Version: 5.0. Effective From: 16/10/2014

Transcription

1 Policy No: PP11 Version: 5.0 Name of Policy: Managing Attendance at Work Procedure Effective From: 16/10/2014 Date Ratified 06/10/2014 Ratified Human Resources Committee Review Date 01/10/2016 Sponsor Director of Transformation and Compliance Expiry Date 05/10/2017 Withdrawn Date This policy supersedes all previous issues. Managing Attendance at Work Procedure v5

2 Version Control Version Release Author / Ratified by / Date Reviewer Authorised by 1.0 Jan 2000 Trust Board Nov 1999 Changes (Please identify page no.) /10/2006 S Duffy TPF Oct Feb 2011 S Duffy Human Resources Committee /08/2012 S Duffy Human Resources Committee /10/2014 S Duffy Human Resources Committee 14/02/2011 Changed to OP27v5.1 format 06/08/ /10/2014 Managing Attendance at Work Procedure v5 2

3 Contents: Page 1.0 Introduction Policy scope Aims of the Policy Duties and responsibilities: Employees Managers Personnel Department Occupational Health Department Payroll Department Staff Side Infection Control Definitions: Short Term Absence Long term Absence Fit Notes The Equality Act & Disability Managing Attendance at Work Notification & recording of Absence Occupational Sick Pay Entitlements Occupational Sick Pay Extension Return to Work Management of Unacceptable Absence Practices Guidelines for Managing Short Term Sickness Absence frequent short term absence Counselling Session Managing Unsatisfactory Attendance frequent short term absence Underlying Health Problem Disability Related Sickness Absence Guidelines for Managing Long Term Sickness Absence Procedure Accrual and Use of Annual Leave during Sickness Absence Absence to Receive Cosmestic Surgery Absence Relating to Work Related Indicent or Accident Accidents/Injury Outside of Work Exclusion on Medical Grounds Sickness Absence During and After Pregnancy Secondary Employment Return to Work Phased Return to Work Redeployment No return to Work and Incapability Training Equality and Diversity Managing Attendance at Work Procedure v5 3

4 9.0 Monitoring Compliance with the Policy Consultation and Review Implementation of the Policy References Appendices Appendix A Sickness Absence Reporting Form Appendix B Return to Work Pro forma Appendix C Referral to Occupational Health Forms Appendix D Responsible Officers for Terminating Contract Appendix E Fit Note Guidance Appendix F Flowchart for Short term Sickness Absence Appendix G Guidelines for Conducting a Counselling Session Appendix H Flowchart for Long term Sickness Absence Appendix I Orientation Checklist for Staff returning to Work Appendix J NHS Injury Benefits & Guidance Information Appendix K Confirmation of Work Related Injury or Disease Form Managing Attendance at Work Procedure v5 4

5 1.0 Introduction 1.1 Each employee of Gateshead Health NHS Foundation Trust is required to attend work regularly on the days/shifts they are required for duty and to perform their duties safely and effectively. 1.2 The Trust is committed to managing attendance effectively to achieve a high standard of attendance and therefore reduce the impact that ill health and sickness absence have on the cost and quality of the service the Trust delivers. 1.3 This policy provides managers with guidance to proactively manage absence effectively, which will underpin the Trust s prime objectives to deliver high quality patient care, improve patient safety and the patient experience. The policy set out the processes in place within the Trust for managing attendance and provides practical guidance on dealing with sickness absence, whilst ensuring that relevant legislation such as the Equality Act 2010 is adhered to and confidentiality is maintained. 1.4 The Trust does acknowledge the linkage between the health and well being of its staff and its performance as an organisation, and recognises that where there is reduced staff wellbeing this may result in poor attendance levels and in particular, high sickness absence. 1.5 This policy therefore focuses primarily on encouraging improved attendance at work through the management of and prevention of sickness absence, however, this policy should also be seen in the context of other Trust strategies, policies and initiatives to support improvements in staff health. 2.0 Policy Scope 2.1 This policy is applicable to all employees of Gateshead Health NHS Foundation Trust. With regard to non medical staff, this policy incorporates Section 14A and Appendix Z of the Agenda for Change Terms and Conditions Handbook which relates to sickness absence provisions. 2.2 This policy does not apply to Lead Employer Trust (LET) Doctors (employed by County Durham & Darlington NHS Foundation Trust) or students working within the Trust. 3.0 Aims of Policy 3.1 This policy is intended to provide a balanced approach to managing attendance at work, primarily in order to address and manage sickness absence and any associated issues, considering the needs of the individual as well as those of the organisation. In order to do so, the Trust will: monitor attendance / sickness absence, investigate areas of concern and take appropriate action in respect of employees who have a poor level of attendance/sickness absence. Its aim is to reduce sickness absence levels, reduce the costs of absence to the organisation, improve service delivery and reduce pressure on other staff/colleagues in the workplace. In addition it is the Trust s aims to achieve national and local targets for achieving effective attendance at work. deal sympathetically and sensitively with attendance/sickness absence issues for those employees who are permanently or temporarily incapacitated for ill health reasons. ensure that an employee s attendance /sickness absence issues are dealt with confidentially. Any documentation relating to these matters should be retained on Managing Attendance at Work Procedure v5 5

6 an employee s personal file and held in accordance with the Data Protection Act ensure whenever an individual s attendance/sickness absence level becomes a concern, investigate and discuss with the employee their attendance /sickness absence issues openly and fairly in a supportive and efficient manner irrespective of its duration or pattern. identify departments which have continuing higher than average sickness absence levels and explore the management of attendance issues. meet its statutory obligations to ensure the health, safety and welfare of its employees, so far as is reasonably practicable. This includes being aware of the requirements of the Equality Act 2010 as well as Employment Rights Act 1996 and Employment Relations Act ensure that appropriate training in managing attendance/sickness absence at work is provided to relevant managers 4.0 Duties (Roles and Responsibilities) 4.1 The key groups of staff who have responsibilities for the management of attendance/sickness absence are: Employees Managers Personnel staff Occupational Health staff Payroll staff Staff Side Representatives Infection Control 4.2 Employees Employees have the following statutory obligations (under the Health and Safety at Work Act 1974 and the Management of Health & Safety at Work Regulations 1992); to take reasonable care for the health and safety at work of themselves and of other persons, who may be affected by their acts or omissions at work to co operate with any person discharging any duty or requirement on behalf of the Trust, which has been imposed on the Trust under any of the health & safety statutory provisions, to enable performance or compliance of that duty or requirement Employees have the following implied contractual obligations: to attend for work, unless unfit to perform duties; to personally notify (in normal circumstances) their employer appropriately of their sickness absence (see section 6). If this is not possible, the Trust should be notified at the earliest opportunity. to keep their employer updated during sickness absence; to do everything possible to assist their own recovery. To submit Fit Notes (from the 8 th calendar day of absence) from their General Practitioner in a timely manner and on a regular basis. In circumstances where employees are unable to fulfil their contractual responsibilities, they have a personal responsibility to satisfy their employer that they are temporarily incapable of performing their duties i.e. that the absence is genuine. Managing Attendance at Work Procedure v5 6

7 4.3 Managers Managers, on behalf of the Trust, have the following statutory obligations (under the Health and Safety at Work Act 1974, the Management of Health & Safety at Work Regulations 1992 and the Equality Act 2010); to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all their employees; to assess and record the health and safety risks to which their employees may be exposed (including measures taken to control such risks); to take reasonable measures to ensure that they are not discriminating against people with disabilities in accordance with the Equality Act to report workplace injuries or diseases via the Risk Management Department any workplace injuries or conditions that may be reportable under RIDDOR procedures and ensure they are in compliance with the relevant Health & Safety legislation Managers have the following implied contractual responsibilities: to record, monitor and analyse the attendance levels of their staff; to take appropriate action if attendance/sickness absence is unsatisfactory; to attend mandatory training in the management of attendance of staff to ensure fairness and equity in accordance with Trust Policy. to complete DATIX information in accordance with Trust s procedures and investigate appropriately In addition, Managers have responsibility to; determine reasonable notification procedures for the sickness absence of their employees. Managers must ensure that their employees are made aware of these procedures, together with the potential consequences of failing to adhere to them. Notification of absence should be made, wherever possible, by the employee directly to the relevant manager. identify and communicate the process for maintaining contact with absent employees. adopt a fair and consistent approach with regard to the handling of the sickness absence of their employees. They should take account of the needs of the service, the nature of/reasons for sickness absence and the attendance record of the employee, the section and/or department. to maintain strict confidentiality when dealing with individual attendance issues with staff. In addition, strict confidentiality must be maintained when handling Fit Notes, compiling file notes of discussions and conducting return to work interviews. to ensure they undertake return to work interviews with their staff (Appendix B) and ensure a copy of the return to work pro forma is provided to the employee. The interview should be carried out sympathetically, should enable the manager to fully understand the relevant issues in order to determine the level of support required for the member of staff and to improve the employee s awareness of their responsibilities. refer to relevant policies and procedures when dealing with staff in relation to managing attendance at work (e.g. Health and Safety, Occupational Health policies (PP45). ascertain, in a sympathetic and understanding manner, from their employees when a return to work is likely. If there is uncertainty, then the manager and employee should agree a course of action Managing Attendance at Work Procedure v5 7

8 communicate with an employee, having received notification from the Payroll Department that the employee is entering into a half pay situation or a nil pay situation regarding the management of their case. In exceptional circumstances, this may include seeking appropriate approval to extend Occupational Sick Pay (see section 8 of this policy). ensure that any attendance issues are recorded appropriately and in a timely manner into the Trust s Time and Attendance system (SMART). reasonably refer employees to the Occupational Health Department when a professional medical opinion is needed. All such referrals must be notified to the employee and submitted using the sickness absence referral pro forma (see Appendix B) which is forwarded directly to the Occupational Health Department. Managers should consult appropriate staff in the Personnel Department before making referrals. nion.docx forward a copy of referrals to the relevant link Personnel Manager. consider potential adjustments/ interventions (in conjunction with Occupational Health), as early as is practically possible to support staff remaining at work, or to enable staff to return to work at the earliest possible opportunity. This may include alternative duties or different working hours/patterns. In conjunction with the Payroll & Occupational Health Departments, managers must determine whether an employee s absence is mainly due to a work related injury or disease this will determine appropriate pay for the employee. There should be appropriate DATIX information available to support any such claim. Where a member of staff is unlikely to be fit to return to work or is unable to carry out the duties of their post, those managers with authority to dismiss (see Appendix D) will need to consider and determine at a final review meeting the most appropriate way forward. Possible outcomes may include: (i) return to post (ii) re deployment to another post (either permanently or on a short term basis). (iii) return to work on reduced hours/adjusted duties (iv) termination of contract. This is not an exhaustive list. 4.4 Personnel Department The Personnel Department is responsible, on behalf of the Trust, for providing training and guidance to managers on the practical operation of this policy. Its role is advisory rather than executive. The Personnel Department will; monitor and analyse attendance / sickness absence levels within the Trust and will provide appropriate reports to the Trust Board, HR Committee, the Joint Consultative Committee and Service Line Managers/Heads of Department on a regular basis. ensure that a copy of the sickness absence referral pro forma is retained on the employee s personal file. If there are any queries, a member of Personnel may seek clarification from the Manager. Managing Attendance at Work Procedure v5 8

9 4.5 Occupational Health advise on an employee s continuous length of NHS service in relation to Occupational Sick Pay entitlement. If there is a query on this, the Personnel Department is available for advice and guidance. maintain appropriate records for Injury Benefit claims and provide quarterly monitoring reports to the Central Team on the number and status of Injury Benefit cases. to undertake regular audits of this policy to ensure consistency and compliance The Occupational Health Department is responsible, on behalf of the Trust, for promoting the physical and mental well being of the Trust s employees. Its role is advisory rather than executive. The Occupational Health Department will; provide advice and guidance for staff who contact or self refer themselves to the department. Any such consultation will be in the strictest of confidence. provide pro active advice and guidance to managers upon request. if they consider that a referral is inappropriate, they will be responsible for contacting the relevant manager. upon receipt of an appropriate referral, will arrange an appointment for the employee as soon as practicable. If the employee fails to attend this appointment, Occupational Health staff will inform the Line Manager accordingly. An electronic referral can be obtained from: nion.docx following an Occupational Health assessment, inform the relevant manager of the outcome in writing and a copy letter will be sent to the Personnel Department and the employee. This information is confidential, however, it will be considered as part of the sickness absence management process. notify the relevant Line Manager where an employee attends the Occupational Health Department without a prior appointment, and is assessed to be unfit to return to the workplace. It is the managers decision as to whether the employee should be sent home taking into account the Occupational Health advice. provide pro active advice on appropriate duties and tasks for employees who need to be redeployed. In addition, the Occupational Health Physician will complete any documentation relating to an employees application to the NHS Pensions Agency (if a member of the scheme) for ill health retirement, or whether a person is likely to have a disability in accordance with appropriate legislation. provide appropriate support in attendance of any Case Management conferences with relevant HR/Staff Side representatives. 4.6 Payroll The Payroll Department is responsible for ensuring that employees are paid appropriately. Occupational sick pay is determined by an employee s length of service and the amount of sickness absence taken in the preceding 365 days. The Payroll Department will; Managing Attendance at Work Procedure v5 9

10 in conjunction with Line Managers, maintain and verify sickness records in a timely manner to help ensure accurate sickness absence records through the SMART system. notify, as soon as practicable (one month prior wherever possible), the employee, the employee s relevant Line Manager, Personnel and Occupational Health Departments when an employee enters into a half pay situation and a nil pay situation. Such notification will be done by a standard letter produced by ESR. maintain appropriate records for Injury Benefits claims and will help provide regular monitoring reports to the Central Team on the payments made to work related injury/disease cases. in exceptional circumstances, action instructions to withhold an employee s occupational sick pay during a period of sickness absence. Such decisions will be taken by the relevant Associate Director/Head of Service in consultation with a senior member of the Personnel Department e.g. repeated failure to attend Occupational Health appointments. In certain situations Occupational Sick Pay may be re instated retrospectively, however this will be the decision of the relevant Divisional Manager/Head of Service. It is the responsibility of the Line Manager to contact the employee in writing to make them aware of any pertinent adjustments in their salary and their responsibilities and the action required by the employee The Pensions Officer is available to advise managers and individual employees of estimated benefits under the NHS Pension Scheme. S/he will action an application for Ill Health Retirement Benefits upon notification from the Personnel Department. On receipt of notification, the Pensions Officer will liaise with the employee concerned to ensure completion of the form. A General Practitioner (GP) or the OHP can also assist with this. The NHS Pensions Agency requires at least two calendar months to complete this process When a Fit Note is received in Payroll that states that an employees absence is work related, they will liaise with the relevant manager to determine whether this is the case Payroll will send the manager a copy of the letter sent to the employee with regards to Occupational Sick pay with particular regards to half pay/no pay. 4.7 Staff Side Responsibilities This policy has been developed in partnership with Staff Side Representatives. The Trust recognises the role that Staff Side representatives can undertake in the management of attendance/sickness absence. Their responsibilities include; to assist individual members of staff with advice and support on the fair and equitable application of this policy. to support appropriate efforts to help staff remain at work and to facilitate a successful return to work for those employees who have been absent due to sickness. to participate in training programmes associated with the Management of Attendance policy. to advise members of staff on other relevant policies which may be applicable to them, e.g. Authorisation of Leave Policy (PP 09) and Managing Attendance at Work Procedure v5 10

11 4.8 Infection Prevention Control 5 Definitions: information on the Carers Direct Website As patients are the prime consideration in the delivery of a quality service by the Trust, all employees will be expected to adopt a responsible approach in minimising the risk of infection to patients, themselves, colleagues, and visitors. Employees must do this by: being familiar with, and adhering to Trust policies and guidance on infection prevention and control attending Trust Induction Programme(s) and statutory education programmes in infection prevention and control including infection prevention and control as an integral part of their continuous personal/professional development taking personal responsibility so far as is reasonably practicable, helping ensure that effective prevention and control of health care assocaited infection is embedded into everyday practice and applied consistently by them and their colleagues Some potentially infectious conditions could put others at risk and the nature of the work of some employees could result in it being necessary to either refrain from attending work, or accept that they will need to work in an alternative environment for a period of time until they are symptom free In such circumstances, employees will be required to liaise with their line manager to agree the appropriate course of action. Managers must consider the implications of infection prevention and control policies, procedures and general health and safety when looking to retain an employee at work or return an employee to work after being absent with an infectious condition. Managers must seek advice from Occupational Health and Infection Prevention & Control as necessary On some occasions where employees may become persistant carriers of MRSA or other infectious diseases who havelong term carrage of the same strain, it may be necessary for these staff to be redeployed to lower risk areas of the Trust in line with Trust policy. 5.1 Short Term Sickness Absence Short term sickness absence is defined as a period of absence due to illness for a period of between 1 day and up to 28 calendar days and the absences may be due to unconnected or intermittent illness 5.2 Long term Sickness Absence Long term sickness absence is defined as a period of absence for a continuous period of 29 calendar days or over, with the related or unrelated health problems. 5.3 Fit Notes The Fit Note should indicate whether an employee is not fit for work, or may be fit for work with some adjustments. Managing Attendance at Work Procedure v5 11

12 A guide for managers, regarding the use of Fit Notes is at Appendix F The Equality Act 2010 The Equality Act 2010 impacts on attendance management in 3 key ways: 1. It includes a legal definition of a disabled person. 2. An employer unlawfully discriminates against a disabled person where for a reason related to their having a disability, they receive less favourable treatment than they would otherwise receive. 3. An employer unlawfully discriminates against a disabled person if they fail to meet any duty to make a reasonable adjustment under Section 6 of the Act Definition of a Disability under the Equality Act 2010 Managers should liaise with the Occupational Health Department for further advice on what may be defined as a disability. Advice on whether or not an individual has a disability under the Equality Act may be obtained from the Occupational Health Department but may be ultimately determined by an Employment Tribunal Reasonable Adjustments 6. Managing Attendance at Work The Trust has a duty to make reasonable adjustments to prevent an employee from being placed at a substantial disadvantage by any physical feature of the premises or by working arrangements. Where it is identified that an employee has a condition, which affects their ability to undertake the duties of their role, managers have a duty to consider reasonable adjustments to the employee s work and/ or work place environment. The Manager will consider each case on its individual merits. 6.1 Notification, Recording and Contact procedures during sickness absence Employees will be made aware by their Line Manager, during their local induction, of their personal responsibility to follow the departmental notification procedures for reporting absence Managers must ensure that a robust and consistent procedure exists within their department to ensure that attendance / sickness absence is notified by employees to them in a timely manner using the pro forma Appendix A All employees should notify their Manager of the absence as soon as is practically possible and wherever possible before they were due to commence duty, in order that appropriate cover arrangements may be made. The employee should indicate the date and reason for absence and the likely duration. Notification of absence either by e mail or text message is not acceptable. The employee must keep their manager informed of any changes and, once known, confirm a return to work date In circumstances, where an employee reports for duty but is subsequently sent home by their Line Manager because they are unfit for duty, this should not be recorded as a day s sickness absence. This should however be recorded in the Managing Attendance at Work Procedure v5 12

13 individual s attendance record in the SMART system as being sent home early. If the employee then does not attend for work the next day/shift, their sickness absence will commence from this point. However, if an employee decides themselves not to commence their duties at their expected start time, this should be recorded as sickness absence in the normal way. Where a manager has concerns that a pattern is emerging with an employee attending work and being sent home, this will be discussed with the employee to try and establish any underlying issues with home, work or their health and appropriate action being taken For sickness absence exceeding 7 calendar days, employees must submit a Fit Note to their Line Manager on the 8 th day of absence and no later than the 10th calendar day of absence. Further Fit Notes will be needed to give continuous cover for the period of absence. All Fit Notes must be forwarded to Payroll as quickly as possible. Please refer to Appendix E for guidance Managers will discuss with staff on long term sickness absence, appropriate ongoing contact arrangements in order to review and manage the employees absence from work Where it is established that an employee has failed to comply with sickness absence notification or contact procedures, or failed to submit a Fit q note in a timely manner, then this may affect payment of wages/salary. Any such absence will be classed as unauthorised absence and staff will not be paid. Furthermore, such failure may be regarded as a breach of contract, which could lead to disciplinary action The Trust s time and attendance system (SMART), sickness absences must be recorded in the system in an accurate and timely manner. Please refer to the How to Enter Sickness Absence guide which can be found on the SMART area of the Trust Intranet, Staff Zone. Managers can access relevant sickness reports from the system using the EHL Management section of the system All paper sickness absence notifications and/or sickness absence entries on SMART must include a sickness absence reason. Other or unknown reasons should only be used in exceptional circumstances. 6.2 Entitlement to Occupational Sick Pay Employees absent owing to illness are entitled to Occupational Sick Pay (OSP) in accordance with Section 14 of the AFC Terms & Conditions Handbook: 1 st year of service one months full pay and two months half pay. 2 nd year of service two months full pay and two months half pay. 3 rd year of service four months pull pay and four months half pay. 4 th & 5 th year of service five months full pay and five months half pay. After 5 years service six months full pay and six months half pay Employees must maintain their statutory professional registration during sick leave, failure to do so may impact upon their entitlement to receive Occupational Sick Pay No enhancements will be paid for staff on pay spine points 9 to 54 for staff absent due to sickness in accordance with Agenda for Change Terms & Conditions. Managing Attendance at Work Procedure v5 13

14 6.3 Extension of Occupational Sick Pay The extension of Occupational Sick Pay is in accordance with Section 14 (a) of the Agenda for Change Terms and Conditions Handbook and will only apply where the failure to undertake the final review meeting is due to delay by the employer. It will not be applicable if the final review meeting is delayed due to reasons other than those caused by the employer. Reasons for delay caused by the employer include: Managerial delay in referral to the Occupational Health Department Managerial delay in reacting to formal Occupational Health recommendations after receipt of recommendations (after 4 weeks). Managerial failure to actively search for reasonable adjustments to duties/workplace and/or suitable alternative employment. Failure to receive a medical update from the Occupational Health Department Team within 10 working days of last appointment or an unreasonable delay in obtaining an Occupational Health appointment. This is not an exhaustive list and any other reasons that are highlighted will be duly considered Sick pay for those who have exhausted sick pay entitlements should be reinstated at half pay, after 12 months of continuous sickness absence, in the following circumstances: staff with more than 5 years reckonable service: sick pay will be reinstated if sick pay entitlement is exhausted before a final review meeting for long term absence has taken place; staff with less than 5 years reckonable service: sick pay will be reinstated if sick pay entitlement is exhausted and a final review does not take place within 12 months of the start of their sickness absence. Reinstatement of sick pay should continue until the final review meeting has taken place. Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence. These arrangements will be in accordance with this policy, established in accordance with Annex Z of the Agenda for Change Handbook and will only apply where the failure to undertake the final review meeting is due to delay by the Trust. This provision will not apply where a review is delayed due to reasons other than those caused by the Trust. The Trust will also have discretion to extend the period of sick pay on full or half pay beyond the scale set out in paragraph14.2 of the Agenda for Change Handbook. where there is the expectation of return to work in the short term and an extension would materially support a return and/or assist recovery, particular consideration should be given to those staff without full sick pay entitlements; Approval for any extension of Occupational Sick Pay must be sought from the relevant Executive Link Director/Associate Director/Head of Department and a senior member of the Personnel Department. Managing Attendance at Work Procedure v5 14

15 6.4 Return to Work Interviews The Return to Work (RTW) interview if the first and most important step in attendance management. The RTW interview is a core management duty and is mandatory and should be part of the day to day management of employees. It is essential that managers carry out their RTW meetings with staff who have been off sick, as soon as is practicable. 6.5 Management of Unacceptable Absence Patters Unacceptable patterns of sickness may occur where an employees overall level of sickness absence is deemed unreasonable or causes operational difficulty. Examples of such may include: Repeated instances on specific days of the week, or during school holidays, specific shifts Repeated instances of long term absence, which could be over a period of years A combination of both long and short term absences It is likely to take longer to recognise these patterns but managers should acknowledge them when they arise In order to recognise unacceptable patterns of sickness absence recording and monitoring is crucial. When patterns emerge which are short term, contact the Personnel Department for further guidance or follow the short term frequent or persistent procedural guidelines With regards to long term sickness absence, when a pattern is identified or the manager becomes concerned at the cumulative amount of absence over a period of time the manager will review previous Occupational Health reports. If necessary a referral can be made to Occupational Health to ascertain whether these absences are linked and/or caused by any underlying health problem. This referral should take place after a sickness review meeting with the individual to explain the reason for the referral. By its nature, this pattern may take longer to identify but it may consist of repeated periods of certificated absence lasting for anything from four weeks to several months but separated by absence free periods at work In all cases regular reviews should be carried out with the employee by the manager with a member of the Personnel Department. The employee has the right to be accompanied at such meetings. 6.6 Guidelines for Managing Short term Sickness Absence frequent short term absence Introduction The purpose of these guidelines is to provide a consistent basis for responding to cases of frequent intermittent sickness absence, which appear to be unrelated and of a transient nature. These guidelines are intended to help managers to deal with the sickness absence of their employees in a fair, reasonable and sensitive manner. Managing Attendance at Work Procedure v5 15

16 6.6.3 A flowchart is given at the end of this policy to provide a brief diagrammatic summary (Appendix F) The Manager should meet the employee to discuss absence which exceeds either: 4 occasions (irrespective of their duration) over a rolling 12 month period 6.7 Counselling Session Or Where there is a pattern to the absences (e.g. absences on consistent days e.g. Mondays), or sickness on days where annual leave has been requested but not authorised by management, or prior to or immediately after annual leave Managers should arrange a meeting with the employee when they have activated one of the above trigger points. The purpose of this meeting is to discuss the reason(s) for the absences and to understand from the employee whether there is any underlying or on going medical condition Where no underlying or on going health problem is identified (e.g. the cause and frequency of absence is unrelated), the employee will be made aware: (i) that their absence record is a cause for concern; (ii) that an immediate and sustained improvement in their attendance is required over a specified period of time e.g. 3 months e.g. in line with the Trust s target of 3.4%; (iii) that their attendance will be regularly monitored; (iv) that their absence impacts on colleagues and the ability of the Trust to deliver its services; (v) that should the required improvement not be achieved or sustained, formal action may be taken under the Trust s Disciplinary Procedure PP1 for unsatisfactory attendance. A written record of the discussion will be given to the employee by the manager and a copy kept on their personal file Should the employee s attendance not improve as required following the any return to work meetings/counselling meetings, the employee s situation will be formally investigated under the Trust s Disciplinary Policy (PP1) If an employees attendance level is of a serious concern prior to the end of the review period, the manager can escalate immediately to PP1 Disciplinary Policy A manager must refer an employee to the Occupational Health Department prior to any formal disciplinary hearing but after action has been taken to set targets to improve attendance but has not resulted in an improvement in attendance. The exception to this is if an employee has an underlying health condition when guidance in section 6.8 should be followed. The purpose of the referral will be to determine if there are any underlying medical factors which prevent regular attendance at work. If the employee fails to attend the Occupational Health appointment, then in the absence of advice from the Occupational Health Department action will be taken using the information available. Managing Attendance at Work Procedure v5 16

17 6.7.6 The Personnel Department is available at all times to discuss any of the points mentioned above and to provide assistance at all stages of the guidelines As guided by the Occupational Health Department and/or appropriately trained, managers may be requested to undertake formal Risk Assessment of employees workplace in order to ensure the risk of any further medical conditions is minimised 6.8 Managing Unsatisfactory Attendance Frequent short term absence Underlying Health Problem Where an underlying or on going health problem is disclosed to the Manager, the employee will be referred to Occupational Health to obtain relevant information about any health condition to enable the Manager to make a decision about how to manage the employee s on going attendance It will also be necessary to obtain confirmation about whether or not the employee s condition is regarded as a disability as defined under the Equality Act If the condition is considered a disability, the Manager will be required to consider what reasonable adjustments may be necessary to help the employee to perform their role. The Personnel Department will provide advice and support on what information should be requested and what consideration is necessary, including consultation with an appropriate external agencies e.g. Access to Work. Any medical issues that may be of sensitive nature, managers should seek relevant advice from Occupational Health or the Personnel Department In these circumstances, advice should be obtained from Occupational Health before any meeting with the employee in order to have a meaningful discussion There is an acceptance that employees with a diagnosed serious health condition will have higher than average sickness absence levels. However, if these absences are having a significant impact on services, managers should seek appropriate advice from the Personnel Department. This does not preclude managers taking appropriate action if employees absences are significantly higher than Departmental/Trust averages. Managers should look at frequency of the absences and the impact this is having on workload of others and service demands. 6.9 Disability Related Sickness Absence It is important to realise that disability is not synonymous with sickness absence. Confusion can cause offence to many disabled persons who do not consider having a disability an illness. However, in some instances a person s disability may result in some level of sickness absence, e.g. an employee with severe asthma or epilepsy who is unable to attend work, due to an attack or seizure, may be considered as absent due to a disability It is important to identify and record disability related absence so that it can be taken into account in the attendance management procedures outlined in the policy It is always appropriate to consider whether it is possible to reduce the extent of disability related absences through reasonable adjustments. Often a reasonable adjustment such as providing appropriate equipment, allowing an individual to Managing Attendance at Work Procedure v5 17

18 work from home or a flexible working arrangement can resolve the need for absence Guidelines for Long Term Sickness Absence Introduction The purpose of these guidelines is to provide a consistent basis for responding to cases of longer term sickness absence (i.e. where an employee either is off sick for 29 days or more, or has had recurrent periods of time with a serious or underlying health problem) A flowchart is given at the end of this policy to provide a brief diagrammatic summary (Appendix H) It is vital that managers undertake regular discussions with their employees who are on long term sickness absence. In doing so, they will be meeting their responsibilities to their employees and other members of staff who may have to cover for their absent colleagues. Managers should advise employees of their rights to seek support and representation from a trade union/professional organisation representative and should record the outcome of any discussions Procedure Contact arrangements between the manager and the employee must be discussed and mutually agreed as soon as practically possible this may include frequency/timing/nature of contact. If it is not possible to reach a mutual agreement, further advice should be sought from either Occupational Health or the Personnel Department It is important to note that an employee has a responsibility to remain contactable during periods of long term sickness absence. If a member of staff has difficulty in discussing their long term absence with their Line Manager, the employee must discuss the matter with the next Line Manager When an employee has been continuously absent, due to illness, for four weeks (or there appears to be a recurrence of a health problem) and there is no imminent return to work planned, then the manager should consider all of the relevant information and review the position with the Personnel Department. The manager should consider the following options, in sequence: take no action arrange a meeting with the employee (if necessary) seek an Occupational Health report agree a return to work strategy consider suitable alternative employment recommend to the manager with authority to dismiss that the employment contract should be terminated on the grounds of incapability. the manager may decide that no action is needed. If this is so, a note to this effect should be made, but the situation must continue to be monitored The manager should arrange to meet the employee at a mutually convenient time and place, subject to the medical condition of the employee. This should be carried Managing Attendance at Work Procedure v5 18

19 out no later than 4 weeks from the first day of absence. The purpose of this meeting is for the manager to: show concern for the employee s well being; discuss any medical reports that may have been received from the Occupational Health Department at this time and establish if the employee has received any appropriate treatment for their illness/condition. establish the employee s prospects for recovery and likely return to work; monitor the employee s sickness absence explicitly; agree how often and by what means subsequent contact will be made. The regularity of any further meetings with the employee should be established at this stage and any discussions with staff should confirmed in writing Managers where appropriate, may wish to have a member of the Personnel Department in attendance at absence review meetings. Employees have the right to be accompanied by a Staff Side representative (or a friend not acting in a professional capacity) at any meetings if they so wish At the review meetings for staff on long term absence, the manager must be aware (in conjunction the Payroll Department) of an employee s Occupational Sick Pay entitlements and to notify the employee of their current sick pay situation Managers must consider the possibility of allowing a member of staff to return to an alternative role for a temporary period following any long term sickness absence. Managers should seek advice and guidance from the Occupational Health and Personnel Departments in such matters Accrual and Use of Annual Leave during Long term Sickness Absence Following the 2009 European Court of Justice and House of Lords decisions, staff who are absent on long term sick leave have the following rights; to accrue and take statutory annual leave entitlement during long term sick leave. to take any untaken statutory leave, i.e. up to the maximum of 28 days per annum (statutory entitlement is in accordance with the European Working Time Directive i.e. 28 days for full time staff, pro rata for part time staff), when they return to work, if they are on sick leave for part or all of the annual leave year. to carry forward any of their accrued statutory annual leave into the next leave year if they have been unable to take their entitlement due to sickness absence in the current leave year. Note: if an employee is able to take their accrued annual leave on their return to work and before the current annual leave year ends, they should do so. If they choose not to do so, the accrued leave will be lost and cannot be carried over. to have a request to take annual leave whilst on sick leave granted, subject to complying with the usual/ written notification arrangements for annual leave request arrangements. Note: Employees who apply for statutory annual leave during sick leave will receive payment equal to their normal rate of full pay for that specific period. If an employee is in receipt of occupational and/or statutory sick pay during that period, this will be made up to their normal full pay for that period. Such periods of paid annual leave will not extend an employee s entitlement to occupational sick pay and payment for the days recorded as Managing Attendance at Work Procedure v5 19

20 annual leave during sick leave will not exceed the employee s normal full pay for that period It is essential that managers maintain accurate records relating to sickness absence and annual leave entitlement Employees, who fall sick during a period of annual leave, will need to adhere to the normal notification procedures, if they wish to reclaim some, or all, of the annual leave for that period Employees who are on long term sick leave and have pre booked leave which will take them away from their home for a period exceeding 3 calendar days must obtain the approval of the Occupational Health Department to the holiday/break. It is also the employee s responsibility to inform their manager of any holidays they are wishing to undertake whilst on sick leave. The Occupational Health Department will wish to ensure that the holiday/break will be of therapeutic value and support the employee s recovery from ill health. Where approval to the holiday/break is given, the Occupational Health Department will be responsible for informing the manager of their decision and the dates the employee will be away from home If an employee reports sick on a public / statutory holiday he/she will not be entitled to an additional Statutory / Public Holiday in accordance with Section 14.8 of Agenda for Change terms and conditions Absence to receive Cosmetic Surgery If an employee is absent from work in order to receive surgical treatment of a cosmetic nature (e.g. corrective eye laser surgery, liposuction etc), this will need to be arranged as annual leave or unpaid authorised absence unless the Trust is provided with written evidence that this procedure had to be performed for medical reasons Absence related to work related incident or accident For staff on pay spine points 1 to 8 and those absent due to a work related injury or disease in the actual discharge of their duties and who are not in receipt of injury allowance, the definition of full pay will include regularly paid supplements, including recruitment and retention premia, payments for work outside of normal hours and high cost supplements. Sick pay is calculated on the basis of what the individual would have received and he/she been at work Employees are expected to notify their manager that their absence is work related at the first available opportunity. Employees who believe their absence to be workrelated need to complete and submit the claim form at Appendix J. The definition of work related absence for the purposes of this policy is considered to be in line with the definition required for NHS Injury Benefits (see Appendix K). Claims must be assessed by the Service Line Manager/Head of Department to determine eligibility. The following should be considered: accident reports/riddor/datix Occupational Health Department notes and records reports of any internal investigation connected with the claim job description sick leave records Managing Attendance at Work Procedure v5 20

21 a full statement of events explaining what injury or disease the applicant is claiming and the circumstances leading to the claim appropriate medical advice any further additional supporting and corroborating evidence Where a claim is considered eligible, the Service Line Manager/Head of Department must complete and sign the relevant sections of the claim form and forward this to the Payroll Department Accidents/Injury Outside of Work It is NHS policy that any employee absent as a result of an accident outside of work is not entitled to any occupational sick pay if damages are receivable from a third party in respect of such an accident. Outside of work is defined as any occurrence at any time whilst not engaged on Trust business The manager and employee must make the Payroll Department aware of the accident/injury In this event, the Trust may, having regard to the circumstances of the case, advance a sum not exceeding the amount of sick pay payable, subject to the employee undertaking to refund to the Trust the full amount of sickness allowance when damages are received. A separate agreement to this repayment must be made with the employee if this agreement does not appear in the terms and conditions of service Sick pay is not normally payable for an absence caused by an accident due to active participation in sport as a profession, or where contributable negligence is proved Exclusion on Medical Grounds Where a manager believes an employee is unfit for work or unfit to return to work, then he/she may be excluded from work pending advice from the Occupational Health Department. Medical exclusion will be treated as sick leave and paid in accordance with the individuals sick pay entitlement Sickness Absence During & After Pregnancy Where a pregnant employee is absent due to sickness within 4 weeks of the Expected Date of Child birth (EDC) and it is not related to pregnancy, it will be treated as sickness until such time as the employee would have started her maternity leave as previously notified on her Maternity Notification Form However, where an employee is on sick leave due to a pregnancy related illness at the beginning of/after the 4th week before the expected week of confinement, she will start her maternity leave at the beginning of the 4th week before or the beginning of the week after the last week worked, whichever is later and will transfer from sick pay to maternity pay Where a return from maternity leave is prevented due to certificated sickness, normal sickness arrangements will apply. Further information about the Interaction of sickness absence and maternity is in the Authorisation of Leave Policy (PP09) on the Trust Intranet. Managing Attendance at Work Procedure v5 21

22 6.18 Secondary Employment Where an employee is unfit to undertake their contractual duties for the Trust but proposes to undertake secondary employment, s/he must, before doing so discuss the matter with their Manager. S/he may be required to attend the Occupational Health Department to assess whether or not undertaking secondary employment will be detrimental to their recovery The recommendation of the Occupational Health Department will be final. The deliberate or attempted falsification of a sickness absence at the Trust in order to work elsewhere may lead to disciplinary and/or criminal action being taken Return to Work When an employee does return to work it is important that the manager agrees a return to work strategy with her/him, in advance. Managers are required to complete a re orientation checklist (Appendix I) with all staff who have been on long term sickness absence The manager must consider any information provided by the employee s GP where this is indicated on a Fit Note. The manager should follow the guidance at Appendix E and may wish to seek advice from the Occupational Health Department Where a phased return to work is recommended, the relevant manager and the employee should, after discussion with the Occupational Health Department, consider and determine whether any temporary/permanent adjustments are required e.g. modified duties (clearly documenting what these duties are) reduced responsibilities reduced hours of work workplace adjustments e.g. when an employee falls under the remit of the Equality Act Phased return to work The purpose of a phased return to work is to rehabilitate the employee to their full duties and gradually build back up to undertaking their normal working hours within the earliest agreed timescale After an employee has been absent from work due to illness and over a prolonged period of time, Occupational Health may recommend a phased return to work to the line manager in the first instance, as part of a rehabilitation programme to allow the employee to re adjust to full attendance/performance at the workplace In terms of a rehabilitation programme the following process should be noted: Occupational Health will make the recommendation relative to the overall period of a phased return to work, dependent on the individual circumstances of each case, but will not normally be effected over more than a 4 week period; The employee will be advised by Occupational Health of a recommended phased return to work programme, subject to line management agreement relative to the general timescale, duties and working arrangements; Managing Attendance at Work Procedure v5 22

23 The Line Manager and the employee will agree the general timescale, duties and working arrangements. Targets should be agreed for each week of the phased return period in relation to the weekly times of attendance and the weekly range of duties to be performed. If restrictions on certain duties are to be placed on the returning employee, Occupational Health should normally be asked to review and reassess these restrictions within an agreed timescale Any request by the employee or recommended alteration by the line manager, in respect of the general timescale, duties and working arrangements during the phased return will be subject to agreement between Occupational Health, the employee and the Line Manager The Line Manager will be responsible for updating the employee on any changes which have taken place within the Team/Ward/Department during their absence The employee will receive full pay during the phased return to work programme. A plan for using accrued annual leave (which is not part of the formal phased return to work strategy) should be agreed in order to utilise as quickly as possible subject to service needs. Any out of date mandatory training will need to be completed The phased return to work will normally not exceed 4 weeks, bearing in mind the need for a degree of flexibility since the employee s progress might be difficult to predetermine. The programme will be time limited and targets will be agreed. Should there be difficulties related to the phased return arrangements, Occupational Health should meet with the employee to review the situation The Line Manager should review the employee's progress on a weekly basis. Should he/she recognise that the employee is unlikely to be able to resume their normal working hours and/or duties before the 4 week period expires, further advice should be sought from Occupational Health. This may result in a further timelimited extension of the phased return or a temporary contractual reduction in working hours, or agreeing the need for the employee to resume sick leave and to re submit medical certificates. In some cases, consideration may be given to a permanent reduction in working hours or the possibility of redeployment As part of a phased return to work, the manager and the employee may agree a temporary move to suitable alternative employment, but input from the Personnel Department will be required before any formal agreement is made. Managers should discuss with the Occupational Health Department and undertake a Risk Assessment as appropriate To ensure that full pay is paid for the phased return programme period, the sickness absence must be end dated in SMART the day before the phased return to work commences. Phased return to work will not count as sickness absence for absent entitlement purposes Redeployment When the Occupational Heath Practitioner considers that the employee is incapable of carrying out the duties of her/his job, the manager must check with the Managing Attendance at Work Procedure v5 23

24 employee that s/he concurs. If not, and the employee wishes to have a second medical opinion, s/he must make her/his own arrangements for this. Having received a medical opinion that the employee is incapable of carrying out the duties of her/his job, the manager should consider making reasonable adjustments to work practices, duties or premises (in accordance with the Equality Act 2010), if it results in the employee either retaining her/his job or securing suitable alternative employment. Specialist help is available from the Personnel Department, the Occupational Health Department and the Employment Service s Disability Employment Adviser Employees, who are seeking suitable alternative employment because they are no longer able to carry out the duties of their substantive post, are entitled to be given non competitive interviews for internal posts (in accordance with the Trust s recruitment and selection procedures) if they meet the essential criteria of the post. The Personnel Department will assess whether such employees meet the essential criteria, and arrange a non competitive interview. The Occupational Health Department will consider whether the employee is fit to perform the duties of the post satisfactorily. A member of the Personnel Department must be part of the panel Unless the employee is clearly unsuitable, in which case appropriate feedback should be given by the manager, then s/he should to be redeployed for a trial period of at least four weeks. This period may be extended by mutual agreement. During the trial period, the employee s substantive terms and conditions may only be varied, albeit temporarily, by mutual consent. The purpose of the trial period is for both the manager and employee to assess the suitability of the redeployment. If both parties are content with the trial period, then a formal offer of new terms and conditions can be made Employees who are not considered fit to perform the duties of a post satisfactorily will remain on the redeployment register, however this must be reviewed on a regular basis as part of the routine sickness absence discussions No Return to Work and Incapability If alternative employment is not appropriate or not available and reasonable adjustments are not practical, the only remaining option for the relevant manager is to consider termination of the individual s contract on the grounds of capability Before a final decision to terminate is made all other options should be fully considered, including: Rehabilitation into their current role Phased return to work A return to their substantive post with or without adjustments Redeployment with or without adjustments A written record should be made by managers documenting that the above areas have been considered and reasons for dismissal The decision to recommend termination on grounds of capability should be discussed with the employee in advance of and confirmed at the final review meeting. Managing Attendance at Work Procedure v5 24

25 7.0 Training The decision to recommend dismissal is not a medical issue but one to be made by the manager in the light of all the information available to her/him at the time. No decision should be made to dismiss without having already sought a medical opinion from the Occupational Health Physician When a decision is made to terminate the contract, the employee will be dismissed with the appropriate notice and this will be confirmed in writing to the employee. The employee must be given the opportunity to appeal against the Trust s decision Managers with authority to dismiss may terminate an employee s contract on the grounds of capability, prior to the expiry of the employee s sick pay provisions. However, this will only be done in consultation with the Personnel Department If the employee is in the NHS Pension Scheme, then the dismissal letter should state whether or not an application is being supported for Ill Health Retirement Benefits to the NHS Pensions Agency If the employee is in receipt of Injury Benefits (or has applied for it), s/he should be advised of her/his right to apply for Permanent Injury Benefit (see Appendix J for further details) Staff within the Personnel Department are available to discuss any of the points mentioned above and to provide assistance at all stages of the guidelines. 7.1 Managers and Staff Side representatives will be expected to undertake Mandatory training on Managing Attendance in the workplace. Any individual who manages staff will be required to attend training on Managing Attendance at work. 8.0 Equality & Diversity 8.1 This policy aims to promote equality of opportunity and eliminate unlawful discrimination, by establishing fair and transparent systems of managing attendance at work. It adopts a human rights approach and seeks to eliminate discrimination by ensuring that all staff regardless of background are treated fairly and equitably in terms of their non attendance at work. 8.2 The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds. This policy has been appropriately equality impact assessed. 9.0 Monitoring Compliance with the Policy 9.1 This policy will be reviewed periodically to ensure uniformity of treatment and justice for all employees in the implementation of the Trust s procedures and to ensure compliance with relevant legislation. Managing Attendance at Work Procedure v5 25

26 Standard / Process / Issue Review policy 12 months after implementation date Monitoring and audit Method By Committee Frequency JCC Sub 12 months after JCC & HR Annually Committee implementation Committees date 10.0 Consultation and review This policy has been reviewed in consultation with the JCC Policy Sub Group Implementation of policy (including raising awareness) This policy will be circulated by the Trust Secretary as detailed in OP 27 Policy for the development, management and authorisation of policies References This policy will operate in conjunction with the following policies and associated documentation: Authorisation of Leave (PP09), Discipline and Dismissal (PP1) NICE Guidelines Managing Long term sickness absence and incapacity for work. ACAS Guidelines for Managing Attendance at Work NHSLA Risk Management Standards Equality Act 2010 Managers Guide on Sickness Absence NHS Employers Managing Attendance at Work Procedure v5 26

27 Appendix A CONFIDENTIAL Sickness Absence Reporting Form Name.... (Record name of employee and name of person reporting absence if different) Date Sickness notified..time.... Absence Started Shift Start Time.. Time left work (if left work sick). Absence Reason... Expected return date/or next agreed communication (please circle)... Was the sickness a result of an accident or incident at work Yes/No If yes, was a DATIX Form completed Yes/No Name of Manager/Supervisor taking message Notification of return to work Return to work notified (Date). Return to work date.. Name of Manager/Supervisor taking message Managing Attendance at Work Procedure v5 27

28 Appendix B Return to Work Interview Form Confidential EMPLOYEE NAME DIRECTORTATE WARD/DEPARTMENT MANAGER CONDUCTING INTERVIEW DATE OF INTERVIEW SUMMARY OF PREVIOUS ABSENCE (last 12 months) Has the employee hit a trust trigger point e.g. 4 periods of absence in 12 months or taking sick leave following an unsuccessful application for annual leave? KEY POINTS DURING INTERVIEW: EMPLOYEE S COMMENTS: Is the absence self certified Is the absence medically certified Is the absence as a result of an accident/incident outside of work If yes, have Payroll been notified Is there a pattern of absence Is there an on going health problem Refer to Occupational Health Yes/No (delete as appropriate) Yes/No Yes/No Yes/No Yes/No Yes/No Yes/No Action to be taken if attendance does not improve: (e.g. review when next sickness occurs, further interview, disciplinary, seek medical advice). Was the employee advised of possible future actions above? Yes/No Signed (Manager) Signed (Employee) Date Date Managing Attendance at Work Procedure v5 28

29 Appendix C REFERRAL FOR OCCUPATIONAL HEALTH OPINION Private and Confidential This form is to be used for any sickness absence or management referral. Reference to the Trust s Managing Attendance Policy P.P.11 should be made when managing sickness absence. Please ensure you complete the form in full as any incomplete forms may need to be returned to you before being acted upon. If on review a referral is felt not to be appropriate, the Specialist Nurse Practitioner will advise you of this. Advice on referrals can be obtained from the Occupational Health Department intranet page, Occupational Health or HR Departments If an employee fails to attend their appointment(s) where possible you will be notified by e mail. The employee s details will be abbreviated to their initials only. It is requested that this form is completed electronically for ease of reading and returned to occupational.health@ghnt.nhs.uk EMPLOYEE S PERSONNEL DETAILS: TITLE NAME (in full) DOB ADDRESS: CONTACT TELEPHONE NUMBER EMPLOYEE S JOB DETAILS: JOB TITLE BANK/OVERTIME SICKNESS ABSENCE DETAILS: HOURS WORKED PER WEEK CONTRACTED HOURS PER WEEK Is the employee currently off sick? YES NO IF YES: First Date of Absence: EXPECTED DATE OF RETURN (IF KNOWN) If a fit note has been issued when does this expire? Reason for absence from fit note Summary of sickness absence over the previous 2 years most recent first (continue on a separate sheet if needed) DATES NO OF DAYS REASON FOR SICKNESS ABSENCE Managing Attendance at Work Procedure v5 29

30 Does the employee have any special needs (e.g. mobility, sight problems, problems leaving the house, etc) that will need to be taken into account when arranging an appointment for them? Yes / No If yes please specify. ESSENTIAL INFORMATION IN SUPPORT OF REFERRAL This should include all relevant background information e.g. job duties and risks, hazards, any changes to their job or tasks, any difficulties the employee is experiencing at work with specific reference to the tasks they perform or are expected to perform. It is also important to know what action has been taken to address short term sickness, the outcome of this along with details of concerns re work performance / behaviour in the workplace. Information regarding any medical or other health care professionals that the employee has been referred to and dates of appointments if known will also be helpful when planning appointments (continue on a separate sheet if needed) OCCUPATIONAL HEALTH OPINION REQUIRED Please tick or indicate which question you would like advice on 1. When is the employee likely to return? Upon returning to work, are any restrictions or recommendations needed to assist the employee to 2. return to/remain at work? Is the condition caused or aggravated by the 3. employee s work? Are frequent short term absences likely to persist? 4. Is there any underlying medical reason for the absences 5. listed in the referral? Is it expected that the current or any underlying health conditions will prevent them from returning to work within the foreseeable future (6 months) Is it expected that the employee will be able to sustain a return to their current employment in the long term? Is redeployment an option to consider at this stage? Is the employee permanently unfit (please note this will be looked at for all types of employment not just existing posts)? Is it likely the employee s condition falls within the remit of the Equality Act 2010 in relation to disability? Other please state 11. Managing Attendance at Work Procedure v5 30

31 STATEMENT BY PERSON MAKING REFERRAL I can confirm that employee is aware of the referral and the reasons for it, that they have been provided with a copy of this referral. I understand that in order to comply with General Medical Council Guidance the employee has he/she the right to see the report before it is sent to me and to refuse consent for it to be sent. I agree to the above referral and confirm the information is accurate. (By entering your name this is accepted as your agreement) NAME: DATE: DESIGNATION: ADDRESS FOR CORRESPONDENCE: CONTACT TELEPHONE NUMBER: E MAIL ADDRESS: NAME OF LINK PERSONNEL MANAGER Managing Attendance at Work Procedure v5 31

32 Appendix D Responsibility for Terminating contract of Employment (on the grounds of incapability) This Appendix is intended as a guide for those managers who are empowered to terminate employment contracts under the Sickness Absence Policy. It should be noted that the level of authority is the minimum level necessary to take action. It does not preclude those officers delegating this authority to a nominated deputy. Category of Staff Chief Executive Director Clinical Director Senior Managers/Heads of Service/Service Managers &Modern Matrons Level of Authority Sub Committee Chairman Chief Executive Link Director/Divisional Director/Director Medical & Dental Consultant Other Senior Medical Staff &Junior Medical Staff (including Foundation Doctors) Chief Executive Director/Medical Director/Head of Service All other staff Link Director/Associate Director/Head of Service Managing Attendance at Work Procedure v5 32

33 Appendix E Statement of Fitness for Work or 'Fit Note' (Med 3) Guidance With the introduction of the new Fit Note from the 6th April 2010, the Trust has devised further guidance on how to deal with any recommendations from General Practitioners. This guidance should be used to help answer any questions Managers may have. Managers should seek the help and advice of the Occupational Health & Personnel Departments if they have any further queries. What are fit notes? How is the fit note different? What does may be fit for work mean? What should managers do if the GP has indicated an employee 'may be fit for work'? What happens when an employee returns on a phased return? Is the GP's advice re changes to work binding? What should a manager do if an employee wishes to return to work contrary to the fit note? What should an employer do if they cannot accommodate a return to work? Can I go back to work before the end date on my fit note? What are fit notes? Back to Top Fit note is the informal name for the Statement of Fitness for Work. From 6 April 2010, the fit note replaced the sick note (medical statement or doctor s note). What does the fit note look like? Back to Top A sample is attached at the end of this guidance. How is the fit note different? Back to Top The main change is that a GP can give advice to help people return to work. This is because work can play an important part in helping people to recover from illness or injury. With the fit note, a GP can choose one of two options: you are not fit for work' you may be fit for work' The fit note also includes: more space for a GP to give general advice about the impact of illnesses or injuries tick boxes for a GP to suggest, where appropriate, common ways in which you as an employer could support an employee to return to work What does may be fit for work mean? Back to Top A GP will choose the may be fit for work option if they think that returning to work with support from the employer will help the employee. A GP can give general advice on the fit note about how illnesses or injuries may affect the employee s ability to work. Managers should discuss this advice with the employee to see if they can return to work. For example, GP s may suggest possible changes, such as: Managing Attendance at Work Procedure v5 33

34 returning to work gradually, for example, by returning to work on a part time basis working different hours temporarily performing different duties or tasks having other support to do the job, for example, avoiding heavy lifting if the employee has back pain, What should managers do if the GP has indicated an employee 'may be fit for work'? Back to Top Where a GP indicates this on the fit slip, they will include some comment and where appropriate also tick one or more of the four tick boxes on the statement. The GP may also indicate the period during which the advice and whether an assessment by an Occupational Health Physician is required. Please note this will be shown in calendar not working days. The GP may also indicate whether they need to assess the employee s fitness for work again at the end of the statement. If this is not indicated, a manager can expect the employee to return to work or to their full duties at the end of the statement. Where a GP indicates that an employee may be fit for work, it is essential that there is a discussion between the employee and employer (and where applicable, Occupational Health). A manager should consider how the advice affects the employee s job. It may be possible to accommodate changes to the job or hours to enable an employee to return to work. These temporary measures should be agreed with the employee. If the employee cannot then return to normal duties, it may be necessary to discuss further temporary measures or the long term effects of their health condition on their job. Health & safety legislation requires all employers to undertake risk assessments to make workplaces safer for employees and visitors, including disabled workers. The Disability Discrimination Act (DDA) requires the employer to make reasonable adjustments to prevent discrimination. What happens when an employee returns on a phased return? Back to Top If am employee has been advised to have a phased return, i.e. returning to work gradually, they will only receive pay for the hours that they actually work. However, employees can supplement the hours that they have worked by using annual leave to increase their income during the phased return to work. Is the GP's advice re changes to work binding? Back to Top Importantly, there is no requirement to act on a GP's advice. Managers have to consider whether the suggestions made by the GP are in fact feasible. The obvious concern is that in some circumstances the GP may recommend a course of action which is costly or not practical from the employer's perspective. The government recognises that it is not the GP, but the employer, in consultation with the employee, who is best placed to make the decision. The manager must consider whether the changes are such that it is safe for the employee to return to work, and whether it is reasonably practicable to make those changes. Managers must bear in mind that the employee's condition may constitute a disability under the DDA. The DDA protects people from discrimination on the grounds of their disability, and requires employers to make reasonable adjustments. If a manager decides not to comply with the measures identified in the fit note, then they should consult with Occupational Health who can help to support their decision. Managing Attendance at Work Procedure v5 34

35 What should a manager do if an employee wishes to return to work contrary to the fit note? Back to Top Managers must exercise caution in situations where an employee expresses a wish to return to work, but their GP has stated that they are not fit to work. In some circumstances, it may be that the GP is unaware of the potential assistance that could be provided to the employee, and has assumed that none of the relevant adjustments could be made. In such circumstances, managers must liaise with Occupational Health to ensure that the adjustments would be considered safe. There may be a need to conduct an individual risk assessment, and record the findings. Conversely, situations may arise where the employer and GP believe that the employee can return to work, but the employee does not wish to do so. Managers should invite the employee to discuss their concerns, and obtain Occupational Health advice to support the fact that a return to work is appropriate and safe. What should an employer do if they cannot accommodate a return to work? Back to Top Sometimes a manager is not able to facilitate the changes or adjustments indicated by the GP on the statement of fitness to work. The advice on these occasions is that that the employee s health or medical condition has prevented them from carrying out their job role. This should be fully discussed with the employee and documented. The employee does not need to go back to their doctor for a new statement to confirm this. Managers must be able to show how they have carefully considered the GP's suggestions. If the employee's condition constitutes a disability under the DDA, then a failure to do so could well result in a tribunal finding that the employer has failed in its duty to make reasonable adjustments. Can an employee go back to work before the end date on their fit note? Back to Top Yes. As long as the Manager and the employee agree, the employee can go back to work or return to normal duties before the end date on their fit note. For example, the employee may want to go back to work sooner if: they have recovered from their illness or injury more quickly than expected the Manager, can offer them support, to help them return to work If the Manager, think it s not safe for the employee to return, the employee will have to stay off work. Employees should not go back to work before the end date on their fit note if their GP has advised that: returning to work would be unsafe returning to work would be bad for their health Does an employee need a note saying they are fit for work? Back to Top No. They do not need to see their GP again to be signed back to work. Unlike the sick note, the fit note does not have an option to say that people are fit for work. If a GP wants to assess the employee s fitness for work again, they will state this on the fit note. Managing Attendance at Work Procedure v5 35

36 Appendix F Flowchart for Short Term Sickness Absence Employee returns from absence NO Manager meets employee. Is there further action required? YES No further action, except normal monitoring NO Manager counsels employee. Is there an improvement? Does the employee need to be referred to the Occupational Health Department? YES NO NO Disciplinary procedure instigated and applied. Is there an improvement? Managing Attendance at Work Procedure v5 36

37 Appendix G Guidelines on Conducting a Counselling Session Preliminary Steps 1 Ensure that all of the relevant facts relating to the employee s performance/conduct are available with specific examples. 2 Arrange for the meeting to be held in a private setting, where interruptions are unlikely. 3 Notify the employee (verbally or in writing) about the interview: what it is about when and where it will take place whether you will be accompanied by a Personnel Officer and, if so, that you are happy for the employee to be accompanied by a friend or representative, if they so wish At the Counselling Session 1 Reiterate to the employee the reason for the meeting 2 Explain to the employee the reasons for your concern and give specific examples 3 Ask the employee if he or she has any explanation to offer or whether there are any factors you need to take into consideration and encourage him/her to talk. 4 Consider the explanation put forward by the employee and evaluate: whether there are any personal circumstances to take into account; whether or not the explanation or factors put forward are reasonable and valid; the previous employment record of the employee. 5 Discuss with the employee what improvement you expect and agree jointly how the problems can be addressed. Establish a plan of action and set targets for improvement. 6 Summarise the agreements you have reached and specify a date to meet to review progress. Inform the employee that he or she is being formally counselled in relation to their performance or conduct and that failure to improve in line with the agreements reached could result in formal disciplinary action being taken. 7 Record the agreements in a file note and ensure that both you and the employee sign the document before forwarding this to the Personnel Department for retention in the employee s Personal File. Reviewing Progress 1 Ensure that you monitor the employee s performance or conduct in line with the agreements reached. 2 Meet with him or her again at the specified date (or earlier if you are dissatisfied with progress): if progress has been satisfactory, agree another review with a potentially longer time scale. Continue to meet to review progress until you are sure there is no longer a need to do so; Managing Attendance at Work Procedure v5 37

38 if progress is unsatisfactory, notify the employee of this together with the reasons for your concern. Encourage the employee to talk and consider any influencing factors or mitigating circumstances which may be affecting performance; Consider the next steps which could include either an extension of the review period or, if appropriate, instigating a formal investigation prior to determining whether or not disciplinary action is required. Managing Attendance at Work Procedure v5 38

39 Appendix H Flowchart for Long Term Sickness Absence Manager notes employee has been off sick for at least 4 weeks Consult Personnel, Occupational Health and/or payroll NO Has manager reviewed all relevant information? YES Meet employee, if practicable NO Has manager met employee to discuss sickness absence? Make a note, if appropriate YES Other than keeping the situation under review, is any further action needed? NO Plan a return to work strategy Seek a medical opinion from Occ Health YES Should employee be referred to Occ Health for a medical opinion? Is a return to work imminent? If Occ Health Physician has not been consulted, seek views. Consider ALL available information. Has OSP expired? YES Has potential termination on grounds of incapacity been discussed with the employee? YES NO Is there any suitable alternative employment? NO Raise the issue YES Terminate contract on grounds of incapacity? Managing Attendance at Work Procedure v5 39

40 Appendix I Staff Re orientation Check List Name: Grade: Commenced: Welcome back to work. This is your Re orientation Check List which has been designed to help you become re acquainted, following your recent absence, to your ward/department, and any new policies and procedures recently introduced to the Trust. In order to monitor your re orientation, you and your manager are required to sign each item when you both agree the topic has been adequately covered. Please bring to the attention of your supervisor/manager within one week any items which are outstanding or those on which you would require further assistance. Your supervisor/manager will keep the completed form in your personal file and give you a copy. Employees must be mindful of their professional regulations/codes of practice/training upon return to work Managing Attendance at Work Procedure v5 40

41 GATESHEAD HEALTH NHS FOUNDATION TRUST Departmental Re orientation 1 Changes to Structure of Department Day One Head of Dept Immediate Supervisor Introduction to new colleagues Week One Month One Signature of Employee Signature of Manager 2 The Job Trust & Department Objectives PDP agreed Trust Rules Confidentiality Holiday entitlement 3 Policies and Procedure Refamiliarisation Policies & Procedures Manual Health & Safety Manual Nursing Practice Handbook (if applicable) 4 Trust Information Network Trust News Team Brief 5 Risk Assessment (update) Fire Procedure Manual Handling Resuscitation (if applicable) Other Please Specify Managing Attendance at Work Procedure v5 41

42 APPENDIX J NHS INJURY BENEFITS SCHEME 1. INTRODUCTION 1.1 This section contains provision for an injury allowance to be paid to eligible employees who, due to a work related injury, illness or other health conditions are on authorised sickness absence or phased return to work with reduced pay or no pay. It also makes provision for the protection of pay in certain circumstances. 1.2 This section should be read in conjunction with Section 14 or Section 14(a) (England) and Annex Z of the NHS Terms and Conditions Handbook. It does not confer an additional period of sickness absence entitlement to eligible employees. 2. ELIGIBILITY 2.1 Eligible employees who have injuries, diseases or other health conditions that are wholly or mainly attributable to their NHS employment, will be entitled to an injury allowance, subject to the conditions set out in this Section. The injury, disease, or other health condition must have been sustained or contracted in the discharge of the employee's duties of employment or an injury that is not sustained on duty but is connected with or arising from the employee's employment. 2.2 The attribution of injury, illness or other health condition will be determined by the employer who should seek appropriate medical advice.2 In all cases the employer should use the civil burden of proof "on the balance of probability" (more likely to than not) to determine the outcome. Where the employee disagrees with the employer's decision then they are entitled to appeal the decision as outlined in this procedure. 2.3 Employees claiming injury allowance are required to provide all relevant information, including medical evidence, that is in their possession or that can reasonably be obtained, to enable the employer to determine the claim. 2.4 Payment of injury allowance is not dependent on length of service. 2.5 The following circumstances will not qualify for consideration of injury allowance: injury whilst on a normal journey travelling to and from work, except where the journey is part of their contractual NHS duties; sickness absence as a result of disputes relating to employment matters, conduct or job applications; injury, disease or other health condition due to or seriously aggravated by the employee's own negligence or misconduct. 2.6 Scale of injury allowance Injury allowance will be paid to eligible employees as a top up to their sick pay or earnings, when on phased return on reduced pay. This calculation will include any contributory state benefits received by the employee to 85 per cent of pay as defined in paragraph 14.4 and paragraphs 14.4 and 14.5 in Section 14(a) in the terms and conditions handbook. Managing Attendance at Work Procedure v5 42

43 2.6.2 The injury allowance payment is subject to National Insurance Contributions and income tax but is not subject to pensions contribution deductions Contributory state benefits received for loss of earnings will be offset at the rate at which they are actually received by the employee. All other benefits or payments received should be ignored Eligible employees are required to claim any contributory state benefits they may be entitled to and to declare receipt of such benefit(s) to their employer. Timely notification will ensure that overpayments of injury allowance are not made. Employers will require repayment when an overpayment is made. 2.7 Payment period The allowance will be restricted to a period of up to 12 months per episode, subject to local absence management, return to work and rehabilitation policies. 2.8 Using injury allowance to support return to work Eligible employees who make a phased return to work can receive the injury allowance as a pay top up to 85 per cent of pay as defined in paragraph 14.4 and paragraphs 14.4 and 14.5 in Section 14(a) (England) NHS Terms and Conditions Handbook and if the employees pay is reduced during an employer approved period of rehabilitation, subject to the timescales set out in paragraph NHS Terma dn Condtions Handbook. 2.9 Pay protection Eligible employees who have to change jobs permanently to a position on lower pay due to a work related injury, illness and/or other health condition, will receive a period of protected pay that is the same as local provision for pay protection during organisational change Recovery of overpayment of injury allowance 3 APPLICATION PROCESS An employer can seek to recover any overpayments made to an employee. Where recovery is necessary employers should take into account the period of time the overpayment was in place when agreeing the programme of repayments. 3.1 There is a pro forma to claim Injury Allowance at the end of this appendix. The applicant should complete Part 1 of this form. The line manager should complete Part 2 of this form, and should ensure that all relevant documents are attached before sending it to the Personnel Department. 3.2 In determining whether an employee is eligible for Injury Allowance, the Personnel Department will arrange a meeting with the line manager and a representative of the Occupational Health & Safety Department. Together, they will consider all of the relevant information before coming to a decision, which should be communicated to the employee Managing Attendance at Work Procedure v5 43

44 in writing. In reaching a decision about paying Injury Allowance, they must be satisfied that the employee is eligible under one of the criterion set out above. 3.3 In circumstances where Injury Allowance is not agreed, the employee has the right to appeal in writing to the relevant Director (unless s/he has already been involved in which case another Director should take over). The Director will ask both the employee and line manager to submit written statements about the claim for consideration by her/him and either the Director of Health Development or a senior member of the Personnel Department, who has not previously been involved in the case. Their decision will be final. 4. PROCEDURES 4.1 The NHS (Injury Benefits) Regulations 1995 are mandatory and form part of the terms and conditions of employment of all NHS employees. 4.2 Within the Trust, the main requirements are for the Personnel and Finance Departments to: identify potential cases; open and maintain appropriate records; act in accordance with the NHS (Injury Benefits) Regulations 1995 and these procedures. 4.3 The Trust operates a system to record accidents/incidents and diseases which occur in the course of an employee s duties. This should enable most potential cases to be identified via Datix Incident Electronic Reporting. 4.4 When an employee enters a reduced pay situation and the manager is aware that the sickness absence may be attributable to an injury, disease or condition caused by her/his NHS employment, then the manager should ask the employee to complete the pro forma for Injury Allowance 4.5 Employees have the right to request a pro forma for Injury Allowance at any time. 4.6 The Personnel and Payroll Departments will maintain appropriate records and provide quarterly monitoring reports to the Central Team on the number, status and payments of Injury Allowance Cases. Managing Attendance at Work Procedure v5 44

45 CLAIM FORM FOR INJURY ALLOWANCE PART 1 PERSONAL DETAILS (to be completed by applicant) (Do not complete this form without reading Appendix C of the Trust s Policy on Managing Attendance at Work Policy). 1. TITLE (i.e. Miss, Mr etc) 2. SURNAME: 3. FORENAMES: 4. DATE OF BIRTH: 5. HOME ADDRESS: 6. WHAT IS YOUR CURRENT NHS EMPLOYMENT? Please include the job title & grade of all NHS posts currently held. 7. WHAT IS YOUR NORMAL WORKBASE? 8. IS YOUR EMPLOYMENT Yes/No If no, please state hours FULL TIME? per week 9. ARE YOU A MEMBER OF THE Yes/No NHS PENSION SCHEME? 10. PLEASE GIVE DETAILS OF ACCIDENT/INCIDENT (continue on a separate sheet if necessary): Managing Attendance at Work Procedure v5 45

46 11. HAS THIS ACCIDENT/INCIDENT EXACERBATED ANY PRIOR MEDICAL CONDITION? Yes/No If yes, please give details (continue on a separate sheet if necessary): 12. Please identify under which of the following categories you are making this application for Temporary Injury Allowance (tick if yes or cross if no): (a) (b) (c) (d) sustained an injury from an accident or incident which occurred whilst on duty; contracted a disease in the course of NHS employment eg Hepatitis B, Tuberculosis; developed a condition that is attributable to the employee s work in the NHS (but there was no specific incident or accident) eg stress; sustained an injury as a result of giving assistance at the scene of an accident even if the employee was off duty. I hereby apply for Temporary Injury Allowance and I confirm that the information given above is correct. Signature: Date: Please forward this form to your Manager to complete Part 2 Managing Attendance at Work Procedure v5 46

47 PART 2 to be completed by Manager 1. IS THERE ANY EVIDENCE TO SUPPORT THAT THE EMPLOYEE (Tick if yes and cross if no) (a) (b) (c) (d) sustained an injury from an accident or incident which occurred whilst on duty? contracted a disease in the course of NHS employment eg Hepatitis B, Tuberculosis? developed a condition that is attributable to the employee s work in the NHS (but there was no specific incident or accident) eg stress? sustained an injury as a result of giving assistance at the scene of an accident even if the employee was off duty? Please attach any relevant documents or give further details to support your views 2. CAN YOU CONFIRM THAT THE EMPLOYEE S ACCOUNT OF EVENTS IS ACCURATE? Yes/No If no, please give your comments: 3. IS THE APPLICANT S CURRENT ABSENCE FROM WORK ATTRIBUTABLE TO THE ACCIDENT/INJURY/CONDITION? Yes/No If no, please give further details: 4. WAS THE ACCIDENT/INJURY/CONDITION DUE TO THE APPLICANT S OWN NEGLIGENCE (e.g. use of lifting /handling techniques)? Yes/No If yes, please give further details: 5. WHEN DOES THE EMPLOYEE S OCCUPATIONAL SICK PAY EXPIRE? Date full pay expires: Date half pay expires: Managing Attendance at Work Procedure v5 47

48 6. PLEASE PROVIDE DETAILS OF ALL RELEVANT SICK LEAVE FOR THE EMPLOYEE (Continue on a separate sheet if necessary): DATES REASON From/To: 7. WHAT RELEVANT TRAINING HAS THE EMPLOYEE RECEIVED, IF ANY, IN RELATION TO THIS APPLICATION? (Continue on a separate sheet if necessary): 8. ARE YOU AWARE OF ANY PRIOR MEDICAL CONDITION WHICH MAY HAVE BEEN EXACERBATED BY THIS ACCIDENT/INCIDENT? Yes/No If yes, please give details: Please attach the following documents with this form (if relevant, delete if not) then sign below to confirm that the above details are accurate and have been verified by you. If you are unable to do so, please state reason. * ACCIDENT FORM (Datix) * REPORT(S) BY OCCUPATIONAL HEALTH DEPARTMENT * JOB DESCRIPTION Signature Date. Job Title Work Tel. No.... Managing Attendance at Work Procedure v5 48

49 Appendix K To: insert line manager Line Manager Internal Memorandum To: insert personnel manager / asst manager Personnel From: insert your name Payroll Team Date: insert date Re: Confirmation of Work Related Injury or Disease The employee named below is currently off sick and we have received fit notes indicating their absence is work related. To ensure the Agenda for Change terms and conditions of service relating payments due to staff while on sick leave as a result of work related injury or disease are applied correctly could you please provide confirmation that the current period of absence is work related. For information, the Agenda for Change handbook defines work related sickness as: injuries, diseases or other health conditions sustained or contracted in the discharge of the employee's duties of employment Full Name Assignment Number Department Job Title First Day of Sickness Please complete the relevant statement below I can confirm that the sickness absence detailed above is work related. Name Signed Date OR I can confirm that the sickness absence detailed above is not work related. Name Signed Date Please complete relevant statement above and return to payroll@ghnt.nhs.uk Managing Attendance at Work Procedure v5 49