1 Sickness Absence Management Policy and Procedure The Trust strives to ensure equality of opportunity for all, both as a major employer and as a provider of health care. This procedural document has been equality impact assessed to ensure fairness and consistency for all those covered by it regardless of their individual differences and the results are shown in Appendix D Policy Profile Policy Reference: HR 2.12 Version: 3.1 Author: Divisional Human Resources Manager Executive sponsor: Director of Human Resources and Organisational Development Target audience: All employees Date issued: 20 June 2014 Review date: June 2017 Consultation Key individuals and committees consulted during drafting Ratification Ratification Committee: Policy Ratification Group Date: 20 June 2014 Interim Corporate Risk Dates Jan 2011 Manager Dates Occupational Health Dates January 2014 Staff Side Dates Document History Version Date Review date Reason for change 2 15 June August June 2011 June 2014 Revised due to integration with CSW and in light of NHSLA requirements. 4
2 Contents Page Number 1 Introduction 5 2 Purpose 5 3 Definitions 5 4 Scope 6 5 Roles and Responsibilities Employees Managers Human Resources Occupational Health Department Role of the Trade Unions and Professional Organisations Director of Human Resources & Organisational Development Organisational Risk Committee with overarching responsibility 9 6 Reporting Absence Including the Process for Maintaining Contact with Absent Employees 9 7 Sickness Recording 11 8 Sickness Absence prior to or after annual leave 11 9 Sickness Absence During the Working Day Sickness Absence on Bank Holidays Accidents at Work Return to Work Interviews Sick Pay Reinstatement of Sick pay Time off for Doctors, Dentist and other health related appointments Disciplinary action relating to Absence Fraud Procedures for Dealing with Persistent Short Term or Long Term Sickness Absence Disability 17.2 Right to be Accompanied Procedure for Persistent Short Term Sickness Absence Stage Stage Stage General Points: Monitoring Periods Review Meetings (short term sickness) Procedure for Long Term Sickness Further Review Meetings Carry over of Annual Leave Final Review Meeting Planning and undertaking workplace controls or adjustments Assessment of Workplace Controls or Adjustments Rehabilitation/Phased Return to Work Redeployment Ill Health Retirement Process for analysing sickness absence data Arrangements for the organisational overview of sickness absence Dissemination and implementation Dissemination Implementation Monitoring Effectiveness and Compliance Process for Monitoring Compliance and Effectiveness Standards/Key Performance Indicators Review of Policy Associated documentation 26
3 25 References 26 Appendices A B C D E Self Certificate (Return to Work Interview Record Form) Sickness Absence Return To Work Plan Template Statement of Fitness for Work (certificate) Guidance Notes for Employees Equality Impact Assessment Policy Approval Checklist
4 Executive Summary St George s Healthcare NHS Trust is committed to promoting and supporting the health and welfare of its employees and achieving excellence in terms of attendance at work. It is in the interests of all employees and service users that sickness absence and its effect upon services is effectively and carefully managed and minimised. Excessive absence levels seriously affect the provision of an efficient and high quality service of essential services to the public and ultimately patient care. All employees have a responsibility to the Trust, colleagues and themselves to attend work. The Trust recognises that although some absence is outside the control of the employee, levels of attendance can be improved by the implementation of positive procedures and guidelines, which are consistently and proactively used. This policy aims to ensure that the Trust adopts a consistent and equitable approach to the management of sickness absence. It outlines the appropriate support available to managers and employees and also positively reinforces good attendance in the Trust. This policy also outlines the main responsibilities of Trade Union Representatives, the employee, Manager, Human Resources, and the Occupational Health department. It sets out the procedure for managing short and long-term sickness.
5 1 Introduction The Trust is committed to the promotion of the health, safety and welfare of employees, and has a responsibility to provide a safe working environment. All employees have a responsibility to the Trust, colleagues and themselves to attend work regularly and fulfil their contract of employment with the Trust. It is recognised that there will be occasions when employees are unable to attend work due to ill-health. The Trust will provide a caring and understanding approach to employees who are suffering ill health and will work to minimise the effect of sickness absence on both service delivery and the remaining employees. It is the policy of the Trust to manage fairly, sympathetically and confidentially all cases of ill health. Repeated short term absences, longer periods of ill health or a combination of the two may lead to an employee being incapable of doing the job for which he/she has been employed. This policy sets out the steps that will be taken to manage absence. 2 Purpose The aim of this policy is to set out the framework for how absence will be managed within the Trust, from a corporate, divisional, departmental and individual perspective. It is designed to ensure that any absence is minimised and that there are proactive and early interventions when any employee is unable to attend work. The policy also aims to: To improve the attendance standards within the Trust which will ultimately increase organisational productivity and support service improvements and safety for patients. Ensure all employees are aware of their responsibility to attend work regularly. Provide a fair and consistent method of dealing with absence due to repeated periods of short-term sickness or long-term sickness or a combination of short and long term absence. Give employees the opportunity to be formally advised of the effects of their absence. Ensure that reasonable steps are taken to ensure that colleagues are supported as necessary when employees report sick. Ensure that every attempt is made to support any employee's ill health including the involvement of the Occupational Health Department as appropriate. To promote the wellbeing of employees. 3 Definitions Sickness Absence: Sickness absence refers to any absence from the work place due to ill health whether short or long term. Workplace refers to any place where the occasion can be identified as part of employment and includes training study days and external meetings. Long Term Sickness: Long term sickness is defined as any period of sickness absence longer than four weeks. Short Term Sickness: Short term sickness is defined as any period of sickness absence shorter than four weeks
6 Unacceptable attendance: any emerging pattern such as amount of time absent, which will act as a trigger to indicate to managers that more formal action is required. 4 Scope This policy applies to all staff directly employed by the Trust working in any of the locations registered by St Georges Healthcare NHS Trust with the Care Quality Commission (CQC) to provide regulated activities. Locations are not necessarily geographically based or determined. Therefore the term locations does not just refer to Trust buildings; it is the term used by the CQC to describe the hub of operations for a service or a range of services and so includes all activities being performed in the course of performing one s role. The policy should be read in conjunction with Section 14 of the Agenda for Change Terms and Conditions of Service Handbook. In the case of medical and dental employees it should be read in conjunction with the Medical and Dental Staff Conduct and Capability Policy and Procedure. 5 Roles and Responsibilities 5.1 Employees Employees are responsible for their attendance at work and should take appropriate action to ensure that their good health and well-being is maintained. It is the responsibility of all employees to adhere to the Sickness Absence Policy and Procedure and to be aware of their responsibilities in respect of: Reporting sickness absence and maintaining regular contact when they are absent (in accordance with Section 6 and local guidelines). Submitting self certificates or medical certificates promptly (in accordance with Section 6 and local guidelines). Attend appointments with the Occupational Health Department, when requested to do so and to co-operate fully with any advice or recommendations made. Attend any meetings with their Manager under this policy and working with their manager to facilitate their prompt return to work. 5.2 Managers Managers have a responsibility to make sure all employees they manage are aware of the local procedures for reporting absence. Managers are responsible for developing a relationship with their employees which allows for open discussion and counselling which will help employees appreciate the importance of their role within the organisation and the problems that can arise from frequent absence. Managers are responsible for managing sickness absence amongst their own employees and should personally monitor the performance, record reasons for sickness absence and attendance of the employees they supervise. They should also ensure employees are aware that attendance will be monitored.
7 Managers will be responsible for maintaining sickness absence records of staff including details of all episodes of sickness absence, days, reasons and causes for absences and reviewing these regularly to identify any patterns warranting further action. Managers are responsible for ensuring that disabled employees are managed in accordance with the Trust s Policy on the Employment of Disabled People, and where appropriate to make reasonable adjustments in working arrangements (see section 18.1 of this policy and paragraph 2.1 of the Policy on the Employment of Disabled People). Managers should be aware that high levels of sickness absence in a department may be an indication of underlying issues such as workplace stress, and they have a responsibility to investigate, carry out risk assessments if appropriate and take steps to address such issues. Managers must be aware/and keep in contact regularly with their employees whilst they are sick. Managers should seek early advice from Human Resources whenever an individual s attendance gives cause for concern. Managers must ensure that all sickness absence of employees is properly and promptly reported in the agreed format and sent through to the payroll department for central monitoring on the Electronic Staff Record system (ESR). It may be appropriate for the manager to refer the employee to Occupational Health, either as part of the process for monitoring absence records or otherwise. The role of Occupational Health is set out at 5.4 below. Work with individual members of staff to support and facilitate their return to work. Managers will conduct return to work interviews after any period of sickness absence and make a record of the discussion. This will help to establish whether any steps or additional support can be given to help employees maintain their fitness for work. Managers will ensure employees are made fully aware of any reasons for referral to the Occupational Health department. 5.3 Human Resources The Human Resources (HR) department will: Advise managers of best practice in the management of sickness absence and will assist them in applying the procedure thoroughly in a consistent and fair manner across the Trust. Ensure that sickness absence reports are produced on a regular basis to assist managers and the Trust Board to monitor and manage absence levels, ensuring managers understand the information they receive and what action should be taken if targets are not being met. Provide comprehensive training to managers on the policy and its application in the workplace.
8 Ensure that all new employees receive a summary of the policy during the Trust induction (as part of the Staff Handbook). Ensure all employees are assessed by the Occupational Health department as being fit to work prior to commencing employment. Work with Occupational Health to advise managers on how to help facilitate a return to work for their employees, including seeking alternative employment when redeployment is recommended and appropriate. 5.4 Occupational Health Department The Occupational Health Department provides impartial advice and education with particular regard to the prevention of ill health and the promotion of a healthier lifestyle. Where ill health does occur, however, the Occupational Health Department will provide appropriate timely support and advice to both the employee and the manager as required. Where appropriate, Occupational Health will liaise with an employee s GP and Medical Specialist to furnish an informed assessment of the employee s fitness for work. With the exception of the report of the referral, Occupational Health records are strictly private and confidential to the Occupational Health Department and are treated in the same way as patients' confidential records, with the exception of vaccination and immunisation information which may be released. At any stage, employees may be referred to, or may themselves approach the Occupational Health Department. Referrals under the short-term absence procedure will normally not take place until stage 2 of the procedure unless the absences have occupational significance. However, referrals will normally be made for long-term sickness absence (periods of four weeks or more). It is a requirement that employees attend Occupational Health on referral and nonattendance without good reason will be viewed as non-compliance with the policy. Regardless of the length of absence, all employees whose absences follow accidents at work or are due to illnesses with possible occupational implications (e.g. diarrhoea in a food handler, back pain in a nurse) must be referred to the Occupational Health Department to ensure appropriate health assessments are carried out. The investigation by the Occupational Health Physician or Clinical Staff may include enquiries to the employee's General Practitioner or Consultant, or examination by a Medical Practitioner nominated by the Trust. The employee's written consent will be required in line with the Access to Medical Reports Act (1988). In the event of the employee withholding consent any decision on subsequent action will, of necessity, be based on such information as is available or can be obtained by the Trust. The Occupational Health Department will provide the referring manager with a report regarding the condition of the employee's health and how this affects his/her capacity to work. The report will set out whether or not an employee has an underlying medical condition, is likely to return to work and whether the
9 employee will be able to perform his/her full duties. A copy of this report will also be given to the employee. 5.5 Role of the Trade Unions and Professional Organisations The Trust recognises the valuable role of trade unions and professional organisations in assisting employees at meetings under this procedure where an employee has the right to be accompanied (see section 17.2). The Trust encourages all employees to be accompanied at meetings where the right to be accompanied applies in order to promote fairness and consistency of treatment across the Trust. It is the employee s responsibility to arrange such representation, and employees are encouraged to contact their representative as soon as possible in order to secure their attendance at a hearing. 5.6 Director of Human Resources & Organisational Development The Director of Human Resources & Organisational Development will ensure that: The Trust Board understands workforce information on sickness absence Targets for reducing absence are agreed by the Board The Trust Board are advised on what remedial actions will be required/should be taken if targets are not met 5.7 Organisational Risk Committee with overarching responsibility The Organisational Risk Committee is the committee with overarching responsibility for the management of sickness absence and receives six monthly reports from the HR department on the operation of the policy. The Committee will read, interrogate the report identifying any weaknesses in the system and act upon them. The required changes will be monitored to ensure lessons learnt will be shared and implemented across the Trust. 6 Reporting Absence Including the Process for Maintaining Contact with Absent Employees All employees should ensure they are aware of the procedure that applies in their department or ward. All employees must speak with their manager of their absence preferably before the start of their work/shift, but in any event either within one hour of the normal starting time or as specified locally by the manager. Employees should call in stating the nature of their absence, its expected duration, whether they intend to see a doctor, whether the condition is a result of an injury at work as soon as reasonably practicable. Notification via a family member or friend is not acceptable unless in an emergency situation or in exceptional circumstances. Text messages and s are not an acceptable form of notifying your manager of your absence. Where local guidelines exist they will specify who should be contacted and the relevant telephone numbers. Unauthorised absence is defined as any period of absence where the employee has not followed the correct sickness absence reporting procedures for their department and/or failure to provide self-certification and/or medical certification in accordance with this procedure.
10 The employee should keep in regular contact with his/her manager during sickness absences and keep him/her up-to-date with regard to treatment and progress. In some circumstances, employees may be required to maintain contact on a daily basis. Any information that the employee gives will be treated in the strictest confidence and will be available only to the employee/manager and Human Resources and Occupational Health where appropriate. On return from sickness, the employee must report to their manager at the beginning of the day/shift. For any period of sickness up to seven calendar days, employees are required to complete a Self Certificate (Return to Work Interview Record Form) (see Appendix A) at the return to work interview. A self-certification form will be required from the first day of absence and days not normally worked are included in the absence period. The form will be signed by the manager and a copy given to the employee. The original will be kept by the manager and a copy put on the employee s personal file. For longer periods of sickness (more than 7 calendar days), in addition to the Self Certificate (Return to Work Interview Record Form) for the first seven calendar days, absence from the eighth calendar day must be covered by a doctor's certificate (also known as Certificate of Fitness to Work). The employee should contact the manager on the day the certificate has been issued to confirm the period the certificate covers and the certificate should be sent to the manager within 6 calendar days from the date of signing by the medical practitioner. Medical certificates are only valid from the date they are signed by the medical practitioner. Retrospective certificates will not normally be accepted and any gaps between certificates will normally be regarded as unpaid unauthorised absence. If for any reason an employee is unable to obtain a medical certificate on the 8th calendar day of absence, they should contact their manager on the day the certificate is due to discuss this. The manager will retain a copy of medical certificates received and forward the original certificate to the employee. In exceptional circumstances a manager may require that any future periods of sickness, including single days of absence, be covered by a doctor's certificate. Employees will be invited to attend meetings and Occupational Health appointments during their sickness absence at times when they would have normally been at work, and have a responsibility to attend these meetings. Employees who work night duty only may be required to attend Occupational Health appointments and meetings during normal office hours. Such meetings should be arranged as close to an employee s night shifts as possible. Non-compliance with the sickness absence procedure may include, but is not limited to, failure to notify the manager prior to commencement of a shift, failure to keep in regular contact with manager, failure to provide certification, non-attendance at Occupational Health appointments, or sickness meetings, etc. Non-compliance with the policy will be viewed as a matter of concern and will be investigated. During the investigation Occupational Sick pay may be withheld for any period of unauthorised absence or non-compliance with the policy. Serious or repeated cases of noncompliance will be the subject of disciplinary action. Falsification of any information on a certificate will be regarded as gross misconduct resulting in summary dismissal. The manager will contact the employee if notification is not received by the time specified and all employees must provide a valid contact number. However, it should be noted that it is the duty of the employee to report in and remain in contact with their Line manager during any period of absence.
11 7 Sickness Recording Sickness Absence will be recorded from the first day of absence. Days not normally worked will count towards a continuous period of absence irrespective of whether an individual is scheduled to work. For the purposes of sickness monitoring under Stage 1, 2 or 3 under this policy, working days rather than calendar days will be counted. Managers will be responsible for recording and maintaining locally records of all episodes of sickness absence, days, reasons and causes for absences. Managers will be responsible for ensuring systems are in place to provide records of all sickness absence to the payroll department for central monitoring on the Electronic Staff Record system (ESR). All sickness absence within the Trust is recorded on ESR. 8 Sickness Absence prior to or after annual leave Employees should not normally take annual leave or time off in lieu during a period of sickness. However, where an employee has a pre-booked holiday they must seek permission from their manager in advance. The manager may request information from the GP or Occupational Health about the fitness of the employee before giving permission. - When an employee falls sick during a period of annual leave, the manager must be notified as soon as is reasonably practical. Employees must produce a medical certificate from the first day of absence to confirm their incapacity. It is not acceptable to self certificate in these circumstances. For example, Annual leave/bank holidays or where patterns are identified or where sickness occurs on a day/days where a request for annual leave or off duty days has been refused. If the employee is abroad and cannot obtain the normal type of medical certificate, a statement must be obtained from a qualified medical practitioner and suitably endorsed to enable Occupational Sick Pay to be paid. Provided that the correct certification, or substitute, is received Occupational Sick Pay will be paid and the annual leave affected reinstated. Employees will be expected to arrange to send certificates as soon as possible. Employees who fall ill whilst in a non EU country will not be entitled to Statutory Sick Pay but may still be entitled to Occupational Sick Pay. Further information on sickness absence in relation to annual leave can be found in the Annual Leave Policy. Where an employee s incapacity prevents travel and a return to work at the end of the holiday period, any medical evidence should clearly state why travel was not possible in the circumstances. The employee will be required to show proof that they intended to return from holiday before they fell ill i.e. by keeping and producing on request, relevant travel documents including all the tickets provided for return travel. Prior to annual leave the same information may be required also. 9 Sickness Absence During the Working Day In cases where employees come into work, and then have to go home because they are unwell, the absence will be recorded and form part of the employee s attendance record but may not affect sick pay. 10 Sickness Absence on Bank Holidays In accordance with Agenda for Change Terms and Conditions, employees will not be entitled to an additional day off if sick on a Bank Holiday that they would otherwise have been required to work as part of their basic week.
12 11 Accidents at Work All employees have a responsibility for the health and safety of self and others and to comply at all times with the requirement of health and safety requirements including reporting of injuries and dangerous occurrences (RIDDOR). The Adverse Incident Reporting Policy and Procedure sets out managers and employees responsibilities under this policy. Injury Allowance is payable in accordance with section 22 of the NHS terms and conditions of service handbook (amendment 28; Pay Circulars 1 and 2/2013) where an employee s injury or other health condition is wholly or mainly attributable to their employment in the Trust. 12 Return to Work Interviews Managers should conduct return-to-work interviews every time an employee returns from any episode of sickness absence. The interview should be brief and conducted on the day the employee returns to work or as soon as practicable. The purpose of the interview is to establish the reason for absence and check that the employee is fit to return to work. It is also an opportunity for the manager to provide an update on any developments within the team /department. At this meeting the self certificate should be completed. This will help establish whether any steps or additional support can be given to help employees maintain their fitness for work. If the employee s attendance record has started to cause concern, the manager should counsel the employee that further action may be considered. 13 Sick Pay Entitlement to sick pay is based on continuous years of NHS service as follows: During the first year of service During the second year of service During the third year of service During fourth and fifth years of service After completing five years of service One months full pay and two months half pay Two months full pay and two months half pay Four months full pay and four months half pay Five months full pay and five months half pay 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 or when the relevant entitlement above is exhausted. Entitlement to sick pay is calculated each time an individual is absent due to sickness, but takes account of the amount of paid sick leave taken during the previous 12 months. The 12 month period is calculated by working backwards from the date upon which sickness absence started Reinstatement of Sick pay In accordance with section 14 of Agenda for Change sick pay for employees who have exhausted sick pay entitlements will be reinstated at half pay, after 12 months of continuous sickness where a final review meeting has not taken place. Reinstatement of sick pay should continue until the date of the final review meeting. If an employee fails to attend the meeting without good reason, the hearing will proceed in their absence and a decision will be made. Sick pay will not continue beyond the original date set for the final review period.
13 Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence. It is important to note that reinstatement will only apply when the final review meeting has not taken place in the 12 month period and where the meeting has been delayed by the Trust. Where the final review meeting is delayed due to any other reason other than a delay by the Trust, reinstatement of pay will not apply. 14 Time Off For Doctors, Dentist and Other Health Related Appointments A supportive approach should be taken for all staff who are undergoing specialist ongoing treatment or rehabilitation. The manager and employee should discuss confidentially the individual circumstances and agree how to manage the situation without disrupting the service. Consideration should be given to flexible working solutions such as reduced hours, flexitime or compressed working hours. (refer to the Trust s Balancing Work & Personal Life Policy). It is expected that routine appointments and G.P. appointments will generally be made at a time when the employee is not scheduled to work or where this is not practical, during an agreed period of annual leave. Alternatively if this is not possible or at the discretion of the line manager, appointments should be arranged where possible at the beginning or end of the working day to minimise disruption to the service. Time off should normally be made up, taken as flexi-time or time off in lieu. Staff should notify their manager as soon as they are aware that they need time off to attend an appointment. Under normal circumstances employees are expected to give their manager at least 5 working days notice for routine or long term appointments, except in the case of an employee needing to seek emergency medical treatment. There may be occasions where, due to service needs, an employee may be asked to rearrange appointments to a more suitable time or suggest swapping rota days off to keep disruption to the working day to a minimum. It is acknowledged that on some occasions it will not be possible to change hospital appointments. Managers and employees are expected to show some flexibility when discussing these arrangements. Pregnant women must be allowed reasonable time off to attend ante-natal appointments (refer to the Trust s Maternity and Adoption, Paternity and Parental Leave Policy and Procedure) Medical appointments of this nature are not recorded as sickness absence. Managers may request evidence of employees attending appointments (except for a first antenatal appointment). 15 Disciplinary Action Relating To Absence There are times when the Trust s Disciplinary Procedure will need to be instigated in absence related cases. Some examples could be: Failure to follow the sickness reporting procedure including local arrangements without good reason Failure to submit self-certificates and medical certificates without good reason. Failure to attend meetings under this procedure, including Occupational Health appointments without good reason. Providing an unsatisfactory reason for being absent from work.
14 Working elsewhere while claiming to be sick (including periods of time when the employee is not scheduled to work). Falsification of information on medical documents, and Taking sick leave for reasons unrelated to the employee s health. This is not an exhaustive list. 16 Fraud Employees who are absent from work due to sickness, whether paid or unpaid, are not allowed to work whether it be for the Trust or an external organisation as this may constitute fraud and be subject to disciplinary action up to and including dismissal. This includes working at times when the employee is not contracted to work for the Trust as sickness absence is regarded as a continuous period. The NHS Counter Fraud Service will also be notified and they may decide to carry out their own investigation and pursue the matter through the courts. 17 Procedures for Dealing with Persistent Short Term or Long Term Sickness Absence All employees are required to maintain high standards of attendance. All periods of sickness absence will be monitored and emerging patterns will trigger management actions Disability The Trust will be flexible, sensitive and reasonable in assisting employees with a disability in accordance with paragraph 11 of the Employment of Disabled People Policy. Where staff with disabilities are managed through the Sickness Policy, managers must ensure that reasonable adjustments have been implemented to reduce the level of absence prior to applying the triggers and to ensure that an employee is not disadvantaged because of their disability. However, if the sickness absence does not improve to satisfactory levels, the employee's absence will be managed in line with the Sickness Absence Procedure Right to be Accompanied An employee has the right to be accompanied by a trade union representative or work colleague at meetings held at stages 1, 2 and 3 of the short-term sickness absence procedure. The review meetings following meetings at stages 1 and 2 will be held between the manager and employee. The employee has the right to be accompanied at any formal meetings held under the long-term absence procedure. Employees with a disability may require additional or alternative support at meetings, and all reasonable requests will be accommodated. Employees will be given 7 calendar days' notice of any meetings under this procedure at which they have the right to be accompanied Procedure for Persistent Short Term Sickness Absence Individual employees who have repeated periods of short term sickness absence should be given the opportunity and help to improve their attendance to an acceptable level. Employees will be advised of the effects and possible consequences on their employment should there not be a satisfactory and sustained improvement in their level of attendance. The level of absence that is regarded as unacceptable will depend on the employee s general attendance record and the manager should consider all the circumstances before deciding whether or not to use the stages of this procedure as set out at and onwards below. As a guideline two absences on separate occasions during a
15 three month period; three absences on separate occasions during a six month period or five absences during a period of twelve months would normally be regarded as unacceptable. However, the fact that a trigger has been breached does not in itself mean that the stages of the procedure will automatically be invoked. Unacceptable level of absence may also include any unusual pattern of absence such as recurrent absences on particular days such as Mondays and Fridays or just before or just after holidays. When an employee's record is considered unacceptable, management will review the situation in accordance with the following procedure Stage Stage 2 If an individual's absence level becomes unacceptable, the manager should set up a stage 1 meeting to review the attendance record with the employee as soon as is practical. The employee will be given 7 calendar days notice in writing and informed that he/she has the right to be accompanied. A copy of the attendance record should be given to the employee in advance of the meeting. The employee should be given the opportunity to discuss their attendance record, explain any patterns that may have emerged and any underlying reasons for the absence. A referral to the Occupational Health Department will not normally be made at this stage unless the reason for the absence has occupational significance. The employee should be informed that if their attendance record remains unsatisfactory the matter will be referred to stage 2 of the procedure. A monitoring period will be set. A record of the discussion including the reasons for absence should be kept and the outcome of the meeting confirmed in writing within 7 calendar days. At the end of the monitoring period the manager should consider the employee s attendance during the monitoring period, and the employee s general record of attendance during their employment with the Trust. The manager will meet with the employee and may decide: That satisfactory improvement has been achieved and the case need not proceed to stage 2. The manager will confirm this in writing to the employee. The employee will be advised however that if absence deteriorates again within 3 months of the end of the monitoring period, then this procedure will be reinstated at Stage 2. Some improvement has been made but the employee s overall attendance remains unsatisfactory in which case it may be appropriate to extend the monitoring period rather than proceed to stage 2. The manager will confirm this in writing to the employee specifying the new end date for the monitoring period. The employee s attendance is unsatisfactory and should be dealt with at stage 2 of the procedure. The manager will write to the employee in accordance with paragraph below. If the employee s attendance record remains unsatisfactory, a meeting will be arranged at Stage 2 of the procedure. The employee will be given 7 calendar days' notice in writing and informed that he/she has the right to be accompanied. An HR Advisor will also normally be in attendance at this meeting. A further monitoring period will be set. The employee will be formally cautioned that continuation of unacceptable attendance may result in
16 Stage 3 termination of employment due to lack of capability on the ground of ill health. A record of the discussion including the reasons for absence should be kept and the outcome of the meeting confirmed in writing within 7 calendar days. At the end of the monitoring period the manager will meet with the employee and may decide: That satisfactory improvement has been achieved and the case need not proceed to stage 3. The manager will confirm this in writing to the employee. The employee will be advised however that if absence deteriorates again within 9 months of the end of the monitoring period, then this procedure will be reinstated at Stage 2. Some improvement has been made but the employee s overall attendance remains unsatisfactory in which case it may be appropriate to extend the monitoring period rather than proceed to stage 3. The manager will confirm this in writing to the employee specifying the new end date for the monitoring period. The employee s attendance is unsatisfactory and should be dealt with at stage 3 of the procedure. The manager will write to the employee in accordance with paragraph below. If the manager decides to refer the case to stage 3 of the procedure, an occupational health assessment will be requested before the stage 3 meeting takes place. Written permission may be requested of the employee to enable the Occupational Health Department to obtain a report from the GP. Occasionally, employees may be required to attend for medical examination by a Medical Practitioner nominated by the Trust. A hearing will be set up by the appropriate designated officer with authority to dismiss. A medical report will be obtained from the Occupational Health Department before the hearing. Where appropriate, reasonable attempts will be made by the Occupational Health Department to obtain a medical report from the employee s G.P. or medical specialist before the meeting but if this is not available within a reasonable time period, the hearing will proceed and a decision will be made on the basis of the information available at the time. The employee will be given 7 calendar days notice of the hearing and informed in writing of the purpose of it and of the right to be accompanied. The employee will be informed that the meeting may result in their dismissal on the grounds of capability due to ill health. The employee may make a request to the designated officer to be accompanied at the meeting by a companion who is not a Trade Union Representative or work colleague, for example, a family member. Such a request will not be unreasonably refused but the companion cannot act in a legal capacity. The employee will be informed that the hearing may result in termination of his/her contract on the grounds of lack of capability due to ill health. An HR Advisor will normally be present at this meeting. The medical report from the Occupational Health Physician will be made available to the employee prior to the hearing. The designated officer will consider all the information available and the employee s overall attendance record during their employment and the impact of their absence on the service. The designated officer may decide:
17 To establish another monitoring period rather than dismiss the employee. At the end of the monitoring period, a further meeting at stage 3 will be arranged. If standards of attendance are not acceptable, the employee's contract of employment will be terminated with due notice. The employee will be informed of the right of appeal. If the manager decides that the employee cannot be retained in the employment for which he/she is contracted, consideration should be given to the availability of redeployment to alternative employment where appropriate (see paragraph 18.3 below). The outcome of the hearing will be confirmed in writing. The right of appeal must be exercised within 21 calendar days of the date of letter of dismissal by writing to the Director of Human Resources setting out the grounds for the appeal. An appeal will be arranged in accordance with the Trust's Appeals Procedure General Points: Monitoring Periods The purpose of a monitoring period is to allow a reasonable period of time for the manager to assess whether or not the employee is able to attend work regularly and to a satisfactory level. The monitoring periods are established as guidelines but managers should use discretion when dealing with individual cases. The monitoring periods will normally be three months but may be exceptionally up to six months, and may be extended rather than referring the employee to the next stage of the procedure. Where absence deteriorates during the monitoring period, the monitoring period may be shortened Review Meetings (short term sickness) Review meetings should be arranged at the end of the monitoring period (except where attendance deteriorates during the monitoring period in which case the monitoring period will be shortened) to allow an opportunity for the line manager and employee to discuss attendance during the review period and the factors that have influenced the employee s ability to attend work before the manager decides how the employee s absence should be addressed. This meeting will be held between the employee and the line manager Procedure for Long Term Sickness Any employee returning to work after four weeks or more sickness absence as a result of an accident at work or where illness may have occupational implications must be referred to Occupational Health. In cases where the reason for absence is known and does not have occupational relevance the manager will seek advice from the Occupational Health department as to whether or not a referral would be appropriate. The Consultant Occupational Health Physician will decide whether the employee should have a health interview with the Occupational Health Nurse Advisor or needs to see a doctor. It is important that contact is maintained during any period of long term sickness, and meetings may be arranged at any point throughout the period of absence but normally after four weeks and at a minimum before the employee commences half pay and before the employee commences no pay.
18 When an employee is absent from work on a long term basis and the date for a return to work is not known, the employee will be referred to Occupational Health as early as possible to determine the prognosis in connection with the absence. A copy of the referral will be sent to the employee: The manager should contact the employee to arrange a long term sickness review meeting to ascertain when a return to work date can be expected. The employee will be given 7 calendar days notice of the date of the meeting and advised of his/her rights to be accompanied. The purpose of the meeting will be to establish the employee s current health situation, a possible date for return to work and any assistance that might reasonably be provided. The outcome of this discussion will determine the next stage in the process as the options may range from an early return to work to early retirement. In the event that the employee is too ill to attend such a meeting, the manager may consider visiting the home of the employee if the employee agrees to this. Alternatively, if it is agreed the employee is too ill to attend a meeting the employee may provide a written statement to their manager which will be considered at the meeting Further Review Meetings The number and frequency of review meetings will be determined on a case by case basis. The employee will be written to asking him/her to attend a further long term sickness review meeting, giving him/her 7 calendar days' notice of the hearing and advising him/her of the right to be accompanied Carry over of Annual Leave If an employee is prevented from taking their accrued annual leave entitlement for that current year due to long term sickness they may be able to carry over up to 28 days (pro rata) statutory entitlement into the next financial year Final Review Meeting If an employee s overall attendance record is not satisfactory or a return to work within a reasonable time scale cannot be established, a meeting will be set up by the appropriate designated officer with authority to dismiss. A medical report will be obtained from the Occupational Health Department before the hearing. Where appropriate, reasonable attempts will be made by the Occupational Health Department to obtain a medical report from the employee s G.P. or medical specialist before the meeting but if this is not available within a reasonable time period, the hearing will proceed and a decision will be made on the basis of the information available at the time. The employee will be given 7 calendar days notice of the hearing and informed in writing of the purpose of it and of the right to be accompanied. The employee will be informed that the hearing may result in termination of his/her contract on the grounds of lack of capability due to ill health. An HR Advisor will normally be present at this meeting. The medical report from the Occupational Health Physician will be made available to the employee. At the meeting, the content of the Occupational Health report and/or medical report will be discussed and the employment implications of the employee's health condition explored. Before deciding on the appropriate course of action the designated officer will discuss with the employee and take into account:
19 the expected length of sickness absence (likely return to work date); the wishes of the employee; the opinion of the Consultant Occupational Health Physician on the fitness of the employee to undertake the work for which he/she is employed; including consideration of ill-health retirement if appropriate. the needs of the service in terms of the capacity in which the individual is employed, the particular requirements of the department and the practicality of providing absence cover; the length of service, previous health record and attendance record. The designated officer will consider all the information available and may decide that a further review period should be set as an alternative to dismissal. If the manager decides that the employee cannot be retained in the employment for which he/she is contracted, consideration should be given to the availability of redeployment to alternative employment where appropriate (see paragraph 18.3 below). The decision will be confirmed in writing with the reasons. The employee will receive the contractual entitlement to paid notice and will have the right of appeal against the decision under the Trust's Appeals Procedure. The right of appeal must be exercised within 21 calendar days of receipt of the letter of dismissal by writing to the Director of Human Resources setting out the reasons for the appeal. An appeal will be arranged in accordance with the Trust's Appeals Procedure. 18 Planning and undertaking workplace controls or adjustments 18.1 Assessment of Workplace Controls or Adjustments Managers should assess whether there are any measures or adjustments that might be made to help employees to return and stay in work. In considering measures or adjustments, managers should take account of any professional advice provided by their GP (for example on a Certificate of Fitness to Work) or occupational health. Such measures may include a change in working hours or work pattern (including Home Working) allowing absence for rehabilitation treatment (see section 14) adjustments to premises, providing new or modifying equipment and tools, providing additional training modifying instructions or reference manuals providing additional supervision, a mentor or workplace buddy reallocating work within the employee s team This is not an exhaustive list of possible measures.
20 Exploration and consultation on any of measures which may be appropriate should take place with the affected staff member so that it takes account of the employee s views and they are able to influence their own return to work Where any of these adjustments are made, managers should record the details in writing as part of a formal Return to Work Plan. The Return to Work Plan may be set out in a letter to the employee or the template in Appendix 2 may alternatively be used. The Return to Work plan should set out a timetable for implanting any adjustments and, if appropriate, a review period to monitor the plan at suitable intervals with the employee. The Return to Work plan must ensure the employee understands any impact on their pay of any adjustments, any control measures have been put in place if alternative arrangements could affect the health and safety of the employees colleagues; and outline what steps will be taken to keep everyone involved, informed and to make sure the plan is respected. The Plan must be reviewed and any alterations to the plan should be clearly documented Rehabilitation/Phased Return to Work Rehabilitation, or a phased return to work, allows the employee to gradually build up their hours of work and/ or range of duties up to their normal contractual hours and responsibilities, to plan and facilitate the employee s return to work. Recommendations regarding a phased return to work may be made by the Trust s Occupational Health team. Line managers have a responsibility to consider the medical advice from the Occupational Health team and whether or not it would be possible to accommodate a phased return to work in their service. The decision as to whether or not a phased return to work can be accommodated rests solely with the manager after taking advice from the Occupational Health department and the HR Department. Where a phased return to work can be accommodated it should be recorded as part of a formal Return to Work Plan. The Return to Work Plan may be set out in a letter to the employee or the template in Appendix 2 may alternatively be used. It is recognised that each case will be different and decisions regarding phased return to work will be on a case by case basis; however, the paragraphs below provide some guidance on how the scheme will work. A phased return to work will only be considered where the employee is expected to return to their post within the near future and can work at least 50% of their normal working hours and perform at least 50% of their duties. During this time, there will be a gradual increase in hours/days/duties as appropriate, with a view to working the full contractual hours and the full range of duties at the end of the period. During this period, the employee will be paid their normal contractual salary. Rehabilitation cannot be used to compensate for financial difficulties when an employee s sick pay entitlement falls into half or no pay. In most cases where rehabilitation is recommended and appropriate, the employee should be able to return to their normal contractual duties within 2-4 weeks. This period of time will allow the employee improve their fitness level and gain in confidence from being back at work if they have been absent for some time. If an employee has outstanding accrued annual leave this may be taken immediately before or after any phased or rehabilitation period. It is recognised that in a minority of cases the nature of an illness may mean that the Occupational Health Department will recommend a longer rehabilitation period and such recommendations will be considered by the line manager on a case by case basis. The rehabilitation period will be time-limited and be subject to review.
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