Policy on the misuse of drugs, substances & alcohol Responsible manager: Joanna Cousins, Deputy Director of HR & OD Endorsed by: Trust Board Date of endorsement: February 2003 Review date: September 2012 Page 1 of 11
Policy on the Misuse of Drugs, Substances & Alcohol Introduction As a responsible employer, the Trust is concerned for the health, safety and welfare of its staff at work and is conscious of its legal responsibility to provide a safe place of work for all staff, patients and members of the public. The objective of this policy is to give staff an awareness of the risks associated with the misuse of alcohol; drugs and other substances, which can be, misused e.g. solvents. In today s society all kinds of people are involved in drug/alcohol misuse, they do not conform to any stereotype. Drug and alcohol misuse harms individuals both physically and mentally, and through the misuser s actions, other people and the environment. This policy has been put in place to help staff who have related problems and the support which can be given includes a number of groups and organisations, including our Trade Unions, Human Resources and outside associated agencies. Scope of the Policy The policy applies to all staff without exception and does not discriminate on grounds of status, sex or race at any level. All employees will have the same opportunities for counselling and referral. Infringements of this policy may be dealt with under the Trust s disciplinary procedures. The policy covers the following areas: 1) Aims of the policy 2) Benefits of the policy 3) Misuse of drugs, substances and alcohol 4) Recognising an employee with a problem 5) Managing an employee suspected of having a related problem 6) Testing Procedure 7) Implementing the policy roles and responsibilities 8) Returning to work following a course of treatment/action 9) Confidentiality 10) Getting help 11) Legislation 1. Aims of the Policy a) To clearly state the Trust s position on drug, alcohol and substance misuse. b) To ensure that the organisation and patient care are not adversely affected by drug, substance or alcohol misuse by staff. Page 2 of 11
c) To clearly inform all staff of the Trust s policy on testing staff who are suspected of being under the influence of drugs or alcohol. d) To prevent the use of illegal drugs/substances and to discourage the misuse of other drugs/substances and alcohol. e) To raise the awareness of the issues and effects associated with drug & alcohol misuse. f) To identify employees affected by drug, alcohol and substance misuse and to encourage them to seek help and treatment. Where it is established that an employee is suffering from a drugs or alcohol problem and the employee admits the problem, this will be treated as a medical matter and in a supportive way. g) To ensure that employees admitting to drug, alcohol or substance misuse have access to advice, counselling, treatment and rehabilitation at the earliest possible opportunity. 2. Benefits of Having a Successful Workplace Policy Successfully tackling drug and alcohol misuse will benefit the Trust, its employees and patients. Highlighted below are just some of the benefits: - Reduces the cost of absenteeism - Reduces the risks of accidents and clinical errors caused by impaired judgement - Creates a more productive work environment - Provides confidential help and support to employees who declare they have a drug or alcohol related problem, thus improving staff morale. - Saves the cost of recruiting and training new employees to replace those whose employment is terminated because of misuse. - Enhances public perception of the Trust as a responsible employer. - Contributes to society s efforts to combat drug misuse. 3. Drugs / Substance / Alcohol Misuse a) Drugs & Substances Many of the problems associated with drug and substance misuse are similar to those of alcohol misuse. This policy relates to the use of illegal drugs and the illegal use of prescribed drugs, and the abuse of substances such as solvents and glue. The Misuse of Drugs Act of 1971 acts to regulate dangerous or otherwise harmful drugs which are designated as controlled drugs. These controlled drugs will be referred to within this policy as illegal drugs. The main drugs of misuse within this illegal group are Opiates e.g. heroin (diamorphine), morphine, methadone, Stimulants, e.g. cocaine, crack cocaine, amphetamines, (speed, methamfetamine), ecstacy and methylphenidate, Benzodiazepines e.g. temazepam & diazepam, Page 3 of 11
Hallucinogens, e.g. LSD & cannabis, and others including codeine, dihydrocodeine, co-proxamol and co-codamol. Drug and substance misuse can affect an organisation, its workforce and productivity in a number of negative ways i.e. it can lead to increased levels of sickness, absenteeism, incidents and accidents as well as adversely affecting performance of the organisation and its employees. b) Alcohol The Trust requires all individuals who are scheduled for work or on-call duties to arrive for work free from the effects of alcohol and forbids its consumption during working hours (and recommends that this should include lunch-times and other allocated breaks). The consumption of alcohol on Trust premises is not permitted. This ban applies to all staff and other personnel on Trust premises. It also includes staff who are on-call in Trust accommodation. The following exceptions are recognised: Cases where a doctor prescribes alcohol, or where it is appropriate to the patient s care. Residences which are deemed to be the member of staff s home. (Staff must however remember their responsibilities as tenants). Alcohol may be served at organised functions, although only to staff who are off duty and who will not subsequently be undertaking Trust duties on the same day. This must however, be agreed in advance, in writing with the Chief Executive. In these circumstances there should also be an equal availability of non-alcoholic drinks. The Trust will ensure that employees have the necessary information to raise awareness of the risks involved in drinking alcohol as well as an understanding of the messages on safe and sensible drinking. There will also be active promotion of local agencies that provide support and advice on alcohol. The Trust will also make all employees aware of this policy and ensure that a copy of it is available in every ward and department. Employees will also receive an educational input on alcohol as part of their induction programme. 4. Recognising an Employee with a Misuse Problem a) Drugs/Substances The effect of any drug or substance misused by an individual depends on the drug/substance itself, how it is used, and on the person using it. The effects of drug misuse are insidious and not easy to detect, particularly in the early stages. Drugs/substance misuse can affect concentration, co-ordination and work performance. The following characteristics may indicate the presence of such a problem. unexplained absences from work Page 4 of 11
excessive level of sickness absence high levels of accidents difficulty in concentration slow reactions loss of interest sudden changes of mood irritability or aggression depression unusual smells, stains or marks on body or clothes sores or rashes, especially on the nose or mouth b) Alcohol An alcohol related problem is defined as any drinking, either intermittent or continual, which interferes with a person s health and social functioning and/or work capability or conduct. Alcohol is not often thought of as a drug and is an important part of many people s social lives. However, drinking too much or at the wrong time can cause serious health and safety risks in the workplace. It is recognised that problems related to drugs, substance or alcohol are primarily health and social concerns and therefore people exhibiting problems require help and treatment. Employees themselves, their managers, their colleagues and the medical profession, can all help to identify individuals for whom misuse is, or may become a problem. Employees who suspect or know that they have an alcohol, drug or substance related problem are encouraged to seek help and treatment voluntarily on a confidential basis, either through this policy s procedures or through resources of their own choosing. 5. Managing employees suspected or identified as requiring help with a Drugs/Substance/Alcohol Problem Employees who are identified, as possibly having a drugs/substance or alcohol-related problem will be offered an opportunity to seek help or advice from a designated person within the Staff Health Department or from an approved external agency. Should Staff Health or external agency decide that the employee requires help/advice, they will provide the appropriate programme on the understanding that: a) Staff who are required to be absent from duty will be paid in accordance with the sick pay scheme appropriate to their employment. Absences of this kind should however not be recorded as sick but as a period of temporary medical suspension. Staff absence to attend treatment sessions etc. should also be supported, but these arrangements must be made with the prior approval of the Manager and where possible fit in with off duty periods. Page 5 of 11
b) Should an employee be deemed fit for duty during the help/advice programme they should be permitted to continue in employment unless such an arrangement would adversely affect the service. c) Should an employee refuse to co-operate with the help/advice programme, when this is deemed necessary, the employee may be subject to disciplinary procedures. Employees who, having come to notice as potentially suffering from a drug/substance or alcohol-related problem and who decline to accept diagnosis or help, or who discontinue their treatment without medical consent, may similarly be subject to action under the Trust s disciplinary procedure. Where disciplinary procedures have been invoked and it transpires that the breach of rules is associated with drug or alcohol misuse, each case will be assessed individually and action taken accordingly. Disciplinary action may be delayed while the employee is receiving treatment for drug misuse. Where the disciplinary process has been instigated and where possession of an illegal substance is not for personal use by the individual then the Trust reserves the right to inform the police. 6. Testing Procedure Peterborough & Stamford Hospitals NHS Foundation Trust reserves the right to subject any employee who is thought to be under the influence of illegal drugs / substances or alcohol to a medical testing procedure. A member of staff from Staff Health Department will carry out this procedure with the employee s consent (at weekends and out of office hours this will be performed by the member of Staff Health who is on-call). The member of staff will be requested to provide samples of breath or urine or blood as needed for analysis. If requested by the employee, duplicate samples for analysis by a laboratory of their choice and at their own expense can be taken. For samples analysed on site, all procedures and paperwork will be carried out within the full view of the member of staff and his/her representative. For samples analysed elsewhere, this will include all stages up to the samples being sealed prior to despatch. Home Office approved chain of custody procedures will be mandatory. Test methods, procedures and analytical cut off values for screening and confirmation of specific drugs used by the Trust, or external laboratories used by the Trust, will be in accordance with UK laboratory Guidelines for Legally defensible Work Place Testing. The Trust or laboratory will retain positive samples for one year for release to a second laboratory or confirmatory testing in case the results are challenged. The limits for alcohol in samples (Breath or urine) will be in accordance with current Road Traffic Acts. The results of any test used by the Trust will be to either confirm or refute the suspicion about the employee s condition in relation to possible drug or alcohol misuse Page 6 of 11
Any member of staff or Trust management wishing to obtain further and more specific details about these testing methods should contact a member of staff Health Department, PDH. Staff Who Decline Consent to Testing If an employee s consent is unreasonably refused the Trust reserves the right to make a judgement about that member of staff in cases where they are exhibiting unusual behaviour. This judgement will be based on evidence presented by the Departmental Manager, Staff Health Medical Officer and Human Resources Manager. The Trust also reserves the right to follow a course of action with the staff member (based upon the judgement made), which could involve either support or discipline depending on the findings/recommendations of the investigating group. This group will be made up from the individuals mentioned above. The staff union representative will also be informed at the earliest opportunity. Once an employee s consent to the test has been obtained through Staff Health, the results, should be acted upon as follows: a) Illegal Drugs If testing has confirmed that if an individual has any trace of illegal drug in their system whilst on duty, they will be suspended on full pay immediately whilst an investigation into the incident takes place. They will also be referred to Staff Health. If, as a result of this referral, the member of staff accepts that his/her misuse is affecting job performance, a confidential assessment will be made, if appropriate, through a specialist Consultant Psychiatrist or other specialist agency. Should the employee not recognise that they have medical condition relating to the misuse of an illegal drug then they will be immediately dealt with under the Trust s disciplinary procedure. b) Legal drugs If an individual is found to have misused a legal drug, they will be referred to Staff Health. If, as a result of this referral, the member of staff accepts that his/her misuse is affecting job performance, a confidential assessment will be made, if appropriate, through a specialist Consultant Psychiatrist or other specialist agency. Should the employee not recognise that they have a medical condition relating to the misuse of a legal drug then they will be immediately dealt with under the Trust s disciplinary procedure. c) Alcohol If an individual is found to have a positive breath test, in accordance with current road traffic act limits, they will be advised by the Manager/Supervisor, in the presence of a third party to go off duty as they appear unfit for work and then suspended with immediate effect, on full pay whilst an investigation takes place. Following the initial breath test, a further urine sample may also be requested. * Where a member of staff is suspended following suspicion that they may be under the influence of drugs or alcohol they must not drive themselves away Page 7 of 11
from Trust premises. The same stipulation applies where a staff member has a positive test result for either alcohol or drugs. The individual will be offered the opportunity to seek help through Staff Health Department. Should the employee not recognise that they have medical condition relating to the misuse of alcohol then they will be immediately dealt with under the Trust s disciplinary procedure. N.B. In the case of a staff member who does not accept the fact that due to the misuse of alcohol or drugs they are unfit for work and therefore refuse to go off duty, they should be suspended on full pay in accordance with Trust disciplinary procedures. On-going Testing Further testing of individuals for the presence of drugs or alcohol will be the responsibility of Occupational health or a specialist agency/psychiatrist under whose care the employee has been placed. Any further testing mandated by the individual s Line Manager can only be called for where the individual s behaviour within the workplace triggers a suspicion that drugs or alcohol have been misused again. Procedures will then be put in place as previously detailed in section 5 of this policy. 7. Implementation of this policy Roles and Responsibilities a) The Manager It is the role of all managers to initiate the following actions: To be familiar with this policy and its procedures. To advise staff of their responsibilities and rights under the policy. To intervene at an early stage where there are signs of a drugs/substance/alcohol misuse problem. To be alert to and monitor changes in work performance, attendance, sickness, accidents and clinical incident patterns. Encourage employees to seek help. Where necessary, refer cases to Staff Health. To help the employee at work and assist with rehabilitation. To identify any aspects of the work situation or content which could be contributing to the misuse and where appropriate, change them. To use disciplinary measures only when appropriate to do so. To offer staff the right to be represented, including though their Trade Union. b) Staff Health Department To provide employee testing service where misuse is suspected. Page 8 of 11
To provide advice and guidance on how best to help an individual who has a problem with behaviour or work performance which may be related to the misuse of drugs/substances or alcohol. To provide impartial, confidential support to staff, which may include counselling, assessment and referral to an appropriate agency. To respond to referrals from Managers or HR Managers. To assist in any Trust education initiative which raises awareness and discourages misuse. c) Employee To be familiar with this policy. To pay heed to the information provided about drugs and alcohol and their potential effects on work and health. To regulate their own drinking and adopt sensible drinking patterns. To seek help if worried about own misuse. To encourage other employees/colleagues to seek help if they have a misuse problem. Trust policy and professional codes of conduct for many of the staff make it clear that no employee should cover up or collude with other employees where alcohol or drugs are causing problems at work. If an employee has an immediate concern regarding a colleague s fitness to work, this should be discussed with the Manager, or advice sought from Staff Health. 8. Returning To Work Following Completion of Help/Advice Programme Following a return to work after completion of, or during, the agreed help/advice programme, should the employee s work performance again suffer as a result of drug or alcohol misuse, an additional opportunity to comply with a help/advice programme may be given. This facility will be granted at the discretion of line manager/hr Manager and will be closely supervised by both the line manager and Staff Health Department. If this additional opportunity to comply is abused then disciplinary action will be taken. On resumption of duties, or on return to work following a period of treatment, the employee will be able to return to the same job unless this would undermine recovery, yield an unsatisfactory level of job performance, or jeopardise the welfare of patients or staff. When the same job cannot be resumed, every consideration will be given to finding alternative employment. 9. Confidentiality All discussions with a member of staff with a problem involving misuse will be confidential. No individual or agency involved in the diagnosis and treatment of an employee with a misuse problem should disclose any details or records to the employer without the employee s written permission. Page 9 of 11
10. Getting Help Help available within the Trust: Personnel Department: HR Managers on extensions 5168/4205/5191 Staff Health: Occupational Health Doctors can be reached via the Staff Health reception on ext 4512. Nursing/Support staff on ext 5579/5570 Your Trade Union/Staff Representative Help Available outside the Trust: Alcoholics Anonymous - National Helpline number, 0845-7697555 (confidential support and advice, details can also be provided of local group meetings). Alcohol Concern - National number telephone, 02079287377. (Confidential advice and support for users of alcohol). Drinksense - Eastfield Road, Peterborough Telephone, 01733-555532 (Offers confidential advice and support for problem drinkers; their families and those affected by alcohol misuse). Peterborough Community Drug Team - 62 Lincoln Road, Peterborough, PE1 2SN Telephone 01733-898385 Drug advice Agency (Bridgegate) Broadway, Peterborough, Telephone 01733314551(Offers advice and information to drug users and their families). ISSD - (Institute for the Study of Drug dependence), Telephone, 02079281211. (A national organisation publishing many excellent books and leaflets on drug misuse). Narcotics Anonymous - Meetings nationally. Recorded meeting list 02072514007. Release - National organisation giving legal advice about drugs and drug use. Advice line (Monday to Friday 10.00am 6.00pm). Telephone 0207295255 SCODA - (Standing Committee on Drug Abuse), telephone 02079289500. (Provides information on residential and rehabilitation services for drug users). Families Anonymous - Telephone, 02074984680. (Self-help groups for those affected by drug abuse or related problems of a relative or friend). Page 10 of 11
11. Relevant Legislation Health & Safety at Work Act (1974) Management of Health & Safety at Work regulations (1999) The Misuse of Drugs Act (1971) This policy is applicable to all employees of the Trust, irrespective of their position. Author: Joanna Cook, Deputy Director of HR Final Version Produced: February 2003 Review due: July 2011 Signed--------------------------------------------------- Date---------------------------- (Ken Thompson, Secretary of staff Side representatives) Signed-------------------------------------------------- Date---------------------------- (Christine Tolond, Director of Human Resources) Page 11 of 11