Promoting Attendance (Health Issues) Policy and Procedures

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1 Promoting Attendance (Health Issues) Policy and Procedures Human Resources Department: June 2013 Revision date: June 2015

2 Promoting Attendance (Health Issues) Policy and Procedures Authors HR Date of issue Approval Next review due date Reviewers/review team June 2013 June 2015 Reviewers Name Reviewers Role Review Date Jenny Porteous HR Director June 2015 Mairi Murray Employee Director June 2015 Distributed to the Following for Information Name Job title Role and responsibility Area Partnership Forum Members Partnership representative Communications Manager Agree policy Ensure partnership working Staff Notification of new policy 2

3 Index Page Introduction 4 Scope 5 Terms and Conditions of Employment 5 Policies 6 Manager s Responsibilities 6 Staff Responsibilities 8 Occupational Health Responsibilities 8 Human Resources Responsibilities 9 Staff Representative Responsibilities 10 Education, Training and Awareness Raising 10 Monitoring and Reviewing 11 Appendix 1 Procedure for Managers 13 Trigger Points 13 Guidance on Conducting a Return to Work Meeting 13 Process to Deal with Long Term Absence 14 Carrying out a Long Term Absence Discussion 15 Employee Rehabilitation 16 Procedure for Return To Work Programme 17 Payment During Return To Work Programme 19 Employee Returns to Work with Permanent Restriction 19 Termination of Employment on Health Grounds 19 Unauthorised Absence 19 Appendix 2 Procedure for Staff 21 Contact Timescales 21 Self Certificate 22 Notification / Certification Timescales Guide 22 Sick Pay Scale 23 Sick Whilst on Annual Leave 23 Breaks in Service 23 Appendix 3 Role of the Occupational Health (OHS) 24 Appendix 4 Staff Side Roles & Responsibilities 27 Appendix 5 - Occupational Health Referral Form 28 Appendix 6 - Self Certification of Absence Form 30 Appendix 7 - Return to Work Meeting (Form) 31 Appendix 8 Case Conferences 33 Appendix 9 Guidance on the use of the Bradford Formula 34 3

4 1. Introduction 1.1 This policy has been developed and agreed in partnership with the NHS Western Isles Area Partnership Forum (APF) and is based on existing recognised good practice, PIN guidelines and conforms to employment law requirements. 1.2 Sickness absence occurs when ill health, including disability, makes a person unfit to work. It also occurs when a doctor advises an individual to stay off work due to illness. 1.3 Attendance levels can act as an indicator of wider staff wellbeing. Monitoring attendance levels is an important tool in detecting variations and trends in absence and identifying where managerial support for staff may be required. 1.4 Ensuring staff awareness of the requirement for good work attendance is an essential prerequisite to this policy. The success of this policy will depend upon a proactive, consistent and effective approach being applied across the organisation. This approach relies on: Good communication between managers, members of staff and staff representatives Compliance with relevant legislation; Involving key groups such as the Occupational Health Service (OHS); The provision of guidance and support to staff, managers and Trade Unions/Professional Organisations. 1.5 This Promoting Attendance Policy aims to: to ensure that sickness absence rates are pro actively monitored managed and maintained within required (4%) levels; provide guidance for managers and staff in relation to unacceptable levels of attendance to reduce staff ill health as far as possible and to give all staff clear guidance on the issues relating to promoting a healthy workplace and promoting staff health and attendance; to help NHS Western Isles reduce both short and long-term absence through promoting positive attitudes to work to ensure there is an agreed process for managers throughout NHS Western Isles to adopt a fair, consistent and supportive approach for all staff with health problems; improve staff retention and prevent discrimination; support the delivery of consistently high-quality services with best possible staff attendance; ensure all relevant employment legislation is adhered to (e.g. Disability Discrimination Act) and all legal requirements met; assist managers in communicating regularly and openly with staff, offering appropriate support to staff as required; make appropriate resources available to staff with health problems through OHS etc; utilise other procedures as appropriate (e.g. redeployment); ensure that the organisation s employment practices are based on good practice; give all staff the opportunity to be represented at all stages in the proceedings by a staff representative, colleague or friend. 4

5 1.6 While the organisation aims to secure the attendance of all staff, it is recognised that a certain level of absence due to sickness may occur and that the sensitive management of health problems and the promotion of good health contributes to the wellbeing and retention of staff. There may be occasions where, after consideration, there will be staff who cannot continue working in their current role, or any other role due to their health problems. 1.7 Managers are responsible for ensuring that individual and departmental sickness absence levels are reviewed and managed on a regular basis to be able to address problem areas and maintain acceptable sickness absence levels within their own department and in accordance with National Targets levels for NHS Western Isles. 1.8 NHS Western Isles will provide absence management training for managers and supervisors and will raise awareness of key aspects of this policy with all staff. Training and awareness will include, as a minimum, the following issues: the benefits of good attendance at work; the benefits of good communication between managers and staff; roles and responsibilities of staff, managers, Human Resources (HR), OHS, Trade Unions/Professional Organisations and the Promoting Attendance Task Force. the procedure for reporting absence; Fit Note - Med 3 (new doctors medical certificate) trigger points used for reviewing/managing absence in NHS Western Isles; return to work interviews; referrals to OHS; and recording and monitoring absence levels. 1.9 The following policies will be referred to in conjunction with certain sections of this policy and should be referred to for guidance on the management of health problems: Management of Employee Conduct (Disciplinary). Management of Employee Capability. Redeployment. Secondment. Drug and Alcohol Stress. 2. Scope This policy and its procedures apply to all staff employed by and seconded to NHS Western Isles. 3. Terms and Conditions of Employment 3.1 All staff have an entitlement to sick leave and pay in accordance with their terms and conditions of service. Please refer to Section 14 of the Agenda for Change Terms and Conditions of Employment and amended by PCS (AFC) 2008/2. Where AFC Terms and Conditions make reference to final reviews this should be read as final case conference regarding this policy. 3.2 It is also stated in the NHS Western Isles Contract of Employment a member of staff may be requested to attend an appointment at the Occupational Health Department if their work appears to be affecting, or be affected by their health. Part 3 Section of the Agenda for Change Terms and Conditions also states that staff do not need to be off sick to be referred by their employer for a medical examination. 5

6 4. Policies 4.1 Failure to adhere to absence reporting procedures, poor attendance or abuse of the sick leave provisions may, be dealt with under our policy for the Management of Employee Conduct. 4.2 Any cases involving alcohol, drug or substance abuse should be managed utilising the NHS Western Isles Drug and Alcohol Policy.. 5. Responsibilities Manager s Responsibilities Proactively address the management of sickness absence The responsibility and accountability for management of sickness absence lies with the line manager for his or her own department. Managers must be familiar with both the local arrangements for absence notification and the arrangement associated with Terms and Conditions of employment covering sickness absence. Managers must ensure that these arrangements are communicated to staff within their own department and that staff have been issued with instructions on how to report absence and sick pay entitlement. The absence reporting procedure should be explained to new staff as part of their departmental induction. Line managers also have a key role in ensuring that this policy is implemented at departmental level Seek advice and guidance in complex cases from next line management and HR Managers must record accurate absence information for all staff on the SSTS (Scottish Standard Time System) including the duration and reason for absence and a indicate when a Return to Work Meeting has taken place. Managers are required to update staff absence data on SSTS on a daily basis to ensure timely and accurate data. In addition, managers will regularly review and monitor statistical information on absence rates within their own department using First Line Manager Reports via BOXI Managers must ensure that all periods of absence as a consequence of sickness are supported by an appropriate level of certification. This includes Self Certification and Certification from the employees GP. Note: Fit Note from the 6th April 2010 the medical certificate changed to a (MED 3)/ Fit Note. The new Fit Note system means that doctors can advise employers whether an employee is unfit for work; or may be fit for work. A doctor may give a may be fit for work statement if they think that their patient s health condition may allow them to work if they get suitable support from their employer. A fit note is still required form the 8th day of absence. On receipt of a Fit Note / Sick Note Managers should seek advice from OHS / regarding any temporary adjustments recommended by the GP If absence is the result of an accident or injury/disease incurred in the workplace this must be immediately notified to the Health and Safety Officer via DATIX Absence recording and management will enable early identification of any potential absence issues. All managers must ensure that they meet with staff to conduct a return to work meeting (Appendix 1 pg. 11) following every period of absence to discuss and complete the Return to Work documentation. It may be appropriate to use delegated responsibility for practical reasons (if the service/department is dispersed, for example). 6

7 5.1.8 Managers should clearly identify on SSTS when an employee is undergoing a return to work programme to ensure payment made is in accordance with Appendix 2 - section 10. A Notification of Change form detailing the pay arrangements associated with the Return to Work Programme should be completed and sent to payroll. see Appendix 1 (9.1) Organisational and departmental absence levels will be monitored and analysed by the HR Department. Monthly absence statistics will be reported via the Human Resources Report to all key groups and Committees Absence levels must be assessed on a monthly basis to enable line managers to pro actively address problems. Whilst judgements of what constitutes acceptable or unacceptable levels of absence is entirely dependent on the individual circumstances of each case, any pattern of absences in a specific period should alert the manager to the need for further action (Appendix 1 Trigger Points). Where frequent absences, continuous absence or inability to perform duties due to ill health are causing problems in the workplace, the manager will discuss this with the staff member, either at a return to work meeting or at another arranged meeting in order to establish what support can be provided by the organisation and agree a way forward. Managers must remind staff of their rights to have representation at such meetings It is important that managers discuss sickness absence issues with the Human Resources Department to ensure that consistent standards are applied across the whole organisation. Professional advice should also be sought from OHS before determining any course of action. Managers should always discuss any proposed referral to Occupational Health with the staff member concerned and inform them of the content of the referral prior to a referral taking place. A formal referral by the manager will take place when a Trigger has been reached. Further advice on this can be sought from OHS. A referral form should be completed, forwarded to Occupational Health and copied to the member of staff. The referral form is included on page 27 of this policy and fuller details of the OHS service is included in Appendix Members of staff referred to Occupational Health must be made aware that non-attendance will be viewed as a failure to follow a reasonable management instruction. It is also a requirement of the NHS Western Isles Contract of Employment and Agenda for Change Terms and Conditions of Employment Part 3 Section 14. The purpose of the referral is to support the employee and the service. Where a member of staff fails or refuses to attend, the manager will be required to act on the information available, even if this is of a limited nature due to the staff member not attending an OHS appointment following a Management referral to Occupational Health. In these circumstances managers should obtain further advice from the Human Resources Department Key Actions for Managers Managers must: pro actively monitor and manage attendance; record all absence details on SSTS and update this system on a weekly basis; ensure that staff provide appropriate certification to cover all periods of absence be supportive to staff who are absent from work through ill health; seek appropriate OH advice in relation to Fit Note (Med 3) requirements; ensure contact is maintained with absent staff according to the requirements outlined in Appendix 2; inform staff about the existence of this policy through their departmental induction; ensure that all their staff are familiar with the contents and aware of the requirements of this policy; inform staff of the provisions of their Terms and Conditions of Employment keep accurate records and notes as required/described; adhere to arrangements for notification of absence including informing Health and Safety Officer if appropriate (e.g. via DATIX); ensure staff are made aware of a referral having being made to Occupational Health; ensure that Payroll are advised when a member of staff returns to work after long-term sick leave; 7

8 ensure that they meet with staff who have been absent, upon their return to work and conduct a Return to Work Meeting as outlined in this policy (see Appendix 1) conduct case conferences in a timely manner and in accordance with policy. 5.3 Staff Responsibilities all staff have a responsibility to ensure they are both familiar with and adhere to the NHS Western Isles absence reporting procedures as outlined in this policy ensure that their line manager or named deputy is notified when sickness occurs (refer to Appendix 2 for further details). Notification must take place prior to the start of the next rostered shift maintain contact with the manager or named deputy during the entire period of sick leave provide managers with the appropriate sickness certificates within the required timescale (i.e. within 24 hours from receipt from GP) or an indication of intent to submit (please refer to Appendix 2 Procedure for Staff) be aware that line managers may have to discuss adjustments with OH if and adjustments are suggested by the GP on the Fit Note / MED 3 Form; be aware of the managerial requirement to make a management referral to OHS for support after a trigger point has been reached, or at anytime where a manager is concerned for a member of staff s health; be aware that absence which is unexplained/ not notified within the required timescale will result in leave being classified as unpaid provide a Fit Note for all periods of absence that occur whilst on a period of Annual Leave (self certificates will not be accepted) make every effort to attend scheduled Occupational Health appointments and provide notification to those concerned where attendance is not possible have an individual responsibility to ensure they are healthy and able to attend work as far as they are able to do so if absence is the result of an accident or injury/disease incurred in the workplace this must be immediately notified to the Health and Safety Officer via DATIX participate in all meetings arranged by their manager regarding issues associated with their absence from work. 5.4 Occupational Health Service (OHS) Responsibilities The OHS is responsible for undertaking confidential health assessments of individual staff who either refer themselves or are referred by management The OHS will support staff in working towards a return to employment and ensuring effective communication with managers, Human Resources, General Practitioners and any specialists involved. The aim is to achieve a constructive outcome that meets the needs of the organisation and the individual The OHS can also provide expert advice and guidance to staff and managers on issues relating to both health and the workplace, including possibilities for reasonable adjustments at work. 8

9 Advice and guidance will shared with the employee s manager with regard to management referrals Staff may access OHS at any time as a self-referral or be referred by their manager if an employee s work appears to be affecting, or be affected by their health. If a manager if makes a referral, specific, limited information regarding the employee s fitness for specific tasks only will be given to the manager (see Referral to OHS Form - Appendix 5). The OHS can also give specialist guidance on the workplace that may assist in creating a healthier environment For further information on Occupational Health Services in NHS Western Isles and referral forms please refer to Appendix 3 of this policy. Key Actions The Occupational Health service will: undertake pre employment checks an assess any known or declared health issues established at the time of employment; undertake staff health assessments (self or management); liaise with GP s and other specialists in support of staff absence issues; support staff return to work programmes in full consultation with Managers; provide expert and confidential advice/guidance to staff following self referrals provide expert and confidential advice to managers following management referrals advise managers on temporary adjustments recommended via Fit Notes (Med 3) participate in Case Conferences associated with staff absence refer staff to the OH Physician where appropriate refer staff for counselling or specialist services where appropriate liaise with Employee Services with regard to adjustments required under the DDA participate in Final Case Conferences / final Reviews as required by this Policy (Appendix 8); support staff who are being retired from employment of the grounds of Ill Health consider and progress redeployment issues where the health of an employee has identified as an issue; be represented at Promoting Attendance Task Force meetings participate in the review of this and other policies associated with absence management 5.5 Human Resources (HR) Responsibilities ensuring that appropriate training and awareness is provided to managers and supervisors regarding the management of sickness absence ensuring that all staff have access to this and other policies associated with absence management and that appropriate guidance is provided highlighting key aspects of this policy providing advice and guidance to managers regarding all non clinical/medical aspects of staff absence provide training to managers in the use of systems designed to monitor staff absence from work (SSTS & BOXI) monitoring the implementation of the Promoting Attendance Policy and Procedures across NHS Western Isles lead the review of this policy in partnership with staff side representatives and managers reporting organisational absence statistics on a regular basis via the Human Resources Report participate in Case Conferences associated with staff absence at the request of managers 9

10 5.5.9 participate in Final Case Conferences / final Reviews as required by this Policy (Appendix 8); be represented at Promoting Attendance Task Force meetings 5.6 Staff Representative Responsibilities act, at all times, in line with the role and responsibilities set out in the Partnership Agreement (see Appendix 4) support the design and delivery of training associated with the promotion of attendance at work participate in Case Conferences associated with staff absence at the request of individual staff participate in Final Case Conferences / final Reviews as required by this Policy (Appendix 8) be represented at Promoting Attendance Task Force meetings participate in the review of this and other policies associated with absence management 5.7 Promoting Attendance Task Force (PATF) This group is formed with a specific remit from the CEO delegated to the NO/COO to improve staff attendance at work the group leads in supporting managers across their system to pro actively and consistently manage their staff sickness absence the group will meet with, and advise managers as required with regard to individual and departments attendance issues the group will lead investigations to ascertain any underlying problems with staff attendance in any department the work of the group will be determined by regular confidential reports on sickness absence activity membership of the group will include senior representation from HR, OH and Staff Side the group will meet on a monthly basis and will report to the CEO the work of this group will drive the Boards performance to achieve the 4% national target associated with staff absence the work of this group does not remove the individual management responsibility to manage staff absence 6 Education, Training and Awareness Raising To promote attendance positively, NHS Western Isles will raise awareness of this policy and its standards as part of departmental and organisational induction for new staff. 10

11 6.1.2 NHS Western Isles will also provide training and awareness raising for staff, managers and Trade Union/Professional Organisation representatives which will include, as a minimum, the following issues: the benefits of good attendance at work; roles and responsibilities of staff, managers, Human Resources, Occupational Health and Trade Unions/Professional Organisations and the PATF; the procedure for reporting absence; trigger points for reviewing and monitoring absence in NHS Western Isles; the use and application of the Bradford Formula as an additional management tool return to work interviews; referrals to Occupational Health; recording and monitoring attendance levels; potential consequences of non adherence to the policy and The management of staff absence via the capability policy 7. Monitoring and Review 7.1 This Policy will be reviewed jointly by Human Resources and the HR Forum every 2 years Proposed changes and amendments will be approved by the APF. 7.2 A review of sickness absence rates, levels of redeployment and the number of retirements through ill-health will also contribute to the evaluation and audit of the policy. 11

12 Appendices Appendix 1 Procedure of Manager Appendix 2 Procedure for Staff Appendix 3 Role of Occupational Health Service (OHS) Appendix 4 Staff Side Roles and Responsibilities Appendix 5 Referral to Occupational Health Service Appendix 6 Self Certification of Sickness Absence Appendix 7 Return to Work Meeting Appendix 8 Final Case Conferences Appendix 9 Guidance on the use of the Bradford Formula 12

13 Appendix 1 Procedure for Managers 1. Each department is required to hold individual absence records detailing the dates of any absences and the time of notification. These should be kept separately and confidentially in the staff member s personal file. 2. The manager is required to record individual staff absences on SSTS as soon as they are informed by the member of staff of their absence. This should occur even where an employee has come to work and has had to go home due to sickness. 3. Annual, special, sick, maternity and other leave must also be recorded on SSTS to allow an illustration of the number, frequency and reasons for absence to make it easier to identify trends. Managers should monitor individual staff s absence on an ongoing basis, preferably after each period of absence, in order to identify areas of concern at an early stage. The earlier issues are identified and discussed with the staff member, the more effective the response and action will be for both employee and manager. 4. When a Fit Note (Med 3) is submitted by a member of staff, managers should seek advice from OH if any adjustments are recommended by the GP. 5. Trigger Points It is important that managers have clear trigger points in place for reviewing sickness absence. These triggers may include: frequent short-term sickness absence; absence that is not satisfactorily explained; absence linked to certain shift patterns; and absence linked to certain days or times. The trigger would be four episodes, more than eight days short-term sickness absence, or four weeks consecutive absence within a 12-month period, which a manager will identify through the local absence recording mechanism. 5. Guidance for Managers on Conducting a Return to Work Meeting 5.1 The manager or supervisor must conduct a return to work meeting with each member of staff on return from all episodes of sick leave (even 1 day). The discussion should take place, in private, as soon as possible after the employee s return to work. The objectives of this discussion are:- a) to demonstrate interest and concern for the employee and ensure the employee has not returned to work prematurely; b) to ensure the employee has not returned to work too early in the interest of patient care and other health and safety risks; c) to identify at an early stage any underlying reasons for absence and ensure that appropriate assistance is given; d) to assist in the monitoring of an individual s sickness record and identify at an early stage any developing patterns of sickness absence; e) to ensure appropriate self/medical certificates are provided; f) to ensure that any necessary support/action is taken at the appropriate time. 13

14 5.2 A Return to Work Form must be completed and signed by both the manager and the employee indicating the content and the outcome of the discussion. The form will be kept in the employee s personal file. 5.3 A general guide for managers carrying out return to work meetings is available from the Human Resources Department. This guide includes information on the preparation and structure of meetings, as well as information on keeping in contact with staff on sick leave and guidance on return to work programmes. 6. Process to Deal with Long-term Absence 6.1 Managers must maintain regular contact in a manner and timescale agreed with any employee who is on long term absence to establish whether the individual requires additional support from either the manager/organisation or when/if the person is fit to return to work. Please refer to Appendix 2 page 19 for further detail. 6.2 It is also important that the employee knows that they remain a valued member of the team. In most cases the member of staff and the manager will meet in the workplace to discuss the absence. Exceptionally, and with the prior agreement of the member of staff, this meeting may occur at another venue or the employee s home. The purpose of maintaining contact is to: a) demonstrate interest and concern for the employee; b) identify whether any assistance/support is required e.g. through the OHS and explain the procedures to be followed; c) provide any required information to the employee regarding their sick pay position etc; d) where appropriate discuss with the employee the likely timescale and best means of returning to work. 6.3 If it is established that the employee is unlikely to be fit to return to their current post (via OH), then the manager must first consider a change of duties/hours of work (taking into account any requirements under the Disability Discrimination Act) or the possibility of redeployment to another area (refer to Redeployment Policy). Where the staff member s health is such that redeployment is not possible, termination/retiral due to ill health may be considered as an option (see section 12). If considering these options the manager should contact the Human Resources Department for advice and guidance. 6.4 If a return to work date is not identified the employee will be referred to OHS to assess their state of health. This must be done after a four week absence. However, OHS support the view that certain illnesses may respond better to an earlier referral i.e. where timeously appropriate clinical intervention can be effected. 6.5 Following assessment by OHS, the line manager will be advised on the state of the employee s health as it affects his/her ability to perform the duties of the post and give an estimate of the likely remaining length of absence. The line manager should then arrange to meet the employee (if possible, depending upon nature of illness) at a mutually convenient location to discuss the report. 14

15 6.6 Is the employee able to return to current post? Yes Not Known No No further action required Termination on the grounds of ill health should be considered Agree with OHS appropriate timescale for review Ill health is such that changes are not possible OHS may recommend that the manager investigates possible: rehabilitation change of duties redeployment The HR Department must always be involved in discussion of cases involving potential retiral/termination/redeployment on health grounds. It is also advisable for staff to seek advice from their Trade Union representative, Citizen s Advice Bureau or Manager if contemplating retirement. 6.7 Line managers have continuing responsibility for the employee and should make reasonable adjustments to the post if possible and where necessary, providing duties for the individual in agreement with the OHS department. 6.8 It is a requirement of the Agenda for Change Terms and Conditions of Service (Section 14and Annex Z) that Managers must arrange a Case Conference (final review) in all instances well before employee s sick pay entitlement becomes exhausted (see Appendix 8). Failure to do this will result in sick pay entitlement being reimbursed until such time as a case conference (final review) takes place. A Case Conference is a meeting of all interested parties i.e. line manager, OHS, HR, employee and staff representative. The purpose of a case conference is to discuss and agree ways forward in an open and transparent way. The outcome of a case conference will usually consider: Agreed return to work programme, if appropriate; Agreed restrictions/adjustments to role, if required; Redeployment, if applicable; and possible; Ill Health Retirement; Capability issues. 7. Guidance on Carrying out a Long-Term Absence Discussion 7.1 Managers should utilise the following guidance when conducting long-term absence discussions with staff as illness allows (on average approximately half way through entitlement to full pay): a) arrange a time to see the member of staff informing them of the reason for the meeting. Staff at this stage may still be signed off; b) inform the member of staff about their right to representation; 15

16 c) arrange a suitable venue for the meeting to take place allowing for privacy and confidentiality; d) write to the member of staff confirming arrangements for the meeting; e) prior to the meeting the manager should have the following information to hand; OHS reports (if already requested); copies of correspondence with the staff; details of length of service and previous record of absence; patterns of sickness absence; any other relevant information; 7.2 The manager will then:- explain the aim of the meeting; review OHS reports and correspondence; ask the member of staff for information about their perception of any on-going problems relating to their absence; check whether there are any other circumstances to be taken into account? agree an action plan with timescales (refer to OHS if required); set a date for another review (if required) in line with the agreed action plan. 7.3 The manager must inform the member of staff that a record of the meeting will be followed up in writing with a copy placed in their personal file and a further copy given to the employee. 8. Employee Rehabilitation (Phased Return to Work Programme) When a staff member is fit to return to work but cannot carry out their full range of duties (either in the short or longer term), every effort should be made to give them the opportunity for an earlier return to work. This might include reducing or amending their range of duties. To comply with eh Disability Discrimination Act 1995, the Disability Rights Commission recommends that organisations: take any steps which it is reasonable for it to have to take, to reduce or remove any substantial disadvantage which a physical feature of the premises or of the organisation s employment arrangements causes a disabled member of staff compared to a non-disabled person. In the short, reasonable adjustments to a staff member s job can include: changes to duties, shifts or hours; changing the place of work; and making adjustments to the features of building or access to it, including its fixtures, fittings and design, although this list is not definitive. Adjustments should only be made after: receiving the advice and recommendations of OHS; discussing the matter with the member of staff; and carrying out a review of their skills and abilities and the likely needs of the service. A clear written programme, including timescales and review period, must be agreed with the Manager and staff member before any return to work can take place. Any programme must not exceed 4 weeks. HR advice should be sought on any agreed variation to a contract and pay 16

17 policy, to make sure that local policy is applied consistently. arrangements and family friendly policies is encouraged. The use of flexible working Assistance is available from the Disability Employment Advisors based within Job Centres and other agencies. They can support the staff member and the workplace with respect to carrying out needs assessments, and they can advise on any equipment and medications that might be required for the working environment. 8.2 Managers must adopt the following procedure before deciding on a return to work programme. The success of any agreed return to work programme will depend on:- a) effective and full communication between employees, managers, OHS, HR and staff representatives; and b) appropriate and realistic rehabilitation options being identified for the employee and the organisation. 8.3 Staff who are on long term sick leave are entitled to carry over any untaken statutory annual leave from one financial year to the next. Annual leave in accordance with current conditions of service. 9. Procedure for Return to Work Programme Stage One: Manager refers employee to OHS to assess:- the nature/extent/prognosis of the illness/disability; any restriction of work capacity caused by the illness/disability; if those restrictions are temporary or permanent; recommendations for rehabilitation. Stage Two: If rehabilitation is considered appropriate by OHS, a range of options will be considered by the manager in conjunction with OH, line manager and the employee, including the following:-. modified work activity; reduced working hours; HR advice can be sought on policy related issues. Stage Three: Following Stage 2, the manager decides on acceptability of return to work programme taking account of:- timescale involved to be realistic to both employee and organisation; likely effects of programme: to department to colleague to employee support and monitoring capability; expectation of return to normal duties. 17

18 Stage Four: Has the 4 Week Programme been agreed? No Yes Employee or manager gives clear reasons why not and considers other courses of action taking advice from OHS and HR Dept., e.g. employee remains on sick leave termination/retiral on health grounds Return to work programme should be in writing and specify: duration place/area of work duties payment monitoring and support arrangement reassessment timescales Stage Five: Was Programme Successful? No Why not? Review between manager, employee, OHS and HR Dept. Any viable alternative? Yes No Yes full recovery/return to normal work Consider implementation return to work with permanent restriction see section 11 (below) return to sick leave discuss with OHS consider termination/retrial on health grounds capability Issues 9.1 When a return to work programme has been agreed between the manager, employee, OHS, a written statement of the outcome must be recorded and kept on the individual s personal file. The manager must ensure any phased return is noted on SSTS and payroll are notified of pay arrangements. Managers must also ensure that staff are notified of their sick pay entitlement during a phased return and agree, with the employee, any annual leave to be taken to maximise earnings. 9.2 An employee s entitlement to sick pay is individual and dependant on their previous sickness absences and length of service. Sick pay entitlement is calculated back 12 months from the first day of any episode of sickness absence. 18

19 10. Payment During a Return to Work Programme 10.1 An agreed rehabilitation/phased return to work programme should not be financially detrimental to employees. A member of staff returning to work on a phased return to work programme will receive full salary payment for up to 4 weeks (maximum) and thereafter will be paid for the hours worked if unable to return to full contracted hours. This period will not be recorded as sickness absence. But the un-worked hours must be recorded as special leave Staff should be made aware by their Line Manager that following a period of sick leave, they are entitled to carry over what remains of their statutory annual leave allowance into the next financial year. 11. Employee Returns to Work with Permanent Restriction The decision on whether this is possible rests with the manager, after an OH referral has been made and management report received back from OHS and consultation with Human Resources. Any decisions regarding adjustments or changed roles or responsibilities will be considered in accordance with the Disability Discrimination Act. 12. Termination of Employment on Health Grounds 12.1 The option to terminate employment on the grounds of incapacity due to ill health should only be considered when all options for reasonable adjustment or redeployment have been fully investigated and exhausted (refer to Redeployment Policy) The employee must be considered as unfit for any reasonable available employment by the Occupational Health Physician For further information regarding the termination of employment on health grounds please refer to SPPA 2008/6 for further details. This can be accesses via the SPPA website A comprehensive assessment of likelihood of return to work and all associated processes must be undertaken well in advance of the date when sick pay is exhausted in order to allow a clear outcome at the no pay date. It is not acceptable to reach the end of the pay period without a clear outcome In considering termination of employment on the grounds of ill health the employer must demonstrate that it has: taken account of written advice from the O.H.S. recommending this; consulted with the staff member and discussed the position with them; made a thorough investigation of the medical and other facts; balanced the staff member s likely future health against the organisation s needs; fully explored other employment options and found these to be unavailable or not practical. 13. Unauthorised Absence 13.1 Unauthorised absence occurs when an employee fails to follow organisational procedures regarding the notification of absence from duty. Employees should inform their line manager, named deputy or shift supervisor (if the line manager is unavailable) before start of shift on the first day of absence that they are unable to attend work. It is important that managers inform all employees, particularly new members of staff during induction, of the precise departmental rules governing notification of absence. [See Appendix 2 for reporting requirements] The following process should be followed in cases of unauthorised absence:- Trigger: 19

20 Employee fails to notify their manager/supervisor that they will be absent from work. Stage One: The manager/supervisor should contact the employee to ascertain their reasons for absence. If they are unable to contact the employee they will arrange to see the individual as soon as they return to work. However if the unauthorised absence continues beyond two days and the manager is unable to make verbal contact a letter should be sent by recorded delivery to seek an explanation of the absence and explain the consequences of not responding. Failure to notify absence in accordance with this policy will result in unpaid leave and the possibility of disciplinary action. No notification = no pay. Stage Two: Following an unauthorised absence the manager should arrange to meet with the employee to ascertain the reason for absence. If the employee is unable to provide a reasonable explanation for unauthorised absence the manager may consider resorting to the Management of Employee Conduct (Disciplinary) Policy. Advice should be sought from the HR Department on this issue as soon as possible. Failure to comply with sickness absence reporting may result in loss of pay and possible disciplinary action. 14 Sick whilst on Annual leave If the employee becomes sick whilst on a period of Annual leave. They must notify their manager on the first day of sickness A Fit Note Med 3v (Medical Certificate) will be required for all periods of absence where staff are reclaiming Annual leave as a consequence of sickness. A self certificate will not be accepted in these Circumstances. 15. What if there is No Obvious Health Problem 15.1 If there is no underlying medical reason for the absence, the manager must advise the staff member that the situation is unsatisfactory. Where there is any doubt about a person s fitness for work, help and advice should be sought from OHS. At the same time, s/he should stress the importance of regular attendance at work and reaffirm the organisational and departmental standards of attendance. In cases where circumstances and investigation indicate a more serious situation, it may be necessary to formally set appropriate standards for attendance which are consistent with the organisational policy. The manager should meet with the staff member to let him or her know that: the level of attendance must improve; the level of attendance will be closely monitored; this monitoring will continue for an appropriate period of time according to individual circumstances; and if there has been no improvement in their level of attendance at the end of the monitoring period, the situation may be looked at under the Management of Employee Conduct policy. 20

21 Appendix 2 Procedure for Staff 1. If you are unable to attend work you must contact your manager, named deputy or shift supervisor at the earliest possible opportunity before your due start time. It is essential for the staff member concerned to ensure that their line manager is informed of their sick leave at the earliest opportunity. In exceptional circumstances where a member of staff is unable to phone personally, a relative or friend may phone on their behalf. The responsibility for reporting absence remains with the individual member of staff. 2. Where the line manager is not available, it is essential that contact is made as follows: with a named deputy or shift supervisor (within same department); only in very exceptional circumstances should messages be left on departmental voice mail; staff must not use text messaging or as a means of contacting their line manager or designated deputy to inform of absence. 3. It is important that you communicate all relevant details when making contact, including:- the reason for absence; reasons for absence do not need to be given to colleagues, however, line managers must be notified of absence details as soon as possible. an indication of when you expect to be fit to return to work; and/or; details of any appointments with your General Practitioner; Staff must leave a contact number where their manager can contact them. Your information will be kept confidential in line with the Data Protection Act Contact Timescales for Staff Members absent through Sick Leave Day 1 of absence Staff Responsibility Contact Line Manager or if unavailable contact a named deputy / shift supervisor. Staff must also leave a contact telephone number. Managerial Responsibility Staff who fail to make this contact will be contacted by their line manager in order to establish the facts relating to the leave and offer support as appropriate. Day 5 of absence Day 7 of absence Day 14 (short to mid term absence) 4 weeks (20 working days) Staff are required to contact line manager or named deputy to update them on progress and likely timescale for return. Inform manager if support of any kind is required. Final day of self certification period. MED 3 Form (Fit Note) now required within 24 hours. Member of staff must contact their line manager/designated deputy to inform of situation and likely return to work Staff must be aware that managers are required to refer staff to OHS once the four week absence has been triggered. Staff must be informed of this referral and be aware that non attendance is contrary to their contractual obligations under Agenda for Change Terms and Conditions of Staff who fail to make this contact will be contacted by their line manager in order to establish the facts relating to the leave and offer support as appropriate. Failure to contact manager and submit a medical certificate, could result in the member of staff being recorded as on unauthorized leave and pay can be withheld. Managers are required to refer staff to OH and members of staff must have been made aware of process of referral to OHS including their contractual obligations in line with Agenda for Change Terms and Conditions of Service requirement. 21

22 Over 4 weeks long term service. Frequency of contact should be agreed with line manager at an early stage. Frequency of contact should be agreed with the member of staff at an early stage. Where agreed beforehand, contact can be made at any time if regarded as beneficial. The above guidelines should be regarded as the minimum requirements. 4. Failure to make contact may lead to staff being treated as absent without authorisation (i.e. unauthorised absence) and may affect sick pay entitlement (see Appendix 1 section 13). 5. Members of staff are individually responsible for keeping their line managers informed of their progress and, in particular, should they be unable to return when anticipated. Staff who are absent immediately before leave days or days off, must advise their manager when they will be fit to come back to work. 6. At this stage the line manager will advise staff members to contact him/her again on day 5 of absence (see table on page 19) to update them on progress and likelihood of return to work. Staff who fail to do this will be contacted by their manager who will offer support as required. If sickness absence continues for more than seven calendar days individuals must get a Fit Note Med 3 (medical certificate) from their GP and submit to their line manager immediately (ie.within 24 hours of receipt). For absences of 1 to 7 calendar days a self certificate is required. Any subsequent certificates should be submitted as quickly as possible ensuring all days in the absence period are covered. Failure to submit a Fit Note Med 3 timeously may result in pay being withheld. 6.1 If a member of staff is absent through ill health for more than 7 calendar days further contact must be made with their line manager after 14 days. After an absence of 4 weeks (20 working days) managers are required to make an informed referral to Occupational Health. Managers are required to inform staff that they are being referred to Occupational Health. 7. Staff who fall ill at work or have to leave due to sickness or other reasons, must inform their line manager/named deputy before leaving work. Such absence will be recorded in line with the SSTS recording mechanism. 8. Self Certification Any member of staff who is absent from work through illness for up to and including seven calendar days is required to complete a self-certificate form to cover this period. This form should only be used for absences of less than seven days that do not require a medical certificate. Selfcertificates must be completed on return to work. Fit Notes (MED 3) (Medical certificates) should be submitted to line managers within 24 hours of being received from a GP. Managers may have to seek advice from OHS in the event that the GP recommends a return to work with adjustments 9. Notification/Certification Timescale Box One to seven calendar days The staff member must complete an NHS Western Isles Self Certification of Sickness Absence form on their return to work. More than seven calendar days A Fit Note Med 3 (medical certificate) A medical certificate from a General Practitioner is required. If a staff member does not return to work when the certificate ends, then further consecutive certificates must be provided. A Fit Note Med 3 (medical certificate) confirming fitness to resume duties may be required and should be received by your line manager before or on the day you return to work, e.g. for communicable diseases etc. 22

23 10. Scale of Sick Pay Allowances (from Section 14 - Agenda for Change Handbook) Employees absent from work owing to illness will be entitled (subject to the conditions of this agreement) to receive sick pay in accordance with the scale below. during the first year of service - one months full pay and two months half pay; during the second year of service - two months full pay and two months half pay; during the third year of service four months full pay and four months half pay; during the fourth and fifth years of service five months full pay and five months half pay; after completing five years of service six months full pay and six months half pay. In the event of employment coming to an end, entitlement to sick pay ceases from the last day of employment. 11. Sick whilst on Annual leave If you becomes sick whilst on a period of Annual leave. You must notify your manager on the first day of your sickness. You must not wait until you return to work A Fit Note Med 3 (Medical Certificate) will be required for all periods of absence where you are reclaiming Annual leave as a consequence of sickness. A self certificate will not be accepted in these Circumstances 12. Breaks in Services Sick Pay Entitlement For those returning to NHS employment, a previous period or periods of NHS service will be counted towards the employee s entitlement to sick leave where there has been a break or breaks in service of twelve months or less. Useful Websites w w w. h m r c. g o v. u k w w w. h s e. g o v. u k w w w. s h o w. s c o t. n h s. u k / p s u / g u i d e. h t m 23

24 Appendix 3 Role of the Occupational Health Service (OHS) 1. Background 1.1 It is recognised that absence from work due to ill health is detrimental to the member of staff and to the organisation. Employees on long term sickness absence are increasingly unlikely to be able to return to gainful employment the longer the time they have off work. Employees may also experience financial hardship if off work longer than necessary. 1.2 Sickness absence costs the employer directly (payment of sick pay) and indirectly (management time, payment of relief staff, cancellation of services). 2. The Role of Occupational Health 2.1 Occupational Health can assess employees with health problems which may cause or have caused them to lose time from work and will deal with employees fairly, sympathetically, and in confidence. 2.2 Occupational Health can advise management of whether or not the employee may be fit to return to work and of any recommendations to consider to keep the employee at work or enable them to return to work. 3. OH Advice may include: (This list is not exhaustive) modifications to the job; shift changes; phased return to work; provision of equipment or training; to advise management of whether any ongoing health surveillance or follow up may be required. possible redeployment likelihood of being fit to return to work at key milestones i.e. pre 6 month (half pay) and pre 12 month (no pay) 4. Principles of Occupational Health 4.1 Occupational Health staff are trained to understand: the effect of illness on the ability to work; the effect of work on the health of the employee; the toxic effects of materials and substances encountered in the work place which may potentially be harmful to health. 4.2 Duty of Care. Occupational health staff are bound by professional codes of conduct with respect to confidentiality and information will only be passed to management with the consent of the employee. 4.3 Early consultation with OH staff may allow an employee with a health problem affecting their ability to work to remain at work or it may limit the time away from work as a result of assessment and the development of a plan to manage the problem. 24

25 4.4 It is usual to advise the employee s manager of actions which will be needed to maintain the employee at work or to effect early return. Such advice may include the effect a medical problem may have on the ability of an employee to do their work, necessary restrictions and advice on action to be taken by the manager. Unless there is significant risk to the employee or others such feedback will not take place without the employees consent. It is for the manager to consider and implement such advice following discussion with the employee. 4.5 Where possible, occupational health staff will assess the whole person taking account of issues which may be having an effect on health. Such issues may be physical, social or psychological. In addition to advice on fitness for work and work modification further signposting of the employee may occur (e.g. for financial advice, psychological support or contact with self help groups). 5. Process 5.1 The aim of OH referral is to get the employee back to suitable work, and as such, early referral is in the best interests of the employee and of the organisation. 5.2 It is therefore recommended that managers refer: employees who they have reason to believe have a medical condition caused or made worse by their work irrespective of whether or not they are absent; employees 4 weeks after going on sickness absence; employees with frequent short term absence if the absence pattern leads them to believe that there may be an underlying health problem - see trigger point guidance; pre half and no pay. employees may also self refer at any time; Well in advance of half pay and no pay milestones 5.3 Following referral, occupational health staff will see the employee and where appropriate take advice from their health care providers, e.g. GP. Following a management referral, a report will be sent to the manager detailing fitness for work, likely timescale for return and any actions/adjustments to be taken by the manager. 5.4 In the event of disagreement between an employee s GP and the occupational health physician as to an employee s fitness to work, the occupational health physician will endeavour to discuss a way forward with the employee s GP in the first instance. If, however, disagreement remains, NHS Western Isles will accept the view of the occupational health physician s knowledge of the medical problem and the environment in which the employee must work. 5.5 In many cases, advice to a manager and a follow up appointment following return will be all that is needed to return an employee successfully to their usual occupation. Sometimes however, the case is more complex and in such circumstances it may be necessary to call a case conference to discuss ongoing issues. 5.6 Case conferences (Appendix 1 - paragraph 6.9) will be required in the following circumstances: Where an employee s absence meets that outlines in Section 14 of the Agenda for change Terms and Conditions of Service (as amended by PCS(ASC) 2008/2. if an employee remains on long term restrictions; if an employee is no longer able to do the job for which they were employed; if due to ongoing disability specialised equipment needs to be provided. In addition a case conference can be arranged by the manger at the point were it is identified that there is likely to be a long term restriction on the individual returning to work (pre 6 and 12 months) If an employee has remained absent for six months Well in advance of half pay and no pay milestones 25

26 5.7 The manager should convene case conferences after discussion with OH and HR. Both OH and HR should be represented at the case conference. The employee should be informed that a case conference is being convened and that they have the right to representation. Whether or not the employee attends they should be consulted and the outcome of discussions at the case conference communicated to them. 5.8 Case conferences allow any issues to be aired and a holistic action plan to be developed. Discussions would include fitness for work and actions to be taken but would not include details of the individual s medical issues without the individual s consent. 26

27 Appendix 4 Staff Side Roles and Responsibilities (extract from NHS Western Isles Partnership Agreement) 4.1 All communications emanating from discussions with the Area Partnership Forum are regarded as a collective responsibility. 4.2 All parties commit to ensuring they maintain confidentiality throughout the stage of formulation. Confidentiality at other times will be agreed within the Forum. Any sensitivities regarding the confidentiality of information should be shared with the Forum. The Western Isles NHS Board has a responsibility in ensuring appropriate facility time is available for all members of the Area Partnership Forum. All parties commit to be responsible for communication, consultation and involvement of the wider staff groups within the Western Isles NHS Board. All parties commit to partnership working and demonstrating confidence and confidentiality in the local partnership process. All contributions should be respected as equal. Disagreement is a group not an individual responsibility. All stakeholders agree to work within the terms of the agreement and any disagreement should not prejudice a stakeholder s position or duty at any later stage in the partnership. There will be situations where, although supportive of partnership working, trade unions or employers are unable to agree a joint approach. There is recognition that trade unions retain the right to represent their members interests. Remaining involved in the partnership process will enable differences to be dealt with appropriately. The current structure for dealing with grievances will be available to support this. When disagreement occurs all parties have a responsibility to support each other. All parties will make aware any sensitivities they hold regarding issues under discussion. 27

28 Appendix 5 REFERRAL TO NHS WESTERN ISLES OCCUPATIONAL HEALTH SERVICE STRICTLY CONFIDENTIAL In assessing any employee referred to the Occupational Health Service for a medical opinion and reporting to his/her employer, it is important that the Occupational Health Nurse/Physician is in possession of all relevant facts. Please complete the following sections. EMPLOYEE DETAILS: Name: Date of Birth: Address: Home Tel No: EMPLOYMENT DETAILS: Department: Job Title: Location: Full time / Part time ( Length of time in current post: Principal Duties: (a copy of job description may be attached) hours) This work has Management Responsibility Yes No Mostly Undertaken seated standing mobile Effort Required heavy medium light Work Pattern days nights shifts Driving Car Small Van Fork Lift Mower Mobile Health Vans NATURE OF THE PROBLEM WHICH HAS INITIATED THIS REQUEST Please describe the problem chronologically and include any other relevant facts such as associations with certain aspects of the job or days of the week. Continue on a separate sheet if necessary. 28

29 SICKNESS ABSENCE DETAILS Please detail past absences for as long as you think relevant or for the last year. Continue on a separate sheet if necessary or attach Budgets can print out. SC = Self Certificate: MC=Medical Certificate Date Days absent Reason SC/MC SPECIFIC ADVICE REQUIRED FROM OCCUPATIONAL HEALTH SERVICE (please tick boxes) What is the employee s current state of fitness for work? What effect will the illness/injury have on the employee s ability to carry out his/her occupation? Are there any particular duties the employee will be unable to carry out on return to work? Are there any work modifications which would alleviate the condition or facilitate rehabilitation? Is the condition likely to recur to the detriment of future employment? Is the sickness absence as a result of an accident / illness / injury sustained at work? If a medical condition exists could it be worsened by work? Is there an underlying cause for frequent short-term sickness absence and is it likely to continue When will the person be fit to return to work? Could this health issue fall within the remit if the Disability Discrimination Act? Is ill health retirement recommended? Other advice sought: Referring Manager to whom report should be sent (please print): Manager Telephone No: I confirm that the reason for referral to the Occupational Health Service has been fully explained to the employee Signature: Date: Please send this form to: Occupational Health Nurse, Western Isles Hospital Copy to Employee / Employees file Rec d by OHS Service. 29

30 Appendix 6 Bòrd SSN nan Eilean Siar Western Isles NHS Board Western Isles Hospital Tel: IN CONFIDENCE SELF CERTIFICATION OF SICKNESS ABSENCE Note: This certificate should only be used for absences of 1 to 7 calendar days, days off duty. including Name: Staff Pay Number: Post Held: Department: Unfit for Work From: Date Notified: Time Notified: My absence from: to: was due to the following symptoms/ Illness* *Note: If you feel your illness is of such a personal nature that you are unable to give details to your manager, please insert personal in the space above. You may subsequently be required to provide, on a confidential basis, details of your reason for absence directly to the Occupational Health Service. (Please tick appropriate box) I have consulted my doctor I have consulted my Pharmacist I have not consulted my doctor or Pharmacist Signed: Date: Manager s signature: Date: This form should be retained in the individual s personal file 30

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