SICKNESS POLICY. Version: 3. Ratified by (name of Committee): Date ratified: 21 June Date issued: 21 June Expiry date:

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1 SICKNESS POLICY Version: 3 Ratified by (name of Committee): JNCC Date ratified: 21 June 2010 Date issued: 21 June 2010 Expiry date: 21 June 2013 (Document is not valid after this date) Review date: 21 June 2012 Lead Executive/Director: Name of originator/author: Target audience: Human Resources Director Human Resources All PCT Staff

2 CONTRIBUTION LIST Key individuals involved in developing the document Name Human Resources JNCC Designation Human Resources Director Staff Side Chair Circulated to the following individuals for consultation Name Human Resources JNCC Designation Page 1

3 WORCESTERSHIRE PRIMARY CARE TRUST SICKNESS POLICY AND PROCEDURES - CONTENTS Page No. 1 Introduction 3 2 Policy Statement 3 3 General Conditions 4 4 Sickness Absence Arrangements 4 5 Absence Due To Sickness 7 6 Reporting Procedures 7 7 Conduct During Absence Due To Sickness 9 8 Sickness Absence During Pregnancy 9 9 Sickness Absence Due To Industrial Injury Medical/Dental Appointments Cosmetic Surgery Concern About An Employee Medical Suspension Conduct/Performance Medical suspension And Sickness Absence Employees Who Develop A Disability During The Course Of Their 13 Employment 16 Terminal Illness Reasonable Adjustment/Alternative Employment Sickness and Annual Leave Monitoring Absence Due To Sickness Short-Term Sickness Sickness Absence Procedure Right of Appeal Long Term Sickness Formal Procedure for Long Term Sickness Right of Appeal Ill Health Retirement Sick Pay Arrangements Statutory Sick Pay How Sick Pay is Made Up Full Pay Period Half Pay Period Exclusions Workplace Injury Benefit Monitoring and Review 36 App 1 App 2 App 3 App 4 Procedure for Appeals Return to work interviews Guidance and pro-forma Self Certification Management Referral to Occupational Health App 5 Managers with authority to dismiss as part of a sickness panel 47 Page 2

4 WORCESTERSHIRE PRIMARY CARE TRUST SICKNESS POLICY AND PROCEDURE Please cross reference this policy with the PCT s Capability Procedure, Disciplinary Procedure, Maternity Leave Policy, Substance Misuse at Work Policy and NHS Terms and Conditions 1. INTRODUCTION 1.1 The purpose of this Policy is to describe the Employing Organisation s approach to managing sickness related absence. The Employing Organisation recognises that there is a need to manage sickness absence in a fair and consistent manner, whilst considering service need, ensuring that the highest level of care is available to patients/service users at all times. 1.2 Managers must approach the problem of ill health in an equitable manner. Clear medical information must be obtained and discussed with employees. Normally this information will be obtained from Occupational Health. 1.3 The Employing Organisation recognises on occasions employees will be absent from work due to ill health. 1.4 The task of balancing service and operational requirements, with consideration for the interests of employees, calls for judgement on the part of managers. The following policy's objective is to help managers take appropriate action as far as ill-health and injury are concerned. 1.5 Employees who are absent for ill health or injury must do everything possible to help their own recovery. 2. POLICY STATEMENT 2.1 The ensuing guidelines and procedures are part of an overall policy towards sickness absence, which can be summarised as: To deal fairly and consistently with all employees who are absent for reasons of sickness or injury, irrespective of their grade or job. To comply with the Disability Discrimination Act To deal with every case of absence due to sickness with care and respect for the individual concerned. To ensure that all employees understand their own responsibilities in relation to absence due to sickness, including the person to whom they should report on the first day of absence. To ensure that all managers receive appropriate training so as to understand their responsibility for managing absence due to sickness. Page 3

5 To ensure that every manager has a responsibility for the collection and monitoring of sickness data. To follow the agreed procedures for dealing with short and long-term sickness. 3. GENERAL CONDITIONS 3.1 It is a condition of employment that all employees comply with the terms of this Policy. 3.2 Payments made under this Policy are made as full or part payment for any wages due, during any period of absence due to sickness or injury, subject to all rules and conditions laid down in this Policy. Any such payments shall include any Statutory Sick Pay (SSP) payments where they fall due. 3.3 It should be understood that anyone who is found abusing these entitlements will be dealt with under the Employing Organisations Disciplinary Procedure, which may result in a formal warning or dismissal. 3.4 In order to determine level of payment during absence, separate periods of absence occurring at intervals will be treated as cumulative within a rolling 12 month period. In aggregating periods of sickness absence within the rolling 12 month period, no account will be taken of any absence: on unpaid sick leave, or due to injury sustained by an employee in the actual discharge of duty and without the employee's own fault, or due to injury resulting from a crime of violence not sustained on duty but connected with or arising from an employee's employment, where the injury has been the subject of a claim to the Criminal Injuries Compensation Board, or due to such injury which has not been the subject of a claim to the Criminal Injuries Compensation Board, on grounds that it has not given rise to more than 3 weeks loss of earnings, or was one where compensation was less than that given by the Criminal Injuries Compensation Board. 4. SICKNESS ABSENCE ARRANGEMENTS 4.1 Employees It is the responsibility of individual employees to: Attend work unless unfit to do so. Page 4

6 Be familiar with and comply with the Employing Organisation s sickness absence reporting procedures including self-certification and attendance at Return to Work interviews. Attend any occupational health referral and/or medical examination arranged to ensure medical advice and treatment, where appropriate, is received as quickly as possible in order to facilitate an early return to work. Avoid any activities, including the undertaking of any other work paid or otherwise, which would be detrimental to an early return to work. Keep in touch with their manager, and inform them of any significant developments during their sickness absence. To attend appropriate review meetings Complete a self certification form from the 4 th consecutive calendar day to the 7 th calendar day of absence. A medical certificate is required if the absence continues beyond seven consecutive calendar days. Should employees fail to submit appropriate medical certificates for their absence, the periods concerned will be recorded as unauthorised and will be on no pay. Raise any concerns with their manager if they believe any aspect of their job is making them ill or is contributing to their illness so that appropriate action, can be taken. Take appropriate measures to look after their own health and safety both inside and outside of work. 4.2 Trade Union Role The role of a trade union representative is to provide representation for their members who are experiencing an employment problem as a result of their medical condition. Employees are encouraged to seek such advice and support as they have a right to be represented at formal hearings and appeals. 4.3 Occupational Health Role The Occupational Health Physician and Advisers are bound by the Data Protection Act and a professional code of ethics in the provision of a confidential, independent and impartial advisory service. The Occupational Health Service is responsible for the provision of clear medical advice to managers about the individual cases referred to them. In cases of long term or recurring short term absence the Employing Organisation will need to seek advice from Occupational Health. (If this involves obtaining a medical report from their GP, or medical consultant, the employee will be asked to sign a consent form). Page 5

7 Occupational Health s responsibilities include: Health assessment, including pre-employment and pre-placement medical screening, health surveillance, fitness for work assessments. To advise managers about the fitness of employees to undertake work activities before commencement of and during employment and following sickness absence. To assist in the identification of the causes of absence. To support employees to regain their health and return to work as soon as possible with referral to appropriate medical support or counselling as appropriate. To liaise with employee s GPs/Specialist and other health professionals as necessary. To assess the suitability of the job and workplace and liaise with the manager and the Human Resources representative regarding rehabilitation as appropriate. Identification and assessment of risk factors hazardous to employees. Collection and communication of information on risk identification and assessment; advising and providing information to managers and employees. Advice and support to employees (e.g. lifestyle, alcohol/drugs etc). Health education/information/training directed at specific risks at workplaces. To assist in identifying a way forward where employees are unable to return to their former duties. To assist the manager in planning for possible future rehabilitation, restrictions or absences. To identify employees that fall under the Disability Discrimination Act and assist managers to enable the employee to continue in their role or alternative role/duties as appropriate. 4.4 Human Resources Role Human Resources will provide: Support and guidance to employees and managers, incorporating best practice, in order to assist in dealing with problems affecting attendance at work. Advice and interpretation in relation to policies and procedures for management, employees and their representatives. Training for managers to equip them with the skills and knowledge to effectively manage absence. Page 6

8 Assistance to employees to find alternative work within the employing organisation where appropriate Timely and accurate sickness absence data to assist in identifying and managing attendance issues. Advice regarding the application process for ill health retirement and permanent injury benefit, liaising with external agencies such as the NHS Pensions Agency. 4.5 Managers Role Managers are responsible for: The active implementation of this policy within the area of their control, ensuring that staff regularly attend for work and follow the correct notification procedures if unable to attend. Ensuring that good working conditions are provided and that health and safety standards are maintained at all times Accurate and timely recording and submission of sickness absence information which in turn allows them to actively monitor and review sickness absence patterns and take the appropriate action. Ensuring that occupational health is involved where appropriate for advice and support and that employees are aware of the support available. Ensuring that confidentiality is maintained at all times and that management of any absence due to sickness is dealt with sensitively but with the needs of the service considered at all stages. 5. ABSENCE DUE TO SICKNESS 5.1 Any absence from work due to sickness will only qualify for pay, where the absence from work is due to genuine sickness or injury, and the employee concerned has complied with the Employing Organisations notification and evidence rules. 5.2 Should the Employing Organisation have any reason to doubt the validity of the illness or injury, the matter will be investigated and, depending on the findings, may result in disciplinary action and reclaiming the sick pay for the period in question. 6. REPORTING PROCEDURES First day of absence the employee must notify their manager/supervisor as soon as possible on the first day of absence. Where it is not possible for the employee to notify due to exceptional circumstances someone acting on their behalf must notify their manager/supervisor of the absence. Page 7

9 This should preferably be before the start of the employee s normal working day and in any case within one hour of their normal starting time, or as soon as practicable on the same day. Notification should be by telephone, Text messages are not acceptable. When calling to notify manager of absence the employee should always ask to speak to their line manager or another senior member of staff on duty. Any delay in notification must be reasonable and justifiable. When reporting in as absent due to illness the employee should advise their manager/supervisor of the actual date they became ill (including Saturdays, Sundays or holidays), the nature of the illness; its likely duration; any critical aspect of their role/work that will need to be covered during this period and a contact point that they can be contacted on during their absence. Employees who attend work and then subsequently have to leave due to illness during the course of the day should be treated as off sick from the following day if they have completed more than 50% of their normal hours for that day. If they have not completed 50% of their hours for that day they should be recorded as absent for that day. Employees with more than one post in the Employing Organisation will need to contact the manager/supervisor for each of their posts, providing such details as previously prescribed in this section. If the episode of absence continues the employee will be expected to follow the reporting procedures outlined below for each post within the Employing Organisation. Upon their return to work the employee will need to complete a self certification pro forma for each post and attend a Return to Work Interview with their manager/supervisor for each post. Employees are required to produce a self certificate from the 4 th up to the 7 th calendar day of absence. After that a medical certificate is required. Fourth Day of Consecutive Absence - If the employee is still unable to work after three days of consecutive absence, they should contact their manager/supervisor again to confirm or amend the information given on the first day. Absence Exceeding Seven Consecutive Days - The employee must see their doctor and send a medical certificate to their manager no later than the eighth day of consecutive absence where possible. Further certificates must be sent to cover the whole of the period of absence and be consecutive. Should employees fail to submit appropriate medical certificates for their absence, the period concerned will be recorded as unauthorised and will be unpaid. If this is the case the manager should record this on the weekly absence return. Page 8

10 The employee is responsible for keeping their manager(s) informed of progress during the sickness absence by contacting on at least a weekly basis by telephone, meeting, or post, unless other arrangements have been agreed in advance. If an employee is required to submit medical certificates to the Department for Work and Pensions (DWP) in order to claim benefits they should still show the original medical certificate to their Line Manager in the first instance to allow a photocopy of the certificate to be taken, and a note to be made indicating that the original has been forwarded to the DWP. It is the manager s responsibility to ensure the completion and filling of selfcertifications forms and all other associated forms and reports. Every manager must ensure that his/her own employees are clearly informed of the procedure for his/her department. This must form part of local induction. Should there be any query or problem regarding any medical certificates, or self certificates submitted, this will be discussed with the employee concerned. The matter may be referred to a higher level of management for investigation, and further action may be taken if necessary. If, following enquires, there is a doubt about the validity of certification, the Employing Organisation reserves the right to reclaim all or part of the sick pay entitlement and if the circumstances warrant it, Statutory Sick Pay (SSP). 7. CONDUCT DURING ABSENCE DUE TO SICKNESS 7.1 In all cases of sickness or injury, which necessitate taking time off work, it is expected that an employee will do his/her utmost to facilitate a speedy return to fitness and to work. In this regard, employees are trusted to act sensibly and honestly. 7.2 An employee who is absent from work due to sickness or injury should not undertake any employment or activity, whether paid or unpaid, which maybe detrimental to his/her recovery. 7.3 Should an employee wish to go on holiday as part of their convalescence, they should discuss this with their manager in advance, both to discuss the appropriateness of the activity and to ensure that the manager is kept informed of the contact arrangements whilst absent. 8. SICKNESS ABSENCE DURING PREGNANCY 8.1 All pregnancy related sickness absence will be recorded in the normal manner. Pregnancy related sickness is defined as any illness that occurs as a result of a woman being pregnant including postnatal depression. 8.2 A return to work interview should be carried following all episodes of pregnancy related sickness absence. Page 9

11 8.3 Sickness related to pregnancy will be dealt with under the Employing Organisation s Maternity Policy. All other sickness absence during pregnancy will be dealt with under this policy. 9. SICKNESS ABSENCE DUE TO INDUSTRIAL INJURY 9.1 For every episode of sickness absence the employee must declare whether the absence was as a result of Industrial Injury. If the employee makes such a declaration the manager must then ensure that the Accident Form and a RIDDOR Form are completed by the employee if possible or by another person if the employee is not able to do this due to injury immediately. The episode should also be clearly recorded as an industrial injury rather than counted as normal sickness absence. 9.2 Where the episode of sickness absence is linked to an injury sustained outside work in circumstances where the employee may have a claim for damages against a third party, the manager should contact Payroll for further guidance. This is necessary as where the claim is successful, the Employing Organisation will reclaim from the employee the sick pay paid to him/her during the absence. The employee should be advised by the manager at the time the absence is recorded that as part of any such claim they should ensure that an element of loss of earnings is included. 9.3 It is essential that detailed records are kept where an employee is on sick leave with a condition that is wholly or partially attributable to an injury sustained at work. 9.4 Managers should note that the period of sickness may not immediately follow the date the accident occurred and in these circumstances, clarification from the employee must be sought as to whether the sickness is related. Occupational health advice may also be required for further advice and confirmation. 9.5 Following an accident/incident at work, the following procedure applies: Ensure that an accident form is completed and forwarded to the Employing Organisations Risk Management Office and to the Occupational Health Service. A copy must be placed on the employee's personal file. The employee should be advised to register their injury with their local Benefits Office. Where it appears that the sickness may be of a long-term nature, Human Resources must be notified and a copy of all relevant information sent to them. Where there is a query over potential entitlement Human Resources will seek written confirmation from the Occupational Health Department that the sickness is wholly or partially attributable to the injury sustained at work. Where confirmation is received from the Occupational Health Department, Human Resources will notify the Employing Organisations Pensions Administrator in writing that the employee is on sick leave attributable to an injury at work and that there is an entitlement to NHS Injury Benefits. Sickness, attributable to an injury at work, must be clearly recorded as such on the employee's timesheet, or weekly absence return, to ensure correct payment of occupational sick pay including any enhancements due. Page 10

12 10. MEDICAL/DENTAL APPOINTMENTS 10.1 Any such appointments should normally be made by the employee outside their normal working time Should this not be possible the employee should provide their manager with a copy of their appointment card/letter and give adequate notice of their appointment to allow cover to be arranged Further details on this can be found in the Employing Organisations Guidance for Provisions for Time Out Policy. 11. COSMETIC SURGERY 11.1 Time off to receive cosmetic surgery treatment that relates to a medical or psychological condition and is supported by a medical certificate may be treated as sick leave. For example, this might be to correct a disfigurement sustained in an accident, or to have a growth removed. Any pre-appointments should be treated in the same way as other medical/dental appointments However, if the cosmetic surgery is undertaken because an employee wishes to otherwise change their appearance, then this should be taken as annual leave or flexi leave. For examples, this would apply if the employee elects to have a face-lift In the event that such treatments results in the employee becoming unfit for work, the usual sickness absence provisions apply, including the procedure for certification If the manager or employee is concerned on this issue they should seek advice from their Human Resources representative. 12. CONCERN ABOUT AN EMPLOYEE 12.1 There may be occasions, due to deteriorating performance or uncharacteristic behaviour, when the manager is concerned about an employee s health, either mental or physical, but they are still attending work. The manager does not have to wait until an employee is absent before they can be referred to the Occupational Health Physician/Adviser If an employee has been signed fit by their own GP and intends to return to work following a period of sickness absence but their manager has concerns that the employee is not yet fully fit, the manager must get a second opinion from the Occupational Health Physician/Adviser. In particular this should be considered after an episode of sickness in excess of 3 months duration. Temporary redeployment to areas of work which do not affect their condition will be considered. If the manager is concerned they should seek advice from their Human Resources representative. Page 11

13 13. MEDICAL SUSPENSION 13.1 Where an employee has refused a suggestion to go home from their manager who is concerned about their state of health, and believes that the health, safety or welfare of the employee concerned or others may be at risk as a consequence, the manager can take action by approaching their Director or Head of Service to suspend the employee. In these circumstances the manager must immediately contact Occupational Health for an urgent referral and Human Resources for advice If an employee is suspended in these circumstances it is deemed to be a medical suspension and he or she will receive an allowance equivalent to their normal rate of pay until advice is received from either occupational health or the employees GP on the suitability of their return to work If the medical advice received is that the employee is fit to return to work, then the medical suspension should end with immediate effect with a return to work date agreed. The period of medical suspension would not be recorded as sickness absence and would not count against the employee s contractual sick pay entitlement If the medical advice received is that the employee is not fit to return to work, then the medical suspension should end with immediate effect and the whole period of absence, including the medical suspension will be recorded as sickness absence. The employee would need to provide medical certificates in accordance with the normal reporting arrangements and it will count towards the employee s contractual sick pay entitlement. If the employee fails to submit a medical certificate in these circumstances they will be recorded as unauthorised, unpaid absence for this period. 14. CONDUCT/PERFORMANCE MEDICAL SUSPENSION AND SICKNESS ABSENCE 14.1 If an employee is on non medical suspension during an investigation into allegations of misconduct or poor performance and states that they are ill, they should be instructed to follow the normal sickness absence reporting procedures during their absence. The formal investigation will continue and advice will be obtained from Occupational Health about whether the employee, although not fit for work, is fit to attend an interview as part of the investigation. During this period of sickness absence the employee should be informed that this period will be recorded as sickness absence and that they will be paid as per their contractual sick pay entitlement. If during this period of sickness absence the employee s sick pay entitlement ends, although the episode of sickness absence continues, the employee should be informed that their sick pay entitlement is now ending and that the terms of their suspension will only recommence when they are declared fit to return to work. Once an employee is declared fit to return to work after such an episode of sickness absence, the manager, in conjunction with their Human Resources representative, should consider whether the employee s suspension should be resumed in order to allow the investigation to be completed or whether the employee should be allowed to Page 12

14 return to work. If the decision is to resume the original suspension then the employee should be informed of this decision and that during such suspension they will be in receipt of full pay If the sickness absence appears to have been triggered by the commencement of formal conduct or poor performance procedures, the employee must be referred immediately to Occupational Health for an assessment of their fitness. Dependent on the assessment from Occupational Health the formal procedures may be suspended with the agreement of all parties. Alternatively, where the employee is absent due to stress caused by the investigation, it may be particularly important to progress the investigation in order to remove the cause of the stress Any delays caused by sickness absence to the conduct and poor performance procedures should be communicated to all parties, so that the issues can be considered and interviews or a hearing be rearranged. 15. EMPLOYEES WHO DEVELOP A DISABILITY DURING THE COURSE OF THEIR EMPLOYMENT 15.1 If an employee is absent from work with an illness or injury which has resulted in a disability the manager should seek advice from their Human Resources representative The purpose of this contact will be to seek appropriate advice to enable any reasonable adjustments to be considered and implemented if required in order that the employee can continue in their role wherever possible. Consideration will need to be given to the implications of the Disability Discrimination Act or any other relevant legislation or regulations Advice may be sought from the Disability Employment Advisers (accessed through Job Centre Plus), including assistance with equipment, training, financial support, etc. 16. TERMINAL ILLNESS 16.1 Such cases must be dealt with sensitively and managers should contact their Human Resources representative and Occupational Health for appropriate advice Early consideration will need to be given to the undertaking of a risk assessment on the nature of work and its environment, to ensure that all reasonable adjustments, including alternative duties, are explored and implemented in order to allow the employee to continue at work if appropriate Where the employee is a member of the Pension Scheme they should be encouraged to make prompt contact with the Pensions Department to ensure that they are fully aware of the options available. If the employee is unable to make such contact then support should be sought from a Human Resources representative or a staff side representative. Page 13

15 17. REASONABLE ADJUSTMENT / ALTERNATIVE EMPLOYMENT 17.1 Where information/advice from an Occupational Health Physician/Adviser confirms that an employee is unable to undertake part or all of their contracted role and/or duties, the manager has a duty to consider reasonable adjustments and redeployment to suitable alternative employment Under the Disability Discrimination Act 2005, an employer must make reasonable adjustments wherever possible to the working arrangements and environment to accommodate an employee who is/or becomes disabled. Advice should be sought from a Human Resources representative in the first instance and/or through the Disability Employment Advisers accessed through Job Centre Plus as appropriate This does not mean that the employer must create a special job for the employee where none exists. The manager must be prepared to make all reasonable attempts to be flexible, particularly with regard to the content of the job and the working hours The consideration of alternative employment is fundamental to the fair and equitable treatment of the employee and managers must investigate the possibility of other work which the employee may be able to do at each stage of formally managing a sickness absence issue. Appropriate retraining opportunities may be considered in an attempt to re-deploy an individual. 18. SICKNESS AND ANNUAL LEAVE 18.1 Employees who become ill during the course of annual leave are eligible to reclaim those days affected as long as they have followed the proper reporting procedures. Any breach of these, or where the manager has any doubts as to it validity, or there is evidence of a pattern emerging should result in the request being declined Where an employee is absent due to sickness on a Bank Holiday they will receive sick pay as normal, but no substitute leave days will be granted Employees who are absent through sickness may request to take annual leave during any of the time they are sick and absent from work Employees who are absent through sickness will continue to accrue an entitlement to annual leave Employees returning to work following a period of sickness absence, who are unable to take all their annual leave entitlement in a particular leave year, due to sickness; are entitled to carry forward any outstanding balance of statutory leave (statutory leave = 5.6 weeks per annum) to the next leave year. To determine the outstanding balance the employing organisation will deduct from this statutory element: Any leave actually taken, NB The first 5.6 weeks of leave taken in any leave year (including public holidays) will be deemed to be statutory leave. Page 14

16 and any leave necessary to support the phased return to work on reduced hours. Then the manager will make arrangements for a payment in lieu of any outstanding statutory leave In the case of an employee leaving the employing organisation due to Ill Health, the manager should establish how much leave is outstanding and arrange for this to be paid as appropriate. Any payment for outstanding leave for the current year will be based on the employee s contractual entitlement. Whereas any payment for outstanding leave from the previous leave year will be determined in accordance with paragraph 18.5 above. 19. MONITORING ABSENCE DUE TO SICKNESS The manager should be the first person to know when an employee is off sick and he/she needs to know the circumstances. By using ESR data on absence due to sickness, the Human Resources Department will produce reports on a monthly basis for managers and the manager will then be expected to closely monitor individual sickness absence patterns for their staff. Human Resources will be informed and advice sought where necessary. However, the robustness of this data is dependent on the manager ensuring that the information has been put onto the weekly absence return as appropriate and is submitted in a timely fashion. A report will also be submitted regularly to the Employing Organisation s Board on the overall sickness levels. This report will not contain personal information on any individual. 20. SHORT-TERM SICKNESS This is defined as a number of absences of short duration (between 1 and 28 days) with no apparent underlying condition, e.g. flu/sore throat/stomach disorder, etc. N.B. There may be an underlying cause which the manager is not aware of. Some employees may have a regular pattern of short-term absences (often for apparently unrelated conditions) for which no medical certificate has been provided. (Medical certificates are normally provided where the period of sickness is more than 7 calendar days). Patterns of absence can adversely affect the morale and motivation of other staff and disrupt the effective running of the provision of the service due to their unforeseen and ad hoc nature. It is difficult to specify the number of days absence after which action becomes necessary, but if a manager becomes concerned Human Resources should be contacted and a meeting arranged with the employee to discuss the situation. When the manager is considering taking formal action against an employee who has a history of short-term sickness episodes then the Short Term Sickness Page 15

17 Absence Formal Procedure should be used. Before any formal action is taken managers must seek advice from their Human Resources representative. As a guide to monitoring short-term absence, 3 episodes in a rolling 6 months period; 5 episodes of sickness absence in a rolling 12 month period or any other pattern of absence that gives cause for concern should trigger a review of that individuals sickness related absence. At this point should the manager have any concerns regarding any underlying medical conditions or support required to help the employee improve their attendance level they should contact occupational health and make a management referral. All employees who are absent due to stress however should be automatically referred to occupational health. 21. SICKNESS ABSENCE PROCEDURE 21.1 Return to work interviews A manager should meet with an employee on their return to work after all periods of sickness absence. This return to work interview should ideally take place on their first day back when possible. Return to work interviews are helpful in ensuring the employee is fit to return to work and to clarify the reason for absence. It can also however provide the manager with an understanding of the any future impact or underlying health issues. The interview should also be an opportunity for the employee to identify any additional support they may require and in cases of longer term absence be an opportunity for the manager to update the employee on any changes within the workplace that may have occurred during their absence. Records of return to work interviews should be kept for future reference. The return to work pro-forma and further guidance notes can be found in appendix 2 of this policy Informal Meetings Having identified concerns with an employee s sickness related absence level or pattern managers should implement the Sickness absence management procedure under this policy. The manager must meet with the employee at the earliest opportunity on a one to one basis to explore whether an informal approach may produce an improved and acceptable level of attendance which may mean there is no need to follow the formal stages. The purpose of this meeting is to explore whether there are any problems facing the employee which may be causing the persistent absences and which the manager can offer help with. A period for sustained improvement will be agreed but the employee must be made aware that any further instances of sickness will be dealt with formally. Following this discussion the manager will confirm in writing the contents of the meeting, any time period agreed for improvement in absence levels and that if there is no improvement, then the formal stages of the Policy will follow. Page 16

18 21.3 Advice from the Employing Organisation s Occupational Health Physician/Adviser may also be sought at any stage of this procedure and should always be obtained before the commencement of formal stages in order to ensure that all relevant medical information is available to assist in the decision making. All stress related absences must be referred to Occupational Health immediately Where an employee refuses to attend an Occupational Health referral, every effort should be made to understand the reasons why and take appropriate action. However, if after this the employee continues to refuse, the employee should be informed that a request to attend Occupational Health is a contractual commitment and must be complied with. Repeated failure to attend occupational health as required may therefore result in disciplinary proceedings. Progression onto or through the formal stages of this procedure however will continue with decisions being based on the information available at that time At any meeting or review under the procedure, the manager will share their concerns over the level and impact of the absences. The employee must have the opportunity to respond. At all stages of this procedure, managers will take into consideration the following when coming to a decision: The nature of the illness, including any underlying cause. The likelihood of recurrence or of some other illness arising. The length of and intervals between the various absences. The impact on the functioning of the service. The possibility of temporary or permanent alternative employment. The possibility of temporary or permanent reduced hours if appropriate. (Protection will not be applicable). All available medical information and recommendations. The information and explanations provided by the employee and their representatives. The need to make reasonable adjustments in the light of any disability covered by the Disability Discrimination Act. The need to ensure that any levels of improvement set are personal and related to the individual circumstances of any particular case. Page 17

19 21.6 Stage One First Formal Meeting Where the manager has continuing concerns because of an emerging pattern of absence following informal action they should arrange a formal meeting with the employee. The manager will arrange a formal meeting with at least 14 calendar days notice which will include the employee, his/her trade union representative/work colleague, and an HR Representative. The employee will be informed of the date and time in writing and will receive all relevant documentation prior to the meeting to enable them to share the information with his/her representative/work colleague. At this meeting the employee should have an opportunity to explain the absences and any possible mitigating circumstances, as well as to suggest/request any support or other measures which they think could help improve attendance. At or after the conclusion of the meeting the manager will reach one of the following decisions and issue a letter to the employee to that effect: 21.7 First Review a) Satisfied with the explanation given by the employee with no further action being deemed necessary apart from ongoing monitoring. b) Sufficient reasons for ongoing concern remain and a package of support is required; improvement levels expected and timescales (review period normally between 1-6 months) should be clearly stipulated on the Absence Review Pro Forma which should be attached to the letter. The employee should be informed that should their attendance not show satisfactory improvement during this review period that it may be necessary to escalate the formal management of the situation to Stage 2. c) Necessary to refer to Occupational Health seeking further clarification or an update on progress. When the report is received a follow up meeting will be convened to determine the package of support required, improvement levels expected and timescales (normally between 1-6 months) involved. These expected outcomes are to be clearly set out on the Absence Review Pro Forma which should be attached to the letter. d) Concerns around poor work performance are confirmed and a formal investigation is required under the appropriate stage of the Employing Organisation s capability management procedures. When approaching the end of the review period the manager must consider whether sufficient improvement has been achieved, and should meet again with the employee. The employee must be given at least 14 calendar days written notice of any meeting described below and advised of their right to be accompanied by a work colleague or trade union representative. Page 18

20 a) Where the required improvement levels have been achieved, the manager should meet with the employee to formally acknowledge this level of improvement has been achieved and that no further action will be taken under the formal stages of the procedure apart from ongoing monitoring. The employee should also be made aware that the Employing Organisation reserves the right to resume action immediately at this stage of the procedure, depending on circumstances, if their sickness absence levels should increase within the twelve month rolling period used to calculate sick pay b) Where the manager decides that the required improvement levels have not been reached but, in conjunction with Human Resources representative, it has been decided that progression to Stage 2 would not be appropriate at this time, the manager should convene a meeting with the employee to discuss where those levels have not been reached and what period of extension is being considered to the review period. At this meeting the employee should have an opportunity to explain any possible mitigating circumstances, as well as suggest/request any support or other measures which they believe could help improve attendance. At the conclusion of this meeting the manager will confirm an extension of 1-3 months to allow identified improvement levels to be achieved and if appropriate a referral to Occupational Health to take place. The manager must conclude the meeting with a clear statement to the employee that failure to achieve the improvement levels agreed will lead to this issue being progressed to Stage 2 of the Formal Procedure. The required improvement levels should be clearly stipulated on the Absence Review Pro Forma which should be sent to the employee with a covering letter. When approaching the end of this extended review period the manager should again consider whether satisfactory levels of attendance have been achieved. If so, the employee should be informed in writing. If not the employee should be informed as per section below. The review period cannot be extended further. c) Where the manager decides that the required improvement levels have not been achieved and that progression to Stage 2 of the Formal Procedure is appropriate, the employee should be informed in writing Stage Two Second formal meeting If the levels of improvement set at the First Formal Meeting or subsequent review meeting are not reached, a second formal meeting will be convened by the manager. Asenior manager and an HR representative who have no previous involvement will form a panel and arrange a stage 2 formal meeting. The hearing will be attended by the employee and his/her trade union representative/work colleague and the manager (involved at previous stages) and their HR representative. The employee must be given at least 14 calendar days written notice of this meeting, including a copy of the manager s report and associated papers to be presented at Page 19

21 the meeting, and of their right to be accompanied by a work colleague /trade union representative. At the meeting the line manager will present a report detailing the nature of their concerns about the employee s absence record and confirming what support and actions have taken place to date. The employee will have an opportunity to explain the absences and any possible mitigating circumstances, as well as to suggest/request any support or other measures which they think could help improve attendance. At the end of the meeting the panel may come to the conclusion that: a) They are satisfied that the required improvement levels have been achieved and therefore no further action should be taken under the formal stages of the procedure apart from ongoing monitoring. The employee however should also be made aware that the PCT reserves the right to resume action immediately at this stage of the procedure, depending on circumstances, if their sickness absence levels should increase again within the rolling 12 months used to calculate sick pay. b) The required improvement has not been met and a further review period is required in which the employee must show a sustained and significant improvement to their sickness absence record (normally between 1-3 months). The review period must be clearly stipulated and the consequences of not meeting the required improvement explained. The panel may also decide that a package of support is required which may involve further occupational health advice. (Please refer to section 21.8 below) c) Exceptional mitigating circumstances apply which would make it inappropriate to consider a further review period at this stage (at which point advice should be obtained from Human Resources) Second Review At the end of the second review period (as implemented above) the panel must meet again with the employee and their line manager to consider whether sufficient improvement has been achieved. The employee must be given at least 14 calendar days written notice of this meeting and be advised of their right to be accompanied by a work colleague or trade union representative. Possible outcomes of this second review meeting are: a) Where the required improvement levels have been achieved, the panel should meet with the employee to formally acknowledge that the required improvement levels have been achieved and that no further action will be taken under the formal stages of the procedure apart for ongoing monitoring. The employee should also be made aware that the Employing Organisation reserves the right to resume action immediately at this stage of the procedure, depending on circumstances, if their sickness absence level should increase again within the rolling twelve month period used to calculate sick pay. Page 20

22 b) Where the manager decides, in conjunction with Human Resources, that the required improvement levels have not been achieved progression to Stage 3 of the Formal Procedure the employee should be informed in writing Stage Three Dismissal Decision Hearing If the levels of improvement set at the Second Formal Meeting or subsequent review meeting are not reached and the manager considers that dismissal may be appropriate, the manager should request the Director, Associate Director or Head of Service to convene a two member panel to consider this matter. The HR department will be requested to arrange a Stage 3 hearing. The panel will comprise one manager with the right to dismiss in sickness cases and an HR representative. Where it is relevant to the case, one member of the panel should be from the employee s own profession. Nither of the panel members will have had previous involvement in the process. The employee must be given at least 14 calendar days written notice of this meeting, including a copy of the manager s report and associated papers to be presented at the meeting, and of their right to be accompanied/represented by a work colleague or trade union representative. Their representative will receive the same papers The individual must be clear that this is a Dismissal Hearing, which may result in their dismissal and that the Hearing will be recorded with their agreement for transcription. The panel shall consider both the manager's and the individual's evidence in order to reach a decision on the action to be taken and therefore both sides should have every opportunity to state their case. The panel hearing the case, having considered all relevant factors, must then determine, in the light of the information presented and available, whether: a) Action short of dismissal is appropriate, i.e. an extension of 1-3 months to allow identified improvement levels to be achieved by the employee and if appropriate a further referral to Occupational Health to take place. b) The employee should be dismissed on the grounds of incapability due to poor health or attendance. The employee will normally be informed of the decision at the end of the hearing, but in any case the decision will be confirmed in writing within 7 calendar days of the hearing. They must be informed of their right of appeal to a three-member panel of the PCT Board, including one Non-Executive Director. The other two must be drawn from the list of dismissing officers listed in the Disciplinary ProcedureThis must be lodged in writing, stating the grounds of the appeal, with the Human Resources Director within 21 calendar days of the date of the letter. One member of the panel shall be from the appellant s own profession where practicable. Where this is not possible, a member of the relevant profession may be in attendance as an adviser to the panel. Page 21

23 On dismissal the employee must be given written confirmation of any pay in lieu of notice due under the terms of his/her contract and any outstanding annual leave entitlement. 22. RIGHT OF APPEAL 22.1 Employees have the right of appeal against dismissal, or action short of dismissal. However, if an appeal is lodged against dismissal, the dismissal still stands until the appeal is heard. If a decision is taken to re-instate, any loss of pay shall be made good If action short of dismissal is taken the status quo will apply until the appeal process is exhausted Details of the arrangements required for an appeal hearing and the procedure to be followed during the hearing can be found in Appendix 1. Subject to the satisfaction of certain conditions, employees who feel that they have been unfairly dismissed have a statutory right to make a complaint of unfair dismissal to an Employment Tribunal. Such complaints must normally be received by the Tribunal within the period of three months beginning with the employee's effective date of termination Where an appeal is lodged and heard the following outcomes may result: a) The appeal against dismissal is upheld and the individual is reinstated, and measures short of dismissal considered. b) The appeal against measures short of dismissal is upheld and measures short of dismissal re-considered. c) The appeal is not upheld and the dismissal or measure short of dismissal stands. Page 22

24 SHORT TERM SICKNESS ABSENCE FLOWCHART INFORMAL PROCEDURES I.E. RETURN TO WORK MEETINGS, REFERRAL TO OCCUPATIONAL HEALTH, PREVENTATIVE MEASURE TAKEN, INFORMAL REVIEW PERIODS CONSIDERED Concerns remain about level of absence Seek Human Resources Advice and refer to Occupational Health, if not already done so STAGE 1 FIRST FORMAL MEETING Satisfied with explanation no further action at this time, except monitoring Referral to Occupational Health* Concerns around misconduct or poor performance possibly resulting in a formal investigation being taken. Improvement levels and timescales confirmed, appropriate package of support identified and put in place. (1-6 months) eg reasonable adjustments (DDA) Underlying Health Problem No Underlying Health Problem Possible review of work arrangements / conduct a risk assessment Improvement levels and timescales confirmed; appropriate package of support identified and put in place (1-6 months) eg reasonable adjustments (DDA) 1 ST REVIEW Satisfactory improvement no further action, except monitoring No significant/insufficient improvement Extension allowed to achieve improvement (1-3 months) REVIEW *OH Advice may also be sought at successive stages of this procedure. No significant/insufficient information STAGE 2 SECOND FORMAL MEETING Satisfactory improvement no further action, except monitoring Panel satisfied satisfactory improvement and no further action No significant/sufficient improvement therefore further review period required Exceptional circumstances 2 ND REVIEW No significant/insufficient improvement Satisfactory improvement no further action, except for monitoring STAGE 3 DISMISSAL DECISION HEARING FINAL DISMISSAL ACTION SHORT OF DISMISSAL Page 23

25 23. LONG-TERM SICKNESS 23.1 Long-term sickness absence must be handled sensitively and with care. The manager must maintain on-going contact with the employee throughout the absence. However, care must be taken that the approach is perceived to be helpful and not exerting pressure. Long-term sickness absence is usually defined as absence of four continuous weeks or more. Typically 4 weeks or more of continuous absence related to an underlying cause or a specific medical condition/problem e.g. an operation or series of treatments in hospital, rest at home due to a back problem, stress or depression or a broken limb, etc. Where an employee indicates at an early stage of the episode that they will be absent for more than 4 weeks, this will normally be considered as long-term absence All stress related illnesses must be referred to Occupational Health immediately. In other cases, when the employee reaches 4 weeks of continuous absence and where there is no identified return to work date they should normally be referred to Occupational Health (unless this has already been done) by their manager using the Occupational Health Referral Form. When the manager is considering taking formal action because an employee is on long term sickness absence then the long term sickness absence formal procedure should be used as outlined below. Before any formal action is taken managers must seek advice from their Human Resources representative. In the case of long term absence, a review meeting should take place between the manager and the employee, supported by the employee s trade union representative or work colleague. This should normally occur at least once during the first 4 weeks of absence and thereafter as frequently as determined appropriate by all parties Any request to attend Occupational Health is a contractual commitment and must be complied with Staff, signed as fit by their General Practitioner following a period of long-term sickness, should have clearance from Occupational Health before returning to work. However, if this has not been achieved the manager may need to put in place restrictions which will minimise any risk to the employee, nursing team or patients until the occupational health appointment has been attended and the manager has received a copy of the report Long term sickness is likely to have one of the following outcomes: a) Employee fit to return to job in the foreseeable future Page 24

26 It is important to have regular contact until the return takes place. subsequent sickness will need a further referral to Occupational Health. Any In order to support a return to work the employee may return initially on reduced hours. This is commonly known as a phased return to work (please refer to the Rehabilitation policy). b) Employee not deemed permanently unfit but no return can be anticipated in the foreseeable future In these circumstances, the manager and appropriate Human Resources Adviser will: Interview the employee, together with a representative if requested in order to explore the situation. Give the employee the opportunity to comment on the medical opinion; give his/her view of his/her health; or provide further medical evidence and an alternative course of action. The Employing Organisation will consider the possibility of holding permanent posts open, even when employees have exhausted their full pay entitlement, to allow them to return to work when fully recovered. The use of temporary cover may facilitate this arrangement. c) If the employee is not fit to return to normal duties The terms of the Disability Discrimination Act place a responsibility on the manager to review the job to see whether any reasonable adjustments can be made which would enable the employee to continue in that role and to explore the feasibility of redeployment. However, pay protection does not apply to any redeployment into a lower graded or lower paid post in these circumstances. The manager will explore the feasibility of any other kind of work as soon as notified. This may require discussion with the Employment Rehabilitation Centre. Alternative employment, retraining and/or career counselling for employment elsewhere must be fully explored by the appropriate Human Resources Adviser. Exactly what level of retraining is appropriate will vary from case to case and, because of the variables involved, this will be considered on an individual basis following discussions with the Manager, the member of staff and the Human Resources Adviser. A reasonable timescale will be agreed in order to explore redeployment opportunities. If the Employing Organisation is unable, following the above, to accommodate the member of staff, it maybe necessary to consider ill health or early retirement or dismissal on health grounds. This should be explored fully with the employee as soon as the manager is notified and, where a pension is involved, an estimate obtained from the Pension Officer. It is important that the employee understands his/her situation and that this is confirmed in writing five days following the interview. Page 25

27 24. FORMAL PROCEDURE FOR LONG TERM SICKNESS 24.1 Keeping in Touch and Arranging Occupational Health Referral Managers must keep in touch with the employee. However there is a mutual expectation that the employee and the manager keep in touch and how this will be undertaken should be agreed with the employee at the commencement of the sickness absence. The purpose for the contact is not only to find out how the employee is, but also to explain what action is being taken in relation to their absence. This can be a very delicate balancing act, especially in cases of stress and depression whether or not apparently related to the workplace. If in doubt advice should be sought from their Human Resources representative. Managers must be sensitive to the fact that some employees will not welcome visits or even telephone calls, and in such circumstances maintaining contact by letter every few weeks may be more appropriate. Records should be kept by the manager of all contact made during sickness absence with the employee. Although the manager will have medical certificates from the employee s General Practitioner or hospital, where possible the manager should discuss the likely length of absence with the employee at the outset. If after 4 weeks continuous absence it is clear that the employee has an expected return date and that there will not be a recurring or subsequent problem, the manager may decide to do nothing further except keep in touch, e.g. absence of approx. 6 weeks due to a broken arm, 3 months for a hysterectomy. Alternatively, the manager may wish to consider whether the employee would benefit from any support at this stage. This could include: A referral to an Occupational Health Physician/Adviser (this should normally be arranged after 4 weeks, if not before, of continuous absence where there is no known identified return to work date). Offering confidential counselling, this can be arranged following a referral to Occupational Health. Arranging for support or specialist equipment through the DDA adviser. Support from a Human Resources representative/staff Side representative. If long term sickness absence appears to have been triggered by the commencement of formal disciplinary or capability procedures, the employee should be referred immediately to Occupational Health for an assessment of their fitness. Dependant on the assessment, the formal procedure may be suspended with the agreement of all parties. At no more than monthly intervals, unless an alternative arrangement has been agreed between the manager and the employee, and always after each referral to Occupational Health, a meeting should be convened normally between the manager and employee (who has the right to be accompanied by a work colleague or trade Page 26

28 union representative) to review the latest advice and the options available. A Human Resources representative should also be consulted and involved as appropriate. At each such review meeting consideration should be given to any reasonable adjustments suggested and to using the Employing Organisation s redeployment arrangements to assist in finding permanent alternative duties that would allow the employee to return to work earlier, if appropriate. The manager should explain to the employee that, although they are sympathetic to and supportive of the employee and their illness, there is a need to balance this against the operational requirements of the Service Formal review A formal review will be appropriate once the advice of the Occupational Health Physician/Adviser is clear, and/or he/she has reached a conclusion regarding the employee s fitness to work. This review should take place either: Normally no later than 6 months after the episode of sickness absence began where no return to work date has been identified. Normally no later than 9 months after the episode of sickness absence began whether a return to work date has been identified or not. The purpose of the review is to consider the latest advice of the Occupational Health Physician/Adviser, and consider any other relevant factors, before deciding on an appropriate course of action. This review should normally involve a management meeting with the employee (who has the right to be accompanied by a work colleague or trade union representative). A Human Resources representative must also be present at any such meeting. Possible outcomes of the review may include any of the following: a) The employee agreeing a return to work date. b) Agreement to put in place certain support measures to ease the employee s return to work. c) Any reasonable adjustments to be made by the employer. d) Consideration of alternative employment in the Directorate/Employing Organisation. e) Agreement about the details of any phased return to work. f) Acceptance of the ongoing nature of the absence, and where appropriate, rereferral or review with the Occupational Health Physician/Adviser, possibly to examine further specific issues. Page 27

29 g) Termination of contract through either mutual consent or resignation. h) Acknowledgement by the employee that the early release of pension on health grounds is the most appropriate course of action subject to advice from an independent medical practitioner and support from the Employing Organisation. i) Consideration of dismissal. When an employee has been absent for a long period they may need extra support to help them settle back into work. The manager should be as flexible as possible about allowing a return to work initially on a reduced hours basis (known as a phased return to work) if appropriate Dismissal Decision Hearing If at the end of the review meeting the manager considers dismissal may be appropriate, they should request the Director or Head of Service to convene a Dismissal Hearing. The HR department will be requested to arrange a Dismissal Hearing. The panel will comprise one manager who has authority to dismiss in sickness cases, and an HR Representative. Where it is relevant to the case one member of the panel should be from the employee s own profession. Neither of the panel members will have had previous involvement in the process. The employee will be informed in writing, clearly stating the reasons for the hearing, and will receive all relevant documentation at least 14 calendar days prior to the Dismissal Hearing as will his/her representative. The individual must be clear that this is a Dismissal Hearing, which may result in their dismissal and that the Hearing will be recorded with their agreement for transcription. The panel shall consider both the manager's and the individual's evidence in order to reach a decision on the action to be taken and therefore both sides should have every opportunity to state their case. The Panel having considered all relevant factors must then determine whether in the light of the information presented and available: a) Action short of dismissal is appropriate e.g. an extension of time, additional support package, alternative employment which may be at a lower grade with no pay protection. b) The employee should be dismissed on the grounds of incapability due to poor health or attendance; or Where the decision is to give an extension to allow more time to find alternative employment then this extension should be for a period no longer than 3 months. If no Page 28

30 suitable alternative is found within that period the employee should be dismissed on the grounds of incapability due to poor health or attendance. Where an employee has been medically certified as permanently unfit to work, they may not wish to contest a recommendation to dismiss. The employee must however be invited to attend the Dismissal Decision Hearing. It is the employee s decision whether to attend or not, the hearing will proceed even if they do not wish to attend. Human Resources advice should be obtained in such circumstances Notification of outcome Action short of dismissal If the decision is taken to take action short of dismissal, two copies of a letter shall be issued within 7 calendar days stating: The action short of dismissal imposed. The right of appeal to a three-member panel of the PCT Board, including one Non- Executive Director which must be lodged in writing, stating the grounds of the appeal, with the Human Resources Director within 21 calendar days of the date of the letter. One member of the panel shall be from the appellant s own profession where practicable. Where this is not possible, a member of the relevant profession may be in attendance as an adviser to the panel The individual must sign and return one copy to be placed on his/her personal file. A further copy should be lodged with the Human Resources Director for information. Dismissal If the decision is taken to dismiss, a letter shall be issued within 7 calendar days, stating: The reasons for the dismissal and the date on which the employment shall terminate. The right of appeal to a three-member panel of the PCT Board, including one Non- Executive Director and two managers with the right to dismiss under the Disciplinary Procedure, which must be lodged in writing, stating the grounds of the appeal, with the Human Resources Director within 21 calendar days of the date of the letter. One member of the panel shall be from the appellant s own profession where practicable. Where this is not possible, a member of the relevant profession may be in attendance as an adviser to the panel. Confirmation of any pay in lieu of notice due under the terms of his/her contract and any outstanding annual leave entitlement. Page 29

31 25. RIGHT OF APPEAL Employees have the right of appeal against dismissal, or action short of dismissal. However, if an appeal is lodged against dismissal, the dismissal still stands until the appeal is heard. If a decision is taken to re-instate, any loss of pay or overpayment will be rectified. If action short of dismissal is taken the status quo will apply until the appeal process is exhausted. Details of the arrangements required for an appeal hearing and the procedure to be followed during the hearing can be found in Appendix 1. Where an appeal is lodged and heard the following outcomes may result: The appeal against dismissal is upheld and the individual is reinstated, and measures short of dismissal considered. The appeal against measures short of dismissal is upheld and measures short of dismissal re-considered. The appeal is not upheld and the dismissal or measure short of dismissal stands. The employee must be given at least 14 calendar days written notice of this meeting, including a copy of the managers report and associated papers to be presented at the meeting, and notification of their right to be accompanied/represented by a work colleague or trade union representative. The Director or Head of Service chairing the hearing, having considered all relevant factors, must then determine whether in the light of the information presented and available. Action short of dismissal is appropriate e.g. an extension of time, additional support package, alternative employment, etc; or The employee should be dismissed on the grounds of incapability due to poor health or attendance; or Early release of pension on grounds of ill health should be explored. Where the decision is to give an extension to allow more time to find alternative employment then this extension should be for a period no longer than 3 months. If no suitable alternative is found within that period the employee should be dismissed on the grounds of incapability due to poor health or attendance. In order for an early release of pension on health grounds to be considered, support from an approved independent medical practitioner who is qualified in occupational health medicine is required. Where the medical evidence does not support permanent incapability (necessary to ensure release of pension benefits), premature retirement in the interests of the service may in certain circumstances Page 30

32 be considered. However, advice must be sought from the Human Resources Department. N.B. Where an employee has been medically certified as permanent unfit to work, they may not wish to contest a recommendation to dismiss. The employee must however be invited to attend the Dismissal Decision Hearing. It is the employee s decision whether to attend or not, the hearing will proceed even if they do not wish to attend. Human Resources advice should be obtained in such circumstances. 26. Ill-Health Retirement If an employee is absent on long term sick and reasonable adjustments and redeployment have been ruled out which would allow the employee to return to work and they are a member of the NHS Pension scheme and meet the qualifying criteria then ill health retirement may be considered. This option can be explored at any time during the management of their absence however applications usually require the support of an occupational health physician and have to be approved by the Pensions Agency therefore if ill-health retirement is considered to be one option in managing the employees absence this process should ideally be started no later than immediately following the formal review. Should the employee wish to apply they should complete an AW33E Application for Ill Health Retirement Benefits form. This form will be provided to the employee via the HR Representative however any further advice required regarding the application should be sought from the Pensions Agency. An application for Ill Health retirement will not preclude the employing organisation from taking any other appropriate action such as dismissal on the grounds of incapability due to ill health. Page 31

33 LONG TERM SICKNESS ABSENCE FLOWCHART Maximum Organisations Timescale Absence Commences Keep in regular contact throughout whole absence Discuss and consider arrangements for the employee to return to work including phased return, reasonable adjustments (including under DDA) alternative work (Job Search Programme) 4 th week Refer to Occupational Health (normally no later than by 4 th week of absence) 1-9 Months Receipt of Occupational Health and any external medical advice followed by meeting with employee Consider all evidence to determine appropriate course of action in conjunction with Human Resources 6 Months Return to work date identified? NO YES 9 Months Employee does not return to work 6-9 Months Formal Review Meeting (No later than 9 months from start of absence) Dismissal Decision Hearing Employee returns to work 1-12 Months Early release of pension on grounds of illhealth explored. Dismissal Action short of dismissal Appeal hearing if requested Page 32

34 27. SICK PAY ARRANGEMENTS 27.1 Employees will be entitled to the following sick pay benefits, provided that the Employing Organisation is satisfied with the reasons given for the absence Depending on your length of service within the NHS, the following benefits may apply: Length of Service Full Pay Half Pay Period Period 0-12 months One month 2 months 1-2 years 2 months 2 months 2-3 years 4 months 4 months 3-5 years 5 months 5 months 5+ years 6 months 6 months Periods of sick pay entitlement are calculated on a rolling 12 months. A rolling 12 month period is defined as a period of 12 calendar months that immediately precedes the date upon which sickness first commences. For example, if sickness start date is , the entitlement to sick pay will be as above minus any other sick pay for the previous 12 months, i.e. back to Therefore, if a member of staff was entitled to 6 months' full pay but had already had a month off-sick during October 2000 for which they had received full pay, then the full pay period for the latest episode of sickness would be reduced to 5 months Service means the total period of continuous employment as an employee in the NHS. If there is any break in employment for a year or more, service before the break will be excluded. Any staff transferring under TUPE will retain their previous continuous service date in accordance with these regulations Reinstatement of sick pay entitlements With regards to those absent on long term sickness absence, sick pay entitlements will be reinstated at half pay (as defined in point 31 below), after 12 months of continuous sickness absence if a final review meeting has not yet taken place and where this failure is due to delay by the employer. Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence for those staff members with less than five years reckonable service. Reinstatement of sick pay at half pay should continue until a final review meeting has taken place. Page 33

35 For the purpose of this policy the final review meeting is deemed to be the formal review meeting as outlined in point Reinstatement of sick pay entitlements will only apply where the failure to undertake a final formal review meeting is due to delay by the employer. This provision will not apply where a review is delayed due to reasons other than those caused by the employer. 28. STATUTORY SICK PAY 28.1 Statutory Sick Pay is payable for up to 28 weeks in any one period of absence from work, as long as there is a gap of 8 weeks between one 28 week period and the next. If this entitlement is exhausted then the employee may be eligible to transfer to State Sickness Benefit or Incapacity Benefit The amount of Statutory Sick Pay paid is dependent upon an employee's salary. Statutory Sick Pay is not paid to those employees who earn less than the lower earnings limit, they will receive Incapacity Benefit. 29. HOW SICK PAY IS MADE UP 29.1 The pay received during sickness absence is made up of the following: Occupational Sick Pay - paid directly by the Employing Organisation and either Statutory Sick Pay - which is funded directly by the Employing Organisation; or (if not entitled to receive SSP) State Sickness Benefit - this must be claimed direct from local DSS offices. The Employing Organisation will send form SSP 1 to those employees not eligible for SSP in order for them to claim State Benefit Sick pay, which is made up of Occupational Sick Pay including SSP or Occupational Sick Pay and State Sickness Benefit will not exceed an employee's normal net pay Statutory Sick Pay and Occupational Sick Pay are subject to deduction of PAYE income tax and National Insurance. State Sickness Benefit is not subject to PAYE income tax or National Insurance. 30. FULL PAY PERIOD Full pay will include any regularly paid enhancements/supplements such as recruitment retention premia or payments for work outside normal hours. This means sick pay is calculated on the basis of what an individual would have earned had she/he been at work. Page 34

36 31. HALF PAY PERIOD Half pay is made of half normal full pay as outlined above, and Statutory Sick Pay as long as the sum payable does not exceed the employee s normal pay. 32. EXCLUSIONS There is no entitlement to any Occupational Sick Pay where the Employing Organisation can demonstrate that an employee has knowingly entered false absence information on a Self-Certification Form or Application Form. This is regarded as gross misconduct, which could result in disciplinary action being taken. Should employees fail to submit appropriate medical certificates their absence, the periods concerned will be recorded as unauthorised and will be unpaid. 33. WORKPLACE INJURY BENEFIT 33.1 NHS Injury Benefit is paid to NHS employees (or their families) who have been injured at work or develop diseases or conditions as a result of work There are three types of benefits: Temporary Injury Allowance: This is paid to an employee who is off sick on reduced pay and ensures that their salary/wages are at least 85% of their earnings immediately prior to the date of the accident. Particular Social Security benefits are included when calculating the 85% pay total and therefore employees must notify the Pensions Administrator of any benefits they are receiving. Permanent Injury Benefits: This is paid to employees who, as a result of their injury/condition, have to leave their job in the NHS, reduce their hours or take a less well paid post in the NHS. The amount of benefit, which can include a lump sum of 50% of their salary, depends upon the extent of their injury/illness together with their age. Death Benefits: an employee s family may make a claim for benefits if the employee dies as a result of a work-related condition All NHS service is counted in calculating the amount of benefit irrespective of any breaks in service. Injury benefits are part of the NHS Pension Scheme regulation but employees do not have to be a member of the scheme to have entitlement to them. Where there is a dispute between the Employing Organisation and the employee over entitlement to injury benefits, the case will be referred to the NHS Pensions Agency for verification. Further information about NHS Injury Benefits can be obtained from the Pensions Administration. Page 35

37 34. MONITORING AND REVIEW This policy is subject to joint monitoring and will be reviewed by the Human Resources Department and the JNCC no later than three years from the date of implementation. Page 36

38 APPENDIX 1 PROCEDURE FOR APPEALS In order to ensure consistency throughout the Employing Organisation, the following arrangements have been agreed with the Trade Unions through the JNCC and must be followed for every appeal under this policy. It should be noted that, in exceptional circumstances, an appeal hearing, which has been arranged, and a date agreed, may be re-arranged at the request of either side on one occasion. However, in the case of a requested second postponement, the hearing will proceed. 1. PRE-HEARING 1.1 Before any appeal hearing commences, Panel members, the presenting manager, the employee and their representative MUST have copies of: The written record of the dismissal hearing Any written management side case presented at the hearing Any written staff side case presented at the hearing The appeal letter to the HR Director outlining the reasons for appeal Neither party may submit new evidence to the appeal hearing that was not available at the time of the original Dismissal Panel. The HR Department will forward the above documents to the Panel and Presenting Manager at least 10 working days before the Appeal. It should be noted that the appeal hearing will be recorded for transcription with the agreement of the employee. 2. ARRANGEMENTS ON THE DAY 2.1 Each party shall be allocated a separate room. 2.2 The designated Chair of the Panel shall introduce all parties and go through the format for the hearing. 2.3 The Chair of the Appeal Hearing will normally open by inviting the staff side to present their case in the presence of the management side. Any witnesses called will be questioned. 2.4 The management side may then ask questions of the staff member or representative and witnesses. 2.5 The panel members may then have an opportunity to ask questions. Page 37

39 2.6 The management side shall then present their case in the presence of the staff side. This will include calling and questioning witnesses. 2.7 The staff side representative may then question the management side and witnesses. 2.8 The panel may then ask questions. 2.9 The staff side shall then be asked to sum up, followed by the management side The Panel shall then adjourn to make a decision. If any points requiring clarification arise, BOTH sides must be recalled together, even if only one side is concerned Once a decision is reached, which is normally on the same day, both sides are recalled and informed together. If a decision cannot be reached immediately, both sides are recalled and informed they shall be notified in writing. This will be within five days of the panel reaching a decision The decision must always be clearly set out including the reasons why this is felt appropriate. The Panel must provide a written decision which is sent to the employee and representative. NOTE: 1. Nothing in the Procedure prevents the Panel from adjourning at any stage to clarify or amplify any statement. The length of any adjournment must be agreed with both parties. Adjournments can be requested by either side or by Panel Members. Page 38

40 APPENDIX 2 RETURN TO WORK INTERVIEWS 1. A return to work interview must take place following every episode of sickness absence, regardless of the nature of length of absence. Such early intervention may prevent problems from arising or getting out of hand. 2. When an employee returns to work after a sickness absence they should ensure that their manager is aware of their return. If the absence is longer than seven days the employee will have to provide a medical certificate from their GP, and the manager may request an additional certificate confirming that they are fit to return to work. In circumstances, such as an absence of 4 weeks or more, the manager will also need to refer the employee to Occupational Health for their advice on the employee s fitness to return to work and any support or adjustments necessary. 3. Managers should normally conduct a Return to Work Interview on the employee s first day back at work or as soon as possible, using the Return to Work Interview pro forma. 4. The nature of this interview will vary depending on the circumstances. It may simply involve a brief discussion to check the employee is well and update them on anything that has happened in their absence, as well as ensuring they have completed a Self Certification form where appropriate. However, where the manager has concerns because of an emerging pattern of absence or a possible underlying health problem, the meeting should follow the guidelines detailed under the Short Term Absence Procedure in the PCT s Sickness Policy and Procedures. 5. In some cases employees will not be working at the same time/location as their manager and therefore a face to face interview may prove operationally difficult. In these circumstances a Return to Work Interview may be carried out by telephone. The employee should still receive a copy of the completed Return to Work Interview form however after the interview has taken place. These non face-to-face Return to Work Interviews should only take place if an employee is returning from a short period of absence and formal action under the policy is not necessary. In all other circumstances a face-to-face Return to Work Interview should take place. 6. If an employee refuses to attend a Return to Work Interview, the manager should discuss the reasons with the employee in order that the reasons and purpose for the interview are clearly understood by the employee. If the employee still refuses to attend the manager should offer the opportunity for a senior manager to conduct the Return to Work Interview with the employee instead. Where the employee still refuses the manager should make a note on the Return to Work Interview form and contact their Human Resources representative for further advice. Employees should be advised that a refusal to attend such an interview, may be treated as a disciplinary matter in itself and/or that management decisions will be taken based on the information available. Page 39

41 RETURN TO WORK INTERVIEW FORM All sections to be completed by the manager and then signed by both the employee and manager. Return to Work Interviews should normally take place on the employee s first day back or as soon as possible. Managers should refer to the guidance notes as appropriate Employee s Name: Job Title:... Date of Meeting:.. Period of Absence: From: To:.Total Calendar Days Absent:. Reason(s) given by Employee for Absence: Is the employee well enough to return to work in the manager s view? Yes No Has the employee submitted the necessary certification? Yes No Was the reason for absence linked to an injury at work? Yes No If yes, has the employee completed the necessary accident reporting documentation in accordance with PCT procedures? Yes No Details of issues discussed: Details of support offered to employee:.. Page 40

42 Actions Agreed (including timescales): Signature of Employee:.. Date: Signature or Manager:.. Date: Page 41

43 Managers Guidance Notes A copy of this form should be given to the employee and a copy retained in the employee s personal file. The purpose of the record will be to monitor the effectiveness of he PCT s Managing Sickness Absence Policy and to enable manager to monitor individual absence levels. All records are kept confidentially. An employee may view their individual absence records by request. Issues to discuss could include: Welcoming the employee back; updating on the work situation; the reason for the employee s absence; the impact of the absence on service delivery; the implications of future absence. Support offered could include: Occupational Health referral; counselling service; specific training; awareness of other leave policies, ie. special/annual leave; advice/support from Human Resources/Senior Management or Trade Union. Action could include: Targets/timescales for improved attendance; Occupational Health referral; investigation if reason for absence was work related; a review of the risk assessment. Points to discuss at the Return to Work Interview: Welcome the employee back at work Establish, as far as possible, if the employee is truly capable or fit to resume their duties. Discuss what has happened at work whilst the employee has been absent such as changes in staffing, systems, procedures or equipment etc. Discussion of any preventative measures to be considered (e.g. early referral to Occupational Health, flexible working, workplace adjustments etc). Determine whether there are any training or development needs that have arisen (such as training on new IT or other systems that have been introduced whilst the employee has been absent). Give the employee an opportunity to access other facilities (e.g. Counselling, Eye Test Scheme) or policies (e.g. Grievance, Harassment & Bullying, Stress, etc) Identify any underlying causes (e.g. Domestic circumstances, Work related problems, Pregnancy, Stress etc) and develop strategies. Give an opportunity to discuss the employee s management of own health (e.g. diet, nutrition, rest breaks, etc). Page 42

44 Agree with the employee how they want their return to work to be treated by others are they happy for other team members to ask them how they are, know why they have been absent, etc? Allow a general discussion on the attendance record, which may include any trends or patterns of absence; this may include future monitoring or performance expectations. Check that all necessary documentation, such as payroll notification, medical certificates, Accident at Work reporting Procedures etc have been received and actioned as appropriate. Review the Risk Assessment Explore any possible support or adjustments, which could assist the employee (e.g. referral to Occupational Health etc). All contacts of this nature must be conducted confidentially and with a degree of sensitivity. Further advice should be sought from Human Resource through-out this process as appropriate, but definitely prior to embarking on any formal action. Page 43

45 CONFIDENTIAL SELF CERTIFICATION APPENDIX 3 To be completed by an employee on their first day back at work following an episode of sickness absence and forwarded to their Manager. Please use BLOCK LETTERS Full Name: Job Title: Location: Service/Department: The day* and date you became unfit: The day and date you were first absent from work: The day and date you were fit: The day and date of your return to work:.. Was this episode of absence linked to an injury sustained at work? Yes No (Note: If answered yes, then you must inform your Manager in order to complete the Accident Form in accordance with Trust Procedures) Was this episode of absence linked to an injury sustained outside of work in circumstances where you may have a claim for damages against someone else? Yes No (Note: If answered yes, then you must inform your Manager). Details of Sickness/Injury. Please say briefly why you were unfit for work give details of your sickness words like unwell or illness are not enough..... I declare the information I have provided above is complete and correct to the best of my knowledge and that I have submitted, as appropriate, all Medical Certificates to my manager. Signed: Date:.. (Employee) Thank you for completing this form. The information provided will be retained on your personal file to assist with monitoring sickness records and to enable appropriate support to be provided quickly and efficiently. Nonpersonally identifiable data may be used for more general sickness absence monitoring across the Trust. Any information provided will be treated in confidence. Signed: (as being seen) Date:.. (Manager) * Please note half days and weekends if appropriate Page 44

46 APPENDIX 4 Worcestershire Royal Hospital, Aconbury West, Charles Hastings Way, Worcester,WR5 1DD Tel: /4 Fax: MANAGEMENT REFERRAL OF MEMBER OF STAFF TO THE OCCUPATIONAL HEALTH DEPARTMENT PLEASE PRINT FULL NAME: DR/MR/MRS/MISS/MS.. ADDRESS:.POSTCODE:.. TEL: DATE OF BIRTH TITLE: DEPARTMENT:.. TRUST:..LOCATION:. HOURS OF WORK..LENGTH OF SERVICE. DETAILS OF SICKNESS ABSENCE (TO DATE) FROM TO TOTAL DAYS ABSENT REASON Member of staff advised about referral to Occupational Health on.. Date of current medical certificate, if relevant. FROM.. TO:. Page 45

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