NHS Circulr: PCS(AFC)2008/2 The Scottish Government Helth Workforce Directorte Employment nd Retention Division bcdefghijklmnopqrstu Der Collegue MANAGING SICKNESS ABSENCE Summry 1. This py circulr informs employers bout greed chnges to Section 14 of the NHS Terms nd Conditions of Service Hndbook nd introduces supporting Annex which provides n outline frmework to support the mngement of sickness bsence. 2. The mngement of sickness bsence within the NHS is chllenging, but provides opportunities to improve overll helth nd wellbeing in the workplce, which will ultimtely boost orgnistionl productivity nd support service improvements for ptients. The chnges greed re complementry to the work round Working Well nd OHSxtr being tken forwrd in Scotlnd in conjunction with the Scottish Workforce nd Governnce Committee (SWAG), nd this work will continue. 3. The chnges to Section 14 of the Hndbook nd the introduction of the supporting Annex hve been tken forwrd on UK-wide bsis nd greed by the UK NHS Stff Council. They ensure tht loclly greed procedures llow for series of reviews to be crried out to ssess nd monitor stff when they re off sick. All necessry review nd decision dtes should be set out in light of n individul s sick py entitlements, ensuring stff re promptly reviewed before their sick py ends. For those members of stff on long term bsence this would culminte in finl review where decision on the pproprite wy forwrd is mde. 4. This greement lso encourges employers to identify pproprite wys of supporting stff to remin in work or return to work t the erliest opportunity through erly intervention so tht ny pproprite tretment cn be considered. 9 My 2008 Addresses For ction Chirs, NHS Bords nd Specil Helth Bords nd NHS Ntionl Services Scotlnd (Common Services Agency) Chief Executives, NHS Bords nd Specil Helth Bords nd NHS Ntionl Services Scotlnd (Common Services Agency) Directors of Finnce, NHS Bords nd Specil Helth Bords nd NHS Ntionl Services Scotlnd (Common Services Agency) Directors of Humn Resources, NHS Bords nd Specil Helth Bords nd NHS Ntionl Services Scotlnd (Common Services Agency) For informtion Members, Scottish Prtnership Forum Members, Scottish Terms nd Conditions Committee Members, Scottish Workforce nd Governnce Committee Enquiries to: Mr Colin Cowie Scottish Government Helth Directortes Helth Workforce Ground Floor Rer St Andrew s House EDINBURGH EH1 3DG Tel: 0131-244 3778 Fx: 0131-244 2837 E-mil: Colin.cowie@scotlnd.gsi.gov.uk
NHS Circulr: PCS(AFC)2008/2 5. In recognition of the need for stff nd employers to work together to effectively mnge sickness bsence the supporting Annex sets out the key responsibilities of both prties. Underpinning this rrngement is the need to foster robust communiction protocols for both stff nd employers. 6. Attched to this circulr is n Appendix listing the chnges to the Agend for Chnge Terms nd Conditions flowing from this greement. Revised sections contining these mendments re lso ttched for ese of reference. Cbinet Secretry pprovl 7. Employers should implement this circulr, which hs been pproved by the Cbinet Secretry under regultions 2 nd 3 of the Ntionl Helth Service (Remunertion nd Conditions of Service) (Scotlnd) Regultions 1991 (S.I. 1991/537). A copy of the forml pprovl is ttched. Action 8. Employers should consider the new rrngements set out in 14.9 in respect of ny stff who re currently on long term sickness bsence nd hve exhusted their sick py entitlements. 9. Employers should note the discretions set out in 14.10 to reinstte member of stff s period of sick py beyond the scle set out in 14.2. 10. Employers should note tht reference should be mde to the pyment of NHS Temporry Injury Allownce in 14.17 for stff who suffer from workplce injury or disese. 11. Employers should consider the requirement to mend their locl rrngements for the mngement of sickness bsence, in prtnership with locl stff side representtives, to ensure consistency with the minimum stndrds set out in the supporting Annex Z. 12. The new rrngements pply to ll stff on Agend for Chnge terms nd conditions. Its ppliction to other stff groups will be considered seprtely by the pproprite joint negotiting committees. 13. Employers should mke their own rrngements for obtining dditionl copies of this circulr, which cn be viewed t: www.show.scot.nhs.uk/sehd/publictions.sp Yours sincerely COLIN MCGOWAN Acting Deputy Director for Helth Workforce Employment nd Retention
NHS Circulr: PCS(AFC)2008/2 The Scottish Government Helth Workforce Directorte Employment nd Retention Division bcdefghijklmnopqrstu NATIONAL HEALTH SERVICE APPROVAL OF REMUNERATION AND CONDITIONS OF SERVICE In ccordnce with regultions 2 nd 3 of the Ntionl Helth Service (Remunertion nd Conditions of Service) (Scotlnd) Regultions 1991 (S.I. 1991/537) the remunertion nd conditions of service set out in the ttched Scottish Government Helth Workforce Directorte circulr of 9 My 2008 PCS(AFC)2008/2 in respect of Mnging Sickness Absence re hereby pproved for the purposes of the sid Regultions. ELINOR MITCHELL Deputy Director for Helth Workforce Scottish Government Helth Directortes St Andrew s House EDINBURGH EH1 3DG 9 My 2008
APPENDIX NHS Circulr: PCS(AFC)2008/2 Chnges to the Agend for Chnge NHS Terms nd Conditions of Service Hndbook Section 14: Sickness Absence hs been revised. The old Section 14 should be destroyed s it is now redundnt nd replced by the new version. Annex Z: Mngement of sickness bsence hs been dded to the Terms nd Conditions. Specific Chnges to Section 14 1. The following words re dded to the existing prgrph 14.1: This section is supplemented by Annex Z which sets out frmework to support employers nd stff in the mngement of sickness bsence nd mnge the risk of premture nd unnecessry ill helth retirements. 2. The following words re dded to the existing 3rd bullet point prgrph 14.6: (Englnd nd Wles), the Criminl Injuries Compenstion Authority (Scotlnd) nd the Compenstion Agency (Northern Irelnd). 3. The existing prgrph 14.9 is replced by the following words: Sick py for those who hve exhusted sick py entitlements should be reinstted t hlf py, fter 12 months of continuous sickness bsence, in the following circumstnces: stff with more thn 5 yers reckonble service - sick py will be reinstted if sick py entitlement is exhusted before finl review meeting for long term bsence hs tken plce. stff with less thn 5 yers reckonble service - sick py will be reinstted if sick py entitlement is exhusted nd finl review does not tke plce within 12 months of the strt of their sickness bsence. Reinsttement of sick py should continue until the finl review meeting hs tken plce. Reinsttement of sick py is not retrospective for ny period of zero py in the preceding 12 months of continuous bsence. These rrngements will be in ccordnce with locl sickness bsence procedures estblished in ccordnce with Annex Z nd will only pply where the filure to undertke the finl review meeting is due to dely by the employer. This provision will not pply where review is delyed due to resons other thn those cused by the employer.
NHS Circulr: PCS(AFC)2008/2 4. A new prgrph hs been inserted t 14.10 with the following words: Employers will hve discretion to reinstte member of stff s period of sick py beyond the scle set out in 14.2 where there is the expecttion of return to work in the short term nd n extension would mterilly support return nd or ssist recovery. Prticulr considertion should be given to those stff without full sick py entitlements. in ny other circumstnce tht the employer deems resonble. 5. Existing prgrph 14.10 hs been moved to 14.11 nd replced with the following words: During the rehbilittion period employers should llow employees to return to work on reduced hours or, where possible, be encourged to work from home without loss of py. Any such rrngements need to be consistent with sttutory sick py rules. 6. Existing prgrphs 14.11 to 14.15 become prgrphs 14.12 to 14.16 7. A new prgrph hs been inserted t 14.17 with the following words Pyment of NHS Temporry Injury Allownce for workplce injuries or disese should be in ccordnce with the NHS Injury Benefit Scheme regultions.
Contents CONTENTS Prt 1 Principles nd prtnership Prt 2 Section 1 Section 2 Section 3 Section 4 Section 5 Section 6 Section 7 Sections 8 9 Py Py structure Mintining round the clock services Overtime pyments Py in high cost res Recruitment nd retention premi Creer nd py progression Pyment of nnul slries (Unllocted) Prt 3 Section 10 Terms nd conditions of service Hours of the working week Section 11 Section 12 Section 13 Section 14 Section 15 Section 16 Prt-time employees nd employees on fixed-term contrcts Contrctul continuity of service Annul leve nd generl public holidys Sickness bsence Mternity leve nd py Redundncy py As mended by PCS(AFC)2008/2
Contents Section 17 Section 18 Section 19 Milege llownces Subsistence llownces Other terms nd conditions Sections 20 24 (Unllocted) Prt 4 Section 25 Section 26 Section 27 Employee reltions Fcilities for stff orgnistions Joint consulttion mchinery Working time regultions Sections 28 29 (Unllocted) Prt 5 Section 30 Section 31 Section 32 Section 33 Section 34 Section 35 Section 36 Equl opportunities Generl sttement on equlity nd diversity Recruitment, promotion nd stff development Dignity t work Cring for children nd dults Flexible working rrngements Blncing work nd personl life Employment brek scheme Sections 37 39 (Unllocted) Prt 6 Section 40 Operting the system New bodies nd procedures As mended by PCS(AFC)2008/2
Contents Sections 41 45 (Unllocted) Prt 7 Section 46 Section 47 Trnsitionl rrngements Assimiltion nd protection Monitoring, reviews nd ppels Annexes Annex A NHS employers Annex B Py bnds nd py points 2004; 2005 nd 2006 Annex C Py bnds nd py points 2007 Annex D Annex E Annex F Annex G Annex H Annex I Annex J Annex K Annex L Annex M Annex N Working or providing emergency cover outside norml hours Provisions for unsocil hours pyments for mbulnce stff nd vilble to erly implementer sites Exmples of specil cses under the provisions for work outside norml hours Good prctice guidnce on mnging working ptterns High cost re pyment zones High cost re supplements Locl recruitment nd retention premium criteri Additionl freedoms for trusts with erned utonomy Milege llownces Lese cr policies Subsistence llownces As mended by PCS(AFC)2008/2
Contents Annex O Annex P Other terms nd conditions Coverge of Nurses nd Other Helth Professions Review Body Implementtion nnexes Annex Q Annex R Annex S Annex T Annex U Annex V Annex W Annex X Annex Y Annex Z Clssifiction of leds nd llownces (listed by stff group) Guidnce on the ppliction of ntionl recruitment nd retention premi Locl ppels procedures Development of professionl roles Arrngements for py nd bnding of trinees NHSScotlnd: Prtnership Informtion Network guidelines Support for professionl fees for stff in bnds 5 to 8A (Englnd only) Working or providing emergency cover outside norml hours Christms nd New Yer holidys t weekends Mnging sickness bsence developing locl policies nd procedures As mended by PCS(AFC)2008/2
Prt 3: Terms nd Conditions Section 14: Sickness Absence SECTION 14 SICKNESS ABSENCE 14.1 These rrngements re intended to supplement sttutory sick py to provide dditionl pyment during bsence due to illness, injury or other disbility. This section is supplemented by Annex Z which sets out frmework to support employers nd stff in the mngement of sickness bsence nd mnge the risk of premture nd unnecessry ill helth retirements. Scle of llownces 14.2 Employees bsent from work owing to illness will be entitled, subject to the conditions of this greement, to receive sick py in ccordnce with the scle below (see Section 12 for provisions governing reckonble service): during the first yer of service one month s full py nd two months hlf py during the second yer of service two months full py nd two months hlf py during the third yer of service four months full py nd four months hlf py during the fourth nd fifth yers of service five months full py nd five months hlf py fter completing five yers of service six months full py nd six months hlf py. 14.3 In the event of employment coming to n end, entitlement to sick py ceses from the lst dy of employment. 14.4 The definition of full py will include regulrly pid supplements, including ny recruitment nd retention premi, pyments for work outside norml hours nd high cost re supplements. Sick py is clculted on the bsis of wht the individul would hve received hd he/she been t work. This would be bsed on the previous three months t work or ny other reference period tht my be loclly greed. Locl prtnerships cn use virtul rots showing wht hours the employee would hve worked in reference period hd he or she been t work. 14.5 Full py needs to be inclusive of ny sttutory benefits (so s not to mke sick py greter thn norml working py). The combined ddition of sttutory sick py to hlf py must not exceed full py. Clcultion of llownces 14.6 The period during which sick py should be pid nd the rte of sick py for ny period of bsence is clculted by deducting from the employee s entitlement on the first dy of sickness the ggregte periods of pid sickness bsence during As mended by PCS(AFC)2008/2
Prt 3: Terms nd Conditions Section 14: Sickness Absence the 12 months immeditely preceding tht dy. In ggregting periods of bsence due to illness no ccount will be tken of: unpid sick bsence; injuries or diseses sustined to members of stff in the ctul dischrge of their duties through no fult of their own; injury resulting from crime of violence not sustined on duty but connected with or rising from the employee s employment where the injury hs been the subject of pyment by the Criminl Injuries Compenstion Bord (Englnd nd Wles), the Criminl Injuries Compenstion Authority (Scotlnd) nd the Compenstion Agency (Northern Irelnd); s bove, but n injury which hs not been the subject of pyment by the Bord on grounds tht it hs not given rise to more thn three weeks loss of ernings or ws not one for which compenstion bove the minimum would rise. 14.7 Sick py pid to n employee under this scheme when dded to ny sttutory sickness, injuries or compenstion benefits, including ny llownces for dult or child dependnts, must not exceed full py (see prgrph 14.4 bove). Conditions for contrctul sick py 14.8 Employees will not be entitled to n dditionl dy off if sick on sttutory holidy. 14.9 Sick py for those who hve exhusted sick py entitlements should be reinstted t hlf py, fter 12 months of continuous sickness bsence, in the following circumstnces: stff with more thn 5 yers reckonble service - sick py will be reinstted if sick py entitlement is exhusted before finl review meeting for long term bsence hs tken plce. stff with less thn 5 yers reckonble service - sick py will be reinstted if sick py entitlement is exhusted nd finl review does not tke plce within 12 months of the strt of their sickness bsence. Reinsttement of sick py should continue until the finl review meeting hs tken plce. Reinsttement of sick py is not retrospective for ny period of zero py in the preceding 12 months of continuous bsence. These rrngements will be in ccordnce with locl sickness bsence procedures estblished in ccordnce with Annex Z nd will only pply where the filure to undertke the finl review meeting is due to dely by the employer. This provision will not pply where review is delyed due to resons other thn those cused by the employer. As mended by PCS(AFC)2008/2
Prt 3: Terms nd Conditions Section 14: Sickness Absence 14.10 Employers will lso hve discretion to extend the period of sick py on full or hlf py beyond the scle set out in 14.2 where there is the expecttion of return to work in the short term nd n extension would mterilly support return nd or ssist recovery. Prticulr considertion should be given to those stff without full sick py entitlements. In ny other circumstnce tht the employer deems resonble 14.11 During the rehbilittion period employers should llow employees to return to work on reduced hours or, where possible, be encourged to work from home without loss of py. Any such rrngements need to be consistent with sttutory sick py rules 14.12 Sick py is not normlly pyble for n bsence cused by n ccident due to ctive prticiption in sport s profession, or where contributble negligence is proved. 14.13 An employee who is bsent s result of n ccident is not entitled to sick py if dmges re received from third prty. Employers will dvnce to n employee sum not exceeding the mount of sick py pyble under this scheme providing the employee repys the full mount of sickness llownce to the employer when dmges re received. Once received the bsence shll not be tken into ccount for the purposes of the scle set out in prgrph 14.2 bove. 14.14 Employers my t ny time require n employee bsent from work due to illness to ttend n exmintion by medicl prctitioner. Furthermore, stff do not need to be off sick to be referred by their employer for medicl. The employer will meet the cost of ny medicl exmintion. 14.15 After investigtion, consulttion nd considertion of other lterntive posts, nd where there is no resonble prospect of the employee returning to work, employers will hve the option to terminte employment before the employee hs reched the end of the contrctul pid sick bsence period, subject to the employers greed sickness bsence policies nd procedures. 14.16 Notifiction procedures nd pyment of sick bsence py when injuries re connected with other insured employment will be for locl determintion. 14.17 Pyment of NHS Temporry Injury Allownce for workplce injuries or disese should be in ccordnce with the NHS Injury Benefit Scheme regultions. As mended by PCS(AFC)2008/2
Annexes Annex Z: Sickness Absence ANNEX Z MANAGING SICKNESS ABSENCE DEVELOPING LOCAL POLICIES AND PROCEDURES The mngement of ill helth within the NHS is chllenging, but provides opportunities to improve the overll helth nd wellbeing in the workplce, which will ultimtely boost orgnistionl productivity nd support service improvements for ptients. The rrngements set out in this nnex re intended to support employers nd stff in the mngement of sickness bsence nd in mnging the risk of premture nd unnecessry ill helth retirements. It is intended tht employers will mend, in prtnership with locl stff sides, their locl policies nd procedures consistent with the provisions of this greement. This greement detils the responsibilities of both stff nd employers in the mngement of ill helth in the NHS. This nnex should be red in conjunction with: Section 14 Section 30 Section 32 Section 34 Sickness Absence Generl sttement on Equlity nd Diversity Dignity t Work Flexible working rrngements Locl sickness bsence procedures Effective prtnership working is crucil in chieving the effective mngement of sickness bsences. Employers therefore, in prtnership with locl stff side representtives, should ensure tht their locl sickness bsence procedure nd working rrngements incorporte the minimum stndrds set out below to minimise the risk of premture nd unnecessry ill helth retirements. This will ensure tht, where possible, stff re ble to continue working despite experiencing periods of ill helth or disbility. legl responsibilities including mutul responsibilities of employers nd stff to comply with helth nd sfety requirements, reporting of injuries nd dngerous occurrences (RIDDOR), disbility discrimintion nd other relevnt legisltion. key employer responsibilities; employers re expected to: communicte ppropritely with bsent stff mnge bsences under the loclly greed sickness bsence procedure provide support nd dvice through the use of occuptionl helth services where pproprite develop reporting rrngements, recognising tht high levels of sickness bsence re finncil risk to the orgnistion hve pproprite mngement systems in plce to collect good qulity dt on sickness bsence. in prtnership with Trde Union representtives, regulrly monitor nd review rrngements to identify where nd how policies cn be improved. As mended by PCS(AFC)2008/2
Annexes Annex Z: Sickness Absence key employee responsibilities; employees re expected to: ensure regulr ttendnce t work communicte ppropritely with employer when bsent from work co-operte fully in the use of the loclly greed sickness bsence procedures Prtnership rrngements should lso ensure the regulr monitoring nd review of locl policies nd procedures is undertken, to identify where nd how policies cn be improved. The key elements of locl procedure will include: A structured review process Regulr reviews should be crried out to ssess nd monitor stff when they re off sick, nd determine wht ction is needed t ech stge. Where member of stff is unlikely to return to work this would culminte in finl review where decision on the pproprite wy forwrd is mde i.e. return to substntive employment/redeployment/termintion of contrct. It is ssumed tht s prt of this process tht resonble djustments hve been considered. Medicl evidence should be mde vilble to support the review process nd occuptionl helth dvice should be sought on the likelihood of: the prospects of likely return to the previous employment with or without djustments phsed return with or without need for djustments redeployment successful ill helth retirement ppliction. Erly interventions In order to void premture nd unnecessry ill helth retirements employers should lso consider the following interventions s erly s is prcticlly possible nd t the ltest within one month of n employee going sick: Rehbilittion identifying pproprite wys of supporting stff to remin in work or return to work t the erliest opportunity through intervention with pproprite tretment. This will men providing stff with direct ccess through pproprite dedicted resources, such s physiotherpy nd cognitive behviourl therpy. Phsed return - enbling stff to work towrds fulfilling ll their duties nd responsibilities within defined nd pproprite time period, through interim flexible working rrngements whilst receiving their norml py. Redeployment - enbling the retention of stff unble to do their own job through ill helth or injury s n lterntive to ill helth retirement or termintion. Stff should be mde wre of the provisions within the NHS Pension scheme to ssist this process through step down nd wind down rrngements. As mended by PCS(AFC)2008/2
Annexes Annex Z: Sickness Absence Sick py entitlements review nd decision dtes should be determined tking ccount of the individul s sick py entitlements nd there should be review before their sick py ends. Procedures should mke reference to the NHS Injury Benefit Scheme nd in prticulr the circumstnces when NHS Temporry Injury Allownce should be pid. Occuptionl helth support Occuptionl helth services hve responsibility to provide dvice nd support to both the individul nd the employer. Line mngers should seek dvice on long term sickness cses from their occuptionl helth service s erly s resonbly prcticl. Individuls my lso self-refer for dvice nd support bout the best wy of seeking return to work. Termintion Where termintion of the contrct of employment on the grounds of incpcity is considered, ll resonble efforts should be mde to obtin pproprite medicl evidence vi the occuptionl helth service, including occuptionl helth dvice on the likely outcome of successful ill helth retirement ppliction. Before decision to terminte is mde ll other options should meningfully be considered, including: Rehbilittion Phsed return A return to work with or without djustments. Redeployment with or without djustments Contrctul notice must be given to member of stff whose contrct is being terminted on grounds of ill-helth. As mended by PCS(AFC)2008/2