ALCOHOL, DRUG OR SUBSTANCE MISUSE POLICY Documentation Control

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1 Supporting Documents and References ALCOHOL, DRUG OR SUBSTANCE MISUSE POLICY Documentation Control Reference HR/P&C/006 HR/P&C/006 Approving Body Trust Board 5th August, 2010 Date Approved Approving Body 5 th August, 2010 Implementation Date Trust Board 1 (Alcohol & Drugs Policy) Date Supersedes Approved Human Resources Consultation NUH Policy Sub Group Directors Group Implementation Date Date of Completion of Equality Impact Assessment Version Target Audience 14 June 2010 All managers and staff 2 Supporting Documents and References Disciplinary Policy, Health & Safety Policy, Sickness & Absence Policy, Supersedes Capability Policy Review Date August 2013 Consultation Lead Executive OME Author/Lead Manager Director of HR Ian Siara, Directorate HR Manager Further Guidance/Information Directorate HR Managers Date of Completion of Equality Impact Assessment 14 June 2010 Target Audience All Senior Managers / Clinical Managers 1

2 CONTENTS Paragraph Title Page 1 Introduction 2 Policy Statement 3 3 Equality and Diversity Statement 4 4 Equality Impact Assessment Statement 5 5 Environmental Impact Assessment Statement 5 6 We Are Here For You Mission Statement 5 7 Responsibilities of Employees 6 8 Responsibilities of Managers 7 9 Role and Responsibilities of the Trust 7 10 Responsibilities of Occupational Health Procedure for Dealing with Employees and Colleagues Suffering from Alcohol / Drug Misuse 8 12 Testing 9 13 Useful Contacts 9 14 Advice 10 Appendix 1 Example Management Letter 11 Appendix 2 Equality Impact Assessment 13 Appendix 3 Employee Record of Having Read the Policy 20 We Are Here for You Policy Assessment 2

3 ALCOHOL, DRUG OR SUBSTANCE MISUSE POLICY 1. INTRODUCTION 1.1 Alcohol, drug or substance misuse by employees of the Trust, though rare, is an important health issue when it occurs. The Trust recognises its responsibilities to minimise any risk to patients and to protect the health and welfare of employees. The Trust should also aim to act as a role model to the population it serves. 1.2 Alcohol misuse is defined as drinking alcohol either intermittently or persistently, to such an extent that it interferes, or is likely to interfere, with health or performance at work. 1.3 Substance misuse is the deliberate use of chemical substances to have a psychological effect. Drug misuse covers improper use of prescription and over the counter medicines in addition to illicit drugs and other substances of misuse. 1.4 Alcohol, drug or substance misuse is treatable, however the success of treatment is linked to the individual acknowledging their problem and seeking help, sooner rather than later. This policy aims to encourage employees with alcohol, drug or substance misuse problems to seek help voluntarily and also to provide a clear framework for the management of these employees in a caring and supportive way, with the help of the Occupational Health Service. 1.5 This policy applies equally to all employees of the Trust, irrespective of discipline and grade. 2. POLICY STATEMENT 2.1 Wherever an employee informs the Trust that they have an alcohol, drug or substance misuse problem and accepts treatment under the relevant Rehabilitation Protocol, this will be treated as an illness and all reasonable help will be provided to the employee to overcome their problem. 2.2 Should a breach of contract or poor performance occur, a range of options exist for dealing with this, which can include action under Trust policies such as the Disciplinary or Capability Policies. The existence of an alcohol, drug or substance misuse problem may be taken into account 3

4 in mitigation where an employee has acknowledged the problem and sought help. 2.3 Where an employee is aware that they have an alcohol, drug or substance misuse problem but has not sought help in advance, or the individual refuses to acknowledge a problem and/or refuses to accept the terms of the relevant Rehabilitation Protocol, the Trust will normally pursue the breach of contract or poor performance as a disciplinary issue, under the Trust s Disciplinary Policy or as a Capability issue under the Capability Policy and the problem is unlikely to be considered in mitigation. NUH acknowledges that admitting a drug and alcohol problem can be very difficult, and that it may take robust challenge about behaviour and time for the individual to reflect, but if after such attempts, the individual still refuses to accept a problem exists the Trust will pursue the breach of contract or poor performance as a disciplinary issue, under the Trust s Disciplinary Procedure. 2.4 If, in connection with an alcohol, drug or substance misuse problem, evidence of any criminal activity should become available to the Trust, this will normally be brought to the attention of the Police and dealt with under the Trust s Disciplinary Procedure where applicable.. 3 EQUALITY AND DIVERSITY STATEMENT 3.1 All patients, employees and members of the public should be treated fairly and with respect, regardless of age, disability, gender, marital status, membership or non membership of a trade union, race, religion, domestic circumstances, sexual orientation, ethnic or national origin, social & employment status, HIV status, or gender re assignment. 3.2 All trust polices and trust wide procedures must comply with the relevant legislation (non exhaustive list) where applicable: Equal Pay Act (1970 and amended 1983) Sex Discrimination Act (1975 amended 1986) Race Relations (Amendment) Act 2000 Disability Discrimination Act (1995) Employment Relations Act (1999) Rehabilitation of Offenders Act (1974) Human Rights Act (1998) 4

5 Trade Union and Labour Relations (Consolidation) Act 1999 Code of Practice on Age Diversity in Employment (1999) Part Time Workers Prevention of Less Favourable Treatment Regulations (2000) Civil Partnership Act 2004 Fixed Term Employees Prevention of Less Favourable Treatment Regulations (2001) Employment Equality (Sexual Orientation) Regulations 2003 Employment Equality (Religion or Belief) Regulations 2003 Employment Equality (Age) Regulations 2006 Equality Act (Sexual Orientation) Regulations EQUALITY IMPACT ASSESSMENT STATEMENT 4.1 NUH is committed to ensuring that none of its policies, procedures, services, projects or functions discriminate unlawfully. In order to ensure this commitment all policies, procedures, services, projects or functions will undergo an Equality Impact Assessment. 4.2 Reviews of Equality Impact Assessments will be conducted inline with the review of the policy, procedure, service, project or function 5. ENVIRONMENTAL IMPACT ASSESSMENT STATEMENT 5.1 The environmental impact of this policy has been considered and no further action is required at this time. 6. WE ARE HERE FOR YOU STANDARD MISSION STATEMENT: 6.1 This Trust is committed to providing the highest quality of care to our patients, so we can pledge to them that we are here for you. This Trust supports a patient centred culture of continuous improvement delivered by our staff. The Trust established the Values and Behaviours programme to enable Nottingham University Hospitals to continue to improve patient safety, outcomes and experiences. The set of twelve agreed values and behaviours explicitly describe to employees the required way of working and behaving, both to patients and each other, which would enable patients to have clear expectations as to their experience of our services. 5

6 7 RESPONSIBILITIES OF EMPLOYEES 7.1 To familiarise themselves with the policy and procedure. 7.2 No employee should drink alcohol or use other substances at a level that may interfere with their health or performance at work. 7.3 Incapacity to work through alcohol or the use of non prescribed or nonmedically required drugs, substances, solvents, gases and the like is considered as Gross Misconduct and is likely to lead to dismissal, even where an underlying health issue exists. Employees are therefore expected to seek help at the earliest opportunity (see 7.8) 7.4 Employees must not use, possess, store or sell illegal and/or illicit drugs, on the Trust s premises or whilst on duty. 7.5 Employees must not consume alcohol or bring alcohol onto the Trust s premises for the purpose of consumption during the working day. 7.6 When on call, ensure that if contacted they are capable of: a) providing advice by telephone as necessary, and b) driving within the legal requirements if called out, and c) performing their duties in a safe and responsible manner. 7.7 Employees must inform their manager at the earliest opportunity where they have any concerns about colleagues whose behaviour or performance may be affected by alcohol or drugs. 7.8 Employees who are aware they have, or suspect they have, an alcohol, drug or substance misuse problem, must: Refer themselves to Occupational Health. This should be before a breach of conduct or poor performance occurs. In such cases, a report will normally only be made to management at the employee s request. No information will be released without the knowledge of the employee; Comply with the terms and conditions of the relevant Rehabilitation Protocol, which will be explained to them by the Occupational Physician, an example of which is attached at Appendix 1 6

7 Seek help from their line manager if they are worried about their own drinking or drug use and its affects on safety, performance or Trust reputation. 8. RESPONSIBILITIES OF MANAGERS 8.1 Managers are expected to: be familiar with the policy and guidance, be aware of the common presentation of an alcohol, drug or substance misuse problem; seek early intervention to support employees; raise any concerns they may have with the individual; refer the employee to an Occupational Physician, where they have concerns; on the advice of the Occupational Physician ask the employee to sign up to the relevant Rehabilitation Protocol; work with Occupational Health in providing support to employees during rehabilitation; follow the relevant Trust Procedure, should a breach of conduct or poor performance occur, taking into account in mitigation the presence of an alcohol, drug or substance misuse problem, where appropriate (see Policy Statement); recognise that they hold a duty of care to prevent intoxicated employees from continuing to work. They must ensure that employees do not injure themselves or others because of drug or alcohol misuse; as with any other health matter, maintain strict confidentiality and limit disclosure to those who need to know i.e. Line Manager/Occupational Health/ Human Resources. 9 ROLE AND RESPONSIBILITIES OF THE TRUST 9.1 To provide a general climate of awareness of the nature and dangers of alcohol or drug abuse. 7

8 9.2 To provide education and advice for those responsible for operating the policy. 9.3 To publicise the policy. 9.4 Have Policies and Procedures in place to effectively manage the issues posed by Alcohol and Drug misuse. 9.5 Provide confidential advice and support to staff and managers through Occupational Health. 10. RESPONSIBILITIES OF OCCUPATIONAL HEALTH 10.1 Occupational Health should: act as an impartial adviser; provide appropriate advice to Management. All medical information will be confidential between the Occupational Physician and the employee, and no information will be released without the knowledge of the employee. In the case of a self referral, a report will normally only be made to management at the employee s request; if the Occupational Adviser considers that a serious risk to health exists, to that person or any other member of staff or to patients, he/she should contact the Director of Human Resources or Medical Director, or failing this any Executive Director, and inform them of the risk; explain the relevant Rehabilitation Protocol to the employee, review progress and provide support to the employee; advise the manager if the employee is not complying with or benefiting from the relevant Rehabilitation Protocol, in order to agree appropriate action. 11 PROCEDURE FOR DEALING WITH EMPLOYEES AND COLLEAGUES SUFFERING FROM ALCOHOL OR DRUG MISUSE 11.1 If an employee believes he or she has a problem, they should seek specialist help as soon as possible. Occupational Health can provide 8

9 assistance in accessing specialist help. Time off for specialist treatment will be given, and should be discussed with the Employee s line manager If a manager suspects an employee has a problem (or is informed of a problem by the employee or a collleague), the manager should discuss this with the member of staff, immediately if there is an urgent problem or arrange a meeting, depending on the circumstances. The manager should seek advice from Occupational Health and Human Resources, which may include referring the employee to Occupational Health for assessment. The manager should discuss this policy and the support available to the employer and confirm the outcome of this in writing (see Appendix 1 for example letter) 11.3 Where Occupational Health confirms there is a health condition, Occupational Health will assist with a rehabilitation/recovery programme If an employee does not accept the recovery programme or defaults from the recovery programme, the manager should consider whether it is appropriate to continue the management of the issues under the Trust s Disciplinary Policy If Occupational Health confirm there is no health condition responsible for the behaviour, the manager must re assess the position and may have to apply the Trust s Disciplinary Policy.. 12 TESTING 12.1 Individuals may agree to testing as part of their rehabilitation protocol Local arrangements may be put in place after consultation, for random testing of staff in areas of high risk, for example driving or using heavy machinery. 13. USEFUL CONTACTS: Employee Helpline Alcoholics Anonymous National Helpline Nottingham Helpline AL ANON Family Groups Helpline APAS (Alcohol Problems Advisory Service) Compass (adult service for drug users)

10 Narcotics Anonymous National Helpline ADVICE 14.1 Advice on the application of the Policy is available from any HR Manager or accredited representative. 10

11 APPENDIX 1 Ref: Date: Name & Address Dear It was really good to see you looking so well when we met on (DATE). I am now writing to confirm the arrangements on your return to work on (DATE). Following our meeting you are aware of the Trusts Alcohol, Drugs or Substance Misuse policy. This is to reassure you that your condition will be treated as an illness provided you comply with the terms and conditions set out below: a) You should not drink alcohol at a level that is likely to interfere with your health or performance at work (the Occupational Physician has advised total abstinence). b) You should attend the Occupational Health Department for regular monitoring and surveillance as required and comply with all medical advice. c) You attend appropriate after care programs as recommended by the doctor such as AA or other support groups. d) You keep all regular medical appointments and comply with the treatment regimes. e) You do not behave in any way which would lead us to believe that you have been drinking alcohol. It is vital that you comply with these terms and conditions. Wherever you do so your condition will continue to be regarded as an illness. However, if you default, disciplinary action is likely to follow which may include your dismissal. Two copies of this letter are enclosed and I would be grateful if you could sign one copy and return it to me as soon as possible to signify your acceptance of the contract terms. The second copy is for you to keep. 11

12 During our discussion I stressed to you the importance of you identifying someone you can talk to if you feel you are having any problems which may result in your breaking this contract. A number of useful contact numbers are highlighted in the Policy, a copy of which is enclosed. You were made aware that Occupational Health, and myself are all supporting you and should you need to contact any of use you can do so. I also confirmed that while you should make every effort to attend appointments and after care programmes outside your normal shift pattern, where this is not possible then I will endeavour to make arrangements for you to do so during work time. We agreed that this would only be necessary on a few occasions and you will need to confirm the details with me in advance. Yours sincerely Signature Title of position Cc: Occupational Health Physician HR Manager FORM OF ACCEPTANCE I agree to comply with the terms and conditions detailed in this contract. I understand that the contract will remain in place permanently unless it is jointly agreed that it is cancelled. I understand that if I default, I will be liable to disciplinary action, which could include dismissal. Signed Date:.. 12

13 Screening Grid Equality Area Race Disability Key Equalities Legislation / Policy (See summary sheet) Race Relations Act 1976 Race Relations (Amendment) Act 2000 Disability Discrimination Act 1995 and 2005 Is this policy or service RELEVANT to this equality area? YES / NO No No Assessment of Potential Impact: HIGH MEDIUM LOW NOT KNOWN positive (+) negative ( ) Low Low Low Low. Age Age Regulations 2006 No Low Low Sexual Equalities Act 2006 Low Low orientation Relevant employment legislation No Religion and Equalities Act 2006 Low Low beliefs Relevant employment legislation No Dignity and Human Rights Act Low Low No Human Rights 1998 (relevant articles) Reasons for Assessment 13

14 Full Impact Assessment Grid Note: Only the equality areas marked as relevant in the screening need to be fully impact assessed Relevant Equality Area (from Screening) Gender Key points of research and consultation Does the policy / service or its implementation: Breach equalities legislation? Prevent discrimin ation or inequality? Promote equality / good relations? Key issues for action [Will form basis of action plan] Race Disability Age Sexual orientation Religion and beliefs Deprivation Dignity and 14

15 Human Rights 15

16 Action Plan Template Name of Policy or Service: Equality groups or comm. unities affected Issue identified Action to be taken By When Respon sible Person Expected Outcome Monitoring Arrangements Data Required 16

17 Equality Impact Assessment Report Outline 1. Name of Policy or Service Alcohol and Drugs Policy 2. Responsible Manager Ian Siara 3. Name of person Completing EIA Ian Siara 4. Date EIA Completed 14 th June Description and Aims of Policy/Service (including relevance to equalities) Alcohol, drug or substance misuse by employees of the Trust, though rare, is an important health issue when it occurs. The Trust recognises its responsibilities to minimise any risk to patients and to protect the health and welfare of employees. The Trust should also aim to act as a role model to the population it serves.. 6. Brief Summary of Research and Relevant Data There is no research or relevant data at the present time. 7. Methods and Outcome of Consultation Consultations have been carried out with the following: Policy Sub Group Directors Group Staff Side 17

18 Comments from the above consultations have been received and incorporated where appropriate 8. Results of Initial Screening or Full Equality Impact Assessment: Equality Group Age Gender Race Sexual Orientation Religion or belief Disability Dignity and Human Rights Working Patterns Social Deprivation Assessment of Impact None None None None None None None None None 9. Decisions and/or Recommendations (including supporting rationale) This policy does not have an impact on the equality strands as the policy provides information for all staff levels, encourage employees with problems to seek help voluntarily and also to provide a clear framework for the management of these employees in a caring and supportive way, regardless of their equality status. From the information contained in the policy, it my decision that a full assessment is not required at the present time. 10. Equality Action Plan (if required) N/A 18

19 11. Monitoring and Review Arrangements (including date of next full review) It is recommended that this policy and EIA be reviewed after three years in order to assess its functionality and thereafter three yearly in line with the guidelines set out in this policy. 19

20 EMPLOYEE RECORD OF HAVING READ THE POLICY Appendix 3 Title of Policy/Procedure: Alcohol, Drugs or Substance Misuse Policy I have read and understand the principles contained in the named policy. PRINT FULL NAME SIGNATURE DATE 20

21 We Are Here For You Policy and Trust wide Procedure Compliance Toolkit The We Are Here For You service standards have been developed together with more than 1,000 staff and patients. They can help us to be more consistent in what we do and say to help people to feel cared for, safe and confident in their treatment. The standards apply to how we behave not only with patients and visitors, but with all of our colleagues too. They apply to all of us, every day, in everything that we do. Therefore, their inclusion in Policies and Trust wide Procedures is essential to embed them in our organisation. This toolkit has been designed for Policy Owners to assess the compliance of their Policy or Trust wide Procedure in light of the We Are Here For You values. It is now mandatory for all Policies and Trust wide Procedures to incorporate the We Are Here For You Values and undergo this compliance assessment. Please complete the grid below to assess your Policy or Trust wide Procedure. The toolkit will then advise Policy owners on the steps they need to take to become We Are Here For You compliant. To what extent is your Policy or Trust wide Procedure affected by the following We Are Here For You values? Please rate each value from 1 3 (1 being not at all, 2 being affected and 3 being very affected) 1. Polite and Respectful Whatever our role we are polite, welcoming and positive in the face of adversity, and are always respectful of people s individuality, privacy and dignity. 1 not at all 2. Communicate and Listen We take the time to listen, asking open 1 not at all 21

22 questions, to hear what people say; and keep people informed of what s happening; providing smooth handovers. 3. Helpful and Kind All of us keep our eyes open for (and don t avoid ) people who need help; we take ownership of delivering the help and can be relied on. 1 not at all 4. Vigilant (patients are safe) Every one of us is vigilant across all aspects of safety, practices hand hygiene and demonstrates attention to detail for a clean and tidy environment everywhere. 1 not at all 5. On Stage (patients feel safe) We imagine anywhere that patients could see or hear us as a stage. Whenever we are on stage we look and behave professionally, acting as an ambassador for the Trust, so patients, families and carers feel safe, and are never unduly worried. 6. Speak Up (patients stay safe) We are confident to speak up if colleagues don t meet these standards, we are appreciative when they do, and are open to positive challenge by colleagues. 1 not at all 1 not at all 7. Informative We involve people as partners in their own care, helping them to be clear about their condition, choices, care plan and how they might feel. We answer their questions without jargon. We do the same when delivering services to colleagues. 2 affected 8. Timely 22

23 We appreciate that other people s time is valuable, and offer a responsive service, to keep waiting to a minimum, with convenient appointments, helping patients get better quicker and spend only appropriate time in hospital. 1 not at all 9. Compassionate We understand the important role that patients and family s feelings play in helping them feel better. We are considerate of patients pain, and compassionate, gentle and reassuring with patients and colleagues. 10. Accountable Take responsibility for our own actions and results 11. Best Use of Time and Resources Simplify processes and eliminate waste, while improving quality 1 not at all 1 not at all 2 affected 12. Improve Our best gets better. Working in teams to innovate and to solve patient frustrations 1 not at all TOTAL 14 23

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