Policy and Procedure for Managing Sickness Absence

Managing Sickness Absence Policy Version 7 Ratified by ISE: January 2013 To be Reviewed: January 2016 Policy and Procedure for Managing Sickness Absence ID# 2013 038 Author Caroline Lankshear & Christine Taylor Author s Job Title HR Manager & HR Manager Division Department Version number Corporate Human Resources 7 Ratifying Committee Integrated Standards Executive Ratified Date January 2013 Review Date January 2016 Upload Date 20 March 2013 Manager responsible for review Laura Bevan Manager Job Title Senior HR Manager E-mail address of Manager Laura.bevan@whht.nhs.uk Source of Evidence (if applicable) N/A Level of Evidence indicated N/A Referenced (Yes/No) Yes Key Words (to aid searching) Sickness, absence, attendance, warnings User Group All staff The Trust is committed to promoting an environment that values diversity. All staff are responsible for ensuring that all patients and their carers are treated equally and fairly and not discriminated against on the grounds of race, sex, disability, religion, age, sexual orientation or any other unjustifiable reason in the application of this policy, and recognising the need to work in partnership with and seek guidance from other agencies and services to ensure that special needs are met.

Contents Page 1. Change History Page 3 2. Introduction Page 3 3. Scope of Policy Page 3 4. Equality & Diversity Statement Page 3 5. Manager Responsibilities Page 4 6. Employee Responsibilities Page 4 7. Occupational Health Responsibilities Page 5 8. Human Resources Responsibilities Page 5 9. General Sickness Information Page 5 10. Management of Short-Term Sickness Absence Page 14 11. Management of Long-Term Sickness Absence Page 18 Appendices Appendix 1 Management Guidelines on Return to Work Interviews Page 25 Appendix 2 Employee Self Certification Form Appendix 3 Occupational Health Management Referral Form Page 28 Page 29 Appendix 4 Request For Fast Track Form Page 32 Appendix 5 Prevention of Sickness Absence relating to MSD s Page 33 Appendix 6 Request for Moving & Handling Services Page 35 Page 2 of 37

1. CHANGE HISTORY POLICY FOR MANAGING SICKNESS ABSENCE Version Date Author Reason Ratification Required Version 3 September 2008 Liz Quick Out of date policy Yes Version 4 August 2009 Laura Bevan & Caroline NHSLA requirement Yes Lankshear Version 5 May 2010 Caroline Lankshear & Tanishka Norris Version 6 November 2011 Caroline Lankshear & Tanishka Norris Version 7 November 2012 Caroline Lankshear & Christine Taylor Review required following transfer of staff from PCT Review required following LCFS report Clarification on a number of points Yes Yes Yes 2. INTRODUCTION The Trust is committed to promoting and maintaining the health, safety and welfare of all employees. The Trust recognises the need for an understanding and supportive approach towards staff on sick leave and will take into consideration individual circumstances as appropriate in the application of this policy. The Trust also recognises the significant impact of ill-health and sickness absence on the cost and quality of service delivery and wishes to encourage a culture of good attendance. 3. SCOPE OF POLICY This policy and procedure applies to all Trust employees. For medical staff, this policy should be read in conjunction with Maintaining High Professional Standards in the NHS Medical and Dental Staff Disciplinary Policy. The Trust reserves the right to fully investigate excessive sickness absence and take any necessary action, in accordance with this policy. This policy should be read in conjunction with related policies to include the following as detailed in this non-exhaustive list: Raising Concerns Policy and Procedure Management of Stress Policy Disciplinary Policy and Procedure Counter Fraud and Corruption Policy Incident Reporting and Investigation Policy Moving and Handling Policy and Procedures 4. EQUALITY & DIVERSITY STATEMENT It is the policy of the West Hertfordshire Hospitals NHS Trust to provide a Managing Sickness Absence Policy & Procedure that ensures appropriate and equitable responses to employee sickness absence in an efficient and fair manner. This document takes into account current employment legislation and must be implemented in conjunction with the Trust s Equalities Framework, The Trust s Equality & Human Rights Policy and equality and diversity legislation: Equality Act 2010 Rehabilitation of Offenders Act 1974 Page 3 of 37

Employment Rights Act 1996 Equal Pay Act 1970 (as amended) Human Rights Act 1998 Part-time Workers Directive 1999 Employment Act 2008 EU Directives and Legislation Managers have a particular responsibility to ensure their management practices do not discriminate in the provision of their service or in the employment of staff. The Trust monitors and publishes information on the profile of its workforce based on age, disability, ethnicity, gender and marital status and appropriate actions will be taken by the Equality & Diversity Group to identify and address any problems. 5. MANAGER RESPONSIBILITIES To ensure that employees are aware of the Managing Sickness Absence Policy To speak to employees during their absence, conduct return to work interviews on their return and complete the return to work interview form (see Appendix 1) To maintain accurate records of employee absences and report to Payroll on a weekly basis (see Trust Intranet: Departments/HR/Management Guidelines) To ensure that employees absences are certificated appropriately To notify and seek support from the Human Resources Department when an employee hits the relevant trigger points To monitor records of attendance of all employees To initiate, monitor and pursue action in relation to the management of short and longterm absences To refer employees to Occupational Health as appropriate (see Appendix 3) To request fast tracking of employees where appropriate (see Appendix 4) To ensure that the outcome of any sickness review meeting is communicated to the employee in writing To treat all employees fairly, sensitively and ensure that any personal information, including medical diagnosis, is kept in complete confidence To support staff who are covering for a colleague s absence due to sickness To encourage a culture of attendance and help employees to minimise absence 6. EMPLOYEE RESPONSIBILITIES To make every effort to attend work regularly and carry out their duties to an acceptable standard To report absence on the first day as early as possible and give a reason for the absence To complete the self certification form for absences of 1 7 calendar days (see Appendix 2) To send in fit notes in a timely manner To remain in regular contact with their manager during sickness To attend formal review meetings arranged in management of both long and short-term sickness absences To ensure that they do not work excessive bank/agency/locum shifts and jeopardise their ability to undertake their permanent post To comply with the Managing Sickness Absence Policy and Procedure To obtain appropriate medical treatment and/or other support or assistance if ill or suffering from a condition that may affect their work performance or make them unable to work To take note of any advice given by Occupational Health or their own Medical Practitioner to protect their own health and that of their colleagues Page 4 of 37

7. OCCUPATIONAL HEALTH RESPONSIBILITIES To provide impartial advice to managers and employees about an individual s fitness to attend work and perform their duties. This will include prospects of returning to work, adjustments to work, redeployment, assessment for ill health retirement and likely future sickness absence To discuss with/give employees details of any letters/reports being sent to their manager To provide confidential advice to employees who have concerns about the impact of their work or working environment on their health To maintain confidentiality of medical matters unless it is essential in connection with the employee s work or in connection with patient safety and in these circumstances, consent from the employee to release information will be sought To liaise with GPs, medical practitioners as required subject to gaining the relevant authorisation from the employee To assist with fast tracking staff who are waiting to be referred or treated within the Trust Provide advice on temporary exclusion from work on medical grounds in cases of contact with notifiable or contagious disease To encourage a culture of attendance and help employees to minimise absence 8. HUMAN RESOURCES RESPONSIBILITIES To assist managers with the fair and consistent application of the policy To provide advice to employees and managers concerning individual sickness issues To provide managers with sickness absence data and assist with the analysis and recommend appropriate management action To provide training for managers on the application of the policy To encourage a culture of attendance and help employees to minimise absence 9. GENERAL SICKNESS INFORMATION 9.1 Sickness Reporting In the event of absence from work due to sickness, injury or accident employees should telephone their manager (or a designated deputy / senior manager) on the first day of absence as early as possible, to ensure the manager has sufficient time to arrange cover. This should be as near as possible to when the shift starts and where possible beforehand but no later than 1 hour after the shift has started. If the employee is unable to telephone their manager they should arrange for someone to do so on their behalf. If a friend or relative makes the telephone call on the employee s behalf, it is important that the employee follows up the call with their manager as soon as possible. When notifying their manager of the absence the employee should state: why they are absent the date their illness started whether they have or intend to contact their GP how long they are likely to be absent from work Employees are required to maintain appropriate regular contact with their manager as per local reporting procedures during their absence from work so that necessary arrangements can be made to cover workload. Employees are expected to communicate by phone as a preferred method of communication. If employees then use an alternative method (e.g. text / e-mail) to update on their sickness absence, this would need to be agreed with the manager in advance. If the absence is the result of an accident/incident at work the employee must advise their manager of this fact and ensure that the Trust Incident Reporting Form has been completed. Page 5 of 37

The employee must also advise their manager if their absence is work related e.g. work related stress or musculo-skeletal disorders. It is the employee s responsibility to notify their line manager as soon as reasonably practicable, that they are fit to work, even if the next day is a weekend / rostered day off. In the event that the employee fails in their duty to report fit for work, then they will continue to be recorded as on sick leave until they actually return to work. Reporting fit for work cannot be done retrospectively and should be done at the time the employee is well again. Failure to abide by the above reporting requirements and failure to keep in touch during the absence could result in the episode as being recorded as unauthorised absence which will affect their entitlement to sick pay. Repeated failure to comply with reporting requirements could result in the matter being referred to the disciplinary policy. 9.2 Certification Employees have an obligation to ensure that sickness absence is certificated appropriately. For periods of sickness lasting between one and seven calendar days, the employee must complete a self-certification form. Please note that when calculating the above number of days, these include days not normally rostered or contracted to work e.g. weekends for Monday to Friday workers or days off for shift workers. The self-certification form should be given to the manager once the employee has returned to work. The self-certificate form can be found in Appendix 2. A fit note is required to cover all periods of sickness absence that exceeds seven consecutive calendar days. Please note that when calculating the above number of days, these include days not normally rostered or contracted to work e.g. weekends for Monday to Friday workers or days off for shift workers. Fit notes are available from General Practitioners, Hospital Doctors or Specialists and these should be sent to the manager within 14 calendar days of the absence starting. Subsequent fit notes should be submitted prior to or straight after the expiry of the preceding one. Employees should be aware that out of date / backdated fit notes will not be accepted unless in exceptional circumstances and this may affect their entitlement to sick pay. Managers should retain fit notes and self-certification forms on the employee s file. There is no requirement for these documents to be forwarded to Payroll or the Human Resources department. A manager is entitled to request a fit note prior to the 8 th calendar day of absence if the employee has a poor short-term sickness absence record. Managers also have the right to request a fit note in the event an employee has had a leave request denied and has then reported sickness absence on the same day. In these situations the manager will meet the cost of obtaining the fit note. 9.3 Accidents and Incidents at Work If an employee suffers an accident or injury at work they must notify their manager immediately. The employee will need to complete a Trust Incident Reporting Form and give this to their manager to sign at the first available opportunity. The manager must also report the event to the Trust s Health and Safety Officer so that they can report to the Health and Safety Executive as required by RIDDOR legislation. Consideration should also be given to referring the employee immediately to Occupational Health for advice and guidance. Page 6 of 37

A period of absence due to injury sustained at work which was not the employees fault will be recorded as an episode of sickness for monitoring purposes but will not be taken into account when considering issuing a sanction in line with this policy. 9.4 Accidents Outside of Working Hours If employees are absent from work as a result of an accident outside of working hours they should notify their manager. If the accident is a third party claimable accident the employee s manager will need to inform the Payroll Department. An employee who is absent as a result of an accident is not entitled to sick pay if damages are received from a third party. Employers will advance to the employee a sum not exceeding the amount of sick pay payable under the NHS sick pay scheme providing the employee repays the sickness allowance to the employer when damages are received. Once received the absence shall not be taken into account for the purposes of calculating the employee s sick pay entitlement in accordance with their contractual entitlements. 9.5 Injury Benefits and Allowances In some circumstances where an accident or incident has occurred at work an Industrial Injury benefit may be payable. An employee may prejudice their right to an entitlement if they fail to report the accident/incident and complete the necessary documentation. Temporary Injury Allowance is payable to an employee on sick leave who is on reduced pay or no pay because of an accepted injury or disease resulting from work. Permanent Injury Benefit is payable to an employee if the injury or disease has been medically diagnosed as permanent. An employee is obliged to inform the Trust if they are claiming or are in receipt of any Social Security Benefits. Payment of these allowances will be in accordance with the NHS Injury Benefit Scheme Regulations. 9.6 Becoming Unwell at Work When an employee is taken ill at work they should notify their manager without delay. The employee should be allowed to go home. Depending on the nature of the illness, consideration should also be given to referring the employee immediately to Occupational Health for advice and guidance. If an employee attends work prior to leaving due to sickness, it will not count as a sick day for Statutory Sick Pay purposes. However in order to accurately monitor sickness absence levels it will be recorded as follows: When the employee leaves work during the first half of their working day/shift a halfday of sickness absence will be recorded When the employee leaves work during the second half of their working day/shift no sickness absence will be recorded 9.7 Support available to employees complaining of stress or pain relating to muscular skeletal disorders The Trust acknowledges that stress and muscular skeletal disorders are two of the main causes for sickness absence and therefore seeks to proactively support staff and where possible take preventative measures to help employees remain healthy and at work. For employees who inform their manager that they are experiencing high levels of stress, either from their work or home life, a stress risk assessment should be completed and the employee Page 7 of 37

should be referred to Occupational Health with their consent for advice and guidance. A copy of the risk assessment can be found in the Trust s Management of Stress policy at: http://wghintra01/uploads/out/stress_policy_v2.pdf For employees who inform their manager that they are experiencing pain related to a muscular skeletal disorder, a referral to the Trusts Moving & Handling service should be made in accordance with Appendix 5. These interventions are intended to be supportive and therefore managers and employees should not wait until the employee has exceeded the triggers for short term or long term sickness. Managers may therefore consider referring an employee immediately they are made aware of the concern, even if this has not resulted in a period of sickness absence. 9.8 Sickness Whilst on Annual Leave or Public Holidays When an employee becomes sick during a period of annual leave they may reclaim the annual leave for the period where they are unfit (not the full leave period) to be used at a later date in the financial year provided that they follow the reporting procedures described in Section 9.1 above and submit a fit note to verify the period of sickness, even when the period of sickness lasted less than 7 calendar days. Where an employee incurs a cost for obtaining a fit note for this purpose, this may be reclaimed from the Trust. Backdated certificates i.e. covering a period prior to the doctor s appointment may not be accepted. Where an employee is sick whilst on annual leave abroad, they are still expected to maintain appropriate contact with their manager to update them regarding their health and obtain appropriate medical certification. If the medical certificate is not in English, the employee should provide an authorised translation. If the sickness prevents the employee from being able to return to the UK as originally planned the employee should make their current contact details available and should provide details of their treating physician so Occupational Health may obtain information about the employee s prognosis. Medical staff may produce a statement, which may be a self-certificate to cover up to the first seven calendar days of sickness absence during annual leave. Fit notes / medical certificates will be required to cover the eighth and subsequent days of sickness as appropriate. Further annual leave shall be suspended from the date of the first statement. When an employee is sick immediately prior to or following annual leave they must contact their manager to advise of the dates of their sickness. A manager is entitled to request a fit note if an employee is absent on the day immediately before and/or after annual leave/public holidays. An employee is not entitled to a day off in lieu if they are sick on a public holiday. Employees who have their annual leave entitlement inclusive of public holidays must deduct their contractual hours for the public holiday from their leave entitlement. 9.9 Sickness and NHSP Working Employees who are off sick or on a phased return to work must not undertake work for NHS Professionals, Agencies or private practices. This restriction is lifted when the employee returns to working their contractual hours. For further details please refer to section 10.9. 9.10 Conduct during Sickness Whilst on sick leave employees will be expected to behave in a manner that will assist their recovery and return to work. Employees should not engage in any activity which is inconsistent with the nature of their illness/injury. It is unacceptable for employees to undertake any work whether paid or unpaid, at this Trust, on Bank or at any other Trust / employer during periods of sickness absence, including work undertaken outside of usual contractual hours, without the prior agreement of their manager and their Human Resources Adviser. Page 8 of 37

The Trust considers it a disciplinary offence to claim occupational sick pay or Statutory Sick Pay (SSP) from the Trust whilst undertaking paid or unpaid employment elsewhere without the prior express agreement of the Trust. It can also be a criminal offence to claim Statutory Sick Pay (SSP) from an employer whilst undertaking paid or unpaid employment elsewhere without the agreement of the Trust. Where the Trust has reason to believe an employee is working elsewhere whilst off sick without prior agreement, an investigation under the Trust s Disciplinary Policy and Procedure will be implemented, which could lead to dismissal, as well as a criminal investigation in accordance with the Trust s Counter Fraud and Corruption Policy. Where the Trust has reason to believe that an employee s conduct during sick leave has been prejudicial to their recovery, sick pay may be withheld, following an investigation into the circumstances. If the Trust has reason to believe that an employee has received any salary fraudulently, including sick pay, this will result in action being taken in accordance with the Trust s Disciplinary Policy and Procedure and in accordance with the Trust s Counter Fraud and Corruption Policy. Where fraudulent claims of sickness absence are suspected, these will be investigated by the Local Counter Fraud Specialist (LCFS). Employees are expected to cooperate in the management of their sickness absence. This expectation extends to making all reasonable efforts to attend review and occupational health meetings. Where an appointment has been made which is inconvenient for the employee, it is their responsibility to contact the manager / occupational health advisor and rearrange the appointment for a more suitable time and date. Persistent failure to attend review and occupational health meetings without good reason (whether notice of the intention not to attend has been given or not) will be viewed as the refusal to follow a reasonable management instruction and may lead to disciplinary action being taken against the employee. 9.11 Doctor, Dentist and Hospital Appointments Doctor and dentist appointments should, wherever possible, take place outside normal working hours. If this is not possible, the employee should try to make an appointment at the start or end of their working day or at a time when the absence will have the least impact on the service. Employees should be given reasonable time off to attend such appointments. Managers reserve the right to request sight of appointment cards for any medical appointments made by employees during working hours. 9.12 Attending the Occupational Health Service A manager may refer an employee to Occupational Health in connection with their sickness absence. The manager should advise the employee of the referral and wherever possible the employee should sign the management referral form. The Occupational Health Practitioner may ask the employee for permission to approach their GP or other medical practitioner as appropriate in order to obtain more detailed information. If this is deemed necessary then a consent form will be sent to the employee to complete and return as soon as possible. The Occupational Health Practitioner will produce a report for the employee s manager. Please see section 11.4 for further information. The Occupational Health Service is a specialist and advisory service for all employees and managers in the Trust. The aim of the service is to enhance the health, safety and welfare of all employees in the Trust. The Occupational Health Service provides Human Resources and Managers with advice on employees fitness to work, identifies any adverse effects of the work on the employees health and advises on any necessary work/workplace adjustments. All individual occupational health records are confidential to the Occupational Health Service. Page 9 of 37

Where a referral to occupational health has been made, employees are expected to make all reasonable efforts to attend appointments. If scheduled appointments are inconvenient, employees are responsible for ensuring these are rearranged to a more suitable time and date. In accordance to assisting their recovery and return to work, the attendance at occupational health appointments is considered a reasonable management instruction. Repeated failure to attend occupational health appointments and refusal to cooperate in the management of their sickness absence may be construed as employee misconduct. 9.13 Medical Suspension In exceptional circumstances it may be necessary to medically suspend an employee, as they are unfit, on health grounds, to undertake the duties of their post. Advice must be sought from Occupational Health and Human Resources prior to medical suspension taking place. An employee who is medically suspended will continue to receive full pay. 9.14 Returning to Work Managers are required to meet with an employee on the employee s return to work following a period of sickness absence. This meeting should occur on the first day back to work or as soon as reasonably practicable. If it is not possible to meet the employee as soon as they return to work a return to work interview can take place over the phone in the first instance. The purpose of the return to work interview is to discuss the absence, identify any support that may be necessary to promote well-being and minimise future absences. Guidance and appropriate documentation to support return to work interviews is contained in Appendix 1. 9.15 Fast Track Service for Employees The Occupational Health Department provides a fast track service for Trust employees who live within the catchment area of the Trust. Employees who are off sick and who are either waiting to be referred or are waiting for treatment with a Consultant in the Trust may be fast tracked through the system, if deemed appropriate by an Occupational Health Practitioner. Occupational Health will seek confirmation from the specialist as to whether fast tracking is appropriate. Managers need to request this service by completing an Occupational Health Request for Fast Track Form see Appendix 4. 9.16 Staff Support during Sickness Absence Employee Assistance Programme (including free counselling service) The Employee Assistance Helpline is a confidential support service, providing practical information, legal advice, telephone and face-to-face counselling that can help employees cope with a variety of personal, family or workplace issues. The service is free and available to all Trust employees by telephoning 0800 328 1437. Further information regarding the counselling services is available from Occupational Health or the Trust Intranet: http://wghintra01/human_resources/staffsupport/documents/eah_leaflet.pdf Management of Stress Policy The Trust has an agreed Management of Stress Policy, which employees may wish to refer to. The policy can be found on the Trust Intranet: http://wghintra01/uploads/out/stress_policy_v2.pdf Trade Union Representatives If employees are members of a trade union or professional association they may wish to contact their representative for support. Page 10 of 37

Harassment Advisers The Trust has a number of Harassment Advisers who have been trained to support staff who feel that they may be suffering from bullying or harassment. Please see the intranet for further details. Well Being at Work Advisers The Trust has a number of employees who have volunteered as Well Being at Work Advisers. They are specially trained in the Managing Sickness Absence Policy and offer advice and support to employees managing a health condition in the workplace. They can offer employees confidential and impartial advice and support employees at meetings as appropriate. Contact details can be found on the intranet using the following link: http://wghintra01/human_resources/staffsupport/wbaw_advisor_scheme.htm Moving & Handling Service The Trust employs a Moving & Handling Manager who is available to: Accept referrals as appropriate from Occupational Health, managers and employees - please use the referral form in Appendix 6 Interview employees who are experiencing health problems relating to Musculoskeletal Disorders (MSDs) that can be exacerbated by or impact on their ability to carry out their work. Provide competent advice to managers regarding fitness to return to work, workplace and working practice adjustments, and support for the rehabilitation of staff. Refer to the flowchart in Appendix 5 on the Prevention of sickness absence relating to MSDs and The management of an employee whose ability to work has been affected as a result of MSDs. 9.17 Accrual of Benefits during Sick Leave Annual Leave Annual leave is accrued during all sickness absence. The leave is accrued as per the employee s contractual entitlement during periods of paid sick leave and based on statutory entitlement, as per the Working Time Directive, during episodes of unpaid sick leave. In the cases of long term sickness absence where an employee is prevented from taking annual leave during the leave year in which it has been accrued as their absence goes from one leave year into the next, they may carry over a maximum of 5.6 weeks annual leave into the new leave year (pro rata for part time staff). The annual leave accrued must be taken immediately following the period of sickness absence, prior to the employee returning to work. Annual leave cannot be replaced by a payment in lieu except where the employee s contract is terminated. Sickness absence cannot be broken to enable the employee to take their annual leave entitlement. Sick Pay The payment of salary during absence through sickness, injury or accident will be in accordance with national terms and conditions. Individual queries regarding sick pay entitlements should be made to the Payroll Department. The following entitlements apply: during the first year of service one month s full pay and two months half pay during the second year of service two months full pay and two months half pay during the third year of service four months full pay and four months half pay during the fourth and fifth years of service five months full pay and five months half pay after completing five years of service six months full pay and six months half pay Page 11 of 37

The payment of sick pay is dependant upon the correct reporting and certification of sickness as detailed above. Failure to comply with the conditions of this policy may lead to payments being withheld. Salary Increments Entitlements to receive salary increments are not affected by sickness absence. Parking Permits There is no entitlement to a refund for parking permits for employees on long term sick leave where they have not surrendered their permit at the start of the sickness absence. 9.18 Right to be Accompanied All employees have the right to be accompanied at any stage of the sickness absence procedure with the exception of the return to work interview. A trade union representative or colleague may accompany the employee. If you have any queries/concerns please contact the relevant HR manager to discuss further. 9.19 Right of Appeal Where an employee considers that they have been treated unfairly in respect of the management of their sickness absence they are entitled to raise the matter under the Trust s Grievance Procedure. An appeal against any sanction issued in accordance with this policy will be heard in line with the Appeal Stage of the Trust Grievance Procedure. Employees should indicate their wish to appeal against a sanction issued in accordance with this policy within 21 calendar days of receiving the letter confirming this by writing to the Director of Workforce at Watford General Hospital. 9.20 Process for Analysing Sickness Absence Data The Trust will monitor employee absence through the data collated by Payroll detailing when employees are absent from work due to sickness. Weekly returns detailing sickness absence dates and reasons for sickness will be sent from each department to Payroll for inputting onto the Electronic Staff Record. This information is used to provide Workforce Reports, which will be analysed monthly by the Trust Workforce Analyst and forwarded to Divisional Managers, HR Managers and HR Advisers. This information will include overall sickness rates, a list of staff currently on long-term sickness, staff with a Bradford Absence Score of over 300 and a complete listing of staff absences over the last 12 months. The information will then be reviewed by the relevant HR Advisers and HR Managers in conjunction with relevant divisional managers on a monthly basis and used to initiate application of the procedure where necessary. Previous analysis of reasons for absence shows that the two main reasons for sickness absence are stress and musculo-skeletal reasons (MSD). An analysis of this information will also be forwarded to the Occupational Health Manager and Moving and Handling Manager with illnesses associated with stress and musculo-skeletal injuries highlighted in order to assist prompt intervention in these areas. 9.21 Arrangements for Organisational Overview of Sickness Absence A complete summary of the Trust s sickness absence data will be forwarded to Divisional Managers on a monthly basis. Page 12 of 37

Workforce information including sickness absence date is included in the Performance Report which goes to the Trust Board at each meeting. 9.22 Dissemination and Implementation of the Policy This policy will be communicated to all staff at local induction and via the staff intranet, communication through team briefs, managerial and departmental meetings. 9.23 Process for Monitoring Compliance and Effectiveness The HR Advisers will maintain a database for each Division detailing a monthly rolling summary of actions taken for members of staff, as a result of the sickness analysis. This will be reviewed with the HR Managers and HR Advisers on a monthly basis to ensure all staff are being managed in accordance with the policy. A summary of the actions being taken with all staff currently on long-term sickness and with the staff with the highest Bradford absence scores in each Division will be reported in HR reports that are subsequently reviewed at monthly meetings between Divisional Management Teams and members of the Executive Team. 9.24 Review of This Procedure This policy is expected to be reviewed within 3 years but if this is deemed unnecessary the policy will remain in force until such time as it is reviewed. Page 13 of 37

10. MANAGEMENT OF SHORT TERM SICKNESS ABSENCE For medical staff, please also refer to section 5 of the Maintaining High Professional Standards in the NHS Medical and Dental Staff Disciplinary Policy. 10.1 Definition of Short-Term Absence Short-term sickness absence is defined as: multiple periods of absence totalling 10 calendar days or more in a rolling year or 4 separate episodes within a rolling year, where an episode is defined as any period of absence lasting one day or more. This includes episodes of long term sickness This policy may also be instigated and applied in circumstances where employees demonstrate a recognisable pattern of short-term sickness absences over a period of 2 years. 10.2 Return to Work Interview Managers (or a nominated deputy) are required to meet with an employee on the employee s return to work following any period of sickness absence. This should be conducted in line with the return to work guidelines in Appendix 1. The manager must also complete the return to work interview form, which should be countersigned by the employee, also found in appendix 1. Where persistent absence has occurred, managers should discuss this with employees during the return to work interview and explain to the employee that should they exceed the trigger points this could result in a referral to Occupational Health and will result in initiation of the formal procedure. For the purposes of this policy, the manager will be the line manager of the employee, thus the Consultant for Junior Doctors and the Clinical Director for Consultants. 10.3 Formal Procedure A representative from Human Resources will be present at each of the review meetings. 10.4 Recommended Timescales During each of the formal stages, all employees will be given a reasonable period of time in which to demonstrate an improvement in their attendance following concerns being raised about their sickness absence record. The timescale for review will be at the manager s discretion. This should be between six weeks and three months. Review periods will be defined in accordance with the frequency, duration, occurrence, and pattern of absence elicited by the employee. 10.5 Failure to Attend the 2 nd, 3 rd and 4 th Review Meetings When an employee is notified of the date of a review meeting, they will be required to confirm their attendance and who will be accompanying them. If the employee confirms with good reason that they are unable to attend on the date set for the review meeting, an alternative date will be convened. This will be arranged in conjunction with the employee, taking into account the employee and their representative s availability. If, in exceptional circumstances, the employee is unable to attend the meeting within a month of the time set and agreed between the parties, it may proceed in their absence. Page 14 of 37

If the employee fails to confirm their attendance and subsequently does not attend the review meeting, a decision may be taken to continue with the meeting in the employee s absence and the full range of sanctions can still be applied based on the information available. Stage 1 First Review Meeting When an employee surpasses one of the trigger points as identified in Section 10.1 above the manager should convene a review meeting with the employee. The purpose of the first review meeting is to discuss the employee s recent sickness and to explore ways in which to support the employee to improve their attendance in future. The meeting will provide an opportunity for: the manager to advise the employee of the concern regarding their level of absence the employee to identify any underlying cause for the absence the manager to provide assistance to alleviate any problems identified wherever possible the manager to advise the employee of the standard by which further absences will be measured during the review period the manager to consider a referral to Occupational Health the manager to set a review date Stage 2 Second Review Meeting The purpose of the second review meeting is to review the employee s attendance during the first review period and to agree an appropriate way forward. This meeting will provide an opportunity for: the employee to identify any further problems which might be contributing to their level of absence the manager to provide assistance to alleviate any problems identified wherever possible the manager to review information obtained from occupational health as appropriate or to consider if a referral to occupational health is now required the manager to consider whether there has been an adequate improvement in the employee s attendance Following a brief adjournment, the manager will make a decision supported by HR regarding any further action to be taken. Where there has been improvement in the employee s attendance, the manager may decide to extend the monitoring period or end the formal process at this stage. Where there have been further absences during the review period, and no satisfactory explanation given, the manager may decide to issue a first written warning (valid for 12 months). In this case, the manager must notify the employee of their right of appeal against the warning. The employee must be advised of the standard by which further absences will be measured during the next review period and the consequences of failing to achieve an improved attendance record. Warnings should not be issued if an employee only has an episode of long term sickness during the review period. Stage 3 Third Review Meeting The purpose of the third review meeting is to review the employee s attendance during the second review period and to agree an appropriate way forward. This meeting will provide an opportunity for: the employee to identify any further problems which might be contributing to their level of absence Page 15 of 37

the manager to provide assistance to alleviate any problems identified wherever possible the manager to review information obtained from occupational health as appropriate the manager to consider whether there has been an adequate improvement in the employee s attendance Following a brief adjournment, the manager will make a decision supported by HR regarding any further action to be taken. Where there has been improvement in the employee s attendance, the manager may decide to extend the monitoring period or end the formal process at this stage. Where there have been further absences during the review period, and no satisfactory explanation given, the manager may decide to issue a final written warning (valid for 18 months). In this case, the manager must notify the employee of their right of appeal against the warning. The employee must be advised of the standard by which further absences will be measured during the next review period and the consequences of failing to achieve an improved attendance record, which may include termination of their contract. A further review meeting should be convened within 3 months where a warning is issued. At this point consideration will need to be given as to whether to refer to a Stage 4 Final Review Meeting. If there has been no further sickness, it may be appropriate to continue monitoring. If there has been further sickness, at this point, the manager must refer the employee to be seen by the Occupational Health Physician before a stage 4 meeting can be held. Stage 4 Final Review Meeting A manager one level removed from the employee must conduct this review meeting, supported by a representative from Human Resources. The employee s immediate line manager should attend the final review meeting to present details of the employee s sickness history. The purpose of the final review meeting is for the senior manager to review the employee s attendance record during the review period, taking into account the content of the feedback from Occupational Health. Where there has been improvement in the employee s attendance, the manager may decide to extend the monitoring period or end the formal process at this stage. If the absence levels remain unacceptable: the employee should provide details of any mitigating circumstances to explain their unacceptable levels of absence the senior manager to dismiss the employee of grounds of incapability due to ill health if insufficient mitigating circumstances are put forward by the employee the senior manager to advise the employee of their right of appeal against their dismissal Dismissal on the grounds of incapability due to ill health for persistent short-term sickness A senior manager will be responsible for making the decision to dismiss an employee for persistent short-term sickness following due consideration of the case at a final review meeting. The dismissal on the grounds of incapability due to ill health will normally take immediate effect and the employee will paid in lieu of notice. The employee will also receive payment in lieu of any annual leave due. Page 16 of 37

The decision to dismiss an employee on the grounds of ill health will be confirmed in writing to the employee within 7 working days of the final review meeting taking place and the decision being made. The employee must be informed of their right of appeal against the dismissal. 10.6 Appeals Procedure An appeal against any sanction issued in accordance with this policy will be heard in accordance with the Appeal Stage of the Trust Grievance Procedure http://wghintra01/uploads/out/grievance_policy_ratified_feb11.pdf The employee should put their reason for appeal in writing to the Director of Workforce within 21 calendar days of receiving the letter confirming the sanction. 10.7 Occupational Health Referral A referral to Occupational Health can be considered at any stage of the managing short-term sickness absence procedure. A referral to the Occupational Health Physician must be made prior to proceeding to Stage 4 of the procedure. 10.8 Alternative Actions During the review meetings the manager can recommend alternative measures to assist in improving sickness levels i.e. changing shift patterns or making adjustments to duties. 10.9 Restriction of NHSP or Overtime Work Following Persistent Short-Term Sickness Absence A decision to restrict the employee from working shifts with NHSP or overtime for a period should take into consideration the regularity with which the employee is absent from working their contracted shifts due to sickness, the nature of the illness, the regularity of the employee s commitment to working bank or overtime and the impact of the restriction on running the service. During the review meetings the manager can decide to restrict the employee from working with NHSP or overtime shifts for a defined period of up to one month following each episode of sickness absence. Advice may be sought by Occupational Health prior to holding the review meeting as appropriate. 10.10 Monitoring of Sickness Absence If there has been a significant and sustained improvement in an employee s sickness absence the manager is able to conclude the sickness absence review process. However, if at any time in the future the sickness absence levels deteriorate the review meetings should be reinstated. If the employee still has a current warning on file, the manager should resume proceedings at the stage where the warning was issued. If there is no current warning on file, the manager should instigate a new review process at Stage 1. Where the sickness absence review process has previously been concluded at Stage 4 and there is a requirement to go back to Stage 4, the employee should be referred back to the Occupational Health Physician prior to the meeting taking place. Page 17 of 37

11. MANAGEMENT OF LONG-TERM SICKNESS ABSENCE It is recognised that employees may be on long-term sick leave for a variety of reasons e.g. injury, medical condition, convalescence or a long-term disability. Each case will be considered individually, assessed sensitively and with fairness. The manager, Occupational Health and Human Resources will explore the reasons for the absence to ascertain what action to take. For medical staff, please also refer to section 5 of the Maintaining High Professional Standards in the NHS Medical and Dental Staff Disciplinary Policy. 11.1 Definition Long-term sickness absence is defined as a period of continuous sickness absence in excess of 3 weeks. 11.2 Maintaining Regular Contact Where an employee is absent due to long-term sickness, regular appropriate contact between the manager and employee is required. The manager and employee should agree at the outset the manner in which contact will be maintained. As a minimum contact should be at least fortnightly. Employees should take responsibility for contacting their manager upon any changes in circumstances or receipt of information that may affect the duration of their sickness absence, and advise as to any potential return to work timescale. 11.3 Absences Anticipated To Last Less Than Six Weeks Where the approximate period of absence is known in advance and is expected to be no more than six weeks e.g. as a result of an operation, the manager should refer the employee to Occupational Health prior to the employee s return wherever possible. The purpose of the referral is to ensure that the employee is fit to return to work, to advise whether a phased return to work is required or whether any adjustments to hours/duties are necessary. 11.4 Occupational Health Referrals If, following an absence in excess of 3 weeks, a date for return to work cannot be established, the manager should refer the employee to Occupational Health. An Occupational Health Practitioner will then contact the employee to arrange to see them or agree an alternative course of action if they are unfit to attend an Occupational Health appointment. The Occupational Health Practitioner may ask the employee for permission to approach their GP or other medical practitioner as appropriate in order to obtain more detailed information. If this is deemed necessary then a consent form will be sent to the employee to complete and return as soon as possible. The Occupational Health Practitioner will produce a report for the employee s manager. The report will inform the manager which of the following options apply: it is not yet possible to determine whether or when the employee will be able to return to work the employee will be unable to return to their current job in the foreseeable future the employee will be able to return to work in the foreseeable future if short-term adjustments are made to their duties/hours or on a phased return the employee has a medical condition or disability and would be able to return if long-term or permanent adjustments were made to the workplace / hours / duties of the post the employee will be able to return to work if redeployed into an alternative post the likelihood of a successful ill-health retirement application Page 18 of 37

11.5 Case Conferences During an employee s absence it may be helpful to convene a case conference between the employee, their representative, the manager, Human Resources and Occupational Health. The purpose of the conference is to enable all parties to openly discuss the management of the employee s sickness absence and to agree a way forward. Case conferences should be considered as early as possible in order to support the employee and aid a return to work. 11.6 Review Meetings Employees will be required to attend meetings when necessary with their manager and Human Resources during periods of long-term sickness absence, taking into account the reason for the absence. If an employee is unable to attend Trust premises for such a meeting, or would prefer for the meeting to be at their home, a home visit can be arranged or an alternative mutually convenient location. The purpose of review meetings is for: the employee to provide information on the progress of recovery, details of any other factors which may affect recovery and/or return to work and a possible date for return to duty the manager to offer help and support which could be given to the employee to assist the individual to return to work the manager to discuss feedback from occupational health with the employee This will include exploration of all available employment options including return to existing job with or without adjustments, a phased return to work, redeployment to an alternative post or ill health retirement 11.7 Formal Sickness Hearing A formal sickness hearing should be convened in the following circumstances: where there is an indication that the employee is unlikely to be fit to return to work in short to medium term future where the employee s period of absence is approaching 12 months multiple episodes of long term sickness absence within a 2 year period where medical advice is received that restricts an employee s ability to carry out less than 70% of their role as detailed in the job description where an employee is at work but for health reasons has to be permanently redeployed and nothing suitable is found within the 12 week redeployment period where the employee is fit to work but not in their substantive post, redeployment has been recommended but nothing suitable has been found A manager one level removed from the employee must conduct the hearing, supported by a representative from Human Resources. The employee s immediate line manager should attend the formal sickness hearing to present details of the employee s sickness history. The purpose of the formal sickness hearing is for the senior manager to review the employee s absence, taking into account the content of the feedback from Occupational Health and make a decision on the way forward with regards to their employment. If a formal sickness hearing has not taken place after 12 months of continuous sickness absence, sick pay for employees who have exhausted sick pay entitlements will have their pay reinstated at half pay. This only applies to staff on Agenda for Change Terms & Conditions. The reinstatement of sick pay will continue until the formal sickness hearing has taken place. Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence. These arrangements will only apply where the failure to Page 19 of 37

undertake the final review meeting is due to delay by the Trust. This provision will not apply where the employee delays the formal sickness hearing. 11.8 Managing Employees with Repeated Episodes of Long Term Sickness Absence Where employees have multiple episodes of long term sickness absence within a 2 year period, the employee should be referred to Occupational Health for advice on their fitness to undertake their role on an ongoing basis. It may then be appropriate to convene a formal sickness hearing to review the employee s sickness absence history and make a decision on the most appropriate way forward. 11.9 Options to Consider for Employees When Returning to Work Phased Return to Work There may be occasions when employees who have been off on long-term sickness, would benefit from returning to work, for a short period, on reduced hours. There is an expectation that the hours worked will gradually increase each week during the phased return. In this situation Occupational Health will provide the manager with recommendations relating to the phased return in their advisory report. During the phased return employees will be paid full pay. Phased returns will not normally last longer than four weeks; although in exceptional circumstances this may be extended, in accordance with Occupational Health recommendations, depending upon the length of sickness absence experienced and individual requirements of the employee. If Occupational Health were to recommend a phased return that continues beyond six weeks consideration may be given to a permanent reduction in contractual hours. The implementation of a phased return is unlikely to be necessary or appropriate for all employees returning from long-term sickness absence, and the duration of the return will be at the manager s discretion. For individuals returning from shorter periods of absence it may be recommended that only a one or two-week phased return is necessary. Return to Work with Adjustments Occupational Health may advise that the employee is fit to return to work with adjustments to either their duties or hours of work, or with the aid of equipment. The recommendations will be sent to the manager and Human Resources. The employee will be required to attend a meeting with their manager and Human Resources to discuss the recommendations made by Occupational Health. Consideration may also be given as to whether it is possible for an employee to work from home for a temporary period without loss of pay. If an employee is to work from home an appropriate risk assessment should be carried out please refer to the Home-working Guidelines for further information in this regard. Redeployment Temporary redeployment due to sickness There may be some occasions whereby Occupational Health reviews the employee on longterm sickness and recommend that they need to be temporarily redeployed to an alternative post. In these instances consideration will initially be given to employee performing a different role within their department for an agreed period. For example a nurse with a broken ankle might be redeployed to undertake administrative duties on the ward whilst they recuperate. Where it is not possible to offer temporary redeployment to the employee within their ward / department, every effort will be made to try and find alternative temporary employment to a suitable post with the support of the HR Representative. Page 20 of 37