Road, Leicester. The request must be received within 7 working days of the date of the sickness absence hearing. The appeal letter must set out in writing the grounds upon which the employee is appealing otherwise the appeal may not be allowed The Procedure to be used at the Appeal is set out in Appendix 7 attached The lodging of an appeal will not suspend notice of dismissal, or in cases of summary dismissal, the actual dismissal. In the event of reinstatement/re-engagement following appeal, the employee will be compensated for loss of income between the date of dismissal and the date of reinstatement/re-engagement. 34

35 Appendix 4 Levels of Authority within Sickness Absence Procedure Category of Staff Level I Verbal Warning (Panel of two people including HR support) Chief Executive Executive Directors and Other Directors Trust Chairman or Non- Executive Director Chief Executive or one Non-Executive Director Level II First Written Warning (Panel of two people including HR support) Trust Chairman or Non- Executive Director Chief Executive or one Non-Executive Director Level III Final Written Warning (Panel of two people including HR support) Trust Chairman or Non- Executive Director Chief Executive or one Non- Executive Director Level IV Dismissal (Panel of three people including HR support) Trust Chair and Non-Executive Director Chief Executive and Non-Executive Director Consultant Medical Staff Specialty Doctors and Training Grade Medical/Dental Staff Managers second in line to Directors e.g. Divisional Managers, Clinical Business Unit Managers, Assistant and Deputy Directors Managers third in line to Directors, e.g. Service Managers Clinical Business Unit Lead or Divisional Director or Medical Director Clinical Business Unit Lead or Head of Service (with advice of Postgraduate Dean as appropriate) Director or Divisional Director Clinical Business Unit Lead or Divisional Director or Medical Director Clinical Business Unit Lead or Head of Service (with advice of Postgraduate Dean as appropriate) Director or Divisional Director Clinical Business Unit Lead or Divisional Director or Medical Director Medical Director or Deputy Medical Director or Clinical Business Unit Lead (with advice of Postgraduate Dean as appropriate) Director or Divisional Director Line Manager Line Manager Second in line Manager to Director / Divisional Director / Divisional Manager/ Clinical Business Unit Managers All other staff Line Manager Line Manager Second in line to Divisional Lead / Manager Chief Executive / Medical Director / Non-Executive Director Medical Director / Divisional Director / Divisional Manager (with advice of Postgraduate Dean as appropriate) Director or Divisional Director, Representative of CE and senior member of HR (decisions relating to Divisional Managers, Nurse/AHP and Clinical Business Unit Managers must involve the Chief Operating Officer or other representative of the Chief Executive) Director / Divisional Director / Divisional Manager / Divisional Nurse / Clinical Business Unit Managers / Nurse Director / Divisional Director / Divisional Manager / Divisional Nurse / Clinical Business Unit Managers / Nurse Note 1 Action may be delegated to designated officers for all levels within grid, as appropriate. Note 2 A direct line manager can be substituted by a line manager from a different area (with authority given in advance by either the Divisional Director / Divisional Manager or Divisional Nursing).

36 Levels of Authority for Reviews and Appeals within Sickness Absence Procedure Category of Staff Level I Verbal Warning Review (Panel of two including HR Support) Level II First Written Warning Review (Panel of two including HR support) Level III Final Written Warning Appeal (Panel of two including HR support) Level IV Dismissal Appeal (Panel of three including HR support) Chief Executive Non Executive Director Non Executive Director Non Executive Director Panel of two Non Executive Directors Executive Directors and Trust Chairman Trust Chairman Trust Chairman Trust Chairman and Non other Directors Executive Director Consultant Medical Staff Chief Executive (or Medical Chief Executive (or Medical Chief Executive (or Medical Chief Executive / Medical Director if Deputy Medical Director if Deputy Medical Director if Deputy Medical Director / Non-Executive Director; Deputy Medical Director; Deputy Medical Director; Deputy Medical Director / Divisional Director Director or Medical Director if Divisional Director has given warning) Director or Medical Director if Divisional Director has given warning) Director or Medical Director if Divisional Director has given warning) Specialty Doctors and Training Grade Medical/ Dental Staff Managers second in line to Directors e.g. Divisional Managers, Clinical Business Unit Managers, Assistant and Deputy Directors Managers third in line to Directors e.g. Service Managers All other staff Medical Director or Deputy Medical Director Director or Divisional Director Next in line manager to the manager deciding on the warning Next in line manager to the manager deciding on the warning Medical Director or Deputy Medical Director Director or Divisional Director Next in line manager to the manager deciding on the warning Next in line manager to the manager deciding on the warning Medical Director or Deputy Medical Director One Director One Director One Director Three Directors, (one of whom may be the Director of Human Resources, and if not the DDHR or Divisional HR Lead must be present) Three Directors (one of whom may be the Director of Human Resources, and if not the DDHR or Divisional HR Lead must be present). Three Directors (one of whom should be the Director of Human Resources, or if not, the DDHR, Divisional HR Lead or an HR Business Partner must be present). Three Directors (one of whom should be the Director of Human Resources, or if not, the DDHR, Divisional HR Lead or an HR Business Partner must be present). Note 1 Note 2 Appropriate senior staff may substitute for Directors where appropriate, and where delegated authority is given by the relevant Director. No person previously involved in the decision about or investigations into the matter previously will be a panel member

37 Guidance on Format of sickness Absence Hearings Appendix 6 Date: Time: Venue: Name of Employee: Order of Events Explain the purpose of the meeting and introduce those present. Explain the format of the hearing Invite Manager to present the case for Management and to call Witnesses (if appropriate.) Panel to question presenting Manager (and Witnesses if appropriate). Allow Staff Side to question presenting Manager (and Witnesses if appropriate) Each Witness to leave the room after giving evidence. Staff Side/employee to present case in response and call any witnesses Presenting Manager to question Staff Side/employee and witnesses Panel to question staff Side/Employee and witnesses. Each witness to leave the room after giving evidence. Presenting Manager asked to summarise case. Staff Side/Employee asked to summarise case. Panel to question staff side/employee as to whether there are any mitigating factors. Adjourn for a decision (Presenting Manager and Staff Side /Employee asked to leave the room) Reconvene (Panel, Staff Side/Employee and Presenting Manager) and announce decision

38 Appendix 7 APPEALS PROCEDURE FOR APPEALS AGAINST LEVEL III (FINAL WRITTEN) AND LEVEL IV (DISMISSAL) OF THE SICKNESS ABSENCE PROCEDURE. 1. The appeal will be heard wherever possible within 15 clear working days of the receipt of the request for appeal. The appellant will receive at least 5 clear working days notice of the date of the hearing. 2. On receipt of the appeal, the Director of Human Resources will set up the appropriate appeals panel as follows :- Appeals against Level III (Final Written) Warning - panel of one Director. A Senior member of the Human Resources directorate will be present to advise the Director. Where the warning concerns professional conduct or performance, and the Director is not of that professional group, it is likely to be appropriate for the Director to be accompanied by an appropriate senior professional advisor. Dismissal - Three Directors. A Senior member of the Human Resources directorate will be present to advise the panel, (unless one of the Directors is the Director of Human Resources.) Where the dismissal concerns professional conduct or performance, and the Directors are not of that professional group, it is likely to be appropriate for the Director to be accompanied by an appropriate senior professional advisor. Where appropriate, a Deputy or Assistant Director may substitute for an Director on an appeal panel. 3. No person previously involved in the decision or investigations into the matters to be considered will be a panel member. 4. The individual appealing will have the right of appearing personally before the appeal panel, either alone or accompanied by an accredited representative of a Trade Union or Professional organisation, or by a fellow work colleague. 5, Both parties must submit a summary of their case to the Director of Human Resources, to be received at least 5 working days before the hearing. These cases will be distributed to the panel and to the other party. 6. Witnesses whether for the appellant or management should be notified to the Director of Human Resources at lease 5 working days before the hearing. 7. The appeal procedure will be conducted in the following way. (Nothing in the following procedure will prevent the person hearing the appeal from inviting either party or their witnesses to clarify or amplify any statement made, or from asking him/her such questions, or to present such evidence as may be felt necessary in the interests of hearing all relevant information.) i. The appellant or his/her representative will put his/her case in the presence of the

39 management representative and may call witnesses. ii. iii iv v vi vii viii ix x xi xii xiii xiv The Management representative will have the opportunity to ask questions of the appellant, his/her representative and his/her witnesses. The members of the appeal panel will have the opportunity to ask questions of the appellant, his/her representative and his/her witnesses. The appellant or his/her representative will have the opportunity to re-examine his/her witnesses on any matter referred to in their examination by members of the appeal panel or management's representative. Witnesses leave. The management representative will state management's case in the presence of the appellant and his/her representative and may call witnesses. The appellant or his/her representative will have the opportunity to ask questions of the management representative and witnesses Members of the Appeal panel will have the opportunity to ask questions of the management representative and witnesses. Management's representative will have the opportunity to re-examine his/her witnesses on any matter referred to in their examination by members of the appeal panel, the appellant or his/her representative. Witnesses leave. The appellant or his/her representative and the management representative will have the opportunity, if they wish, to sum up their case. The appellant or his/her representative will have the right to speak last. In their summing up, neither party may produce any new matter. Panel members may ask any party to clarify any matter on which they have questions. New evidence will not normally be admissible on the day. If new evidence is produced on the day by either the management representative or the appellant, the panel may at their discretion adjourn the appeal in order to consider whether the new evidence is admissible. The panel may at their discretion adjourn the appeal for any other reason. Adjournments during the course of the appeal will not normally exceed 15 minutes except in exceptional circumstances as agreed by the panel. The management representative, the appellant and his/her representative will withdraw

40 xv xvi The panel (with any appropriate advisors), will reach their conclusions and make their decisions in private only recalling both parties to clear points of uncertainty on evidence already taken. If recall is necessary, both parties will return even if only one is concerned with the point. The panel has the power to rescind or confirm management's decision, to refer the case back to management for further enquiries or reconsideration or to change management's decision in favour of a lesser penalty. 8. The decision will be confirmed in writing to both parties. 9. If the employee does not attend the first appeal hearing date, for reasons which the appeal panel accept as reasonable, a second date will be offered. However, if the employee declines the second date the hearing may be held in their absence and he/she will be informed of this in writing