SICKNESS ABSENCE POLICY

SICKNESS ABSENCE POLICY Policy Number: Version: 001 Ratified By: Date Ratified: Name of Sponsor: Name of Originator/Author: Date Issued: February 2015 Review Date: February 2017 Target Audience: All CCG employees

Contents 1.0 INTRODUCTION... 3 2.0 PURPOSE... 3 3.0 DUTIES... 4 4.0 DEFINITIONS... 4 5.0 PROCEDURE... 5 5.1 Notification of Sickness Absence... 5 5.2 Self Certification... 6 5.3 Statement of Fitness for Work (replaces medical certificate)... 6 5.4 Trigger Points... 7 5.5 Doctor, Dental & Hospital Appointments... 7 5.6 The Role of Occupational Health... 7 5.7 The Role of Human Resources... 9 5.8 Representation... 9 5.9 Sickness Before or During Annual Leave... 9 5.10 Sickness Prior To/During Maternity Leave...10 5.11 Accrual of Annual Leave During Sickness Absence...10 5.12 Returning to Work...10 5.13 Return to Work Meetings...10 5.14 Redeployment...10 5.15 Training and Retraining...12 5.16 Applying for Retirement on the Grounds of Ill Health...12 5.17 Dismissal on the Grounds of Ill Health...12 6.0 Review and Revision Arrangements including version control... 13 7.0 Process for Monitoring Compliance and Effectiveness... 14 8.0 EQUALITY IMPACT ASSESSMENT... 14 9.0 APPENDICES... 14 10.0 LIST OF STAKEHOLDERS CONSULTED... 14 11.0 VERSION CONTROL SHEET... 15 APPENDIX 1... 16 APPENDIX 2... 18 APPENDIX 3... 23 APPENDIX 4... 24 APPENDIX 5... 25 APPENDIX 6... 27

1.0 INTRODUCTION 1.1 The CCG aims to promote good employment relations and practices and recognises and values the support, contribution and commitment of all our employees. 1.2 This policy is to assist the CCG in ensuring that it meets its obligations under the Disability Discrimination Act (DDA) 1995. 1.3 The management of sickness absence provides an opportunity to improve overall health and wellbeing in the workplace, which will ultimately boost the CCG s productivity and support service improvements to patients whilst striking a balance between the need for the employee to be given time to recover from illness. 1.4 On 6 th April 2010 the way in which General Practitioner s issue medical certificates changed from medical certificates (Med 3) to a Statement of Fitness for Work (fit note). The decision to change the medical certification system moves the focus away from the requirement to be fully fit in order to work and recognises that work is generally good for people s physical and mental health and wellbeing. The changes are not intended to get people back to work before they are ready but to remove any obstacles in the process that may prevent them returning. 2.0 PURPOSE 2.1 The purpose of this policy is to ensure that arrangements are in place for handling absence from work in a manner which minimises the impact of absence on both the employee and on the organisation and applies flexibility whilst maintaining consistency. 2.2 High levels of sickness absence within a department have a detrimental effect on the level of service provided and can affect patient care either directly or indirectly. Sickness absence places an added burden on other employees and frequently results in increased costs to the CCG. This policy intends to support management and employees to reduce sickness absence and improve overall attendance at work. The CCG s principles in managing sickness absence issues are to ensure a fair, reasonable and consistent approach whilst enabling the CCG to provide an efficient, quality service. 2.3 The CCG reserves the right to fully investigate excessive sickness absence and take necessary action, in accordance with this policy, to ensure that the needs of the service are fully met.

3.0 DUTIES 3.1 It is the responsibility of the Accountable Officer to implement this policy and procedure. 3.2 It is the responsibility of the Manager for ensuring that they follow the procedures outlined in this policy and that they take timely action as required. Please refer to Appendix 1 for full managerial responsibilities. 3.3 It is the responsibility of the Human Resources department for providing advice and guidance to employees and managers in relation to this Policy and Procedure. 3.4 It is the responsibility of employees to provide the required notification of their absence to their line manager and to follow the procedure as detailed. Please refer to Appendix 1 for full employee responsibilities. 4.0 DEFINITIONS 4.1 Employee An employee is an individual who has entered into or works under a contract of employment with the CCG contract. 4.2 Line Manager Is the manager who has day to day management of the service and employee. 4.3 Executive Leads Refers to both Executive Leads within the CCG organisational structures. 4.4 Trigger Point Is the benchmark to effectively and consistently manage and control sickness absence. 4.5 Persistent Short Term Sickness Absence Refers to sickness absence made up of odd days where there may be no underlying medical reason and is covered by a self-certificate. 4.6 Long Term Sickness Absence This refers to a situation when the employee has had an illness/injury that exceeds one month and over and will be covered by a fit note 4.7 Unsatisfactory attendance - Is defined as periods of absence that exceed the trigger points detailed in this policy. 4.8 Unauthorised Absence - An employee who is absent for any full day or part day without permission and without contacting their manager/supervisor. 4.9 Disability - The DDA 1995 defines a disabled person as someone who has a physical or mental impairment that has a substantial and long term adverse

effect on his or her ability to carry out normal day to day activities. 4.10 Statutory Sick pay (SSP) - Is the minimum amount employers must pay any employee unable to attend work due to illness. 4.11 Occupational Sick pay (OSP) - Is paid by the CCG and is intended to supplement SSP to provide additional payment during absence due to illness, injury or disability. 4.12 Occupational Health Department - Provide the CCG with medical advice and suggest recommendation to managers on how to deal with an absence issue. 5.0 PROCEDURE 5.1 Notification of Sickness Absence 5.1.1 An employee who becomes sick must inform their line manager or delegated person of their absence as soon as possible, preferably one hour before the start of their normal shift, on the first day of absence. This notification must be made verbally by the employee, and must include the reason for the absence and likely duration. Text messages are only acceptable if the department is not open and the manager is not available one hour before the start of the shift. The text message must be followed by a telephone call from the employee to the line manager within 3 hours of the commencement of the shift. 5.1.2 If an employee has not arrived for their shift and no contact has been made with the line manager by one hour from the commencement of the shift, the line manager can telephone the individual to establish the situation. 5.1.3 It is recognised that in certain circumstances for example due to an accident or emergency hospital admission that the above notification procedure may not be followed. In such cases employees should arrange for another person to make the call within the same timescale. The employee should personally make contact as soon as is reasonably practicable. 5.1.4 Employees must continue to keep managers informed of the likely duration of absence and when known of the return to work date. If this is not forthcoming Managers may initiate contact to establish the facts. 5.1.5 It is the employee s responsibility to ensure that the sickness certificate appropriate to the duration of the absence is submitted as detailed in sections 5.2 and 5.3, and that it covers the period for which they have been sick. Fit notes should not be backdated. 5.1.6 Sick pay entitlement is subject to compliance with this policy and procedure and the Statutory Sick pay rules and regulation.

Length of service Full pay Half pay Up to 1 year 1 month 2 months Up to 2 years 2 months 2 months Up to 3 years 4 months 4 months Up to 5 years 5 months 5 months Over 5 years 6 months 6 months Please be aware if you are joining the CCG from within the NHS the length of service and sick pay entitlement is continuous. 5.2 Self Certification Self-certification applies for absences of up to 7 calendar days, and includes any time off duty (and includes weekends) even if it is for part of a day. A copy of the self-certificate form is attached in Appendix 3. The employee must submit a completed self-certificate to their line manager prior to their return, or on their immediate return. 5.3 Statement of Fitness for Work (replaces medical certificate) 5.3.1 Where sickness absence exceeds 7 calendar days, the employee must provide a fit note from day 8, within 2 working days of this date, if not the manager will make contact with the employee to establish the situation. 5.3.2 Failure to follow the above procedure may result in pay being delayed or withheld whether statutory sick pay and/or occupational sick pay. Managers are required to discuss any decision to accept late submission of a fit note (later than 2 working days after day 8 of sickness) with the Service Executive Lead prior to authorising payment. Individual circumstances will be taken into account in any decision made. 5.3.3 Fit note must run consecutively as sick pay cannot be made for days not covered by a fit note and each fit note must be submitted within 2 days of receipt. 5.3.4 If considered appropriate a fit note can be requested for all periods of sickness absence by the manager, the cost incurred by the individual will be reimbursed by the CCG on production of a receipt. Human Resources advice must be sought prior to taking this action. 5.3.5 The new fit note arrangements make it easier for doctors to provide simple, clear advice on fitness for work, and make it possible for them to advise on an earlier return to work by offering a new option: may be fit for work taking into account the following advice if they think their patient s condition may allow them to work with suitable support from their employer with the introduction of temporary adaptations.

5.3.6 The information on the fit note for work is advice and is not binding for the employer. If there is genuine reason the recommendations cannot be accommodated by the manager following discussion with HR then the fit note should be considered as if the doctor had advised that the employee is not fit for work. 5.4 Trigger Points 5.4.1 The short term sickness absence trigger is 3 periods or a total of 7 days in a 3 month rolling period. The 7 days should be pro rata for part time employees. Days worked each total days absence in a 3 month rolling week period 5 7 4 6 3 4 2 3 1 1 5.4.2 The long term sickness absence trigger is continuous sickness absence of one month and over. 5.5 Doctor, Dental & Hospital Appointments 5.5.1 In order to cause minimum disruption to the service, employees whether full or part time, are expected to book hospital/doctor/dental and other related appointments in their own time, giving as much notice as possible if time off work is required. 5.5.2 Where this is not possible, employees are asked to book appointments either at the start or end of their normal shift. 5.5.3 If this is still not possible, especially in relation to hospital appointments or emergency dental treatments, etc. reasonable time off will be given following discussion with the line manager. Appointment cards must be shown to the line manager. 5.6 The Role of Occupational Health 5.6.1 An Occupational Health referral may take place for the following reasons, although this is not an exhaustive list: where employees with a potential health problem, either physical or mental, which is affecting their ability to fulfil their normal work requirements where trigger points have been reached and further explanation is

necessary long term sickness if: (i) the expected recovery rate is longer than anticipated (ii) the employee is symptomatic but is signed fit by their doctor where medical retirement on the grounds of ill health is being considered where there are alcohol/drug dependency concerns to determine if reasonable adjustments/redeployment is an option to identify what support the CCG can offer the employee to facilitate a return to work. 5.6.2 In line with this procedure it is a condition of employment for all staff employed by the CCG that their manager has the right to refer them for a medical assessment during the course of their employment. 5.6.3 Employees will be asked to give their consent for a medical referral and assessment and for the Occupational Health Department to seek information from their doctor/medical specialist by signing an Occupational Health referral form. A full explanation should be given as to the reasons for the referral by the manager. If an employee has any concerns about this referral, the manager should meet and discuss these with them prior to the consent being obtained. 5.6.4 Following clinical assessment of the referred employee, the Occupational Health provider will send a report to the line manager advising them of the employee's medical suitability in relation to their current work demands. All reports submitted to management will be based on the Physician's/Adviser's assessment in conjunction with any relevant external medical reports, if considered appropriate. 5.6.5 Occupational Health recommendations are guidelines which are intended to assist managers with decision making regarding future employment, adaptations, redeployment, or modification of work activity (where possible). 5.6.6 Employees must co-operate with their managers by attending any Occupational Health appointments resulting from a manager s referral. 5.6.7 If any employee cancels, fails to give consent or fails to attend two consecutive appointments and the manager is unable to establish a valid reason, the manager will have to act on the basis of the facts available, and make a management decision without the benefit of medical advice. The manager will also need to investigate the non-attendance and decide whether further action is appropriate under the Conduct and Capability policy. It is essential that advice is sought from the Human Resources Department at this stage, prior to taking any further action.

5.7 The Role of Human Resources 5.7.1 Human Resources advice should be sought immediately when a trigger point has been reached or when it has been identified that a problem exists which requires action under this policy. 5.7.2 The role of Human Resources includes: giving advice and assistance to managers on the appropriate action to take in dealing with issues of sickness absence advising employees in relation to this policy attending any formal meetings held in accordance with this policy 5.8 Representation 5.8.1 Employees have the right to be accompanied by an accredited representative of their Trade Union/professional body or by a work colleague employed by the CCG to formal meetings held under this policy. 5.8.2 It is the responsibility of the individual to arrange their representation and if their preferred representative is unable to attend the meeting then alternative representation should be considered in order to expedite the process. 5.8.3 In circumstances where the employee needs to reschedule due to their chosen representative not being available it is the employee s responsibility to liaise with their representative and Human Resources regarding alternative dates. Every effort will be made to agree a mutually convenient date however should the meeting be cancelled on two occasions the employee will be informed that if their representation is not available on the third occasion the meeting will proceed. 5.9 Sickness Before or During Annual Leave 5.9.1 In the event of any employee either being unable to commence their annual leave due to ill health or falling sick once their annual leave has commenced, either in the UK or abroad, the absence can be treated as sickness absence and a further period of annual leave agreed with the manager. 5.9.2 This is conditional upon the employee notifying their manager in line with this procedure either before or during the annual leave period on the first day of sickness, and submitting self and/or fit notes for the relevant period. Acceptable notification of sickness absence when the employee is abroad is either email or verbal communication or if this is not possible due to different time zones then a text message will be acceptable on the first day of sickness. Where email or text message is used verbal communication with their manager must take place upon return to the UK.

5.9.3 Failure to report as per 5.9.2 will result in the absence being treated as annual leave. 5.9.4 Annual leave may be taken during periods of sickness absence. 5.10 Sickness Prior To/During Maternity Leave 5.10.1 Any sickness absence that is pregnancy related must be kept separate from sickness absence records and will not be counted towards trigger points. Refer to the CCG s Policy on Maternity Leave for further guidance 5.11 Accrual of Annual Leave During Sickness Absence Entitlement to annual leave under the employee s contract of employment will accrue during any period of sick leave whether paid or unpaid in accordance with the current statutory requirements of the Working Time Regulations 1998. Annual leave will continue to be accrued during any period of sick leave up to a maximum of 28 days per annum, this includes Bank Holidays. 5.12 Returning to Work 5.12.1 Employees should give as much notice as possible of the date they intend to return to work, to enable their manager to make any necessary arrangements to cancel bank staff or temporary cover. 5.12.2 On returning to work after short-term sickness absence the employee must contact their manager (or delegated person) on the first day of their return in order to complete a return to work meeting and self-certification form. In certain circumstances the return to work meeting may need to be by telephone in the first instance although a face to face meeting should to take place as soon as possible. It is especially imperative that all employees returning from long term absence have a face to face meeting. 5.13 Return to Work Meetings 5.13.1 A return to work meeting will be conducted by the line manager in private at the beginning of the period of duty or as soon as practically possible, following all periods of sickness absence. During the meeting the manager will establish the reason for the absence, identify any contributing problems that may exist. The manager will offer help and advice where appropriate and discuss any support mechanisms which may available. A written summary of this meeting must be recorded using Appendix 4. 5.14 Redeployment

5.14.1 When it has been agreed that an individual cannot return to their current role redeployment is an option to be considered either temporarily or on a permanent basis to facilitate a return to work. In considering redeployment the following factors should be taken into account: suitability for re-training previous experience and skills qualifications where applicable any restriction due to medical condition until the situation has been resolved the permanent post may only be covered on a temporary basis availability of suitable posts for the individual to be redeployed into 5.14.2 Care should be taken to ensure that any temporary redeployment does not have an adverse effect on the planned return to the original post. In all prospective redeployment assistance should be sought from the Human Resources Department in identifying suitable alternative posts. In short term sickness absence cases where a genuine underlying medical reason has been established, it may be possible to make minor adjustments to hours of work, etc., or to consider re-deployment into another post within the department or CCG. 5.14.3 In long term sickness absence cases where medical advice has indicated a return to work date to the existing post 1-2 months in the future temporary redeployment could be considered for this period as an interim measure. This could be a vacant post in a different department. Managers are expected to co-ordinate any such arrangements within the CCG with the support of the Human Resources Department. 5.14.4 The manager should seek Occupational Health advice establishing the suitability of any such post and its role in any planned return to work. The employee would need to submit a fit note confirming their fitness to return to this post. 5.14.5 Where medical advice has indicated that the employee is unfit to return to their existing post, but would be able to return to work in a different capacity, both the manager and the employee are responsible for identifying any suitable alternative employment that may be available at that time. Individual circumstances should be respected and recorded, and alternative options discussed and agreed. 5.14.6 The employee will be sent (via the Human Resources Department) details of suitable vacant positions within the CCG as they arise, initially for a period of one month, with a meeting to review progress at the end of this period. In exceptional circumstances a further period of up to two months could be agreed. 5.14.7 Should alternative employment not be available at the end of the agreed search period, the options of retirement or dismissal on grounds of ill health will be discussed with the employee.

5.14.8 It should be noted that there is no requirement for the CCG to create suitable posts and consideration will therefore be given to existing vacant posts 5.15 Training and Retraining 5.15.1 When it has been agreed that an individual cannot return to their current role it may be possible to consider a period of training or refresher training to enable the employee to take up an alternative post within the CCG. The manager will need to balance the cost, length and type of training in deciding whether it is a reasonable and practical option. 5.16 Applying for Retirement on the Grounds of Ill Health 5.16.1 When it has been agreed that an individual cannot return to their current role retirement on ill health grounds is an option to be considered in cases of longterm sickness, where the options of return to work, redeployment/retraining have been exhausted or have been agreed as being inappropriate. It is essential to seek advice from the Human Resources Department prior to taking this action and to recognise that this should be treated sensitively. If ill health retirement has been approved by NHS pensions then a final review meeting will be held with the employee. 5.16.2 The employee should be advised, in advance and in writing that the final meeting is to consider their dismissal for reason of retirement on ill health grounds and be reminded of their right of representation of trade union member/professional body or fellow CCG employee. Also present will be a manager who has authority to dismiss and a Human Resources representative. Employees will be entitled to paid notice. 5.17 Dismissal on the Grounds of Ill Health 5.17.1 Dismissal on ill health grounds is the final option when all others have been exhausted. It is essential that advice be sought from the Human Resources Department prior to taking this action. 5.17.2 Dismissal on the grounds of ill health will sometimes be appropriate in cases of persistent short-term sickness, but more usually in cases of longterm sickness. This decision should only be taken following a process of consultation with the employee and an accredited representative of their trade union/professional body and in the light of medical and Human Resources advice. 5.17.3 Criteria to be considered in the potential dismissal of an employee on health grounds are: Nature of the employment Nature of the illness or injury Length of the illness or injury

Prospects of a full recovery and return to duties Prospects of redeployment Suitability of ill health retirement as an alternative. Full consideration of all reasonable adjustments Impact of absence on service 5.17.4 Before a final decision is reached on dismissal on the grounds of ill health, the employee may need to be referred for a final medical assessment if there is any likelihood that the condition may have improved/changed or if a significant time has lapsed since the initial medical assessment. 5.17.5 When dismissed on ill health grounds, employees are entitled to paid notice or pay in lieu of notice. 5.17.6 The employee should be advised, in advance and in writing that the final meeting is to consider their dismissal on ill health grounds and be reminded of their right of representation of trade union member/professional body or fellow CCG employee. 5.17.7 At the meeting the individual and their representative and the line manager and a Human Resources representative who have been involved in managing the sickness absence will present and discuss the situation with a panel comprising the next level of line management (who must have the authority to dismiss) and a Human Resources representative. At this meeting the panel will consider the actions taken so far to ensure that all options have been given full consideration before a decision is taken to progress to dismissal. 5.17.8 At the time of the dismissal the following must be confirmed in writing by the dismissing manager: Reasons for dismissal The period of notice, and the effective date of termination of employment Details of the right of appeal (this will be dealt with under the CCG Appeals Policy) 6.0 REVIEW AND REVISION ARRANGEMENTS INCLUDING VERSION CONTROL HR Policy and Procedure Number HRP8 Version 1.0 Executive Lead responsible for monitoring Chief Executive Officer and reviewing this procedure Implementation Date: Review Date: Date approved by CCG Governing Body:

Age Disability Gender Race Sexuality Pregnancy Maternity Religion Human Rights 7.0 PROCESS FOR MONITORING COMPLIANCE AND EFFECTIVENESS 7.1 The policy on sickness absence will be subject to formal review every two years by the Human Resources Department. Additionally on going reviews will be undertaken as and when the need arises due to factors such as changing employment law or amendments to the Agenda for Change Handbook. 7.2 The effectiveness of this policy will be monitored against and in accordance with the CCG s attendance target set by the board. 8.0 EQUALITY IMPACT ASSESSMENT Scoring: 13-18 points High Relevance 7 12 points Medium Relevance 0 6 points - Low or No Relevance Service / Function / Policy / Procedure Total Points Impact (High Medium Low) Sickness Absence 0 0 0 0 0 0 0 0 0 0 L Equality Impact Assessment not required. The equality target groups are all covered by the policy. This policy is intended to ensure that all staff sickness absence is managed fairly and consistently. It is intended to bring clarity for both managers and staff. 9.0 APPENDICES Appendix 1 Line Manager and Employee Responsibilities Appendix 2 - Sickness Absence Guidelines for Managers Appendix 3 - Self -Certification Form Appendix 4 Return to Work Interview Form Appendix 5 Occupational Health Management Referral Form Appendix 6 Sickness Absence Return Form 10.0 LIST OF STAKEHOLDERS CONSULTED Name Title Comments received Y/N Former PCT policy group Various members Y Y CCG policy assurance group Various members Y Y CCG staff involvement group Various members Y Y Comments incorporated Y/N

11.0 VERSION CONTROL SHEET Version Date Issued Date of next review 001 February February 2017 2015 002 Author Name and Title Former PCT policy, reviewed and adopted by the CCG Comment

APPENDIX 1 LINE MANAGER AND EMPLOYEE RESPONSIBILITIES AND ROLE Line Manager Responsibilities and Role Line Managers are responsible for managing sickness absence within their areas of responsibility, this includes maintaining accurate, confidential records which are kept in a secure place and will include dates and reasons for absence. Managers are required to: Ensure that all necessary documents and records are completed/submitted in a timely manner as required; these include positive returns, self-certification forms, return to work forms, management referral forms and absence records. Maintain communication/contact, as appropriate, with the employee during the period of absence and keep a factual record.. Ensure contact is made with the employee on the day they return from sickness/absence or as soon as practically possible and carry out in private an informal return to work interview. Act in a consistent, fair, reasonable way taking full account of all the factors and individual circumstances. Ensure that up-to-date information is available and taken into account. Identify employees whose absence reaches the CCG s sickness absence trigger levels, as per section 5.4 of this policy,and invite them to a meeting with Human Resources present where they have the right to representation Ensure that appropriate Human Resources and medical advice is sought prior to any formal action being taken. Employees Responsibilities and Role Employees are responsible for complying with this policy and are required to: comply with sickness notification procedures ensure that positive returns are completed accurately and within monthly deadlines as set out keep in verbal contact with their line manager on a regular basis during the period of absence, with regards to their progress and their intention to return to work notify their manager of any intention to go on holiday whilst on sick leave. attend Occupational Health appointments as appropriate

advise their line manager of any medical problems or sickness, which may affect their work and co-operate with their line manager in trying to resolve any such problems act in a way that will assist their timely return to work in all cases of sickness absence not undertake any other employment whether paid, unpaid, including work on the Bank or in any other capacity within the CCG or any other CCG or employer including agency work while absent on sick leave. not take part in sports, hobbies or other activities that could in any way aggravate their condition or delay recovery with the exception of any such activities designed to improve an employee s health as part of a therapeutic/convalescent programme. It is an offence to carry out other paid employment either within the CCG or for another employer within the NHS or private sector whilst claiming sickness payment from this CCG. Any instances will be investigated by Counter Fraud and may lead to action being taken under the CCG s Conduct and Capability policy and/or prosecution. Any other suspected abuse of this policy or unauthorised absence from work will be dealt with under the CCG s Conduct and Capability policy. If an employee has any concerns regarding action taken under this policy they should refer to the CCG s Grievance policy regarding the steps that can be taken.

APPENDIX 2 SICKNESS ABSENCE MANAGEMENT FOR ALL EMPLOYEES Short-Term Sickness Absence Trigger point met When the short-term sickness trigger points are met, managers are required to arrange an informal meeting with the employee. This is not a disciplinary meeting, but it is essential to keep notes, recording any agreed action, dates etc. It is also essential to handle the meeting with understanding and sensitivity. The purpose of this meeting is to try to establish whether a problem exists and which of the following reasons is applicable: an underlying medical condition which is diagnosed a work related problem a family, domestic or personal problem If there could be a possible underlying medical condition then a referral to occupational health should be made to establish the facts. If it is established at this first meeting that the reasons for the persistent absence are not due to an underlying medical reason then options to overcoming these problems should be discussed and agreed with the employee. These may include, periods of annual leave, Flexible working, Carers leave. Advice should be sought from Human Resources. Clear expectations and specific time limited improvements should be documented and further monitoring continued, with a review period agreed, (usually between 1-6 months) and a review date set. 2 nd Review Date Formal Meeting If the jointly agreed improvement has not been achieved, by the review date, resulting in unsatisfactory attendance, a formal meeting will take place. The employee must be offered the opportunity to be accompanied by an accredited representative of their trade union/professional body or a work colleague. Human Resources advice must be sought and at this meeting desired improvements should be agreed and documented with clear timeframes detailed. When agreeing these actions, managers must take into consideration any issues raised and any relevant training/ additional support should be discussed and agreed. A review date must be agreed and the individual advised in writing of the contents of the meeting and that if the agreed improvement is not met, then the matter may be addressed under the CCG s Conduct and Capability policy. 3 rd Review Date Disciplinary Procedure If there is still no improvement by the agreed review date, action may be taken under the CCG's Conduct and Capability policy, progressing through all the stages if

necessary. Entry into the above procedure will be at Stage One. Managers are required to seek advice from the Human Resources Department prior to taking any action. If the matter is referred to a disciplinary hearing copies of relevant records used throughout the process will be used as the basis of the investigation and the management case. Outcome of Referral to Occupational Health Underlying Medical Condition In the case of a serious underlying medical condition advice should be taken from the Human Resources Department and a meeting arranged with the employee to discuss the medical report from Occupational Health and agree any further action. One of the possible outcomes of this meeting is that it could develop into a long-term sickness issue in which case the guidelines below relating to Long Term Sickness Absence may be followed. The manager should consider the following options (either on a temporary or permanent basis) as a way of trying to resolve the situation: A change of working conditions (if practical, possible and available) e.g. reduction in hours, change of location, change of duties A reduction in responsibilities taking into account the advice which has been provided by Occupational Health and Human Resources A period of review (1-6 months) should be agreed and the employee advised that an improvement is expected within this period. Should the required improvement be achieved at the end of this review period, no further action is required other than continued monitoring. If the improvement is not achieved by the end of the review period the manager with advice from Human Resources could consider setting another review period or refer to the guidelines below relating to Long Term Sickness and section 5.15 of the policy Outcome of Referral to Occupational Health following Informal Meeting No Underlying Medical Problem If the Occupational Health Department cannot establish an underlying medical problem, a formal meeting (2 nd Review Meeting) should be arranged and clear expectations and specific time limited improvements should be documented with further monitoring Care should be taken to ensure that any temporary redeployment does not have an adverse effect on the planned return to the original post. In all prospective redeployment assistance should be sought from the Human Resources Department in identifying suitable alternative posts a review period agreed (usually between 1-6 months). The purpose of this meeting will be to discuss levels of absence; the advice received from Occupational Health and to advise the individual that their level of absence is not acceptable. Where applicable the subsequent stages after the 2 nd Review Meeting should then be followed.

Long Term Sickness Absence This refers to a situation where the employee has had a serious illness/injury and is likely to be away from work on a long-term basis or may never return. When the trigger point of continuous sickness absence of one month or over is met, contact arrangements must be discussed and agreed between the manager and the employee. It is essential that regular contact is maintained with employees during long-term sickness to maintain their morale and encourage them to return to duty as soon as possible. Depending on the nature of the illness and the personal circumstances, meetings will be arranged to take place at an agreed location e.g. the usual work base or at the employee's home. Should it not be possible to meet staff regularly, contact should be maintained by letter, or telephone. The frequency of this contact will vary depending on the nature of the illness, but should be in the range of 1-3 weeks. The purpose of these meetings/contact will be to: Discuss the employee s progress and any medical advice Discuss other related matters, which may give the employee concern, such as pay, pension, temporary injury, other benefits The Manager must keep a written record of the meeting. A letter confirming actions/improvements agreed will be issued to the employee who should sign and accept these actions, if they are in agreement. When the trigger point has been met, the line Manager should initiate a referral to the Occupational Health Department. It is requested that all management referrals to the Occupational Health Department be submitted on the Management Referral/Employee Consent Form (see Appendix 5). A completed management referral form by the referring manager should include: Personal details Employment record Sickness/absence record, including dates, reasons for absence and details of accident at work, if any Description of duties and of any relevant physical/mental aptitudes required (including a job description is helpful) Description of working environments

Any other relevant information that may help the Occupational Health Department to make an accurate assessment. Specific duties and sickness record must be identified by the managers prior to the employee attending the Occupational Health Department. On the Occupational Health form, it is advisable to list any questions you require specific replies to. Here are some examples of guidelines, which may be used or adapted, dependent on the circumstances: What is the likely return to work date for the employee? Do the employee's current health issues prevent him/her carrying out normal work requirements? Does the employee have previous or current health problems, which may incur further episodes of sickness absence? Does the employee's recent sickness absence relate to an on-going health issue? Will the employee's current health status merit ill health retirement? Would temporary/permanent modification of the employee's current job requirements expedite his/her return to work? Following the accepted period of convalescence for the employee's current health problem, will the employee be able to fulfil his/her normal work requirements without restrictions? Is the employee's existing health problem controlled sufficiently as to enable him/her to fulfil work requirements without supervision? Referral to the Occupational Health Department should take place as soon as possible after the appropriate trigger levels have been reached. There may be instances where a referral at this stage would not be appropriate or helpful, e.g. where a member of staff is undergoing medical treatment. Advice from the Occupational Health or Human Resources Department should be sought in these cases. It is essential to keep notes, recording any agreed actions, dates etc. It is also essential to handle all meetings with understanding and sensitivity. Upon receipt of the Occupational Health report, the line manager should ensure the medical advice received is discussed with the employee. Depending on the medical advice, it may be necessary to arrange a formal meeting at which the individual should be advised of their right to be accompanied by a member of their trade union/professional body or a fellow work colleague. At the meeting the following areas should be discussed: Further referral to Occupational Health Identify ways of supporting staff to return to work at the earliest opportunity Temporary change in working conditions on return to work Graduated return Discuss possible redeployment. 3

Discussion on early retirement if appropriate If the employee has paid into the pension scheme and is unfit to continue in any employment, applying for retirement on the grounds of ill health. Progression to dismissal on the ground of ill health. Returning to Work after Long-Term Sickness Absence If as a result of medical advice (doctor or Occupational Health) an employee is assessed as being fit to return to work after a period of long-term sickness absence, the manager should seek advice from the Occupational Health Department and Human Resources Department prior to their return to work. The manager should consider, in the light of the above advice and the needs of the service, whether the following options would be appropriate: (a) (b) (c) Returning to part-time hours on a temporary basis. Where this is short term and part of a planned return to full time/normal hours, employees should not lose pay, and full pay including enhancements should be maintained. Occupational Health approval must be given for a graduated return to work. Returning to part-time hours on a permanent basis. In these circumstances, the employee s pay would be amended to reflect the change in hours. Returning to a different post (i.e. Redeployment). In addition to the above options, the manager of the new post will need to agree the responsibilities and working hours with the employee and provide appropriate induction and training. The manager, Human Resources Department, the employee and the Occupational Health Department should review the situation. Where appropriate a programme covering a specific period of time for any graduated return to work should be agreed. The period of time will depend on the individual circumstances and relevant advice, but should not normally be longer than 1 month. At the end of the agreed programme for a graduated return, a further Occupational Health referral will be required if the employee is not able to return to their normal duties. A meeting should then be arranged between the manager, a Human Resources Representative and the employee to review the options in the light of medical advice.

APPENDIX 3 NHS SOUTHEND CLINICAL COMMISSIONING GROUP SICKNESS SELF CERTIFICATION FORM Notes: 1. You must complete this form and forward it to your manager who will retain it until your return to work interview is completed. 2. The form covers day(s) 1 7 of sickness. A fit note is required from day 8 onwards. 3. Further guidance is available in the CCG s Sickness Absence Policy and Procedures. 4. This information may be held on computer. Section 1: Self Certificate Full Name (in capitals) D.O.B Home Address Job Title Workbase First day of sickness (including a non-working day) Last date of sickness (including a non-working day) Actual number of working days lost Reason for Absence Did you consult a GP during this sickness absence? If yes, please detail the date, name and address. I declare that the information given is true to the best of my knowledge. I understand that false information may result in disciplinary action and/or loss of sick pay. Signature Date

APPENDIX 4 NHS SOUTHEND CLINICAL COMMISSIONING GROUP EMPLOYEE RETURN TO WORK INTERVIEW FORM FOR ALL SICKNESS ABSENCE To be completed by the manager with the individual on the 1 st day back at work or as soon as reasonably possible. Section One Employee Details Full Name (in capitals) Job Title Workbase Section Two Absence Details First day of sickness (including a non-working day) Last date of sickness (including a non-working day) Number of working days absent Reason for Absence Yes No Was correct notification of absence received? (If not detail why in the comments section) Did the employee consult a doctor or attend hospital? (If yes detail in the comments section) If the absence was due to an injury at work was an incident form completed? Is the absence due to a Road Accident (if so payroll need to be informed) Does the employee have or suffer from a disability? (If yes detail in the comments section) Is there any suggestion that factors at work may have caused or contributed to the absence? (If so details the factors and the action agreed to support the employee in the comments section) Is the absence part of an overall pattern? (If yes please detail the actions agreed in the comments section) Comments (please continue on a separate sheet and attach to this form if necessary): Employees Signature:.. Manager s Signature:. Date: Date:...

APPENDIX 5 OCCUPATIONAL HEALTH MANAGEMENT REFERRAL FORM NHS SOUTHEND HOSPITALS UNIVERSITY FOUNDATION TRUST OCCUPATIONAL HEALTH SERVICE Please Print Name of Employee: Address: Ward/Department: Position: Referring Manager: Name: Work Address: MANAGEMENT REFERRAL PROFORMA DOB: Tel No Work: Tel No Home: Tel No Work: AGREEMENT TO BE ASSESSED BY THE OCCUPATIONAL HEALTH SERVICE AND CONSENT TO DISCLOSE INFORMATION I confirm that I understand the reason why I have been referred by my manager to be assessed in the Occupational Health Service and agree to be assessed by the Occupational Health Nurse Adviser or Occupational Health Physician. I confirm that I have received and read a copy of the Management Referral Form I understand that at the end of the assessment, a report will be sent to my manager and copies sent to my General Practitioner and myself. The report will not contain medical facts without my specific permission. Signed Employee Date All referrals by Management must include the following 1. Completion of this form 2. Employee s written consent (see attached) 3. Job description to include role and job tasks 4. Sickness Absence record for the previous two years.

5. Please advise the employee to bring a list of any medication taken and the dosage, when they attend the Occupational Health Service The Manager seeks clarification on the following. Tick boxes as appropriate The employee s sickness absence is above the accepted level, therefore I seek clarification whether there is an underlying significant medical factor. Does the employee s health status currently, or is it likely in the future, to fall under the Disability Discrimination Act if so, please indicate if reasonable workplace adjustment is, or will be required Does the employee require modification to his/her work if so, please specify (to include time-scale) Will a graded return to work be necessary for this employee, if yes, please indicate time scales Will further medical information be required prior to the outcome of the assessment and availability of recommendations Will the employee s current problem merit application for Ill Health Retirement. Please indicate if known, when the employee is expected to return to work Will a review appointment in the Occupational Health Service be required, if so please give date and time. To assist the Occupational Health Service, please tick the appropriate box Please give an overview with respect to the reason for referral, which should include any physical, mental, behavioural or dependency problems. If it is necessary for you to give further specific information, please attach a letter with further details. Managers Signature Date \Occupational Health Service\manref1a\OCTOBER2001 Amended March 2002/June 2002/Aug 2002/Jan 2003/Jan 2004/Jan 2005

APPENDIX 6 SICKNESS ABSENCE RETURN Team/ Department/ Base NHS SOUTHEND CCG - CONFIDENTIAL Month Ending: Name Dates of Sickness Absence Certificate Self cert or Medical Long Term Persistent Short Term Trigger point reached Management action to date ATTACH ALL RELEVENT MEDICAL/SELF CERTIFICATION FORMS ENSURING DATES ON THE CERTIFICATE CORRESPOND WITH THE POSITIVE RETURN. To be completed by the Manager who completes the Positive Returns and sent to Human Resources on the first day of month (for previous month) Signed Departmental Manager: Print Name: Date Sickness Absence Policy 27 Policy Date: February 2015 Review Date: February 2017