Managing Sickness Absence

Managing Sickness Absence Human Resources Policy No. HR31 Additionally refer to HR01 Equality and Diversity Policy HR06 Maintaining High Standards of Performance HR07 Disciplinary Policy for Doctors and Dentists HR09 Alcohol and Substance Misuse HR21 NHS Injury Benefits HR24 Maternity Leave HR29 Special Leave HR30 Annual Leave & Public Holidays HR32 Ill Health Retirement HR36 Disciplinary Procedure HR40 Employment of People with Disabilities HR47 Managing Exposure to Blood Borne Viruses HR48 Managing Staff with MRSA HR65 Occupational Health Service HR66 Staff Counselling Service HS01 Health and Safety policy HS03 Accident & Incident Reporting Policy HS13 Stress Management Policy and Risk Assessment Procedure NHS Employers Mental Health and Employment in the NHS This policy should be read in conjunction with Managing Sickness Absence Guidance Notes for Managers Version: V2.10 Originally issued August 2010 Approved by TNCC Date approved June 2012 Ratified by: Date ratified: Document lead Lead Director Date issued: Date of Next Review Target audience: Trust Board Deputy Head of HR - Workforce Workforce Director TBC All Staff, managers Page 0

Version Control Sheet Author/Contact: Keith Hudson, Deputy Head of HR - Workforce Document ID HR31 Version 2.9 Status DRAFT Date Equality Impact Assessment completed Issue Date Review Date Distribution Key Words Dissemination Please refer to the intranet version for the latest version of this policy. Any printed copies may not necessarily be the most up to date Staff Quarterly Update; HR pages on intranet; HR Centre reports Version history Version Date Author Status Comment 1 Aug 10 Liz Walton Final 2.0 Sept 10 Keith Hudson Draft Revision of policy following establishment of absence targets by Strategic Health Authority 2.1 Nov 10 Keith Hudson Draft Further amendments following TNCC Working Party 2.2 Dec 10 Keith Hudson Draft Further amendments following TNCC Working Party 2.3 Feb 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.4 March 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.5 April 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.6 Dec 11 Keith Hudson Draft Further amendments following TNCC Working Party 2.7 March 12 Keith Hudson Draft Further amendments following TNCC Working Party 2.8 April 12 Keith Hudson Draft Further amendments following TNCC Working Party 2.9 May 12 Keith Hudson Draft Further amendments following TNCC Working Party 2.10 June 12 Keith Hudson Draft Further amendments following TNCC Policies meeting Page 1

Section Contents Title Page Number Section 1 Policy Statement 4 Section 2 Introduction 4 Section 3 Scope 4-5 Section 4 General Principles 5-7 Section 5 Reporting Sickness Absence 7-8 Section 6 Recording, Monitoring and Review 9 Section 7 Return to Work Interviews 9-11 Section 8 Special Circumstances 11 Section 9 Managing Frequent Short-Term Sickness Absence 11-12 Section 10 Managing Long-Term Sickness Absence 12-13 Section 11 Managing Patterns of Absence 13 Section 12 The Procedure 14-17 Section 13 Review Meetings/Postponements 17 Section 14 Disability Discrimination 17-18 Section 15 Graduated Return to Work 18 Section 16 Extended Paid Sick Leave 18-19 Section 17 Termination of Employment on the Grounds of Incapability due to Ill Health 19 Section 18 Appeals Against Termination of Employment 19 Section 19 Applications for Ill Health Retirement 20 Section 20 Occupational Health 20-21 Section 21 Work Related Injury/Absence 21 Section 22 Sickness and Annual Leave/Bank Holidays 21-22 Section 23 Training 22 Section 24 Review Process 22 Section 25 Equality Impact Assessment 22 Page 2

Section 26 Process for Monitoring Compliance 23 Section 27 References 23-24 Appendix A Return to Work form 25-27 Appendix B Assessment of Fitness to Return to Work 28 Appendix C Leave Accrued During Periods of Sickness Absence 29 Appendix D Appendix E Short Term/Frequent Absence Flow Chart Long Term sickness Absence Flow Chart 30 31 Page 3

1. POLICY STATEMENT The health and well-being of our staff is crucial to the delivery of high quality patient care. As a Trust we are committed to developing a strategy to support the health and well-being of our staff. This policy details the processes in place for staff affected by sickness absence issues, and describes the necessary processes to follow in the management of such issues. 2. INTRODUCTION 2.1 This policy sets out how the Trust manages issues concerning sickness absence. It provides guidance on how to encourage good health and good attendance at work and how to manage individuals whose attendance is unsatisfactory due to ill health or physical/psychological injury. It should also be read in conjunction with Managing Sickness Absence Guidance Notes for Managers. 2.2 The Trust is committed to encouraging and supporting staff in sustaining good health and attendance at work and, as far as is reasonably possible, to retaining staff in employment should they become disabled. Therefore, in managing unsatisfactory attendance, the emphasis must be on supporting the individual; however, consideration must be given at all times to ensuring high standards of service are maintained. 2.3 Where poor or deteriorating performance is identified as possibly being the result of ill or declining health, the manager should refer the matter to HR for guidance. The matter should then be handled in accordance with the appropriate HR policy. In such cases an Occupational Health assessment will be sought ahead of any decision, and alternatives may include making reasonable adjustments to the current role or redeployment into a suitable alternative position. 2.4 It should be noted that there is no entitlement to sick leave and therefore individuals do not have a right to take any number of days of sickness absence in a year. Rather, it is inevitable that employees will be absent from work from time to time due to sickness and this policy sets out standards detailing how managers should manage sickness absence and how individuals may expect to be treated following a period of ill-health. 2.5 This policy is not designed to be used to manage poor performance unless the underlying cause of the poor performance is related to an individual s health condition, in accordance with HR06, Maintaining High Standards of Performance and HR07, Disciplinary Policy for Doctors and Dentists. 3. SCOPE 3.1 This policy applies to all staff who are directly employed by the Trust, whether full time or part time, permanent or temporary including those employed by the Trust via the Temporary Staffing Department. 3.2 The policy does not apply to individuals employed by agencies or other contractors. Issues relating to sickness absence for these individuals should be referred to the appropriate employer. 3.3 In implementing this policy, managers must ensure that all staff are treated fairly and within the provisions and spirit of the Trust s Equality & Diversity Policy, (HR01). Page 4

Special attention should be paid to ensure the policy is understood when using it for staff new to the NHS or Trust, by staff whose literacy or use of english is weak, or for persons with little experience of working life. 4. GENERAL PRINCIPLES 4.1 Managers will handle sickness absence issues for all staff in their area in a positive, supportive, fair and consistent way, taking account of relevant circumstances in each individual case. They, and other authorised individuals, will also ensure they are fully trained in the use of this policy and conversant with the document Managing Sickness Guidance Notes for Managers. 4.2 The need for confidentiality must be respected in all cases. Information regarding the health of an individual will be made available only on a need to know basis. 4.3 The following factors will be taken into account in deciding how a sickness absence matter should be managed: The continuing length of absence Frequency of absences and reason The individual s previous attendance record Occupational Health or other medical reports Prognosis on a return to work The impact of making reasonable adjustments Impact on service provision 4.4 Where guidance is given in this policy for progressing the management of sickness absence, only days/shifts designated as work days/shifts should be counted for monitoring purposes (although calendar days are used for certification purposes ((see Section 5.13)). 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 periods of paid sickness absence during the 12 months immediately preceeding that day. (Agenda for Change, Terms & Conditions Handbook, Section 14.6). 4.5 Where a number of days are given as guidance for trigger points in the process, these should be applied consistently across all staff groups. Examples of where pro-rating should be applied include: for part time employees based on number of days worked per week; for full time staff working fewer than 5 shifts per week; and for employees with under one year of service, based on number of months service. 4.6 All employees of the Trust are expected to observe this policy and comply with all reasonable management requests to attend meetings, including Occupational Health appointments, to ensure relevant information can be obtained. Failure to do so, without justifiable reasons, may result in action being taken in accordance with the Trust s Disciplinary Procedure (HR36). 4.7 At all stages of the procedure, staff have the right to be accompanied by an accredited representative of a Trade Union / Professional Organisation or work colleague. 4.8 At Stage 3 Short-Term and Stage 3, Part 2 Long-Term of the procedure, the employee has the right of appeal. Page 5

4.9 All staff are eligible for sick pay in accordance with NHS Terms and Conditions of Service Handbook or National Conditions of Service for Medical Staff except in the following circumstances: where a member of staff fails to adhere to Trust policy and/or departmental procedures, or where the absence is found not to be due to the sickness of the individual receiving sick pay, or where the absence is caused by an accident due to active participation in sport as a profession, or where contributory negligence is proven, or where, following an accident, damages are received from a third party. Where any of the above circumstances occur please liaise with the HR Advisory Team for further advice. 4.10 Sickness absence is not a disciplinary matter, although in managing sickness absence, employees may be issued with a series of formal warnings. These warnings are to inform the individual of the potential consequences of further or continued periods of sickness absence. 4.11 Any abuse of this procedure or regulations for sickness absence may lead to the individual losing their entitlement to NHS sick pay and Statutory Sick Pay and disciplinary action being taken in accordance with the Trust s Disciplinary Procedure (HR 36). 4.12 Where management has evidence that an individual is not sick as reported or has lied in any aspect of the management of their absence, action may be taken in accordance with the Trust s Disciplinary Procedure (HR 36). 4.13 Where management has evidence that an individual has provided misleading information to management or the Occupational Health Department, either during preemployment checks or during the course of their employment, (for example by failing to declare a long standing health problem), disciplinary action may be considered in accordance with the Trust s Disciplinary Procedure, (HR 36). 4.14 Where it is suspected that an individual s health problems may be attributable to alcohol or substance misuse, reference will be made to the Alcohol and Substance Misuse Policy (HR09). 4.15 Where it is suspected that an individual s sickness absence may be attributable to domestic violence, support may be available through the Occupational Health Service, details of which can be found on the Trust s intranet. 4.16 Where a member of staff is away from the Trust due to sickness absence, no secondary employment should be undertaken during the period of sickness, unless the secondary employment is specified and allowed on the GP Fit note covering that particular absence. Where secondary employment is to be undertaken during a period of sickness, the staff member must inform their line manager that they are working elsewhere and the GP Fit Note must be provided immediately to confirm that they are fit to carry out their secondary role. 4.17 Where a member of staff is found to be working elsewhere whilst in receipt of contractual sick pay and a GP Fit Note cannot be provided to confirm there eligibility to work, the Trust Counter Fraud Officer may be notified to carry out further investigation into the matter. Page 6

4.18 Dishonestly working elsewhere whilst in receipt of sick pay may be treated as gross misconduct and/or a fraud by false representation and may result in disciplinary action or criminal prosecution. 5. REPORTING SICKNESS ABSENCE 5.1 Managers must ensure that each department has in place procedures to ensure that sickness absence is properly reported, recorded and monitored and that these procedures are consistent with this policy, and are accessible to all relevant staff. 5.2 Managers must report sickness absence for pay purposes, using the relevant paper or electronic system as soon as possible at the start and end of each episode of absence. If a member of staff reports for duty but is not fit to stay at work, this day/shift will be counted as a normal working day for pay purposes. However, the period away from work should be recorded for sickness absence management monitoring purposes only. However, a pattern of absence (see Section 6.2) may be taken into account in the management of the case. A Return to Work Interview must still be completed where absence of this nature is recorded. 5.3 Where sickness absence is a result of an accident or physical/psychological injury at work, please refer to Section 21 of this policy. 5.4 Any individual who is unable to attend work due to illness is required to personally notify their manager (or other authorised person as specified in departmental procedures) before the start of their duty or as soon as is reasonably possible. If they are not able to notify their manager personally, clear reasons for this should be given by the individual reporting the absence. Notification by text message or e-mail is not acceptable. The individual should inform the manager, or authorised person, of the nature of the illness and if possible, give some indication of the likely period of absence to assist the manager in planning for any cover that may be required. 5.5 Where reasonably possible: in areas such as wards which operate a 24 hour service, employees must report sick no later than 1 hour before the start of their shift; for staff on night duty, the notification should be no later than 4 hours before the start of their shift, bearing in mind that it will be necessary to find cover for the absence; in areas staffed during usual office hours, (eg 9am 5pm), the notification should normally coincide with the normal start time, and in any case, no later than 30 minutes after. 5.6 If an individual fails to report sickness absence in accordance with departmental and Trust procedures, the leave will be counted as unauthorised absence and will be unpaid for the entire shift/duty, unless exceptional circumstances prevail. In this situation the manager must notify Pay Services. Reference should also be made to the Annual Leave and Public Holiday policy (HR30). 5.7 If an individual finds they are able to return to work sooner than indicated, they should inform their department as soon as possible so that any cover that has been arranged can be cancelled. Where absence is being covered by a Statement of Fitness for Work, (Fit Note), the individual must obtain written confirmation of their fitness to return to work earlier than expected from their GP or the Occupational Health Department. Page 7

5.8 If an individual is unable to return to work as expected, they are required to inform their manager as soon as possible. 5.9 Where an individual is able to return to work but is rostered for off-duty on that day, it is important that they telephone their manager to confirm that they are fit to return to work. 5.10 Where an individual falls ill during a period of annual leave, reference should be made to Section 22 of this policy. 5.11 Where an individual falls ill during a period of Maternity, Adoption, Maternity Support Leave, Parental or Special Leave, the leave will continue as planned and will not be treated as sick leave. 5.12 If an individual is sick immediately following a period of Maternity Leave, this will be treated as sickness absence. The manager must notify Pay Services that the individual has returned to work from Maternity Leave as normal and has commenced sickness absence (using the appropriate paper or electronic recording system.) Absence will then be managed in accordance with this Policy. 5.13 Certification 5.13.1 Return to Work Form A Return to Work Form (Appendix A) must be completed by the immediate line manager in a timely manner and countersigned by the member of staff following EVERY episode of sickness absence. Where required, this form serves as the self-certification of sickness absence for Statutory Sick Pay purposes, and confirms that an individual is fit to return to work. 5.13.2 Assessment of Fitness A Fitness to Return to Work form (Appendix B), if To Return to Work applicable, must also be completed BEFORE an individual returns to their work area. 5.13.3 Medical Certification For absences longer than 7 calendar days, the employee is required to obtain a Statement of Fitness for Work, (Fit Note), to cover the absence from day 8 onwards. It is the responsibility of the individual to ensure that the medical certificate is received by the manager within three days of it being issued. Any subsequent continuous absence must also be covered by a medical certificate which must be received within three days of the expiry of the previous certificate. Failure to submit a medical certificate within the specified time may result in payment of NHS sick pay and Statutory Sick Pay being withheld. Copies of Statements of Fitness for Work, (Fit Notes) still need to be provided even when an employee has entered a period of nil pay. 5.13.4 All certificates should be treated as confidential and retained on the individual s personal file. 6. RECORDING, MONITORING AND REVIEW Page 8

6.1 Individual attendance records will be maintained in each department and these should be reviewed regularly by the manager. Information held should include dates and reasons for absences (e.g. sickness absence, special leave, study leave). For sickness absence, information should also include the nature of the illness, the total number of days/shifts absence and details of any occurrences where the individual has left work before the end of their working day/shift. This will enable the manager to accurately monitor attendance and deal consistently with all staff, (see Section 5.2). 6.2 When looking for patterns or trends, the following should be considered: regular Monday or Friday absence, or absence before or after rostered days off; regular absence on a certain shift pattern (e.g. earlies, lates, nights or weekend shifts); absences immediately before or after a period of annual leave; regular absence during school holidays; regular absence on an annual basis (e.g around public holidays such as New Years Day, or during major sporting events such as major national/local football matches, the Olympics); regular absence at a specific time each year; regulularly reporting for duty but not fit to stay at work; a regular pattern of almost reaching the threshold for formal action to be taken 6.3 In order to manage sickness absence effectively and fairly, managers should review absence records regularly and deal with any issues as soon as they arise. Sections 9 and 10 below give guidance on the management of individuals whose attendance is unsatisfactory due to sickness absence. Section 11 provides guidance on how to manage an individual who has demonstrated a pattern of absence. It should be noted, however, that each case is different and must be handled appropriately, depending upon the particular circumstances of the individual, their health condition, their attendance record, their role and the department in which they work. 6.4 Where an individual is on secondment either within or outside the organisation, the manager employing them in their permanent post is responsible for monitoring and managing sickness absence during the period of secondment to ensure continuity. However, this should be in consultation with the manager accepting the seconded employee and therefore, systems must be put in place to ensure any absence is reported to the substantive manager. 7. RETURN TO WORK INTERVIEWS 7.1 Return to Work interviews are considered to be highly effective in reducing the absence of employees. Their purpose is to welcome the employee back to work and identify what, if any, support is necessary to integrate the employee back into the workplace. The tone of the meeting should be positive, providing an opportunity to make an employee aware of how valued they are. 7.2 It is important for managers, or authorised person, to meet with all employees after each absence episode, ideally on the first day of return, but must be within a timely manner, as this will assist in identifying if the employee is fit to resume duty and whether reasonable adjustments should be made. If managers do not talk to every employee upon their return, this becomes inconsistent and may lead to accusations of unfair treatment. It is also useful to establish whether further advice is needed e.g. Page 9

Occupational Health. It is anticipated these meetings should take no longer than a few minutes however they should be tailored to individual needs. 7.3 Before commencing work, staff who have been off sick MUST report to the most senior person on duty in their work area, to confirm their fitness for work. 7.4 A Return to Work Form (Appendix A) must be completed in ALL instances. According to circumstances, the nature of the discussion may include: to confirm that the individual is fit to return to work; to confirm the nature of the ill health; to establish whether the sickness absence is related to a disability as defined by the Equality Act 2010 (Section 14); to establish whether the sickness absence is related to an on-going health matter; to assess the likelihood of any recurrence; to establish whether support from the Occupational Health Department or any other support (e.g. counselling) may be appropriate; to review the attendance record of the individual to establish whether formal management action is required and, if appropriate inform the individual of what action will be taken either immediately or if unsatisfactory attendance continues; to advise the individual of any work issues that may have arisen during the absence. to confirm that if the individual is in receipt of damages from a third party following an accident, that they are entitled to receive sick pay whilst absent from work, but that any sick pay maybe recovered from any subsequent award and that pay services have been advised accordingly. It is the individual s responsibility to inform the Trust. 7.5 In reaching a decision as to whether further action, if any, should be taken, consideration should be given to the following factors: working environment; managerial issues such as organisational change; work patterns such as long shifts; extra work being undertaken by the individual, such as external employment, excessive overtime or work on the nursing/other bank; whether any absence is as a result of a physical/psychological work-related injury (see Section 21) whether any absence is due to inability to return to work for health and safety reasons (e.g. diarrhoea and vomiting); domestic circumstances; patterns of absence for example where episodes tend to precede or follow long shifts, periods of night duty, days off or holidays; absence levels of colleagues which may increase the workload of the individual; hospital-wide or department-wide infection or illness causing higher than usual absence amongst the workforce; whether the individual has a disability as defined by the Equality Act 2010, (see Section 14); what support has been provided in order to improve attendance; if Special Circumstances apply (see Section 8) 7.6 No absence should be discounted because of any of the above factors, but these factors should be taken into consideration in deciding how to manage the situation. Page 10

7.7 Should a formal warning be issued, the effective start date will be the date of the individual s return to work. 8. SPECIAL CIRCUMSTANCES 8.1 The Trust recognises that there are occasions when absence should not be counted towards triggers, for example, medical exclusion, or when an individual is fit to attend work but unable to do so due to Health & Safety or infection control reasons. Periods of absence resulting from work-related accident or injury, whether physical or psychological, should be discounted when calculating whether a trigger point has been reached. However, such factors must be taken into account in deciding how to manage the individuals case. The following are examples of such special circumstances; Accepted hospital acquired illness, physical or psychological injury sustained during and in the course of employment; (see HR48 Managing Staff with MRSA); Medical exclusion, where an individual is fit to attend work, but unable to do so due to Health & Safety or infection control reasons; Terminal illness; Pregnancy related illness, (see HR24 Maternity Leave) ; A medical condition that comes under the remit of the Equality Act 2010 (Section 14); Delays caused by access to assessment/treatment 8.2 Advice must be sought by the manager from HR Advisory Team, who will monitor consistency across the Trust. 9. MANAGING SHORT-TERM SICKNESS ABSENCE 9.1 In taking any action on short-term absences, the manager must demonstrate that they have attempted to find out whether there is an underlying medical cause for the absences, both through discussion with the employee (at the Return to Work interview) and where applicable, by referral to Occupational Health. 9.2 When dealing with short-term absence, the following information needs to be considered at the Return to Work Interview:- Previous Return to Work documentation. The employee s attendance record over the past 12 months. Any other information that may be relevant, e.g. Occupational Health reports 9.3 Where Special Circumstances exist, (Section 8) it may not be appropriate to move the employee to the next stage in the procedure. However, any decision based on Special Circumstances must be reviewed at each stage. 9.4 Depending upon the information provided about the cause of the absence (and the conclusions drawn), further action may include one or more of the following:- A decision to take no further action. Page 11

Referral to Occupational Health if not already done so or to gain more up-todate information, to establish if there is an underlying medical condition causing the absence. If the employee refuses to attend, without reasonable justification, and he/she is on sick leave, sick pay may be withheld. The Manager must inform the employee prior to this action being taken. The Manager may consider a temporary or permanent change in working hours, role, or discuss with the employee possible re-deployment to a different job. In these circumstances a referral should be made to Occupational Health for advice on whether redeployment is appropriate on medical grounds and advice should also be sought from the HR Advisory Team. Managers should refer to Section 21 where they suspect work related factors maybe affecting the employee s attendance. A decision to take formal action (see Section 12). The employee must be warned in writing as to the potential consequences of continued poor attendance. 9.5 Triggers have been broadly set in order to achieve the Trust s annual targets, and are based on number of days absent and/or number of occasions. 9.6 Stages and Triggers of absence are (pro-rata see Section 4.5): Stage Trigger 1 A total of 10 working days or 4 episodes in a rolling 12 month period. 2 A further 5 working days or 2 episodes in the following 6 months. 3 A further 5 working days or 2 episodes in the following 6 months. 10. MANAGING LONG-TERM SICKNESS ABSENCE 10.1 Long-term absence is defined as a continuous period of 4 calendar weeks or as soon as it becomes apparent that the period of absence is likely to extend to this period. The aim in managing long-term absence is to provide support to an employee through a period of ill health, or physical/psychological injury, and to effect a return to work as soon as is reasonably possible. 10.2 The first trigger during long-term absence is 4 calendar weeks, when a Stage 1 meeting will be convened. The triggers following the issue of a Stage 1 warning for Stages 2 and 3 are detailed below:- Stage Trigger 1 After 4 weeks absence 2 After 12 weeks absence 3 After 20 weeks absence 10.3 During a period of long-term sickness absence, it is the responsibility of the employee to maintain contact with their manager, to advise of progress with regard to any treatment, anticipated return to work and provide a Statement of Fitness for Work (Fit Note) from their GP. However, managers also have an obligation to maintain regular contact with the employee, usually on a fortnightly basis, initially via a telephone call or letter if deemed to be appropriate. This timescale may be extended depending on the sensitivities and circumstances of the case. Employees are also required to advise their manager if they are not available for regular contact, e.g. in-patient attendance at hospital or long periods away from home. Page 12

10.4 As soon as it becomes apparent that a period of absence is likely to extend to 4 weeks or more, the manager should discuss the matter with the employee, in accordance with Stage 1 of the procedure, (Section 12). The meeting may take place at the workplace, or if they are not fit to attend at work, the individual s home, subject to their agreement. In the absence of not being able to meet with the employee in either of the aforementioned settings, it may take place by telephone. The discussion should be conducted in a positive and supportive manner, and it s purpose is to:- Identify the employee s current state of health. Ascertain their progress with regard to any treatment, and anticipated return to work. Clarify whether the individual could undertake any work to prevent the sickness absence continuing, providing that the individual has been declared medically fit to carry out identified tasks. For example, where the individual is unable to drive but is able to carry out some tasks from home, or is unable to carry out their full range of duties, but could do other work. Establish whether it would be appropriate to seek advice from Occupational Health. Inform the employee of their current Trust sick pay position. 10.5 If appropriate, the discussion will also enable the manager and the employee to plan their return to work. 10.6 In cases where a specific date of return to work is anticipated, the manager and the employee should continue to maintain contact to monitor progress and plan for their return to work. 10.7 Where there is no prospect of a return to work within a reasonable and predictable recovery period, or where the employee does not return to work as planned within the 8 week timeframe following the Stage 1 meeting, (i.e. after a total of 12 weeks absence), the manager should move to Stage 2 of the procedure in accordance with the long-term absence trigger points. 10.8 The manager should keep notes of all discussions, and these should be made available to the employee on request. 10.9 Staff who return to work from a long-term absence, but then report absent due to a reoccurrence of the same condition within a month of returning to work will be managed at the same stage of the procedure as they were being managed at previously. 11. MANAGING PATTERNS OF ABSENCE 11.1 When patterns or trends of absence have been identified, (see Section 6.2), the manager will meet with the individual to discuss their concerns and understand the reasons for the pattern of absence. 11.2 If appropriate, the individual will be referred to Occupational health. 11.3 Depending on the outcome of the above, the manager may take the decision to agree an action plan to support the individual to attend work, or take action in accordance with the Trust s Disciplinary Procedure (HR36). Page 13

12. THE PROCEDURE 12.1 This section details the various stages to be followed in the management of both short-term and long term absence. At all stages, the employee may be referred to Occupational Health, and where a disability exists, as defined by the Equality Act 2010, it is management s responsibility to explore whether reasonable adjustments can be made, in conjunction with advice from Occupational Health to working conditions or workplace. A copy of the Occupational Health report will be forwarded to the individual in advance of the review meeting. The outcome of any review meeting must be confirmed in writing to the employee. 12.2 SHORT-TERM SICKNESS ABSENCE Stage 1 12.2.1 When an employee breaches a trigger point for short-term sickness absence, (i.e. after a total of 10 working days or 4 episodes in a rolling 12 month period), the manager will arrange a meeting with the employee, on returning to work. If the manager accepts that absence is due to special circumstances, (see Section 8), consideration will be given as to whether a Stage 1 warning will be issued, or if no action is to be taken on this occasion. If no special circumstances exist, the manager will issue a Stage 1 warning. The warning will include details of the standard of attendance required during its life (the standard Trust triggers as defined, unless special circumstances apply). The warning will be live for 6 months and if the employee does not breach a further trigger during this period, (i.e. pro-rata of 5 working days or 2 episodes, whichever figure is exceeded first), the warning will expire. If the specific triggers are breached, a Stage 2 meeting will be convened. Stage 2 12.2.2 Should the employee breach a further trigger (i.e. after a further 5 working days or 2 episodes) in the following 6 months, the manager will arrange a Stage 2 meeting with the employee (a member of the HR Advisory Team may also be invited). This should be done within 10 working days of the breach, and not left until the end of the warning period. If the manager accepts that absence is due to special circumstances, (see Section 8), it is at management s discretion whether to extend the warning for a maximum of a further 6 months, or allow it to run its course. If no special circumstances exist, the manager will issue a Stage 2 warning. The warning will include details of the standard Trust triggers as defined but consideration can be given to specific circumstances. The warning will be live for 6 months, and if the employee does not breach a further trigger during this period (i.e. short-term pro-rata of 5 working days or 2 episodes, whichever figure is exceeded first), the warning will be replaced by a Stage 1 warning as above. If the specific triggers are breached, a Stage 3 hearing will be convened and the employee made aware that failure to improve their attendance in-line with Trust trigger points may result in their dismissal from the Trust. Stage 3 12.2.3 Should the employee breach a further trigger (i.e. after a further 5 working days or 2 episodes) in the following 6 months, following a Stage 2 warning, and unless special circumstances apply (see Section 8), a hearing will be convened, the arrangements for which will be confirmed in writing. At this hearing a decision will be made regarding the continued employment of the individual and will be chaired by a Senior Manager not previously involved in the case, who has the authority to dismiss. A member of the HR Advisory team will also be present at the hearing, as well as the individual and their representative, plus the individuals line manager and HR support. The decision taken will be one, or a combination of, the following: Page 14

To be retained in employment under alternative arrangements as specified in 12.2.4 Early retirement on the grounds of incapability due to ill health (Section 19) Termination of employment on the grounds of incapability due to ill health (Section 17) The manager will then confirm the course of action to be taken and the individual will be advised that if they are unable to return to work, their employment will be terminated. 12.2.4 Alternative arrangements to be considered include: The individual continuing in their existing post but with defined restricted duties; The individual continuing in their existing post but with permanently reduced hours and/or alternative shift patterns; The individual continuing in their existing post with agreed permanent adaptations to the workplace; The individual re-locating to an alternative workplace on a permanent basis; The individual being permanently re-deployed to an alternative post; Where appropriate, to enlist the assistance of support agencies. 12.2.5 Where an individual is retained in employment under alternative arrangements specified above, he/she will be employed on the terms and conditions applicable to the new role. The Protection of Pay policy does not apply in such circumstances. 12.2.6 Where the individual is retained in employment under alternative arrangements, he/she should be advised that it is expected that these arrangements will result in good attendance being resumed. The individual should also be advised that if there is a further 5 days or 2 episodes of absence in the following 6 months, (unless special circumstances apply (see Section 8)), their employment may be terminated with due notice. Should no further absence occur within this period, the matter will be considered closed. 12.2.7 The decision will be confirmed in writing to the individual within 7 working days, with a copy of the letter retained on the personal file. If the decision is to dismiss the employee with notice, (in accordance with the individual s contract of employment), the individual has the right of appeal against the decision (Section 18). 12.2.8 In certain circumstances and normally with the consent of the individual, it may be appropriate to conduct this meeting in their absence. Such circumstances may include, when the individual is not well enough to attend the meeting and is aware that the consequence is that their employment may be terminated or where the individual has failed to attend without good reason. 12.3 LONG-TERM SICKNESS ABSENCE Stage 1 12.3.1 When an employee breaches the trigger point for long-term absence, (ie after 4 weeks continuous absence), the manager will arrange a meeting with the employee, either at home or in the workplace. If the absence is due to special circumstances, (see Section 8), consideration will be given as to whether a Stage 1 warning will be issued, or if no action is to be taken on this occasion. If no special circumstances exist, the manager will issue a Stage 1 warning. Page 15

Stage 2 12.3.2 Should the employee breach the trigger point for Stage 2, (ie after 12 weeks continuous absence), the manager will arrange a Stage 2 meeting with the employee, (a member of the HR Advisory Team may also be invited). This should be done within 10 working days of the breach and if no special circumstances exist (see Section 8), the manager will issue a Stage 2 warning. Stage 3 - Part 1 12.3.3 Should the employee breach the trigger point for Stage 3, (ie after 20 weeks continuous absence), the manager will arrange a Stage 3 Part 1 meeting with the individual, (a member of the HR Advisory Team will also be in attendance). This should be done within 10 working days of the breach. At this point it is also recommended that a medical report is obtained from Occupational Health. 12.3.4 The purpose of the meeting is: To inform the employee of their current sick pay position To review the Occupational Health report To review any special circumstances To discuss the individual continuing in their existing post but with defined restricted duties To discuss the individual continuing in their existing post but with permanently reduced hours and/or alternative shift patterns To discuss the individual continuing in their existing post with agreed permanent adaptations to the workplace To discuss the individual re-locating to an alternative workplace on a permanent basis To discuss the individual being permanently re-deployed to an alternative post Where appropriate, to enlist the assistance of support agencies To discuss the possibility of termination of employment on the grounds of incapability and when relevant an application by the individual for ill health retirement (for those individual s who are members of the NHS Pension Scheme) To make arrangements for a further meeting under Stage 3 Part 1 if required, and confirm the course of action to be taken To advise the individual that if they are unable to return to work, their employment may be terminated under Stage 3 Part 2 of the procedure 12.3.5 If appropriate, the discussion will also enable the manager and the individual to plan the individual s return to work. 12.3.6 In cases where a specific date of return to work is anticipated, the manager and the individual should continue to maintain contact to monitor progress and plan for the individual s return to work. 12.3.7 The outcome of the meeting will be confirmed in writing to the employee. Stage 3 - Part 2 12.3.8 As soon as is practicably possible a hearing will be convened, the arrangements for which will be confirmed in writing. At this hearing a decision will be made regarding the continued employment of the individual and will be chaired by a Senior Manager, not previously involved in the case, who has the authority to dismiss. A member of the HR Advisory team will also be present at the hearing, as well as the individual and their representative, plus the individuals line manager and HR support. Page 16

12.3.9 The decision taken will be one, or a combination of, the following: To be retained in employment under alternative arrangements as specified in 12.3.4 Early retirement on the grounds of incapability due to ill health (Section 19) Termination of employment on the grounds of incapability due to ill health (Section 17) 12.3.10 Where an individual is retained in employment under alternative arrangements specified above, he/she will be employed on the terms and conditions applicable to the new role. The Protection of Pay policy does not apply in such circumstances. 12.3.11 Where the individual is retained in employment under alternative arrangements, he/she should be advised that it is expected that these arrangements will result in good attendance being resumed and that, if this is not the case, the individual s employment may be terminated with due notice. 12.3.12 The decision will be confirmed in writing to the individual within 7 working days, with a copy of the letter retained on the personal file. If the decision is to dismiss the employee with notice, (in accordance with the individual s contract of employment), the individual has the right of appeal against the decision, (see Section 18). 12.3.13 In certain circumstances and normally with the consent of the individual, it may be appropriate to conduct this meeting in their absence. Such circumstances may include, when the individual is not well enough to attend the meeting and is aware that the consequence is that their employment may be terminated or where the individual has failed to attend without good reason. 13. REVIEW MEETINGS AND POSTPONEMENTS 13.1 At all stages in the procedure, the employee will be given 1 week s calendar notice of a review meeting/hearing/appeal. In the event that representation cannot be arranged for the appointed time/date or the employee is unavailable to attend, a re-scheduled hearing will be arranged as quickly as possible, but not later than 7 days after the original hearing date. In the event that either the employee or their representative fails to attend the re-scheduled hearing, a decision will be made in their absence, based upon the evidence available and the individual notified of the outcome in writing. 13.2 When an individual is not fit enough to attend meetings at the workplace, it may be appropriate to conduct a sickness meeting at an individual s home, or a mutually agreed location if the individual s home is not suitable. This will be done with prior agreement and consent of the employee. 14. DISABILITY DISCRIMINATION 14.1 Consideration must be given in all cases to whether or not an individual may fall within the scope of Equality legislation. This may apply to any employee who has a physical or mental impairment which has a substantial and long-term adverse effect on his/her ability to carry out normal day to day activities. The condition must: Be one which affects an individual s everyday living activities and may or may not affect their ability to perform their work duties. Such activities include washing, dressing, eating, walking, catching a bus etc and Have lasted for, or be likely to last for, at least twelve months or be terminal. Page 17

14.2 An individual may still be considered to have an impairment if the condition goes into remission but is likely to recur. Additionally, a condition which is controlled or treated by drugs or physical aids, is still considered to be on-going if the absence of measures is likely to lead to a recurrence of symptoms. 14.3 Individuals falling within the scope of Equality Act 2010 are protected against discrimination on the grounds of their disability and the Trust has a legal obligation to accommodate their disability as far as is reasonable. 14.4 Reference should be made to Trust Policy HR40 Employment of People with Disabilities. 15. GRADUATED RETURN TO WORK 15.1 Following a period of long term sickness absence, it is important that an individual is properly supported in their return to work. In some circumstances, it may be possible to put in place arrangements for the individual to return to work on a graduated basis in order to help them to acclimatise back into the workplace. Such arrangements may be made at the discretion of the line manager and will require medical certification or approval from Occupational Health. 15.2 The same principles will apply whether the individual is returning to their current role or to alternative working arrangements on a temporary or permanent basis. 15.3 Where arrangements are made to enable an individual to return to work initially on reduced hours, they should receive their normal contractual pay (including any unsocial hours payments) during the phased return, for the first 4 weeks. 15.4 In developing a graduated return to work programme, it is important that a realistic timetable is agreed (which would normally be between one to four weeks and in exceptional circumstances may extend beyond this timescale, subject to Occupational Health advice), so that both the manager and the individual are clear as to the expected date for return to full duties. Progress against this timetable should then be regularly reviewed and adapted if necessary. 15.5 In order to further extend the period of the graduated return, it may be agreed by the manager and the individual that annual leave may be used. 15.6 If, at any stage, it becomes apparent that the individual will not be able to return to full duties within a reasonable period of time (for example if the time is anticipated to be more than double the time allowed in the agreed graduated return to work programme), then action will be taken in accordance with Section 12 of this policy. 16. EXTENDED PAID SICK LEAVE 16.1 In exceptional circumstances the Trust may use its discretion to extend the period of paid sick leave beyond the standard period. 16.2 An application for extended paid sick leave must be made in writing to the Workforce Director and relevant Senior Manager. The individual making the request will be expected to demonstrate that they have made all efforts to obtain State benefits before any such request will be considered. The Workforce Director will consider the application and their decision will be final, and will inform both the employee and Senior Manager, and employee representative (if relevant). Page 18

16.3 The authority to extend paid sick leave rests with the Workforce Director. 17. TERMINATION OF EMPLOYMENT ON THE GROUNDS OF INCAPABILITY DUE TO ILL HEALTH 17.1 The authority to terminate employment rests with the Senior Manager. Advice must be sought from a member of the HR Advisory Team prior to any decision being made. 17.2 Termination of employment will be regarded as a last resort in cases of short term and long term absence and considered only after the following criteria have been satisfied: the employee has been fully consulted and advised of the consequences of their continued inability to attend work regularly a medical opinion has been considered all options to retain the individual in employment have been considered. 17.3 Termination of employment may take place before occupational sick pay has expired where there is no prospect of a return to work in the foreseeable future. 17.4 Where an individual s employment is to be terminated, notice with full pay will be given in accordance with their contract of employment. 17.5 If an individual s employment is terminated under this policy, any annual leave accrued in the leave year but not taken prior to the commencement of long term sickness absence or accrued during sickness absence will be paid in lieu. 18. APPEALS AGAINST TERMINATION OF EMPLOYMENT 18.1 Employees have a right of appeal against termination of employment. Any appeal must be made in writing within 14 calendar days of receipt of written notice of such action to the line manager of the Senior Manager who effected the termination, stating the grounds for the appeal. 18.2 The lodging of an appeal will not suspend the notice of dismissal. 18.3 The Manager hearing the appeal will arrange a hearing at which the employee may be accompanied by an accredited representative of a Trade Union/Professional Organisation or work colleague. 18.4 Appellants are required to attend the appeal hearing. If it is necessary to postpone the meeting, another will be arranged by the Trust, normally within 14 calendar days of the original date. Where an appellant fails to attend a meeting without giving prior notice or without good reason, the meeting will proceed in their absence. 18.5 The purpose of the appeal panel is not to re-hear the case. It is to review the decision to dismiss, and to assess whether this was appropriate on the evidence presented at the hearing. The appeal hearing will consider: Why the employee considers the decision unfair or unreasonable and The rationale and justification of the decision to dismiss 19. APPLICATIONS FOR ILL HEALTH RETIREMENT Page 19

19.1 The decision to terminate the employment of an individual on the grounds of incapability will be made independently of any application to the NHS Pension Scheme for ill health retirement and will be taken in accordance with Section 12. 19.2 Where an application for ill health retirement is being considered, the individual should refer to the Trust s Pensions Officer and their immediate line manager and to HR32 Ill Health Retirement Policy for advice and guidance. 19.3 Members of the NHS Pension Scheme may apply for ill health retirement without the support of their manager however, any application must be supported by a medical practitioner who may be the Occupational Health Consultant or the individual s own GP or consultant. 19.4 Where ill health retirement has been approved, a formal meeting must be held in accordance with Section 12. 20. OCCUPATIONAL HEALTH 20.1 Reference should also be made to the Trust Occupational Health guidance (HR65). The role of the Occupational Health Service in assisting in the management of sickness absence is: to provide support and advice to any employee suffering health problems to provide an independent medical opinion to managers regarding the health condition of individuals to advise managers of any work-related factors that may affect an individual s ability to attend work regularly to advise managers of the anticipated date of return to work and/or likely duration of the illness to advise managers of the potential for recurrence of the illness to advise managers of any short or long term workplace adjustments which may be made to enable an individual to remain in employment to advise managers on the likely outcome of any ill health retirement application to correspond with any other medical professional involved in individual cases in order to ascertain the information required. 20.2 An employee may be referred to the Occupational Health Department at any time during their employment and must comply with any such request. Cases where referral to the Occupational Health Department may be appropriate include: where an individual s performance at work is impaired by ill health where an individual returns to work under different working arrangements such as a new post or with adjustments to the workplace (to confirm the suitability of the changes) where an individual is absent from work for four weeks or more (long term sickness absence) where an individual has a number of episodes of short term absence (less than four weeks duration) and where formal action is being considered. 20.3 Referral to the Occupational Health Department by a manager should be made using the standard referral form. 20.4 Where an employee has been referred to the Occupational Health Department by his/her manager and fails to attend without prior notification or an acceptable reason, Page 20

this may result in action being taken in accordance with this policy, based on the information available. 20.5 Any member of staff may to self-refer to Occupational Health Counselling Services, (see Staff counselling services policy, HR66, Sections 4.2 and 4.3) 21. WORK-RELATED INJURY/ABSENCE 21.1 Where an employee is absent due to an accident or physical/psychological injury at work, a DATIX form must formally be completed and, once the details have been confirmed, the manager must notify Pay Services immediately as the employee may be eligible to claim Temporary Injury Allowance, (see Policy HR21 NHS Injury Benefits). In all such cases, managers should refer to Human Resources for guidance. 21.2 Where a physical injury at work results in absence lasting three days or more (whether immediately or some time after the event), or where it is linked to an occupational disease, the incident must be reported to the Health and Safety Executive under RIDDOR regulations (see Accident and Incident Reporting Policy, HS03). Further advice is available from the Health & Safety team. 21.3 Where an absence through illness is as a result of a physical/psychological injury sustained by staff in the discharge of their duties through no fault of their own, the days of absence will not count against the period during which sick pay should be paid. 21.4 Where an individual is unable to return to work following illness for health and safety reasons/medical suspension (e.g. following an episode of diarrhoea and vomiting), this will be discounted (see Section 8 Special Circumstances) in deciding how to manage the overall attendance record. 22. SICKNESS AND ANNUAL LEAVE / BANK HOLIDAYS 22.1 If an employee falls ill during a period of annual leave they must inform their manager on the first day of illness in accordance with Section 5, Reporting Sickness Absence. 22.2 In order to re-claim annual leave when sickness absence falls during a period of annual leave, employees must contact their manager and follow normal reporting procedures. Annual leave will be cancelled and may be taken at a later date within the same or next annual leave year. Failure to follow normal reporting procedures will result in annual leave not being rescheduled. 22.3 Employees on long term sickness absence will accrue their full occupational annual leave entitlement during the first 3 months of sickness absence. After this time full time employees will accrue statutory annual leave only, at the rate of 12.5 hours per month, (pro-rata for employees contracted for less or more than 37.5 hours per week). The entitlement will be calculated on a rolling monthly basis, the detail of which is contained in Appendix C. 22.4 Where an employee has taken more annual leave than they are entitled to, the time owed should either be re-paid by the employee or an agreement reached with the Line Manager for the time to be worked over an agreed period. 22.5 Where an employee requests payment in-lieu of annual leave, payment will only be made for those days in the leave year, where entitlement is over and above the Page 21

statutory 20 days, (28 days minus 8 Bank Holidays), accrued up to the date payment is made. 22.6 Annual leave accrued prior to and during the commencement of long term sickness absence may be taken during periods of long term sickness absence in blocks of one or two weeks provided that advance notice is given to the manager. In these circumstances, the employee will remain off sick and pay will be granted as if the individual were not absent due to ill health. 22.7 An employee on sick leave for all or part of the annual leave year, is entitled to any untaken annual leave when they return to work, which might be in the next leave year, up to the statutory maximum of 20 days, (pro-rata for part time staff). 22.8 Employees are not entitled to an additional day off if sick on a Bank Holiday. 23. TRAINING 23.1 Any training required to fulfil this guidance will be provided in accordance with the Trust s Training Needs analysis. Management and monitoring of training will be in accordance with the Trust s Risk Management Training Policy. These can be accessed via the Learning Zone pages on the Trust intranet. 24. REVIEW PROCESS 24.1 The Trust will review this policy when there are changes to relevant legislation or good practice, or within the normal policy review cycle. 25. EQUALITY IMPACT ASSESSMENT (EQIA) 25.1 This policy applies to all employees equally and does not discriminate positively or negatively between protected characteristics. 26. PROCESS FOR MONITORING COMPLIANCE Page 22

Aspect of compliance or effectiveness being monitored Duties The Trust is committed to encouraging and supporting staff in sustaining good health and attendance at work.therefore, in managing unsatisfactory attendance, the emphasis must be on supporting the individual. Reporting Arrangements Occurences of 10 days absence Referrals into the Disciplinary Procedure Organisations expectations in relation to staff training Monitoring method Responsibility for monitoring Frequency of monitoring To be addressed through the monitoring below Review of policy when updated Monthly sickness absence reports ESR report HR Activity report Workforce Director ESR Team HR Team Deputy Head of HR - Workforce Deputy Head of HR - Workforce On policy review TNCC Monthly Annuual report 6 months postimplementation 6 months postimplementation Group or Committee that will review the findings and monitor completion of any resulting action plan TNCC, Hospital Executive Committee, Operating Delivery Group, Trust Board TNCC Policies TNCC Policies Management and monitoring of training will be in accordance with the Trust's Development & Training Support (HR59) and Risk Management Training Policy 27 REFERENCES Legislation Equality Act 2010 (as amended) Other References Agenda for Change Terms and Conditions handbook. Available from: http://intranet/hr/non_medical_staff_terms_and_conditions.asp NHS Employers Mental Health and Employment in the NHS. Available from http://www.nhsemployers.org/health_work_&_wellbeing/stress_&_mental health/mental_health_and_employment_facts HR01 Equality and Diversity Policy. Available from http://intranet/hr/hr_policies.asp HR06 Maintaining High Standards of Performance. Available from http://intranet/hr/hr_policies.asp HR07 Disciplinary Policy for Doctors and Dentists. Available from http://intranet/hr/hr_policies.asp HR09 Alcohol and Substance Misuse. Available from http://intranet/hr/hr_policies.asp HR21 NHS Injury Benefits. Available from http://intranet/hr/hr_policies.asp HR24 Maternity Leave. Available from http://intranet/hr/hr_policies.asp HR29 Special Leave. Available from http://intranet/hr/hr_policies.asp HR30 Annual Leave & Public Holidays. Available from http://intranet/hr/hr_policies.asp Page 23

HR32 Ill Health Retirement. Available from http://intranet/hr/hr_policies.asp HR36 Disciplinary Procedure. Available from http://intranet/hr/hr_policies.asp HR40 Employment of People with Disabilities. Available from http://intranet/hr/hr_policies.asp HR47 Managing Exposure to Blood Borne Viruses. Available from http://intranet/hr/hr_policies.asp HR48 Managing Staff with MRSA. Available from http://intranet/hr/hr_policies.asp HR65 Occupational Health Service. Available from http://intranet/hr/hr_policies.asp HR66 Staff Counselling Service. Available from http://intranet/hr/hr_policies.asp HS01 Health and Safety policy. Available from http://intranet/non-clinical Services & Departments/Health and Safety_Policies.asp HS03 Accident & Incident Reporting Policy. Available from http://intranet/non-clinical Services & Departments/Health and Safety_Policies.asp HS13 Stress Management Policy and Risk Assessment Procedure. Available from http://intranet/non-clinical Services & Departments/Health and Safety_Policies.asp RETURN TO WORK FORM APPENDIX A Page 24

This form must be completed and signed by all members of staff following EVERY episode of sickness absence and countersigned by their immediate line manager. The form will be held on the individual s Personal File. For absences exceeding 7 calendar days, a Fitness for Work (Fit Note) must also be provided by the member of staff. IMPORTANT Food handlers (Catering & Non-Catering Staff) and those involved in direct patient care where absence has been due to Gastro-Intestinal illness, septic skin lesions, jaundice or contact with Hepatitis A, MUST also complete Appendix B to indicate whether or not the member of staff is fit to return to work. The first parts of the form may be completed by the person receiving the initial notification of absence. Surname... Other names... Post Title Department.. Absence reported to at (time) on (date) Reason for absence....... First day of illness Last day of illness... First day of absence Date of return to work. Total number of days/shifts of absence on this episode... Has a Statement of Fitness for Work ( Fit Note ) been provided? YES/NO/Not required Is there a likelihood that the condition will occur or require further treatment? YES/NO If yes, please give further details.. Was this episode of sickness related to a disability or an ongoing health condition (if yes see Action Required on page 3 of this form)? YES/NO Was your absence a result of an injury at work or work related accident or illness? YES/NO If yes, please refer to Section 19 of the policy and give further details........ Date reported:... To whom reported: Incident report form completed YES/NO Datix No: Incident reported to HSE under RIDDOR YES/NO Page 25

Was your absence a result of an accident where damages may be claimed from a third party (e.g. road traffic accident)? YES/NO If yes, please give details (Pay Services should be advised accordingly).... SUMMARY OF SICKNESS ABSENCE IN PREVIOUS 12 MONTHS Number of days/shifts.... Number of episodes.. Detail absences below (including date; number of days/shifts taken; condition): 1... 2... 3... 4... a) Has the individual breached Stage 1 of the policy with the current episode? YES/NO/NA If yes, has the individual been advised during the meeting that their next set of triggers will be as follows: YES/NO/NA Number of days/shifts.... Number of episodes.. b) Does the individual currently have a live warning in place at Stage 1 of the policy (Section 12) YES/NO/NA If yes, indicate the date that this was issued: If yes, has the individual been informed if their Stage 1 triggers have been exceeded and that they will progress to Stage 2 of the policy (see Action Required below): YES/NO/NA c) Does the individual currently have in place a live warning at Stage 2 of the policy (Section 12): YES/NO/NA If yes, indicate the date that this was issued: If yes, has this episode of sickness exceeded the live warning at Stage 2? YES/NO If yes, has the individual been advised that a further formal Stage 2 meeting will be arranged in accordance with Managing Sickness Absence Policy (Section 10)? YES/NO SUMMARY OF RETURN TO WORK INTERVIEW......... Page 26

......... ACTION REQUIRED Referral to Occupational Health. Referral to Staff Counselling Service. Referral to support agencies (e.g. Disability Employment Advisory Service; Job Centre Plus; Remploy, Access to Work).. Mechanisms of Support (e.g. agreed alterations to working arrangements; hours/environment/work patterns etc)....... Formal meeting arranged with HR Representative in accordance with Managing Sickness Absence Policy (see Section 10 of the policy)........ Additional Comments (ie notification of any changes which have occurred in the workplace during the absence period etc): Manager s Signature Date... I certify that I have been unable to work during the period above due to sickness as stated and confirm the content of discussions as above. Employee s Signature Date.. Page 27

ASSESSMENT OF FITNESS TO RETURN TO WORK APPENDIX B To be completed by manager/supervisor for all Food Handlers (Catering & Non- Catering Staff) and those involved in direct patient care where absence has been due to Gastro-Intestinal illness, septic skin lesions, jaundice or contact with Hepatitis A Please answer ALL statements. GASTRO-INTESTINAL ILLNESS 1. ANY DIARRHOEA OR VOMITING IN PAST 48 HOURS YES/NO If symptoms present in past 48 hours, sample must be taken and results received before return to work 2. DIARRHOEA OR VOMITING WHILST ABROAD OR WITHIN YES/NO 2 WEEKS OF RETURN Sample must be taken and member of staff to refrain from work until sample results obtained 3. BLOOD PRESENT IN STOOL DURING ILLNESS YES/NO 4. ABSENT WITH GASTRO-INTESTINAL ILLNESS FOR YES/NO MORE THAN 5 DAYS If YES, refer to Occupational Health with faecal sample) If the staff member answers NO to ALL statements they can return to normal duties. If they answer YES to any questions (1,2,3, or 4) they must be referred to the Occupational Health Department for assessment. They must not work with patients or food until medical clearance is given, OTHER ILLNESS 5. SEPTIC SKIN LESION PRESENT: YES/NO (i) If YES, cover with a blue waterproof dressing. (ii) If not able to cover, refer to Occupational Health 6. ANY JAUNDICE OR CONTACT WITH HEPATITIS A YES/NO If YES, refer to Occupational Health Signed (Supervisor/Manager in Charge) Date For office use only: Referred to Occupational Health Department Sample taken Date/time to Pathology.. YES/NO YES/NO Occupational Health result: Pathogen grown from stool specimen YES/NO Declared fit to work (Date ) YES/NO Return to work column completed in Leave file YES/NO Page 28

APPENDIX C LEAVE ACCRUED DURING PERIODS OF SICKNESS ABSENCE Month of Absence Leave Earned During Sickness Absence (hrs), in Years 1-5 of Employment Total Leave Accrued (hrs) 1 16.875 16.875 2 16.875 33.75 3 16.875 50.625 4 12.5 63.125 5 12.5 75.625 6 12.5 88.125 7 12.5 100.625 8 12.5 113.125 9 12.5 125.625 10 12.5 138.125 11 12.5 150.625 12 12.5 163.125 Month of Absence Leave Earned During Sickness Absence (hrs), in Years 5-10 of Employment Total Leave Accrued (hrs) 1 18.125 18.125 2 18.125 36.25 3 18.125 54.375 4 12.5 66.875 5 12.5 79.375 6 12.5 91.875 7 12.5 104.375 8 12.5 116.875 9 12.5 129.375 10 12.5 141.875 11 12.5 154.375 12 12.5 166.875 Month of Absence Leave Earned During Sickness Absence (hrs), After More Than 10 Years of Employment Total Leave Accrued (hrs) 1 20.625 20.625 2 20.625 41.25 3 20.625 61.875 4 12.5 74.375 5 12.5 86.875 6 12.5 99.375 7 12.5 111.875 8 12.5 124.375 9 12.5 136.875 10 12.5 149.375 11 12.5 161.875 12 12.5 174.375 Please note: Managers must remember that the above tables apply to full-time staff, and that part-time employees accrue leave pro-rata. Page 29

APPENDIX D Short Term/ Frequent Sickness Absence Flow Chart Employee triggers Stage 1 i.e. 10 working days or 4 episodes of sickness within a rolling 12 month period (pro-rata if part time) Consider referral to occupational health No special circumstances apply Return to work meeting held. Special circumstances apply No breach further Stage 1 warning issued and employee notified of Stage 2 triggers. No warning issued Consider referral to occupational health Employee triggers Stage 2 i.e. a further 5 working days or 2 episodes of sickness within the following 6 month period (pro-rata if part time) Stage 2 meeting held between manager and employee within 10 working days of breach. HR and TUPO representatives invited as appropriate. Extend Stage 1 warning No special circumstances apply Special circumstances apply No breach further Stage 2 warning issued and employee notified of stage 3 triggers. Let Stage 1 warning run its course Employee triggers Stage 3 i.e. a further 5 working days or 2 episodes of sickness within the following 6 month period (pro-rata if part time) Employee to be retained in employment under alternative arrangements as in 10.2.4 Triggers not breached Case closed Triggers breached Stage 3 hearing convened and arrangements confirmed in writing to employee. The hearing is chaired by a senior manager. The employee, HR representative, TUPO representative, line manager and HR support are invited. Termination with notice on grounds of ill health Right of appeal (see section 16) Early retirement due to ill health (see section 15) Page 30

Long Term Sickness Absence Flow Chart APPENDIX E Employee triggers Stage 1 (absence of or likely absence of 4 weeks or more) Stage 1 Manager and employee (telephone, work or homevisit) discuss sickness and potential return to work. Determine if change at work could help. Discuss possibility of Occupational Health visit and current sickpay situation. If no planned return or progression doesn t continue as planned then move to Stage 2. If return date planned, maintain contact and plan for employee s return. Stage 2 Determine current health condition, discuss treatment and any likely return to work, clarify if any workplace changes could help, organise Occ Health visit, inform employee of potential consequences if return to work remain uncertain at next meeting. Further formal warnings to monitor progress and ensure that any temporary arrangements are effective. Employee informed in writing of the outcome of each meeting Meeting to discuss outcome of Occupational Health report. Clarify when/if return to work possible, consider alternative employment within Trust, consider whether absence falls within into Disability Discrimination Act. Review sickpay position, arrange next meeting at Stage 2 or 3. Warn of consequences if return to work uncertain. If return date If return planned, date maintain contact and contact plan and for employee s plan for return. employees return If the employee is not likely to return to their permanent post in the foreseeable future then move to Stage 3 following further Occupational Health appointment. Stage 3 Inform employee of sickpay position, review Occupational Health report, consider possible changes to duties/hours etc, discuss and advise of possibility of termination (see Section 12.3.4). Confirm arrangements for next formal meeting. Outcome confirmed to employee in writing. Stage 3 Chaired by Senior Manager, not previously involved in the case, with authority to dismiss. Make 1 of following decisions. Continue but with restricted duties, with permanently reduced hours or shifts, adaptations to workplace, permanently relocate, permanently redeployed to different position, early retirement due to ill health, termination due to incapability. Decision confirmed in writing. Individual has right to appeal if employment terminated Page 31