SICKNESS ABSENCE PROCEDURE

SICKNESS ABSENCE PROCEDURE Sickness Absence Procedure Page: 1 of 25

Recommended by Approved by Policy Group Executive Management Team Approval Date 22 nd October 2014 Version Number Version 1.3 Review Date May 2015 Responsible Executive Director Responsible Manager For use by Director of Organisational Development Assistant Director of Employment Practices All Trust Employees This policy is available in alternative formats on request. Please contact the Corporate Governance Assistant on 01204 498379 Sickness Absence Procedure Page: 2 of 25

CHANGE RECORD FORM Version Date of change Date of release Changed by Reason for change 0.1 February 2014 February 2014 V Camfield Document creation 0.2 7 th March 2014 7 th March 2014 V Camfield Policy Group Discussions 0.3 21 st March 2014 21 st March 2014 V Camfield Policy Group Discussions 0.4 4 th April 2014 4 th April 2014 V Camfield Policy Group Discussions 0.5 14 th May 2014 14 th May 2014 V Camfield Amendments following Joint Negotiation Group 1.0 21 st May 2014 21 st May 2014 V Camfield Approved by EMT 1.1 2 nd July 2014 2 nd July 2014 V Camfield Minor amendment 1.2 16 th July 2014 16 th July 2014 V Camfield Minor amendment to references 1.3 22 nd October 2014 22 nd October 2014 V Camfield Amendment to the probationary trigger to match agreement at Joint Negotiating Group Sickness Absence Procedure Page: 3 of 25

Sickness Absence Procedure Contents 1. Introduction... 5 2. Reporting Sickness... 5 3. Certifying Sickness... 6 4. Reporting of accidents, injuries, diseases and dangerous occurrences... 7 5. Sickness Absence recording and monitoring procedures... 7 6. Occupational Health Service... 10 7. Return to Work Interview... 11 8. Formal Sickness Absence Procedure... 12 9. Review meetings... 13 10. Long-term Sickness Absences... 17 11. Return to Work following an extended period of absence... 18 12. Welfare meetings... 18 13. Formal Review meetings... 19 14. Final Review meeting... 19 15. Long Term sickness capability hearing... 20 16. Ill Health Retirement... 20 17. Cancellation of formal meetings... 21 18. Appeal Procedure... 21 19. Other relevant documents and Procedures... 21 20. Monitoring of the procedure... 22 Appendix A: Definitions... 23 Appendix B: Disciplinary scheme of delegation... 24 Sickness Absence Procedure Page: 4 of 25

1. Introduction 1.1 This procedure relates to all categories of North West Ambulance Service NHS Trust (NWAS) staff and sets out procedures for reporting and recording sickness absence, and for managing short and long-term absence in a consistent and fair way across NWAS. All arrangements for managing sickness absence are conducted in keeping with the principles of Equality and Diversity and in line with the principles set out in the Attendance Management Policy. Further guidance on sickness absence can be found on the HR portal. 1.2 Employees will want to see understanding shown to those who need to be absent and appropriate action taken against those whose absence falls outside of the expected parameters. The development and operation of sound, fair and consistent procedure is essential, within which the role of line manager not only in managing sickness absence but also in creating a positive working environment is key. 1.3 Members of the HR Team are available to advise and assist managers in the application of this policy at any stage. 1.4 The Trust, through this procedure and others, will endeavour to reduce absence amongst staff through a fair and consistent approach and to provide a safe and healthy environment for staff to work in. 2. Reporting sickness 2.1 A member of staff who is sick and cannot attend work should comply with the following: Emergency Services Staff Sickness should be reported to the Support Centre in the first instance. Staff will be contacted by an appropriate manager as soon as practicable who will discuss their absence in more detail. All other staff: Staff should contact their line manager by telephone as soon as they know they will not be able to attend for work or as early as possible before the start of the shift on the first day of absence. Contact via text messages or email is not acceptable Staff should not normally ask anyone else to make contact on their behalf unless they are physically or mentally unable to do so. Where departments have specific arrangements for reporting absences, these should be communicated to staff on a regular basis and must be observed by all staff. 2.2 When reporting absence from work due to sickness, staff will be asked to give their line manager as much of following information as possible: The nature of illness - if the employee does not wish to reveal the exact nature of the illness s/he must indicate broadly the cause of the absence. In exceptional circumstances if an employee is not willing to disclose the reasons for their absence to their line manager, they will be asked to contact the Occupational Health Service to discuss the reason for their absence with a clinical professional. Sickness Absence Procedure Page: 5 of 25

The anticipated length of absence (only an estimated indication is expected i.e. "I'll be back tomorrow" or "I don't expect to be in for the rest of the week") ; Sickness over 7 days - If the absence is expected to be of 7 calendar days or more, any steps s/he is taking in relation to it e.g. details of any doctor's appointments arranged; Handover of work - Details of any outstanding or urgent work that needs to be dealt with during the absence; Contact details- Details of how s/he can be contacted if necessary, especially where the employee is staying at a different address during their absence. Contact arrangements - Staff who are expected to be off for an extended period of time would be expected to give regular updates to their manager and it is recommended that managers initially contact the employee and agree to make regular contact with the employee which should be no less frequent that every 4 weeks. 2.3 Where a member of staff becomes ill while at work and feels too unwell to continue working, s/he must advise the manager that they no longer feel well enough to continue with their work or follow appropriate reporting arrangements out of hours (either temporarily or for the day). Managers should review the situation and respond accordingly and if necessary to seek medical advice where appropriate. The absence will be recorded and monitored as specified in Section 5. 3 Certifying Sickness 3.1 Sickness over 3 days - If the sickness absence continues beyond three consecutive days, including non working days, the member of staff should contact his/her line manager again, as early as possible on the fourth day of sickness absence and complete a self certificate form upon return to work. 3.2 Sickness over 7 days - If the manager is advised that it is likely that the absence will continue beyond seven consecutive days, the member of staff must be reminded of the need to obtain and submit a medical certificate (Med3) (Statement of fitness) from their Medical Professional. The requirement to obtain a medical certificate applies to the full period of absence and not just working days. As a result staff should phone to resume work as soon as they are fit even if this is an off duty day. 3.3 The medical statement is known as a statement of fitness for work or FIT NOTE and means doctors can advise that the patient either: Is not fit for work May be fit for work o A doctor can advise if an employ may be fit for work with some support or alternative duties until they are fit to return to their substantive role; o More space for a doctor to provide information on how the employee s condition will affect what they do; and o tick boxes for doctors to suggest common ways to help an employee return to work 3.4 If the GP suggests that an employee may be fit for alternative duties e.g. office work, this does not commit the Trust to the provision of such work. Alternative duties will only be considered in the context of the procedure. If alternative duties are not considered to be as option, the fit note should be used as if it were signed unfit to return to work. Sickness Absence Procedure Page: 6 of 25

3.5 If the employee refuses to return to work on the advice of their doctor (with or without a restriction), the Trust would manage this employee as if fit but refusing to work. The role of the Occupational Health Service remains unchanged and they are there to help assess staff s fitness to work. 3.6 A member of staff who fails to follow the sickness absence procedure may be subject to action under the NWAS Disciplinary Policy and Procedure. Unauthorised absence is considered to be misconduct and will be considered in accordance with the Disciplinary Procedure. In exceptional circumstances, NWAS reserves the right to withhold Occupational Sick Pay if an employee does not co-operate with reasonable requests from the HR Department, or does not comply with the requirements within this procedure, including the provision of a fit note. 4 Reporting of accidents, injuries, disease and dangerous occurrences procedure 4.1 When an absence is due to a work related accident, incident, disease or dangerous occurrence an Incident Report Form (IRF) must be completed in addition to the absence being reported to the line manager in the normal way. Absences must still be supported by a doctor s certificate if they persist for longer than seven calendar days. 4.2 An employee must take responsibility for completing the IRF within 72 hours. An IRF can be completed via the Intranet at home, as well as at work. The manager receiving the IRF has a responsibility to progress an investigation into the issue in a timely manner to ensure that feedback is given to the employee and to advise Payroll where an absence is work related. An IRF may be completed by a line manager if requested by the employee concerned. 4.3 Managers should review the outcomes of investigations resulting in an Industrial Injury and give support/training to employees if appropriate or identify organizational learning. 4.4 It is accepted that the Trust reserves the right to sensitively manage employees where they cannot come into work and who are deemed incapable of carrying out their duties as a result of a work related injury. 4.5 The line manager should seek advice as appropriate from HR and/or the Area health and safety advisor at any stage. It is the line manager s responsibility (see NPS/HS/1 in the National Health and Safety Policy) to ensure that accident/incident reports are completed so that where necessary reports and information relating to work related stress, muscular skeletal disorders (e.g. RSI), and reportable diseases can be forwarded to the National Patient Safety Authority NPSA or to the HSE in line with the RIDDOR Regulations. 4.6 Where absence is a result of a work related injury, staff will be eligible for payment of Injury Allowance. Staff should refer to the Injury Allowance Guidance for further information. 5. Sickness Absence Recording and Monitoring Procedures 5.1 Both managers and staff have responsibilities to ensure that the correct procedures for recording and monitoring of sickness are followed. 5.2 Heads of Departments are expected to: Sickness Absence Procedure Page: 7 of 25

Ensure that a record is kept of the whereabouts of the staff in their department (for example who is on holiday, sickness absence or special leave; Ensure that all incidents of sickness absence amongst all the staff in the department are accurately recorded, kept confidential and stored securely and advised to Payroll in a timely manner; Ensure that all incidents/accidents at work are accurately recorded and investigated in a timely manner and if work related that this is advised to Payroll; Regularly review sickness absence to ensure that the department is able to function effectively and to check for patterns that indicate the possibility of health problems which may be exacerbated by the working environment. Ensure that all staff are informed of the sickness absence reporting procedure and the sickness absence policy. 5.3 Employees are expected to: Take responsibility for ensuring that they follow the correct certification procedures; Complete the necessary forms, such as an IRF form, to record work related injuries; Familiarise themselves for the sickness absence reporting procedures in their team. 5.4 Recording sickness 5.4.1 The manager (or designated person) will pass the Sickness Absence Record Form with any medical certificate(s) where appropriate, to whoever maintains the sickness absence records for the department. 5.4.2 They will be required to record the departmental sickness absence records on a return on a monthly basis to the Payroll provider where the information will be recorded for pay and monitoring purposes. 5.4.3 Sickness absence returns from all departments are collated and recorded. Analysis of sickness absence data is reported throughout the Trust on a regular basis. 5.5 The following clarifies how sickness will be recorded in specific circumstances: 5.6 Part Shift Absence - Absence from work commenced during a shift is recorded on an employee s personal sickness record and a return to work interview would be required upon an employee's resumption at work. 5.7 Absence from home address when absent on sick leave - There are occasions when an employee who is absent on sick leave is away from his/her home address, e.g. to stay with parents; for convalescence; go on holiday (acceptable as long as nothing is done which might worsen the condition or otherwise prolong the sickness absence). The employee must provide the line manager with the revised necessary contact details prior to them changing their location. Sickness Absence Procedure Page: 8 of 25

5.8 Sickness and annual leave - If an employee falls sick whilst on annual leave or on a day adjacent to annual leave, normal reporting and certification arrangements apply. Annual leave may be reclaimed for the days that s/he is sick provided that an appropriate certificate is supplied to cover these days. Employees will not be entitled to an additional day off if sick on a statutory holiday. Medical certificates (or equivalent) issued abroad should be copied and sent to the manager where the absence is going to be four weeks or longer. The original documents must be supplied on the return to work. If the employee is unable to travel, medical confirmation along with full contact details must be provided. 5.8.1 If an employee is refused annual leave and subsequently reports absent due to sickness during the period requested as annual leave, managers have the right to investigate the circumstances. 5.8.2 If an employee recovers from their period of sickness and has pre-planned annual leave, they must resume with the Trust, in line with the procedure in their area of work, before their annual leave commences, in order to ensure their sickness is recorded accurately and they are paid correctly. 5.9 Medical appointments - Arrangements covering medical and dentist appointments are covered by NWAS's Special Leave Procedure; such appointments should not be recorded as sickness absence unless the appointment requires a whole day's absence. Where staff have an option appointments should be on days off or as near to the beginning or end of a shift as possible. 5.9.1 Attendance at medical appointments associated with the management of a disability will be recorded as Disability leave and not sickness. Further information is available in the Special Leave Procedure. 5.10 Pregnancy-related sickness - Pregnancy-related sickness absence should be recorded separately and should not be taken into account when looking at targets. An employee who is absent due to a pregnancy-related illness during the last four weeks before the expected week of childbirth, maternity leave will normally commence at the beginning of the fourth week before the expected week of childbirth or the beginning of the next week after the employee last worked, whichever is the later. 5.11 Enforced Sick Leave - From time to time, management may feel that an employee may not be well enough to attend work, despite attending. The Health and Safety at Work Act places an obligation on managers to ensure that all staff are well enough to undertake work. Where a manager has concerns in relation to an employee fitness to remain in work the manager may send the employee home, request that they refrain from returning to work until the symptoms/ condition improves and/or produce evidence from their G.P. that they are indeed well enough to undertake work. In such circumstances management should ensure that the employee is well enough to travel home, unaccompanied and, if necessary, make arrangements for their safe journey home (for example by taxi). 5.11.1 Employees on enforced sick leave are still required to produce medical certificates and self certification of the absence. Enforced sick leave will be treated consistently with all other types of sick leave in the management of the absence(s) under this procedure. 5.12 Criteria for managing career development Sickness Absence Procedure Page: 9 of 25

5.12.1 The regular attendance of employees is fundamental to the ability of the Ambulance Service to deliver an effective service and as such employees seeking transfer to a different role, promotion, or undergoing a selection process or personal development opportunities, will need to demonstrate that their attendance record is acceptable. Absences related to disability and/or pregnancy, and/or gender reassignment will be excluded from these considerations. 5.12.2 When making selections in any of these areas, line managers must take into consideration records of attendance, which will be fully considered along with other relevant matters such as ability, experience, potential and performance. It is crucial to ensure that these decisions do not discriminate either intentionally or unintentionally against a disabled employee. 5.13 Working elsewhere (either voluntary or in paid employment) while on sick leave 5.13.1 Employees who undertake voluntary or paid employment outside of their employment with the Trust, must not continue to engage in any form of work whilst off sick. In the event that an employee continues to work elsewhere in a paid or voluntary capacity, their behaviour would be considered to be fraudulent and proceedings under the Trust's Disciplinary Policy and Procedure or through the NHS Counter Fraud Services may be taken. 5.13.2 If an employee wishes to continue to undertake voluntary work whilst they are off sick, they should discuss this with their manager before proceeding to continue their voluntary work. 5.13.3 Employees should consider any other activities they undertake that may compromise their recovery e.g. sporting activities, and discuss with line manager the continuation of these activities whilst off sick. 6 Occupational Health Service 6.1 Ill health, of whatever nature, may affect the work performance of the employee and may also have an impact on their colleagues. If a manager has any concerns about the effects of work on an employee's health, or the effects of a health problem on an employee's attendance or performance a management referral to the NWAS Occupational Health Service (OHS) should be made. 6.2 Managers should discuss the referral with the employee giving reason(s) and encouraging open exchange of information. Similarly, if a member of staff believes that his/her condition may be related to an activity at work s/he should inform his/her manager via the appropriate documentation. 6.3 Staff can refer themselves to the OHS for advice on health matters related to their work/environment. The OHS is not a replacement for a member of staff s own GP and the employees GP would still be responsible for their personal health care. 6.4 Management referral should be made to OHS to seek advice regarding: The impact of a health problem on the staff member's ability to work; Timescales for expected improvement; Temporary or permanent adjustments to the work place or tasks that would assist in maintaining health and reducing the effects of the health problem on attendance and performance; An opinion on the implications of the Equality Act 2010; Sickness Absence Procedure Page: 10 of 25

An option on the suitability for continued employment in current role; Anticipated sustainable deployment date An opinion on suitability for redeployment; Proposals for case management or a rehabilitation programme where appropriate. Occupational health advice on the likely outcome of a successful ill health retirement application. Before a decision to terminate is made all other options should meaningfully be considered, including: Rehabilitation; Phased return; A return to work with or without adjustments; Redeployment with or without adjustments. 6.5 Occupational health advice given to the manager will not contain confidential medical detail, but is concerned with the effects of a health problem on an employee's work attendance or performance, or the effects of work on an employee's health. Full details of the procedure and referral forms are given in the document Occupational Health Referrals (see Section 19 below for further details). OHS reports are sent to the referring manager and copied to HR and the employee. 6.6 The OHS may advise that a member of staff is fit to return to work in some capacity even though s/he has a GP's medical certificate for Statutory Sick Pay purposes. The manager, in consultation with HR, will make a decision on the course of action to follow in such circumstances, based on all the advice provided by all informed parties 6.7 Failure to attend an Occupational Health Appointment 6.7.1 If an employee does not attend their OHS appointment arranged through the management referral process, the manager will follow up the reason with the employee for non attendance when informed by the OHS, before a further appointment will be made. 6.7.2 If an appointment is missed for a second time, the manager will arrange a review meeting with the employee, at which the employee can bring with them a TU representative or colleague. Any decisions made at this meeting regarding the on-going management of the employee's absence will be based on the information available at that time and in the absence of advice that would have been available had the employee attended the NWAS OHS appointment as requested. The requirement to attend for medical assessment is contained within the employee s Contract of Employment and a repeated failure to attend may result in disciplinary action. 7. Return to work interview 7.1 On the return to work, the manager will meet with the employee to hold a Return to Work Interview. The interview should ideally take place on the first day that an employee returns to work. The purpose of the interview is to discuss the period of absence, ensure that the employee is fit to be in work and also take account of any OHS recommendations. 7.2 The interview should be held in an appropriate location and setting, with a focus on ensuring confidentiality. Sickness Absence Procedure Page: 11 of 25

7.3 A Return to Work Interview form should be completed, all pertinent information should be noted, including any further supportive actions required. The manager should also inform the employee if they have triggered the sickness procedure. The form will be signed by both parties and stored securely. 8. Formal Sickness Absence Procedure 8.1 The formal Sickness Absence Procedure will be triggered for the following levels of absence: The absence of a member of staff due to sickness for 4 periods of absence in a rolling 12 month period or A cumulative sickness absence record of 118 hours in a rolling 12 month period (pro rata for part time staff). Example of part time absence calculation Part time member of staff works 22.5 hours per week Pro rata calculation of a full time post: 22.5 / 37.5 = 0.6 Calculation of hours absent to trigger procedure: 0.6 x 118 = 71 hours For clarity, all absence will count towards triggers, including long term sickness and work related absences, but the action taken at each stage will take into account the cause of absence, overall absence record and any relevant patterns of absence. 8.2 Triggering the Policy 8.2.1 The trigger points above should not be interpreted as accepted norms of absence and the Trust would be working in partnership with staff side colleagues to achieve as best practice the lowest sickness absence rate possible 8.3 Part shift absence - If an employee works over half of their shift then the absence would be recorded, but would not count towards any potential triggers of the procedure. However, the absence may be taken into account when looking at patterns of absence. 8.3.1 If an employee is unable to complete half of their shift, the remaining hours would contribute towards the triggers points detailed in the procedure. 8.4 Industrial Injuries - Where an absence has been accepted as work related and has not taken place in the context of similar work related injuries, it is not anticipated that this absence would necessarily result in formal action. However, in the event that the manager identifies a pattern relating to the absence, then the concerns may be considered at a formal meeting. 8.5 Triggering the policy following a period of long term sickness absence 8.5.1 If there is an episode of sickness of more than 4 weeks, which would trigger the above, a Sickness Absence Review meeting at the appropriate level should be convened. The review period or warning given at the absence review meeting should be at the discretion of the Sickness Absence Procedure Page: 12 of 25

manager, based on the circumstances of the case and the history pattern of sickness. If the sickness absence has triggered a Stage 1 Review Meeting, the review period can range from zero to twelve months in duration. All other stages, if triggered, should follow the guidance within the procedure for that particular stage. 8.6 Staff on their probationary period 8.6.1 New entrants to the Trust who are in their probationary period are expected to demonstrate excellent attendance. Given their short period of employment a truncated procedure will apply. 8.6.2 Where there are concerns emerging regarding a probationary level of absenteeism then a warning may be issued. If a probationer reaches the trigger points pro rata to their employment length i.e. 59 hours or 2 instances in their first 6 months of employment, they will enter the formal procedure at stage 3. 9 Review meetings 9.1 Review meetings under Stages 1 to 4 of the procedure should take place as soon as possible after the Return to Work meeting and within 6 weeks of their return to work. Where there has been an unreasonable delay on the part of management in arranging the hearing and the employee has had no absence during the delay, this should be taken into account when setting the duration of the review period or deciding on the duration of any warnings. 9.2 The stage 2 and 3 warnings will remain on file for a period of 12 months after which they will be taken off file and will not be referred to. However, local sickness absence records should be retained and can be used to illustrate a historical pattern of attendance levels. 9.3 Stage 1-1 st Sickness Absence Review Meeting 9.3.1 This is a non-formal stage and the purpose of the 1st Review Meeting will be as follows: To review the member of staff's attendance record during the relevant period; To give the member of staff the opportunity to discuss any problems or raise any concerns; To decide whether any further action is required such as a referral to the OHS (see section 6 above); To set a target for improvement (see 9.3.3 below) and a period over which absence levels will be monitored; To arrange for support or work adjustments as recommended by OHS; To inform the member of staff that if attendance does not improve within the time period being monitored, a 2 nd Sickness Absence Review meeting will be held where a warning may be issued. The manager conducting the meeting should ensure that clear rationale for the decision taken at the meeting. 9.3.2 The employee will be given at least 14 calendar days' written notice of the meeting (unless the employee agrees, in writing, to less) and s/he has a right to be accompanied by a trade union representative, work colleague or friend not acting in a professional capacity. If the Sickness Absence Procedure Page: 13 of 25

employee's trade union representative or work colleague is unavailable to attend the meeting at the appointed time, s/he may request postponement and suggest an alternative time and date. Where the suggested alternative is reasonable and ideally within 5 working days of the original date, the meeting will be postponed. 9.3.3 When setting targets for improvement, managers will, need to take into account the employee circumstances of the case, any advice received from the OHS, the impact of any underlying medical condition or disability, and any reasonable work place adjustments that need to be put in place to enable the employee to improve their attendance. 9.3.4 The outcome of the Sickness Absence Review meeting will be confirmed to the employee in writing by their manager within 10 working days, and a copy sent to their contact in the HR Team and representative if applicable. 9.3.5 The monitoring period does not constitute a formal sanction and therefore the employee is not eligible to appeal the decision taken at Stage 1 of the policy. The outcome letter should include justification for the decision taken. If there is a discrepancy in the letter confirming the outcome of the Stage 1 Review meeting the employee should discuss this with their manager. If the employee does not agree with the outcome of the Stage 1 review Meeting, they should raise this with the line manager of the manager who chaired the meeting. 9.3.6 As confirmed at the Sickness Absence Review the employee's sickness absence pattern will be monitored over an appropriate, specified period (in determining this period an account should be taken of the employee s absence history). During this period, regular reviews should be undertaken by the manager to review the member of staff's attendance, give them an opportunity to discuss any problems they have encountered, discuss the need for further OHS advice and ensure that any reasonable adjustments recommended have been put in place and that they are receiving the support needed to improve their attendance at work. 9.4 Stage 2-2 nd Sickness Absence Review Meeting 9.4.1 If during the specified monitoring period following the 1 st Sickness Absence Review meeting, absence exceeds the improvement target set this will trigger a 2nd Sickness Absence Review meeting with the manager (or person deputed by him/her) and this may be the same manager who chaired the Stage 1 meeting. The meeting must be chaired by a manager who has authority to issue a formal written warning in accordance with the scheme of delegation (Appendix B). 9.4.2 The purpose of the 2 nd Review Meeting will be as follows: To review the member of staff's attendance record during the relevant period; To review the steps that have been taken to support him/her in achieving the required level of attendance; To give the member of staff the opportunity to discuss any problems or raise any concerns; To discuss any Occupational Health advice that has been received; To decide whether any new information requires further referral to the OHS (see section 6 above); To set a target for improvement (see 9.3.3 above) and a period over which absence levels will be monitored; Sickness Absence Procedure Page: 14 of 25

To inform the member of staff that if attendance does not improve a 3 rd Sickness Absence Review meeting will be held. 9.4.3 The employee will be given at least 14 calendar days' written notice of the meeting (unless the employee agrees, in writing, to less) and s/he has a right to be accompanied by a trade union representative or work colleague. If the employee's trade union representative or work colleague is unavailable to attend the meeting at the appointed time, s/he may request postponement and suggest an alternative time and date. Where the suggested alternative is reasonable and within 5 working days of the original date, the meeting will be postponed. If an employee is absent again, before the Stage 2 meeting can be convened, both periods of absence will be taken into account by the manager chairing the meeting. 9.4.4 The outcome of the 2 nd Sickness Absence Review meeting will be confirmed to the employee in writing by their manager within 10 working days and a copy sent to their contact in the HR Team and representative if applicable. 9.4.5 As confirmed at the 2 nd Sickness Absence Review meeting, the employee's sickness absence pattern will be monitored over an appropriate, specified period and appropriate targets will be set within this period depending on the improvement in attendance that is required and taking into account the factors outlined in 9.3.3 above. 9.4.6 Regular reviews should be undertaken by the manager during the monitoring period (see 9.3.6 above). 9.4.7 If, after a period of satisfactory improvement based on the targets set, the employee's absence levels reach those defined in 8.1 above (repeated short term absence), Stage 2 of the Sickness Absence Policy will be repeated. 9.4.8 Staff will be informed that if their attendance does not improve it may result in the next stage of the process being instigated. 9.4.10 A formal written warning for a period of 12 months may be issued at this stage. After the warning has expired, the warning will not be considered for the formal triggering of the stages of the procedure. However, managers have the discretion to take into account the employees attendance history over a reasonable period prior to the current sickness period. If a warning is issued the member of staff has the right to appeal against this (see section 18). 9.5 Stage 3-3 rd Sickness Absence Review Meeting 9.5.1 If during the specified monitoring period following the 2 nd Sickness Absence Review meeting, absence exceeds the improvement target this will trigger a 3 rd Sickness Absence Review Meeting. The meeting will be with the line manager (or person deputed by him/her) and this may be the same manager who chaired the meeting at stages 1and 2. The meeting must be chaired by a manager who has authorisation to issue a final written warning in accordance with scheme of delegation (Appendix B). 9.5.2 The purpose of the 3 rd Review meeting will be as follows: To review the member of staff's attendance record during the relevant period; Sickness Absence Procedure Page: 15 of 25

To review the steps that have been taken to support him/her in achieving the required level of attendance; To give the member of staff the opportunity to discuss any problems or raise any concerns, or to highlight any mitigating circumstances that they wish to be taken into account; To discuss any OH advice that has been received; To decide whether any new information requires further referral to the NWAS OHS (see section 6 above); To inform the member of staff that his/her job may therefore be at risk if their attendance levels do not improve; To issue a final warning, set a target for improvement (see 9.3.3 above) and a period over which absence levels will be monitored, if appropriate. 9.5.3 The employee will be given at least 14 calendar days' written notice of the meeting (unless the employee agrees, in writing, to less) and s/he has a right to be accompanied by a trade union representative or work colleague. If the employee's trade union representative or work colleague is unavailable to attend the meeting at the appointed time, s/he may request postponement and suggest an alternative time and date. Where the suggested alternative is reasonable and ideally within 5 working days of the original date, the meeting will be postponed. 9.5.4 A final written warning may be given for unsatisfactory attendance and this will be confirmed to the employee in writing within 10 working days. If a warning is issued the member of staff has the right to appeal against this (see section 18) 9.5.5 If it has been decided not to issue a final warning, but to extend the monitoring period for up to a maximum of six months, the employee's sickness absence pattern will be monitored over the specified period and the first written warning extended. 9.5.6 Regular reviews should be undertaken by the manager during the monitoring period (see 9.3.6 above) and any return to work interviews should be undertaken by the manager. 9.5.7 If, after a period of satisfactory improvement based on the targets set, the employee's absence levels reach those defined in 8.1 above (repeated short term absence), Stage 3 of the Sickness Absence Policy will be repeated. 9.5.8 Staff will be informed that if their attendance does not improve it may result in the next stage of the process being instigated and ultimately in a decision to dismiss the member of staff on the grounds of incapacity. 9.6 Stage 4 - Final Absence Review Meeting 9.6.1 If during the specified monitoring period following the issue of a final warning, absence exceeds the improvement target this will trigger a Final Sickness Absence Review meeting. The meeting will be with the relevant manager under the disciplinary scheme of delegation (Appendix B), the manager and a representative of the HR Team. 9.6.2 The purpose of this meeting will be as follows: To review the member of staff's attendance record during the relevant period; Sickness Absence Procedure Page: 16 of 25

To review the steps that have been taken to support him/her in achieving the required level of attendance; To give him/her the opportunity to discuss any problems or raise any concerns, or to highlight any mitigating circumstances that they wish to be taken into account; To discuss any OH advice that has been received; To decide whether any new information requires further referral to the NWAS OHS (see section 6 above); To inform them of whether they will be dismissed on the grounds of capability, or whether the final warning will be extended to allow further time for a sustained improvement; If the final warning is extended, to set a target for improvement (see 9.3.3 above) and a period over which absence levels will be monitored. 9.6.3 The employee will be given at least 14 calendar days' written notice of the meeting (unless the employee agrees, in writing, to less) and s/he has a right to be accompanied by a trade union representative or work colleague. If the employee's trade union representative or work colleague is unavailable to attend the meeting at the appointed time, s/he may request postponement and suggest an alternative time and date. Where the suggested alternative is reasonable and ideally within 5 working days of the original date, the meeting will be postponed. 9.6.4 Following the meeting, a decision will be taken by the appropriate manager to either dismiss the member of staff on the grounds of capability, or to extend the final warning to allow further time for a sustained improvement. The option of allowing further time for improvement will only be considered if there is evidence that this is likely to lead to the required improvement in attendance. If a member of staff is dismissed or a warning extended the member of staff has the right to appeal against this (see section 18) 9.6.5 In the event that the final warning is extended, the employee's sickness absence pattern will be monitored over an appropriate, specified period. 9.6.6 Regular reviews should be undertaken by the manager during the monitoring period (see 9.3.6 above). 9.6.7 The Manager will confirm the decision, the reasons for it and the right of appeal in the case of dismissal, in writing to the employee and their representative if applicable. 9.6.8 If, following an extension of the final warning and after a period of satisfactory improvement based on the target set, the employee's absence levels deteriorate and reach those defined in 8.1 above (repeated short term absence), Stage 4 of the Sickness Absence Policy will be repeated which may result in a decision to dismiss the member of staff on the grounds of incapacity. 10. Long-term Sickness Absences 10.1 Although long term sickness absence may be dealt with under the formal procedure outlined above, once an employee has returned to work, it is recognised that whilst an employee is absent from work additional management and welfare support may be required. Sickness Absence Procedure Page: 17 of 25

10.2 Managers should seek the advice of the HR Team in cases of long-term sickness absence of 4 weeks or more, sooner if there is indication that the health issue may be related to work. Evidence based guidelines recommend early intervention, particularly for stress, mental health or musculoskeletal problems. 10.3 Managers will maintain contact with the member of staff in order to reduce feelings of isolation, to remain informed about the likely duration of the sickness absence and to keep them in touch with any major workplace developments. An appropriate manager should contact the employee at least within 4 weeks of the employee going off sick and agree a period of time for the next contact which should be no less than 4 weekly. Managers should not, however, have detailed discussions regarding work-related issues with staff who are absent. The member of staff has a responsibility to update his/her manager regularly on his/her likely date of return to work. 11. Return to Work following an extended period of absence 11.1 Following an extended period of absence and prior to the member of staff returning to work, the manager must hold a return to work interview with them. 11.2 At this meeting, any advice given by the NWAS OHS for rehabilitation and support to facilitate a sustained return to work will be discussed. The return to work programme will be agreed between the member of staff and the line manager. If there is an agreed structured return to work program this would normally be on full pay for the recommended period and will be reviewed thereafter. If the normal hours of work are reduced over a longer period, a corresponding reduction in salary may result or Injury Allowance may be payable. However, the employee circumstances of the case will be taken into account. 11.3 Discussions may also include any induction/training that may be necessary and any expectations by the member of staff of any further periods of absence where appropriate. The line manager may also discuss arrangements around the undertaking of overtime upon the return to work 11.4 An employee has a right to be accompanied by a union representative or work colleague, and at least 7 calendar days notice will be given (unless the employee agrees to less). If the employee's trade union representative or work colleague is unavailable to attend the meeting at the appointed time, s/he may request postponement and suggest an alternative time and date. Where the suggested alternative is reasonable and within 5 working days of the original date, the meeting will be postponed. If the employee is unable to travel, the meeting will be conducted via the telephone or, in exceptional circumstances, a meeting may take place at the employee s home or a venue nearer to his/her home. Alternatively, written representation can be submitted or a representative acting on their behalf can attend. 11.5 In exceptional circumstances, if s/he does not return to work on the date advised, entitlement to Occupational Sick Pay may be withdrawn and disciplinary action may be taken. In such circumstances independent specialist advice sought by the employee may be considered by the Occupational Health Service. Entitlement to Statutory Sick Pay will not be affected if the continued absence is covered by a medical certificate but occupational sick pay may be affected. 12 Welfare meetings Sickness Absence Procedure Page: 18 of 25

12.1 During a period of long term sickness, regular informal welfare meetings should be held between the employee and their line manager. The purpose of the meeting will be for the employee to update the manager on their current health status and where applicable, to discuss the latest OHS report. The welfare meeting should be held every 4 weeks during a period of absence and the normal notice period for such a meeting would be one week. However, a shorter notice period may be agreed by mutual consent. 12.2 If the employee wishes to have a Trade Union representative, it is their responsibility to make contact and this should be in sufficient time as to not delay the meeting going ahead. If there is a risk of the meeting being unduly delayed then the manager can proceed with the meeting. 13. Formal Review Meetings 13.1 To ensure there is a structured review process during an extended period of absence regular formal reviews should be carried out to assess and monitor staff when they are off sick, and determine what action is needed at each stage. 13.2 It is anticipated that the formal review meetings should be held as well as the welfare meetings and should occur at least every 12 weeks during period of long term sickness absence i.e. at 3, 6 and 9 months into the period of absence. The meeting would be considered formal and therefore the employee has the right to be accompanied by a Trade Union Representatives, Colleagues or family friend, not acting in a professional capacity. A representative from the HR department may also be present. The expected notice period for a formal review meeting would be 2 weeks. 13.3 3, 6 and 9 month formal review meetings - Discussion regarding the advice received from OHS including advice from any treating practitioners e.g. GP, consultants. The meeting may also include a discussion around the potential to return to work and how this may be supported. 13.4 In the event that the advice from the OHS indicates that the member of staff is unfit to resume his/her duties, despite reasonable adjustments being made, alternative options such as job redesign, an amendment to the job description or redeployment into another type of work will be explored with advice from the OHS. 13.5 Advice provided by the OHS and the employee's views will be taken into account in the exploration of options at the formal review meetings. Following a formal review meeting, the content of the discussion and any action to be taken, will be confirmed in writing. 14. Final Review Meeting 14.1 Where a member of staff is unlikely to return to work or they are approaching the end of sick pay provision, this would culminate in a final review meeting where a decision on the appropriate way forward is made i.e. return to substantive employment, redeployment or progression to a long term sickness capability hearing. The meeting may be convened at any point at which there is medical evidence to indicate that a return to substantive employment is unlikely to be possible. 14.2 The meeting would be considered formal and therefore the employee has the right to be accompanied by a Union Representatives, Colleagues or family friend, not acting in a Sickness Absence Procedure Page: 19 of 25

professional capacity. A representative from the HR department may also be present. The expected notice period for a formal review meeting would be 2 weeks. 14.3 It is assumed that as part of the discussions leading to the convening of a final review meeting, that any reasonable adjustments to support the employee in future employment will have been considered. 14.4 Medical evidence should be made available to support the final review meeting and occupational health advice should be sought on the likelihood of: The prospects of a likely return to the previous employment with or without adjustments a phased return with or without a need for adjustments redeployment A successful ill health retirement application. In accordance with Annex Z of Agenda for Change, advice from Occupational health on the likely outcome of a successful ill health retirement application. Before a decision to terminate is made all other options should meaningfully be considered, including: Rehabilitation; Phased return; A return to work with or without adjustments; Redeployment with or without adjustments. 14.5 An outcome of a Final Review Meeting may be a recommendation to place the employee on the redeployment register and plan to convene a long term sickness capability hearing. 15. Long Term Sickness Capability hearing 15.1 The member of staff will be invited to attend a meeting with an appropriate manager under the Scheme of Delegation and a representative of the HR Team to discuss the proposed termination of their employment. They will be given at least 14 calendar days' written notice of the meeting (unless the employee agrees, in writing, to less) and s/he has a right to be accompanied by a union representative or work colleague. 15.2 A long term sickness capability hearing is chaired by a manager with the authority to terminate an employee s contract of employment. The chair of the meeting would normally be support by a Head of HR or HR Manager. The member of staff s line manager would present a management statement of case and the employee has a right to be accompanied by a Union Representatives, Colleagues or family friend, not acting in a professional capacity. 15.3 The panel will review the information presented and this should include a chronology of the employee s absence leading to the hearing, along with the OHS reports and any other pertinent medical information. 15.4 The panel will consider if options for reasonable adjustments or redeployment have been explored and whether termination on the grounds of ill health capability is appropriate. 16. Ill health retirement 16.1 Early retirement on the grounds of ill health may be pursued in accordance with the arrangements of the NHS Pension Scheme. The Pensions Agency will advise employees of Sickness Absence Procedure Page: 20 of 25

their entitlements in such circumstances. The application for an ill health pension is a separate process from consideration of termination of employment and although the two processes may be pursued in parallel. The Trust s decision regarding termination will not be dependent on the outcome of a pension application. 17. Cancellation of formal meetings 17.1 In the event that an employee requests a postponement of a formal meeting under the sickness procedure the reasons for this will be discussed with the line manager. 17.2 If the reason for the request to postpone the formal meeting is due to the employee's union representative or work colleague being unavailable to attend the meeting at the appointed time, s/he may request postponement and suggest an alternative time and date. Where the suggested alternative is reasonable and within 5 working days of the original date, the meeting will be postponed. Following consultation, if termination of employment is appropriate this will be confirmed in writing by the HR Team. The right of appeal against the decision and the appeals procedure will also be explained. 18 Appeal Procedure 18.1 All employees have the right to appeal against any formal action taken against them (Stages 2 to Stage 4 and the long term sickness capability hearing). The Appeals procedure should not normally be used as a rehearing of the written warning but should focus on the key reason for the appeal. Appeals will be raised on one of the following grounds: the procedure: a failure to follow procedure had a material effect on the decision the decision - the evidence did not support the conclusion reached the penalty - was too severe given the circumstances of the case New evidence - which has genuinely come to light since the first hearing. If the evidence is medical sufficient time should be given to allow the Trust to seek the view of their Occupational Medical advisor. 18.2 Appeals against action short of dismissal will be heard by a higher level of manager than the hearing officer issuing the warning. 18.3 Appeals against dismissal will be heard by a panel of two Directors. The Appeal Panel will not include any member who has been in any way connected with the formal process leading to dismissal. A Senior HR representative will act as adviser to the Appeal Panel. To ensure equality and diversity issues are addressed an employee member of staff can request the Trust appoint a representative member in an advisory capacity for the panel. 18.4 Appeals should be lodged in writing to the area Head of HR, providing details of the grounds for appeal and must be received no later than fourteen calendar days from the time when the member of staff was notified in writing of the outcome of the sickness meeting. Further information on the appeal procedure is detailed in the Trust s Disciplinary Policy and Procedure. 19. Other Relevant Documents and Procedures 19.1 At any time during the implementation of the Sickness Absence Policy it may be appropriate to refer to documents covering: Sickness Absence Procedure Page: 21 of 25

Management Guidance on Sickness Absence: Employee Guidance on Sickness Absence: Disability in Employment: Alcohol and Substance Misuse: Stress at Work Injury Allowance Special Leave Flexible Working Work Life Balance: Harassment & Bullying Annex Z of the AfC terms and conditions (Managing sickness absences) Management Guide to making an Occupational Health Referral 19.2 These documents may be accessed via the NWAS Web pages or may be obtained from the HR Department in printed form. Advice on their implementation or interpretation is available from the HR Team. 20. Monitoring of the Procedure 20.1 The HR Department in conjunction with the recognised Trade Unions will keep the monitoring of sickness absence and the operation of this policy under review. Sickness Absence Procedure Page: 22 of 25

Appendix A Definitions Sickness Absence Any absence from work due to sickness/ill health which is properly reported /recorded by the employee Short term absence periods of absence lasting less than 28 calendar days. There will however, be occasions where sickness is determined to be long-term from the outset of the absence. Long term absence a continuous period of absence of 28 calendar days or more. Self Certificate a form completed by an employee on return to work giving dates and reasons for any absence of up to 7 calendar days Fit Note a statement of fitness completed by a GP or medical practitioner advising whether an employee is unfit for work, fit for work or may be fit for some work Shift period of time where the employee is expected to be at work. Patterns of absence periods of absence which suggest a possible trend in the frequency or formulate a pattern of absence, for example. An occasion of sickness a period of sickness that lasts part of a shift or more though all absence trends will be monitored. Rolling 12-month period 12-month period which precedes any stated calendar date Review period - A period of time (from 0 up to 12 months) where an employee's attendance will be monitored. The review period does not constitute formal action but non-attendance during the review period may result in a formal stage of the policy being invoked. Formal action - From Stage 2 and onwards of the procedure, staff may be issued with a formal written, final written warning or up to dismissal for unacceptable levels of attendance. Welfare Meeting An informal meeting with a member of staff to exchange information and offer support, often during long term absence. This meeting is usually with the member of staff and their line manager. Trigger points Levels of absence defined in the procedure that will lead to further action. Sickness Absence Procedure Page: 23 of 25

Appendix B SICKNESS WARNING APPEAL ARRAGEMENTS SCHEME OF DELEGATION (As per the Disciplinary Appeal arrangements) Decision Maker Trust Board: Chief Executive: Non-Executive Directors Director: Senior Manager: Responsibilities Chairman Hearing officer for dismissal of CEO. Hearing officer for cases against Executive Directors. Appeal panel members for cases against the Chief Executive and Executive Directors. Director of Human Resources Development of Trust procedure Directors Acting as Hearing Officers for cases involving Deputy/Assistant Directors Heads of Service Acting as panel members on Appeals against dismissal in accordance with approved procedures. (Appeal panels to comprise of two members drawn from the following groups Executive Directors, Associate Directors, Deputy Directors) Heads of HR / HR Managers Responsible for arrangements for appeals against dismissal for all staff. Attending Appeals Panel for appeals against dismissal as required in accordance with approved procedures. Responsible for advice and administration of the relevant policies. Advice to Hearing Officer during a hearing or appeals hearing when a fellow Manager is the hearing officer. All Assistant Directors/Heads of Service / PTS General Managers Act as hearing officer in the following situations: Stage 4 hearings and Long Term Sickness Capability Hearings Where the employee is subject to a current final written warning. Any cases where dismissal is a possible sanction. Where they are the immediate line manager for the person charged. Act as Appeals Officer in the following circumstances: All appeals against a final written warning. All cases where the hearing has been heard by one of the managers reporting directly to them. Sickness Absence Procedure Page: 24 of 25

Other Managers: Middle Managers or above Act as hearing officer in cases where the sanction applied may be up to and including a final written warning (Stages 1 to 3). Act as Appeals Officer in cases where the sanction applied is a formal written warning. First line managers Stage 1 Delivered by Team Leaders / Supervisor / Assistant Operations Managers Human Resources Managers/Advisors Provide advice to hearing officers during disciplinary hearings and appeals. All staff: Compliance with policy Participation in investigative procedures Sickness Absence Procedure Page: 25 of 25