Managing Attendance Protocol & Procedure

This is an official Northern Trust policy and should not be edited in any way Managing Attendance Protocol & Procedure Reference Number: NHSCT/11/419 Target audience: This protocol is directed to all Trust staff. Sources of advice in relation to this document: Elizabeth Brownlees, Assistant Director of Human Resources Janet McCartney, Senior Human Resources Manager Replaces (if appropriate): NHSCT Interim Managing Absence Policy (Ref: NHSCT/08/04) Type of Document: Trust Wide Approved by: Policy Committee Date Approved: 29 July 2011 Date Issued by Policy Unit: 3 August 2011 NHSCT Mission Statement To provide for all, the quality of service we expect for our families, and ourselves.

Managing Attendance Protocol & Procedure July 2011 1

Index Page Section 1 Introduction 1.1 Target Audience 4 Section 2 Roles and Responsibilities 4 2.1 Senior Management Team 4 2.2 Managers 5 2.3 Employees 6 2.4 Human Resources Department 7 2.5 Occupational Health Department 8 2.6 Governance Department 9 2.7 Trade Unions 9 Section 3 Reporting and contact during absence 10 3.1 Notification 10 3.2 Certification of sickness absence 10 3.3 Travel to areas with increased risk of tuberculosis (TB) 11 3.4 Sickness during annual leave and public holidays 12 3.5 Taking a holiday during sick leave 12 3.6 Working elsewhere when on sick leave 12 3.7 Failure to follow notification requirements 12 3.8 Contractual sick pay 12 3.9 Recording of absence 13 Section 4 Meetings/Occupational Health referrals 14 4.1 Triggers 14 4.2 Absence during the probationary period 14 4.3 Return to work interview 15 4.4 Procedure for referral to Occupational Health 15 Section 5 Management of short term absence 16 5.1 Definition 16 5.2 Formal Attendance Review Stage 1 16 5.3 Formal Attendance Review Stage 2 17 5.4 Formal Attendance Review Stage 3 17 5.5 Final Attendance Review - Stage 4 - Termination of employment (dismissal) procedure 17 5.6 Mixture of short/long term absence 18 2

Section 6 Management of long term absence 20 6.1 Definition 20 6.2 Formal Attendance Review First meeting 20 6.3 Formal Attendance Review Subsequent meetings 20 6.4 Final Review meeting 20 6.5 Rehabilitation/phased return programmes 21 6.6 Redeployment 21 6.7 Ill health retirement (for employees who are members of HSC Pensions Scheme) 22 6.8 Termination of employment (Dismissal) procedure 23 6.9 Recurring long term absence 24 Section 7 Injury at work / HSC Injury Benefit Scheme 24 Section 8 Misconduct during absences 24 Appendices Occupational Health referral form - Appendix A Notification of foreign travel for Health Care Workers Appendix B Return to work interview form Appendix C Absence/Leave Record Appendix D Record of Sickness Absence Notification Appendix E Absence meetings checklist for managers Appendix F Monthly Sickness Absence Return form & Guidance for completion & codes Appendix G Short term absence flowchart Appendix H Long term absence flowchart Appendix I Levels of Management responsibility for Termination/Review Appendix J Useful Contacts Appendix K Sample letter advising of requirement to submit timely medical Fit notes Appendix L Sample letter advising of withholding of pay due to repeated failure to submit timely medical Fit notes Appendix M 3

Section 1 Introduction This protocol, which has been developed in partnership with local Trade Unions, should be read in conjunction with the Regional Policy Framework of Best Practice for Managing Attendance, which sets out agreed core principles for the management of attendance in respect of the Northern Ireland Health and Social Care workforce. The Regional Policy Framework document states: The agreed approach is based on the acceptance that the health and wellbeing of the workforce is critical to the effective functioning of any organisation and that the management of attendance is an important management issue which requires to be pursued in an open and transparent manner. Recognition must be given to the duty of the employer to support staff when they become ill, facilitating them, in so far as possible, to return to work safely as early as they can. In addition, the employer has a responsibility to actively encourage a culture of health and well being within the workforce while equally expecting employees to take personal responsibility for their own health and well being. The partners to the regional framework also recognise that HSC organisations have a primary responsibility to provide high quality services to their population and that absence places additional pressure on employees who are not affected by illness. The National Audit Office Report (2003) indicates that Staff absence has a direct impact on the ability of NHS Trusts to treat patients and can increase costs through the use of bank and agency staff 1.1 Target Audience This protocol is directed to all Trust staff. Section 2 Roles and Responsibilities 2.1 Senior Management Team / Directors Senior Management Team / Directors will: have ultimate responsibility to reduce risks to the organisation which may affect the quality and delivery of services; regularly monitor absence rates, causes and trends and develop appropriate performance and reporting arrangements to satisfy the Trust that absence is being effectively managed in accordance with the protocol; and Delegate day to day responsibility for the implementation of all aspects of the protocol to managers. 4

2.2 Managers Managers will: make sure the Managing Attendance protocol is implemented; make sure they attend the mandatory training programme so they can implement their responsibilities effectively under the Managing Attendance protocol, and seek advice if they are unsure of any aspect of the policy; monitor attendance, keep accurate records and make sure that all sickness absence is communicated to the Payroll Department within the required timescales Appendix G; as part of their departmental induction programme, make sure that employees know about the Managing Attendance protocol in particular the reporting procedure and the submission of certificates; be responsible for making referrals to Occupational Health as laid down in the Regional Policy Framework document and this protocol Appendix A; when recommended by Occupational Health, consider redeployment to other roles, another team/department/location, either on a temporary or permanent basis, to reduce the length of the employee s absence or maintain the employee at work. This would include consideration/facilitation of temporary alternative working arrangements pending the resolution of conflict issues under the Trust s Working Well Together or Management of Harassment in the Workplace policies; ensure that a return to work plan is discussed with employees and put in place rehabilitative measures, where appropriate and practicable; be responsible for considering action under legislation such as health and safety and disability; immediately inform the Governance Department when it becomes known that an employee s absence arises from an injury or other condition associated with their employment with the Trust and take action in relation to the Trust s incident reporting arrangements; inform Occupational Health Department, in advance of travel, if any employee whether at work or on sick leave requests annual leave or 5

unpaid leave in excess of 3 weeks for the purposes of foreign travel; and initiate action in accordance with the Trust s disciplinary procedures if appropriate to deal with issues of misconduct. Notify Payroll to make deductions from an employee s pay if they fail to submit appropriate certificates/absence is not reported as detailed in the protocol despite being reminded of the notification requirements. Managers should remember it is not their role to determine whether illnesses are genuine but to manage unacceptable levels of absence. 2.3 Employees The employee will: take responsibility for their own health so that they can carry out their job responsibilities; read and adhere to the Managing Attendance protocol and procedure and make sure that they know what they have to do if they are not able to attend for work because they are sick; commit to the attendance management programme, give regular and effective attendance at work and not remain away from work where adjustments or modifications could be made to facilitate their return; participate in developing return to work plans and make best use of rehabilitative measures; seek to resolve conflict issues immediately through the Working Well Together or Management of Harassment in the Workplace policies. Staff should be aware that they will be expected to remain in work pending the resolution of such issues which may involve the manager facilitating alternative working arrangements; ensure that they notify their manager and Occupational Health Department immediately if, at any time when outside the work environment, they come into contact with any infectious disease so that appropriate precautions can be taken, where necessary, in order to protect the employee and patients or clients; when requesting annual leave or unpaid leave in excess of 3 weeks, notify Occupational Health through their manager if travelling to countries outside Europe, North America or Australia where they may be at increased risk of developing Tuberculosis (TB), particularly if they are going on a prolonged visit Appendix B. 6

keep in regular contact with their manager, or appointed contact, as laid down in the protocol, provide self and medical certificates as required, and attend any meetings with their manager about their absence; as a requirement of their contract of employment attend any appointments made for them with Occupational Health; during an absence, not participate in any activity (such as domestic, social and sporting) which may delay their recovery or be likely to raise doubts about the reason for their continued absence; not work elsewhere whilst on sick leave from the Trust. If the employee has more than one job and their doctor considers, due to their condition, this work to be beneficial, they must advise their manager, who may seek a view from Occupational Health to assess their fitness for the other work; contact their manager if they are thinking of taking a holiday during their sick leave, but are still unfit for work, to seek approval and obtain a report from Occupational Health to support this; make their managers aware of any concerns they have regarding health and safety, and welfare issues; on their return to work, complete a return to work interview form Appendix C and contact their manager regarding arrangements for a return to work interview; be aware that the sick pay scheme is for their ill health, and not for other purposes such as caring responsibilities; and be aware that up to 5 day s annual leave may be carried forward from one leave year to the next (pro rata for part-time employees) in accordance with the Agenda for Change handbook. 2.4 Human Resources Department The Human Resources Department will: provide managers with advice and guidance on this protocol, including necessary support to prepare for meetings with staff in accordance with the Managing Attendance Protocol; at the Trust induction programme, make sure that new employees are made aware of the existence of the Managing Attendance protocol and advise them to check with their manager what their responsibilities are; 7

provide training to managers on this protocol so that they may more effectively manage absence; attend Directorate Managing Attendance forum meetings with managers and Occupational Health as appropriate; provide Directors and Trust Board with information on a regular basis to facilitate the monitoring of absence rates, the analysis of causes and trends, and development of action plans; review the Managing Attendance protocol and procedures, and update these as and when necessary; and provide information on ill health retirement benefits and process, and progress ill health retirement applications. 2.5 Occupational Health Service (OHS) The Occupational Health Service will: carry out health assessments on employees absent from work due to sickness; provide managers with a formal report, advising on medical/health related issues on request so that managers can decide how to manage the absence. In complex cases, Occupational Health will participate in multi-disciplinary case management discussions if necessary; provide advice to employees and help them to understand the illness and to minimise its impact on their ability to work; make assessments and provide a report for HSC Pensions Branch in relation to applications for ill-health retirement; when requested, provide advice to managers regarding the appropriateness of the employee undertaking other employment whilst absent from work; when requested provide a recommendation to managers regarding the appropriateness of the employee taking a holiday whilst absent from work; provide preventative measures to minimise absence such as annual flu immunisation; and provide counselling and physiotherapy services to employees. 8

2.6 Governance Department The Governance Department will: investigate incidents where the employee has or could have suffered harm in the course of their duties and provide advice on action to be taken to reduce the likelihood of the repetition of such incidents; recorded on risk registers where necessary; provide advice on work practices and environmental issues where considered as possibly contributing to, or increasing the likelihood of employee absence; advise on the personal injury litigation implications arising from a termination of employment of an employee whose absence arises from a work related injury or associated condition; advise on the eligibility of the employee to receive payment of Injury Benefit; and provide the Senior Management Team with information relating to sickness absence that is associated with reported incidents. 2.7 Trade Unions Trade unions will: support the implementation of this protocol and participate in the review of the protocol/procedures; participate in initiatives and work in partnership with management to reduce the Trust s absence levels; accompany their members as requested at meetings arranged under the Managing Attendance protocol to discuss short-term absences, long-term absence or misconduct during absence; and provide advice and support to their members in absence situations to help improve attendance. 9

Section 3: Reporting and contact during absence 3.1 Notification Employees are required to notify their manager by telephone if they are sick as soon as possible before the time they are due to go on duty or, if in exceptional circumstances this is not possible, within an hour of the time they were due start work. If the manager is unavailable the employee should speak to the appropriate line manager or other contact as directed by local departmental arrangements. Communication by text or computer is not an acceptable means of communication. Those who work shifts, evenings or night duty must tell their manager at least four hours before the shift starts. Employees must tell their manager: the reason for their absence; how long they are likely to be off; what tasks will have to be covered during their absence; what action they have taken in respect of their illness e.g. doctor s appointment; This information is essential to enable the manager to plan cover for the absence as necessary or to rearrange duties. The employee will also agree with the manager when they will next make contact and in cases of extended periods of absence taking account the sensitivities involved, how regularly contact will be made. It is the responsibility of both managers and employees to maintain regular contact. In some circumstances employees may not wish to discuss the reason for their absence with their manager when circumstances are personal/sensitive. If this is the case, the employee will be referred immediately to the Occupational Health Department, to facilitate the management of their absence. Managers should record the detail of the telephone contacts made. The Record of Sickness Absence Notification form Appendix E may be used for this purpose. 3.2 Certification of sickness absence To avail of the sick pay scheme, employees must comply with the following requirements. For period of sickness between 1-3 calendar days - no certificate required. The exception would be in the management of short term absence as laid down in this 10

protocol the employee is informed by their manager that a medical certificate is required for each period of absence regardless of length. For period of sickness between 4-7 calendar days (includes weekends whether the employee is scheduled to work them or not)- employees must send their manager a self certificate of absence within seven calendar days of the first day of the absence, dated from the first date of absence. The manager must forward the self certificate to the relevant Payroll office immediately. For periods of absence lasting 8 or more calendar days - employees must send their manager a medical certificate from their general practitioner (or hospital inpatient certificate) to cover from Day 8 to the date of return to work. From 6 April 2010 a new Statement of Fitness to Work or fit note was introduced which allows GPs to advise on one of two options: Not fit for work where the GP s assessment of their patient is that they should refrain from work for a stated period of time or May be fit for work taking account of the following advice where the GP s assessment is that their patient s health condition does not necessarily mean they cannot return to work. GPs may give patients, and through them the Trust, information about the functional effects of their health condition, assisting in the early identification of support or changes that could facilitate a return to work sooner. Ultimately it will be for the Trust to decide whether any such measures can be accommodated. If it is not possible for the Trust to provide the support for the employee to return to work, the employee and the Trust can use the fit note as if the GP had advised not fit for work. The employee does not need to return to their GP to confirm this. As of 6 April 2010 the medical certificate no longer includes the facility to state that the patient need not refrain from work. Therefore managers will not be in a position to advise employees to remain off work until they produce a final medical certificate. If managers receive a fit note indicating may be fit for work taking account of the following advice but are concerned about the employee s fitness to return to work even if the measures suggested by the GP could be implemented, the manager should make a referral to Occupational Health in the normal way. If an Occupational Health referral has already been made, the manager should inform the Occupational Health department of the information received from the GP and seek advice on how to proceed. 3.3 Travel to areas with increased risk of tuberculosis (TB) Employees requesting annual leave or unpaid leave in excess of 3 weeks to travel to countries outside Europe, North America or Australia where they may be at increased risk of developing Tuberculosis (TB), must notify Occupational Health 11

Department through their manager in advance of travel. The employee should use the notification form for this purpose. On receipt of this notification, the Occupational Health Department will provide advice and information to the employee on what precautions they should take during their stay. 3.4 Sickness during Annual Leave and Public Holidays Employees who become unfit for work during a period of annual leave must notify their manager on the first day of sickness absence, or as soon as possible, in accordance with this protocol and not wait until they return to work. Certificates should be provided as above. If these conditions are complied with, the annual leave will be converted into sick leave and the annual leave credited back to the employee. Otherwise this will result in the loss of annual leave. Employees will not be entitled to an additional day off if sick on a Public Holiday. 3.5 Taking a holiday during sick leave Employees thinking of taking a holiday during their sick leave, but are still unfit for work, must contact their manager to seek approval and obtain a report from Occupational Health to support this. 3.6 Working elsewhere when on sick leave If an employee has more than one job and their doctor considers, due to their condition, this work to be beneficial, they must advise their manager, who may seek a view from Occupational Health to assess their fitness for the other work. 3.7 Failure to follow notification requirements It is the employee s responsibility to comply with the Trust s notification arrangements, and to make sure that the full period of sick leave is covered by the appropriate certificates and submitted to their manager on time. Failure to do so may result in the Trust s disciplinary procedure being initiated. If an employee fails to submit the appropriate certificate within the timescales or absence is not reported as detailed in the protocol, the manager will write to the employee to remind them of the notification requirements Appendix L and that if there is a reoccurrence, the relevant Payroll office will be informed to make deductions from the employee s pay Appendix M. Payments may be reinstated from the submission of up-to-date certificates or correct reporting of absence. 3.8 Contractual sick pay Employees absent from work due to illness will be entitled to receive contractual sick pay as follows: 12

During the first year of service one month s full pay and two month s half pay During the second year of service two month s full pay and two month s half pay During the third year of service four month s full pay and four month s half pay During the fourth and fifth year s of service five month s full pay and five month s half pay After completing five year s service six month s full pay and six month s half pay Sick pay for those who have exhausted sick pay entitlements should be reinstated at half pay, after 12 months sickness absence in the following circumstances: Staff with more than 5 years reckonable service sick pay will be reinstated if sick pay entitlement is exhausted before a final review meeting for long term absence has taken place, only if the delay in undertaking a final review meeting is caused by the manager. Staff with less than 5 years reckonable service sick pay will be reinstated if sick pay entitlement is exhausted and a final review meeting does not take place within 12 months of the start of their sickness absence. Reinstated pay will continue until the final review meeting takes place. The manager will make arrangements for the reinstatement of pay by processing a Notification of change form in accordance with normal arrangements. 3.9 Recording of absence Managers are required to keep accurate records of employees absences and the reason for absence Appendix D. Recording of sickness absence and related information is fundamental to good practice in the management of sickness absence. It is essential in identifying absence levels and patterns, highlighting short/long term absences and to make sure correct payments are made under the sick pay scheme. It is important that managers keep records in case of ongoing or recurring problems. Managers must submit accurate and fully completed sick leave records, including the reason for sickness absence codes, on the Monthly Sickness Absence return (Appendix G) for monthly paid staff to the Payroll office before the 3 rd working day of the next month, and other agreed method of returns for weekly/fortnightly paid staff by the stipulated dates to make sure correct payments are made and so that timely and complete absence reports can be generated to enable the Trust to monitor absence levels on a monthly basis. Where no monthly return is received by the Payroll office by the third working day of the month, it will be assumed that no absence has occurred during the previous month. 13

Section 4: Meetings/Occupational Health referrals 4.1 Triggers Meetings and Occupational health referrals will be arranged at various stages as laid down in the protocol even if the employee is pregnant or has a disability. The manager should consider any support/reasonable adjustments that would help to reduce the amount of time the employee has to take off work. There are certain legislative requirements that apply to pregnant workers and employees with a disability. An employee will not be dismissed due to her pregnancy as this would automatically be an unfair dismissal. Under disability legislation, there is a legal requirement to consider reasonable adjustments. This will involve an assessment of: o How practical it is to make the adjustment; o The financial and other costs involved in making the adjustment and the extent of any disruption caused; o The extent of financial or other resources available; and, The availability of financial or other assistance to help make the adjustment. 4.2 Absence during the probationary period Employees should be aware that their absence record is considered during their probationary period, and the manager can take action if this is not satisfactory, including termination. The probationary period of the contract of employment should be used constructively to assess, amongst other things, the employees attendance records. If attendance is poor or gives cause for concern during the probationary period, managers should make employees aware of that concern during the probationary period and give them an opportunity to improve. Employees should also be advised of the consequences of poor attendance and that it may result in the termination of their contract of employment. If managers are considering the extension of the probationary period solely on the basis of the employee s attendance record, they should always seek advice from the Human Resources Department before doing so. It should be noted that whilst the management of an employee s performance is addressed under the Capability Procedure, it may be appropriate to extend the probationary period if there is significant absence during the probationary period. 14

The extension of the probationary period would only be in exceptional circumstances. Such exceptional circumstances might be hospitalisation or bereavement. The extension of the probationary period would be for the sole purpose of allowing the manager the opportunity to properly assess the individual s performance, which due to the length of the employee s absence, they have not been in a position to do during the 6 month period. In other cases where the absence has been addressed with the employee during their probationary period and their attendance has not improved or been maintained at a satisfactory level, the termination (dismissal) procedure should be initiated by following the steps at paragraph 5.5. 4.3 Return to Work Interview On return to work from every spell of absence, a manager should hold a return to work interview with the employee. The purpose of the interview will be to discuss the reason for the absence and for managers to make the employee aware of their concern for their well-being. The return to work proforma should be completed by the employee and manager on each occasion of sickness absence. Further guidance is contained on the return to work proforma - Appendix C. 4.4 Procedure for referral to Occupational Health In support of the principle of early intervention, managers should ensure that appropriate and timely support from Occupational Health is made available to employees. The following timescales for referral are to be used: Stress immediate referral Injury at work immediate referral Musculoskeletal immediate referral Where a member of staff is the victim of a violent incident at work immediate referral Absence following maternity leave immediate referral Long term absence where absence has reached or is expected to reach a period of 4 calendar weeks or more Short term absence where there has been 3 periods of absence or more in the rolling 12 month period Where an employee is absent and does not wish to share reason with their manager. Having discussed the purpose and reason for the referral with the employee, managers should fully complete the Occupational Health referral form and give a copy to the employee. 15

Section 5: Management of short term absence 5.1 Definition The definition of short term absence for the purpose of this protocol is absence which is likely to be one day up to a week, but can extend up to 4 calendar weeks. 5.2 Formal Attendance Review Stage 1 At the third spell of absence or where absence totals 10 working days in any 12 month rolling period, managers should write to the employee inviting them to a meeting. The letter should indicate that this is a Formal Attendance Review Stage 1 meeting under the protocol and the employee may be accompanied by a Trade Union representative or work colleague. The manager should discuss the level of absences with the employee. Such discussions will include the reasons for absence, what mitigating circumstances might be contributing to the absenteeism, gaining information to make a referral to Occupational Health to find out whether or not there is an underlying medical condition. The employee will then be informed that their sickness absence levels will continue to be monitored and informed of the next stages in the protocol. If indications are that the pattern of frequent absenteeism is due to an underlying medical condition, the manager should consider the following: the information provided by Occupational Health when available, and if necessary, consider if reasonable adjustment is appropriate under the Disability Discrimination Act 1995. Further guidance may be obtained from the Human Resources Department; the possibility of providing different working arrangements e.g. reduced hours, restricted duties which may assist the employee to overcome their difficulties in attending work; whether the medical condition is such that redeployment to another area of work would eliminate the need for the employee to take time off. The manager should discuss the area(s) of work which may be suitable. The manager should also advise the employee that it is not possible to guarantee that suitable alternative work will be available and if a post is available, Occupational Health will have to confirm their fitness for the post. The manager will be guided by the essential criteria for a particular post in determining whether or not it is a suitable alternative. However, where employees do not meet the essential criteria for a potential post, consideration may be given to the possibility/feasibility of training. 16

The manager must note the main points of discussion at meetings held under this protocol. Notes of the meeting or a letter noting the main points of discussion should be issued to the employee following the meeting and they should be requested to return any amendments that they might wish made within one week. 5.3 Formal Attendance Review - Stage 2 If there is a further period of absence within the rolling 12 month period, the manager should again meet the employee to discuss the current state of health, the causes of the absence and to inform the employee that their level of absence is causing concern. The manager should make a referral or re-referral to Occupational Health. The opinion of the occupational health practitioner including assessment of whether or not there is an underlying medical condition, should be discussed. The manager should ensure that the employee understands what improvement is expected and what are the possible outcomes should the improvement not be made, such as, different working arrangements; alternative employment; ill health retirement (if employee is a member of the HSC Pension scheme and is eligible to apply); or termination if there are further periods of absence or alternative working arrangements or alternative employment are not available. The employee will also be instructed that any further periods of absence will require a medical certificate. 5.4 Formal Attendance Review - Stage 3 If there is a further period of sickness absence in the rolling 12 month period, the manager should request an updated Occupational Health report. Another meeting with the employee will be held to discuss the employee s current state of health, occupational health reports, any reasonable adjustments which have been made to support improved attendance, possible further adjustments which may be considered necessary and to consider any further information which the employee may present. The manager will further discuss in some detail with the employee the possibility/feasibility of redeployment if recommended by Occupational Health, ill health retirement (if the employee is a member of the HSC pension scheme and is eligible to apply) or termination of the contract of employment. The employee will be informed that if there is a further period of absence the procedure for termination of their contract of employment (dismissal) will be initiated. 5.5 Final Attendance Review - Stage 4 Termination of employment (Dismissal) Procedure If there is a further period of sickness absence, the following steps should be taken to take account of the statutory obligations: 17

Step 1 The manager should write to the employee inviting them to a meeting stating that the meeting is to discuss their level of absence and that the Trust would be contemplating the termination of their contract of employment. Also that they may be accompanied by a trade union/staff organisation representative or work colleague if they wish. Step 2 The meeting is held and the panel (Level 4 Manager and Senior HR Manager, or above who have authority to terminate contract of employment) will review all of the relevant information as documented by the manager and will take into account any further points the employee/their trade union representative wish to make. The manager, who managed the absence under the protocol, will also be in attendance at this meeting. The panel s decision will be communicated in writing to the employee within seven working days of the meeting. Where there is a termination of the contract of employment the employee is entitled to receive pay in lieu of notice along with accrued annual leave. The carry over of leave arrangements as laid down in the terms and conditions handbook apply. Step 3 - If the panel s decision is to terminate the employee s contract of employment the employee may appeal this decision. To do this they should write to the Director of Human Resources within 7 working days of receipt of the decision to terminate their contract of employment. The Director of Human Resources will arrange for an Assistant Director from the relevant directorate and an Assistant Director from Human Resources to meet with the employee. The review process will include consideration of the circumstances of the appeal and the reasonableness of the decision to terminate the contract of employment. The manager, who managed the absence under the protocol, will also be in attendance at this meeting. An appeal will be conducted, as early as is practicable following receipt of the written request. A trade union/staff organisation representative, or a work colleague may accompany the employee. 5.6 Mixture of short/long term absence There may be occasions when employees have had a mixture of short term and long term absence or a number of spells of long term absence. At the time of each of the absences, the manager will take action in accordance with the long term or short term absence section of the Managing Attendance protocol. Where an employee has had 2 short term absences amounting to less than 10 days followed by a long term absence, whilst the long term absence is dealt with in accordance with the long term section of the protocol it also means that this should be considered as the 3 rd period of absence in 12 months. Therefore, at the return to work interview with the employee the manager should inform the employee that as this is the 3 rd period of absence in 12 months for the purposes of the Managing 18

Attendance protocol it is considered as Stage 1 and therefore a further period of absence in the rolling 12 month period will take them to Stage 2 of the policy. In this particular circumstance referral to Occupational Health will have already taken place in respect of the long term absence, therefore a further referral will not be necessary unless there is a further absence If the employee was on long term sick leave initially followed by a further short term absence, a Stage 2 meeting would be held as the first absence was more than 10 days. And a further referral to OH will be required. 19

Section 6: Management of Long-term absence 6.1 Definition Long term sickness absence for the purpose of this protocol is defined as continuous absence of 4 calendar weeks or more. 6.2 Formal Attendance Review - First Meeting The manager will meet the employee to discuss progress after 4 weeks continuous absence at the latest, unless in exceptional circumstances eg hospitalisation or the employee is undergoing treatment and is not well enough to participate in a meeting. At this stage the manager will refer the employee to Occupational Health if they have not already done so. The manager should discuss the referral and the purpose of the referral with the employee; this is generally undertaken at the absence meeting. The Occupational Health referral form should be completed by the manager and forwarded to the Occupational Health Department along with sick leave details and an up-to-date job description, which accurately reflects the duties of the post. The manager should give a copy of the completed Occupational Health referral form to the employee. The manager will meet with the employee again when they receive the report from Occupational Health. During the meeting the discussion should include: o the employee's current state of health; o rate of recovery and likely date of return to duty; o the opinion of the occupational health physician; and o possible outcomes such as different working arrangements, alternative employment, ill health retirement (if employee is a member of the HSC pension scheme) or termination. 6.3 Formal Attendance Review - Subsequent meetings The manager should next meet with the employee when they have been off work for 12 weeks. The manager should make sure that they have an updated Occupational Health report in advance for discussion at this meeting. Further meetings will be held every 8 weeks ie at 20, 28, 36, 44 weeks (or immediately following an Occupational Health appointment whichever is sooner) unless during the sickness absence Occupational Health gives a clear indication that an individual is not likely to return in the near future or not at all, in which case a final review meeting should be arranged by the Manager. 6.4 Final review meeting At no later than 52 weeks absence a final review meeting will be held. The final review is where a decision on the appropriate way forward is made ie return to substantive employment/redeployment/application for ill health retirement/ initiate termination (dismissal) procedure. 20

After 12 months of continuous sickness absence if the final review meeting has not taken place due to the delay by the manager, the employee s half pay will be reinstated until a final review meeting takes place, in accordance with AfC terms and conditions of service. This provision will not apply where the meeting has been delayed due to reasons other than those caused by the manager. 6.5 Rehabilitation/phased return programmes Rehabilitation/phased return is a time limited restriction either on the hours worked and / or the role the employee undertakes pending a return to the full duties of the employee s post Where possible, the employee will be assisted in their return to work. An employee returning from sickness absence on a rehabilitative programme recommended by Occupational Health and agreed with management will experience no loss of pay during the rehabilitative period, which will not exceed 6 weeks. It should be noted that the length of the rehabilitative period may be a matter of a few days ranging through one week to four weeks depending on the specific circumstances of the case with, in very exceptional circumstances, scope to extend this to five or six weeks for specific reasons recommended by Occupational Health. It is the manager s responsibility to determine the feasibility of a rehabilitation programme and to plan the programme in consultation with the employee and Occupational Health. When an employee is on a rehabilitative return to work on reduced hours, that employee for recording purposes, will be recorded as being at work, not on sick leave. It is in order for a manager to agree a phased return with an employee using annual leave including where an amount of annual leave needs to be used up before the end of the leave year and the service can accommodate this, or a combination of the full pay rehabilitation period and annual leave. Any arrangement for a phased return to work, which may involve e.g. reduced hours, temporary redeployment to another post, restricted/alternative duties, different start/finish times, use of annual leave should be discussed and agreed between the manager and the employee beforehand. The manager should confirm the arrangement in writing to the employee and advise the Human Resources department on a Notification of Change form of any adjustment required to the employee s salary. 6.6 Redeployment The Regional Policy Framework states that where alternative employment is being sought for an employee who is found unable to return to their post as a result of health-related problems, this search will take place during a time limited period of no longer than 8 weeks from the point when it was agreed that the search should begin. 21

Taking account of the significant level of change within the organisation, the Trust will attempt to give every opportunity to health redeployments however, the Trust may not manage to facilitate redeployment. If alternative employment is secured, protection will not apply in the circumstances that the redeployment is to a post of a lower grade. 6.7 Ill health retirement (for employees who are members of HSC Pensions Scheme) Members of the HSC Pension scheme who have the requisite membership and become permanently incapable of doing their present job or any other regular employment because of ill health, may be able to receive a pension. There are two tiers of ill-health benefits: Tier 1 if the Scheme member is accepted by the HSC Pensions Service medical advisers as permanently incapable of doing their current HSC job, or Tier 2 if the scheme member is accepted by the HSC Pensions Service medical advisers as permanently incapable of both doing their current HSC job AND permanently incapable of regular employment of like duration to their HSC job, taking account of their mental and physical capacity; previous training; and previous practical, professional and vocational experience irrespective of whether or not such employment is actually available to them (Tier 2). Further information can be obtained from http://www.dhsspsni.gov.uk/ill-health-retirement-oct.pdf. Please note there is a significant change to the way in which tax relief is provided to members of the HSC Pensions Scheme from 6 April 2011. The annual allowance on tax relief is currently set at 255,000 per year and this will reduce to 50,000 per year. This will impact on applications for ill health retirement tier 2. Information is available on the website www.hscpensions.hcsni.net. ` `` Where a member of staff becomes terminally ill, and medical evidence is available that they have a reduced life expectancy which is on the balance of probabilities less than 12 months, they will be allowed to commute their pension for a one off lump sum. An application for ill-health retirement is voluntary and cannot be processed against the wishes of the employee. Employees must be aware that it is the HSC Pensions Service medical advisers who assess the medical evidence and advise whether the applicant is permanently incapable of either carrying out their present HSC duties or doing any regular work. If Occupational Health declare that an employee is unfit to continue work and is a member of the HSC Pensions Scheme, the employee should be encouraged to make application for ill-health retirement on form AW33-09. Even if sick pay allowance has not expired, this would still be the case. 22

Managers should discuss the option of ill health retirement at an early stage and seek information regarding benefits from Human Resources Workforce Governance Pay and Conditions Team. Ill health retirement takes a number of months to process, so the application should be made at the earliest opportunity (at least 3 months before a potential retirement date) to ensure that the employee s sick pay does not expire before their pension is available. If the employee does not wish to make application for ill health retirement or does not pay superannuation the termination process will be followed. Applications for ill health retirement can be progressed concurrently with the termination process. 6.8 Termination of employment (Dismissal) procedure If employees are likely to remain sick for the foreseeable future, and ill health retirement/redeployment is not an option, it may be necessary as a last resort, to terminate their contract of employment on the grounds of ill health. Consideration should be given to factors such as: the length of absence to date; the likely length of the continuing absence; the nature of illness; any medical opinion/prognosis; and the effect of the continuing absence on the provision of service and on other employees. When it is clear that the employee is not going to be fit within a timescale that can be accommodated, the manager should take action to terminate the contract of employment. This is also the case where the Occupational Health report indicates a review appointment has been made. Occupational Health should be advised of this. It is not expected that anyone will remain in employment beyond 12 months sick leave, but if Occupational Health gives a clear indication that an individual is not likely to return in the near future or not at all, the termination may be processed sooner. There is no automatic entitlement for the employee to exhaust their entitlement to sick pay before a decision is taken to terminate their employment on medical grounds. Step 1 The manager should write to the employee inviting them to a meeting, stating that the meeting is to discuss their level of absence and that the Trust would be contemplating the termination of their contract of employment. Also that they may be accompanied by a trade union/staff organisation representative or work colleague if they wish. Step 2 The meeting is held and the panel (Level 4 Manager and Senior HR Manager, or above who have authority to terminate the contract of employment) will review all of the relevant information as documented by the manager and will take into account any further points the employee/their trade union representative wish to make. The manager, who 23

managed the absence under the protocol, will also be in attendance at this meeting. The panel s decision will be communicated in writing to the employee within seven working days of the meeting. Step 3 - If the panel s decision is to terminate the employee s contract of employment the employee may appeal this decision. To do this they should write to the Director of Human Resources within 7 working days of receipt of the decision to terminate their contract of employment. The Director of Human Resources will arrange for an Assistant Director from the relevant directorate and an Assistant Director from Human Resources to meet with the employee, if a personal hearing has been requested. The review process will include consideration of the circumstances of the appeal and the reasonableness of the decision to terminate the contract of employment. The manager, who managed the absence under the protocol, will also be in attendance at this meeting. All reviews will be conducted as early as is practicable following receipt of the written request. A trade union/staff organisation representative, or a work colleague may accompany the employee. On termination of their employment on grounds of ill health, employees are entitled to one week s paid notice for each year of continuous employment subject to an overall maximum of twelve weeks. 6.9 Recurring long-term absences There may be occasions when a manager identifies a pattern of long term sick leave eg the employee has a period of long term sickness absence each year. In such cases the manager should seek advice from the Human Resources Department. The basic principles laid down in this policy for the management of sickness absence will apply and may result in termination of the contract of employment on ill health grounds where the level of absence has become unsustainable. Section 7: Injury at work / HSC Injury Benefit Scheme Managers must immediately inform the Governance Department when it becomes known that an employee s absence arises from an injury or other condition associated with their employment with the Trust and take action in relation to the Trust s incident reporting arrangements. The manager must also make an immediate referral to the Occupational Health department. Under the HSC Injury Benefit Scheme, if an employee is on authorised absence with reduced pay or no pay because of an injury or disease wholly or mainly attributable to their employment, they may be entitled to temporary injury allowance; Information on HSC Injury Benefit Scheme Temporary Injury Allowance and Permanent Injury Benefits can be found on http://www.dhsspsni.gov.uk/members-fs or advice can be sought from the Trust s Governance Department. Section 8: Misconduct during absences Misconduct during absences will be dealt with in accordance with the Trust's Disciplinary procedure. Examples of misconduct which may result in disciplinary action and/or 24