Managing Sickness Absence Policy

SH HR 54 Summary: Keywords (minimum of 5): (To assist policy search engine) Target Audience: This policy sets out the Trust s standards and expectations on how managers and staff manage sickness absence. This is considered a binding document within staff terms and conditions of service. Sickness, Absence, Support, Equality Act, Disability, Fit Note, Frequent Short Term (Sporadic) Sickness Absence, Long Term Sickness Absence, Return to Work. All staff employed by Southern Health NHS Foundation Trust. Next Review Date: October 2018 Approved and Ratified by: Staffside Policy Scrutiny Group Joint Consultative and Negotiating Committee Date of meeting: 22 December 2014 20 January 2015 Date issued: Author: Sponsor: Rita Hawkshaw- HR Manager Best Practice Sandra Grant Director of People and Communications 1

Version Control Change Record Date Author Version Section Reason for Change Feb 2014 Jan 2015 Rita Hawkshaw, HR Manager- Best Practice Staffside Policy Scrutiny Group 2 5.8 Throughout General update of terminology. General alignment of timelines and process with other workforce (employment relations) policies and procedures. 4.3 Added staff s responsibility to provide consecutive fit notes as soon as they receive them. Throughout Minor amendments in wording throughout to enable management of sickness of an individual characterised by both short term and long term sickness absence. 3 Throughout Increased focus on early intervention in terms of support and management to reduce the likelihood of short term absences becoming long term. 16/3/17 Review date extended from April to August 2017 4/8/17 Review date extended to December2017 9/11/17 Review date extended to March 2018 2/2/18 Review date extended to October 2018 Reviewers/Contributors Name Position Version Reviewed & Date Liz Skeats Head of HR Integrated Community Services V 1, December 2012 Human Resources Team, Staff Side, Joint Consultative and Negotiating Committee, V 1, December 2012 and Local Counter Fraud Specialists HR Team, Staffside Policy Scrutiny Group and Joint Consultative and Negotiating Committee V 2, November 2013 February 2014 Rita Hawkshaw HR Manager Best Practice V 2, November 2013 HR Team, Staffside Policy Scrutiny Group and Joint Consultative and Negotiating V 3, December 2014 Committee 2

Contents Page 1. Introduction 4 2. Scope 4 3. Definitions 4 4. Roles and Responsibilities 5 5. Policy 9 6. Monitoring Compliance 10 7. Policy Review 10 8. Associated Documents 11 9. Supporting References 11 A1. Equality Impact Analysis Screening Tool 12 3

1. Introduction 1.1. Southern Health NHS Foundation Trust (the Trust ) aims to provide a safe and healthy work environment for its staff, applying appropriate measures to manage sickness to maximise the possibility to attend the workplace and minimise the impact of absence on service delivery. 1.2. This policy is designed to enable staff to maximise attendance and to encourage return to work as soon as possible following periods of absence enabling staff, wherever possible, to fulfill their contractual obligations. 1.3. This policy should be viewed in conjunction with the Managing Sickness Absence Procedure and the Manager s Sickness Absence Toolkit, which provides clear guidance on how to implement these principles. 1.4 Information and guidance is also available in the Managing Stress and Enhancing Wellbeing Policy and Procedure. 2. Scope 2.1. This policy and its associated procedures will apply to all staff directly employed by the Trust. This also includes trainees, secondees and staff on honorary contracts or on joint contracts with the Trust and another employer. 3. Definitions For the purposes of the and Procedure the following definitions apply: 3.1. Sickness 3.1.1. The Trust recognises that there are many different causes of absence from work. However, sickness will be defined as an illness, injury or health problem experienced directly by the member of staff employed by the Trust or falling within one of the categories outlined within the paragraph 2.1. 3.1.2. This policy does not differentiate between genuine and non-genuine absence, as it is assumed that every episode of sickness reported by a member of staff is genuine. All sickness absence will contribute to monitoring under this and Procedure, unless the policy and procedure specifically excludes it. 3.2. Short Term Sickness Absence Short term sickness absence is defined as an episode of sickness absence, which could be a few hours, one single day, or a number of continuous days not exceeding twenty-one (21) days. 4

3.3. Long Term Sickness Absence Long term episode of sickness absence is classified as sickness absence for a continuous period of twenty-one (21) days or more; or recurrent periods of time away due to the same health problem. 4. Roles and responsibilities 4.1. Trust 4.1.1. The Trust will: Operate an occupational sick pay scheme which provides sick pay to staff that are genuinely unfit for work in accordance with their service entitlements. It is a condition of this scheme that staff do nothing to aggravate their condition and prejudice their return to work. Provide an Occupational Health service to which staff may be referred to enable professional medical opinion or advice may be obtained to facilitate a return to work or other decisions relevant to employment. Monitor levels of sickness/absence and make every effort to reduce these levels by investigating any underlying causes of high levels of sickness within jobs or job groups attributable to, for example, stress, high accident rates or health and safety hazards. Provide a free, confidential and accessible counselling and advisory service to all staff (Employee Assistance Programme (EAP)). Identify staff whose absence record due to sickness is excessive and investigate the circumstances, ensuring that all possible steps are taken to assist the member of staff to improve their attendance record and support a return to work. Ensure working conditions are as safe and healthy as possible and statutory requirements are met. Ensure that all staff are dealt with fairly, consistently and confidentially in accordance with the Trusts agreed policy and procedures for managing sickness absence. Ensure all staff are aware of the procedures for reporting sickness absence and the standards of attendance, which are expected of them. Ensure all staff whose attendance is of concern are given the opportunity and support to improve. Ensure all those involved in managing sickness absence receive training in the application of this policy and are fully conversant with their responsibilities with this policy and associated procedures. 4.2. Managers 4.2.1. Managers must: Have robust sickness absence reporting procedures in place and communicate these to all staff. Apply the guidance contained within this document in a consistent, equitable and supportive manner. 5

Make informed decisions when managing a staff member s sickness absence, based on the Human Resources and medical advice provided, available evidence and the needs of the service. Maintain, on a daily basis, accurate and up to date records of each employee s absence. To ensure payroll and workforce has accurate absence information. Maintain the e-rostering system to accurately reflect staff attendance and respond to the system warnings when staff reaches sickness absence triggers. Agree a plan of regular (e.g. weekly) telephone contact with staff whilst they are on sick leave. Employ a principle of actively planning, with the member of staff, for their return work from the start of any absence and keep this under review. Carry out Return to Work interviews after each occasion of absence, including half days and one day absences, within twenty-four (24) hours of a return, or as soon as reasonably practicable. To carry out a full and fair assessment of the ability of their service to accommodate a phased return to work within a GP s Fit Note or Occupational Health report. Check that there have not been any alterations on the Fit Note and retain these on the member of staff s local file. Show commitment to the health, safety and welfare of those in their teams, both physical and psychological. Consult with Human Resources before taking formal action related to sickness absence and the management of a disability Seek clear, medical advice and medical evidence to assist in any decision making processes concerning a staff member s health and their employment. Managers must inform the member of staff that an occupational health referral is being arranged. Involve the Occupational Health services especially in cases of stress/depressions, anxiety, work related incidents and musculoskeletal related illness. Actively signpost the EAP service if staff are showing signs of distress/stress or anxiety. When a member of staff or a team indicate concerns about psychological wellbeing e.g. rising levels of stress, coordinate a response and refer to Trust s Managing Stress and Enhancing Wellbeing Policy and Procedure. Constructively challenge occupational health reports that do not provide sufficient guidance relating to a clear way forward for the member of staff. Agree an action plan, with reasonable adjustments, to minimise and manage any potential sickness absence, if sickness absence has been raised as a concern for a new member of staff. 6

Maintain their expertise in the implementation and application of this policy. Communicate this policy to all their staff and include as standard as part of the induction for new starters. Be aware of the cost of absence for staff they manage i.e. administration cost, replacement costs and salary costs. Managers should not expect staff to work from home while staff are on sick leave. Manager should remind staff that they must not undertake any secondary employment whilst claiming sick leave. Managers must inform the Trust s Local Counter Fraud Specialists where they have a suspicion that any member of staff is undertaking secondary employment whilst claiming sick leave, or where there has been any unauthorised alteration to a Fit Note. 4.3. Staff 4.3.1. Staff must: In accordance with staffs contractual obligation, make every effort to attend work regularly. Be aware of the standards of attendance expected by the Trust Understand the need to maintain attendance at work and the effect of absence on the Trusts ability to provide consistent, high quality care to service users. Familiarise themselves and adhere to the sickness absence reporting process for their service. Let their line manager know about any illness or condition, that may affect them at work. Follow the terms of this policy and to be aware of other related policies. Engage with the line manager (or delegate) once a week during periods of sickness absence, unless in exceptional circumstances. Send in their fit notes to their line manager as soon as they receive them. If the fit note has expired, and the individual is still unfit to return to work, they must provide a further fit note covering consecutive days. Staff must contact their line manager on their last day of sickness to discuss their return to work plan To complete, with their manager, a Return to Work interview within 24 hours of each episode of sickness absence, within twenty-four (24) hours of a return, or as soon as reasonably practicable. Staff are expected to co-operate and participate in Occupational Health appointments and any other appointments in relation to their wellbeing. Staff should make use of the 24 hour, confidential counselling and advisory service, which is free of charge, should they start to experience high levels of stress or anxiety for any reason. 7

Staff have the right to see referral documentation in relation to their Occupational Health report. Staff should not work from home when they are on sick leave. Staff should not work for another employer whilst claiming sick leave from the Trust. Any contravention of this will be treated as fraud against the Trust. The Trust s Local Counter Fraud Specialists will be notified and this may be considered as gross misconduct in accordance with the Disciplinary Policy and Procedure which could lead to summary dismissal. In exceptional circumstances this may be permitted if staff have obtained written agreement from their Line Manager in advance. 4.4. Human Resources 4.4.1. The Director of Workforce, Development and Communications has delegated responsibility from the Board to ensure this Policy and associated procedure is properly implemented and monitored. 4.4.2. The Human Resources Team has a responsibility to ensure that the policy is followed, fairly and consistently. Their duties will involve: Actively engaging with services to minimise the impact of sickness absence on service delivery. Ensuring that managers are held to account for managing attendance effectively. Providing training and guidance to managers on this policy and associated procedure, in agreement with, and supported by, the Trade Unions/Professional Bodies. Monitoring that all new staff receive pre-employment checks by Occupational Health before contracts of employment are issued. Providing regular reports on sickness absence to Management Teams, the Trust, Strategic Workforce Committee and Trust Board. 4.5. Occupational Health 4.5.1. Occupational Health will: 4.6. Trade Unions Work in partnership with the Trust/managers and staff to improve attendance and performance. Undertake an impartial and objective assessment of the reasons for absence (medical and non-medical). Provide advice on measures which will facilitate attendance. Provide advice to enable managers to make informed decisions. Support managers in making decisions. 4.6.1 Trade Union representatives have an important role to play in providing advice, support and, if required, representation to their members and working in partnership with managers and the Human Resources Team in 8

5. Policy looking to ensure that the Trust s and Procedure is applied reasonably and fairly. 5.1. The Trust will apply a consistent approach to the management of sickness absence. This will include the application of both informal and formal processes by managers as outlined in the associated procedures. 5.2. As part of the Informal Sickness Absence Monitoring process, Line managers should manage each sickness absence individually completing:- a Return to Work Plan where appropriate to support an individual s return to work; and a mandatory Return to Work Interview with the member of staff upon their return after each occasion of short term sickness absence. 5.3. The Trust has set frequent short term (sporadic) sickness absence triggers, before the trigger is reached the line manager will monitor informally (see Section 5.2). The following will trigger the formal procedure: Three (3 )occasions of absence over a six (6) month period, Five (5) occasions of absence within a rolling twelve (12) month period. 5.4. The long term sickness absence trigger is twenty-one (21) days of consecutive absence; this will trigger the informal procedure. If a period of absence continues into a third month (i.e. duration of over 2 months) monitoring should proceed on a formal basis. 5.5. An absence of twenty-one (21) consecutive days triggers the need for consideration of a management referral to Occupation Health. 5.6. The identification of stress/depressions, anxiety, work related incidents and musculo-skeletal related illness triggers the need for consideration of a management referral to Occupational Health and the manager should direct the member of staff to the Employee Assistance Programme (EAP) provider. 5.7. Special consideration will be given to those staff who receive protection under the Equality Act 2010. Each case will be treated on its own merits and individual circumstances. Guidance from a Human Resources professional should be sought. 5.8. When a member of staff becomes pregnant, any sickness which is directly related to the pregnancy (supported by medical advice) will not be included when monitoring sickness absence. 5.9. It is essential that the manager is able to demonstrate that a fair procedure has been followed. If after investigation it appears that the absence was not sickness related the absence may be dealt with in accordance with the Trust s Disciplinary Policy and Procedure. 5.10. When a member of staff has a period of absence the line manager will follow the Managing Sickness Absence Procedure. This includes an informal process and, if the absence continues, the implementation of the formal 9

procedure. Stage One includes formal monitoring and review and Stage Two involves a further review in which a potential outcome is dismissal. 5.11. Any member of staff who is being monitored under the formal stages of this policy will not be permitted to work additional shifts/hours, including Bank. In addition, a review of any secondary employment arrangements should be undertaken as it could impact on the substantive role and a decision made as to whether those arrangements can continue under the circumstances. If necessary the member of staff s attention should be drawn to the Working Time Regulations (1998). 5.12. These formal stages should be constructive and used to reflect on the actions taken to date to support the member of staff s return to work and the likelihood of a successful return based on professional medical advice. 5.13. Following a referral to Occupational Health or a GP Fit note, a phased return to work may be proposed. Service needs as well as the individual needs and medical advice must be considered when accommodating a phased return to work period. A phased return to work period would not normally be expected to exceed 4 weeks or expected to exceed a total of eight (8) weeks in each twelve month rolling year. 5.14. The percentage of leave accrued whilst sick may be used as part of a graduated return to work when necessary. 5.15. Managers and staff have an obligation to fulfil their contractual obligations by applying the and Procedure consistently and fairly. Staff have an obligation to adhere to this policy and associated procedures and to fulfil their contractual obligation by making themselves available to work. 6. Monitoring compliance 6.1. Human Resources (HR) will monitor and analyse data on a quarterly basis. HR will use the data to monitor the implementation of the policy and management of cases. In addition, the data will be collated and analysed for information regarding the reasons for absences, by specifically reviewing patterns and frequency of absences occurring. 6.2. Subsequently, the data will be used to inform and improve policies, as well as provide recommendations for improving working practices. HR will provide relevant reports, based on this data, to the Strategic Workforce Committee (SWC), Executive Board and the Joint Consultative and Negotiating Committee (JCNC). 7. Policy review 7.1. The policy and procedures contained within these documents will be in place for three years, following approval of a review and amendments. An earlier review can take place should exceptional circumstances arise resulting from this policy; in whole or in part, being insufficient for the purpose and/or if there are legislative changes. 10

8. Associated documents Bullying and Harassment Policy and Procedure Disciplinary Policy and Procedure Equality, Diversity and Human Rights Policy Grievance Policy and Procedure Managing Performance (Capability) Policy and Procedure Managing Stress and Enhancing Wellbeing Policy and Procedure Workforce Investigation Policy and Procedure Equality Act 2010 Managing Attendance and Employee Turnover (ACAS, 2005) 9. Supporting references www.acas.gov.uk Advisory, Conciliation and Arbitration Service (ACAS) promotes employment relations and HR excellence. www.hse.gov.uk/stress/standards/index.htm Health and Safety Executive s (HSE) website containing information on work related stress and HSE Management Standards. 11

APPENDIX 1 Equality impact analysis screening tool Equality Impact Assessment (or Equality Analysis ) is a process of systematically analysing a new or existing policy/practice or service to identify what impact or likely impact it will have on protected groups. It involves using equality information, and the results of engagement with protected groups and others, to understand the actual effect or the potential effect of your functions, policies or decisions. The form is a written record that demonstrates that you have shown due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations with respect to the characteristics protected by equality law. Name of policy/service/project/plan: and Procedure Policy Number: SH HR 54 Department: Lead officer for assessment: Date Assessment Carried Out: January 2013 Human Resources Rita Hawkshaw: HR Best Practice Lead & Ricky Somal: E&D Lead 1. Identify the aims of the policy and how it is implemented. Key questions Answers / Notes Briefly describe purpose of the policy including How the policy is delivered and by whom Intended outcomes The aim of the Managing Sickness Absence Policy is to provide guidance on how to manage sickness absence in a fair and consistent way across the Trust. This policy and procedure is based on best practice guidelines laid down by the Department of Health Managing Sickness Absence in the NHS - and is designed to promote a consistent approach to managing sickness absence within both service areas. It also incorporates ACAS Guidance on best practice for managing attendance. The policy commits to providing a healthy and safe work environment for everyone and supporting the rehabilitation of individuals with longer term ill health. 2. Consideration of available data, research and information Monitoring data and other information involves using equality information, and the results of engagement with protected groups and others, to understand the actual effect or the potential effect of your functions, policies or decisions. It can help you to identify practical steps to tackle any negative effects or discrimination, to advance equality and to foster good relations. Please consider the availability of the following as potential sources: 12

Demographic data and other statistics, including census findings Recent research findings (local and national) Results from consultation or engagement you have undertaken Service user monitoring data Information from relevant groups or agencies, for example trade unions and voluntary/community organisations Analysis of records of enquiries about your service, or complaints or compliments about them Recommendations of external inspections or audit reports Key questions 2.1 What is the equalities profile of the team delivering the service/policy? Data, research and information that you can refer to The Equality and Diversity team will report on Workforce data on an annual basis. 2.2 What equalities training have staff received? 2.3 What is the equalities profile of service users? All Trust staff have a requirement to undertake Equality and Diversity training as part of Organisational Induction (Respect and Values) and E-Assessment The Trust Equality and Diversity team report on Trust patient equality data profiling on an annual basis 2.4 What other data do you have in terms of service users or staff? (e.g. results of customer satisfaction surveys, consultation findings). Are there any gaps? Managing sickness absence in the public sector, HSE, 2004 recommends: Accurate data collection on sickness absence: Systems in place to ensure that, at every level, staff are aware of their responsibilities to submit injury, illness and sickness absence data Monitoring and analysis of data takes place at organisational and team level so that trends can be identified and addressed Monitoring/identification of costs of absences Setting of targets for reduction. Establish departmental baselines. The Trust is preparing to implement the Equality Delivery System which will allow a robust examination of Trust performance on Equality, Diversity and Human Rights. This will be based on 4 key objectives that include: 1. Better health outcomes for all 2. Improved patient access and experience 3. Empowered, engaged and included staff 4. Inclusive leadership 13

Targets and milestones to achieving them to be agreed in conjunction with employee representatives (Staff Side, etc.). Implementation of measures to reduce ill health, injury and sickness absence. Identify key areas from data sources. Put in place procedures for the rehabilitation of sick or injured employees to get them back to work as soon as possible. Develop and implement measures (with employee involvement) with built in evaluation aspects. Arrangements in place for monitoring and evaluating success of measures in meeting targets. Systems in place for checking against agreed milestones. The policy and procedure will embrace the guidance commended by: ACAS Code of Practice 2009, Employment Act 2002, Employment Act 2002 (Disputes Resolution) Regulations 2004, Employment Rights Act 1996, ERA 1999 & ERA 2004, Disability Discrimination Act 1995, Agenda for Change, Information & Consultation of Employees Regulations 2004, Trade Union & Labour Relations (Consolidation Act 1992, NHS Pension Scheme Regulations (2003 and 2008), Human Rights Act 1998 & Equality Act 2010. 2.5 What internal engagement or consultation has been undertaken as part of this EIA and with whom? What were the results? Service users/carers/staff 2.6 What external engagement or consultation has been undertaken as part of this EIA and with whom? What were the results? General Public/Commissioners/Local Authority/Voluntary Organisations 14

Age Positive impact (including examples of what the policy/service has done to promote equality) The Policy and Procedure will ensure fair and equitable management of sickness absence. To ensure appropriate managers receive support and appropriate training to reduce sickness absence. Negative Impact Stereotypes about the level of attendance of older workers are not objective and it is not appropriate to make assumptions about sickness absence based on these factors. Older workers have a greater potential for the impact of ill health or long term health issues, and may therefore fall into the processes of the policy. In such cases despite the raised awareness the inherent cultural prejudice/perception/impact of age in the workforce and the potential for limited access to case management resources the outcome could be a failure to apply reasonable adjustments and redeployment processes. Action Plan to address negative impact Actions to overcome problem/barrier The Trust will gather data to evidence its compliance with the Equality and Diversity. The Diversity Scorecard will monitor trust sickness absence data by protected characteristics and will be published annually by 31 st January. Resources required ESR Training Communication Responsibility Human Resources Learning, Education and Development Communications Workforce Annual Reports Target date On-going 15

Disability The Policy and Procedure will ensure sickness absence is managed fairly by managers, following Occupational Health Advice when required including making reasonable adjustments when necessary. Stereotypes about the level of attendance of employees with disabilities are not objective and it is not appropriate to make assumptions about sickness absence based on these factors. Managers will require support and guidance to pay due regard to the impact of disability in sickness absence and having the awareness of reasonable adjustments. ESR Training Communication Human Resources Learning, Education and Development Communications Workforce Annual Reports On-going The importance of making reasonable adjustments for employees with disabilities has been reflected in the policy, but such adjustments will only be made on the basis of Occupational Health and/or other expert medical advice. Gender Reassignment Absence relating to gender reassignment may require specific expertise 16

and support over and above standard procedures Marriage and Civil Partnership Pregnancy and Maternity When a member of staff becomes pregnant, any sickness which is directly related to the pregnancy (supported by medical advice) will not be included when monitoring sickness absence. Race Religion or Belief Some BME groups face a higher risk of certain health conditions which may affect attendance. Specific religious rituals/practices e.g. Ramadan/fasting may potentially affect sickness absence Such cases can be managed through Human Resources and Equality and Diversity team in accordance with 17

Sex Sexual Orientation The use of sickness and absence entitlement in lieu of annual leave etc. could have a detrimental effect on sickness monitoring figures. This could affect male or female carers. Actions need to be identified to promote health and alleviate the effects of gender specific conditions including certain cancers, effects of pregnancy and menopause, domestic violence etc. that can cause absence. Health inequality data identifies that men are less likely to access health and well-being initiatives and mental health support annual leave policy regarding cultural observance This should be managed through the Flexible Working, Annual Leave Policy and parental leave should also be considered Workplace Health and Well- Being. 18