SICKNESS ABSENCE POLICY AND PROCEDURE

SICKNESS ABSENCE POLICY AND PROCEDURE Last Review Date September 2017 Approving Body Executive Committee Date of Approval 4 th October 2017 Date of Implementation 4 th October 2017 Next Review Date September 2020 Review Responsibility Associate Director of HR & Corporate Services Version 0.3 Page 1 of 25

REVISIONS/AMENDMENTS SINCE LAST VERSION Date of Review Amendment Details July 2013 The original PCT document has been revised to: Reflect the Clinical Commissioning Group Establishment Reflect the Clinical Commissioning Group structure Align to the Clinical Commissioning Group Human Resources and Organisational Development Policies and procedures February 2017 Section included to address the management of intermittent related absence Policy cross referenced with the Domestic Violence Policy September 2017 Amended to reflect new organisational structure Page 2 of 25

CONTENTS SECTION A POLICY Page 1. Policy Statement, Aims and Objectives 4 2. Legislation and Guidance 4 3. Scope 5 4. Accountabilities and Responsibilities 5 5. Dissemination, Training and Review 7 SECTION B PROCEDURE 1. Notification of Sickness Absence 9 2. Communication During Sickness Absence 9 3. Return to Work Interview 10 4. Domestic/Personal Issues/Work Related Stress 11 5. Monitoring and Recording of Sickness Absence 12 6. Managing Sickness 13 7. Occupational Sickness Pay Entitlements 20 8. Working Whilst Sick 21 9. Third Party Compensation 21 10. Medical Evidence 21 11. Workplace Assessments 221 12. Terms and Conditions of Service During Sickness 22 13. Access to Work Assistance 22 Appendices Appendix 1 Sickness Absence Return to Work Form Page 3 of 25

SECTION A POLICY 1. Policy Statement, Aims and Objectives 1.1. NHS Doncaster Clinical Commissioning Group (CCG) is committed to being a caring employer and places a high priority on the welfare of its employees. It is recognised that from time to time employees will suffer ill health and that the management of sickness absence should be handled sensitively. 1.2. The CCG seeks to lower sickness absence rates to the lowest level whilst ensuring employees are supported during periods of ill health. It is acknowledged that this requires a high degree of management commitment. 1.3. The CCG recognises that some employees may have disabilities or long term conditions which may impact upon their attendance at work either on a permanent, temporary, frequent or infrequent basis. Employees are encouraged to disclose the nature of the issues impacting on them in order that the management of their attendance at work is handled appropriately and sensitively. Management of these circumstances will require individual consideration and the procedure contained within this policy may be adjusted where appropriate. 1.4. Employees will have the right to be represented by a recognised Trade Union/Professional Organisation Representative or be accompanied by a fellow employee at any formal meeting held relating to sickness absence records. In exceptional circumstances a family member/carer may accompany the employee to meetings to provide support. Managers will be supported by a member of the Human Resources Department. A collaborative style of managing the employee s sickness absence will be encouraged. 1.5. The development of this policy: Provides standards for the management of sickness absence Ensures fairness and equality of treatment of employees Minimises disruption to work Ensures the use of the Electronic Staff Record (ESR) System to collect and report information on sickness absence To keep absence levels within the CCG to below 5% 1.4 Sickness absence figures are reported on a quarterly basis to the Governing Body of the CCG. 2. Legislation and Guidance 2.1. The following legislation and guidance has been taken into consideration in the development of this procedural document. Page 4 of 25

Disability Discrimination Acts 1995 and 2005 NHS Staff Council National Terms and Conditions of Employment 3. Scope 3.1 This policy applies to those members of staff that are directly employed by NHS Doncaster CCG and for whom NHS Doncaster CCG has legal responsibility. For those staff covered by a letter of authority / honorary contract or work experience this policy is also applicable whilst undertaking duties on behalf of NHS Doncaster CCG or working on NHS Doncaster CCG premises and forms part of their arrangements with NHS Doncaster CCG. As part of good employment practice, agency workers are also required to abide by NHS Doncaster CCG policies and procedures, as appropriate, to ensure their health, safety and welfare whilst undertaking work for NHS Doncaster CCG. 4. Accountabilities and Responsibilities 4.1 Overall accountability for ensuring as far as reasonably practicable that the CCG provides a healthy and safe working environment, compliance with health and safety requirements, reporting of injuries and dangerous occurrences (RIDDOR), and other legislation lies with the Chief Officer. Responsibility is delegated to the following: Associate Director of HR & Corporate Services Has delegated responsibility for: Maintaining an overview of the corporate ratification and governance process associated with the policy. Leading the development, implementation and review of the policy. Monitoring and reporting sickness absence on a quarterly basis Ensuring line managers are taking appropriate action where an employee reaches a trigger point for absence monitoring Providing support and advice to employees Providing support and advice to line managers Page 5 of 25

Occupational Health Services Has delegated responsibility for: Assessing employees fitness during periods of sickness absence or where there is a cause for concern Advising line managers Advising where employees are unable to return to work due to health reasons or of suitability for ill health retirement Appointing Officers Have delegated responsibility for: Ensuring that all employees are given the appropriate support with regard to health problems and will encourage them to seek assurance when necessary. Recognising situation at an early stage that may lead to health problems. Identifying any sources of help for employees with health problems, including ensuring staff are aware of their right to refer themselves directly to Occupational Health and of the availability of the counselling and fast track physiotherapy service. Making every reasonable effort to consider reasonable adjustments to an employee s working environment/duties and responsibilities and to find suitable alternative employment or to provide reasonable retraining opportunities wherever possible where an employee, due to health reasons, is prevented from carrying out the duties and responsibilities of their original post. This should be undertaken in accordance with the Management of Change Policy. Considering the options available to employees under the Flexible Working Policy that may help them to manage long term health conditions or disabilities whilst enabling them to fulfil their contractual obligations. Monitoring and managing absence on a day to day basis and of ensuring that reporting and recording procedures are being followed. Ensuring that employees are made aware that misrepresentation of sickness absence may be considered as fraud which could result in disciplinary action including dismissal. Page 6 of 25

Staff Side Have responsibility for: Providing advice/representation to employees who are members of a recognised Trade Union. All Staff Have delegated responsibility for: Ensuring they are familiar with the policy and procedure and are fully compliant with it. Ensuring that absence due to sickness is reported within one hour of normal start time or as soon as is reasonable practicable. Taking appropriate steps to remedy any health problem to enable them to return to work as soon as possible. 5. Dissemination, Training and Review 5.1. Dissemination 5.1.1. The effective implementation of this procedural document will support openness and transparency. NHS Doncaster CCG will: Ensure all staff and stakeholders have access to a copy of this procedural document via the organisation s website. Ensure that relevant training programmes raise and sustain awareness of the importance of effective sickness absence management. 5.1.2. This procedural document is located on the CCG website. A set of hard copy Procedural Document Manuals are held by the Governance Team for business continuity purposes and all procedural documents are available via the organisation s website. Staff are notified by email of new or updated procedural documents. 5.2. Training 5.2.1. All staff will be offered relevant training commensurate with their duties and responsibilities. Staff requiring support should speak to their line manager in the first instance. Support may also be obtained through their HR Department. 5.3. Review 5.3.1. As part of its development, this procedural document and its impact on staff, patients and the public has been reviewed in line with NHS Doncaster CCG s Equality Duties. The purpose of the assessment is to identify and if possible Page 7 of 25

remove any disproportionate adverse impact on employees, patients and the public on the grounds of the protected characteristics under the Equality Act. 5.3.2. The procedural document will be reviewed every three years, and in accordance with the following on an as and when required basis: Legislatives changes Good practice guidelines Case Law Significant incidents reported New vulnerabilities identified Changes to organisational infrastructure Changes in practice 5.3.3. Procedural document management will be performance monitored to ensure that procedural documents are in-date and relevant to the core business of the CCG. The results will be published in the regular Governance Reports. Page 8 of 25

SECTION B PROCEDURE 1. Notification of Sickness Absence 1.1. An employee must report their absence due to sickness within one hour of their normal start time, or as soon as is reasonably possible, in person. In exceptional circumstances where an employee is unable to report their absence personally an individual acting on their behalf may report the absence. 1.2. Employees should report their sickness absence to their line manager by telephone. In exceptional circumstances the employee may use other forms of communication. If the line manager is unavailable to take the telephone call the employee should speak to another manager of the same or higher seniority. The employee will be required to give the reason for their sickness absence and give an indication of the likely length of absence. 1.3. The line manager should notify the Sickness Absence Administrator of the absence. The Sickness Absence Administrator will enter the details in to the Electronic Staff Record. 2. Communication during Sickness Absence 2.1. Communication with employees during periods of sickness absence is a line management responsibility. Communication should include, if appropriate, handover of any work that is due to be completed or requires action during the expected sickness absence period. 2.2. Line managers are required to maintain effective and relevant communication either verbally or in writing on at least a 4 weekly basis during periods of longer term sickness absence. Line managers should keep a brief summary of verbal discussions. It is recognised that formal written communication may be required to confirm the discussion and outcomes at meetings and/or to agree an action plan. 2.3. It is important to recognise individual circumstances may impact on the ability of the employee to maintain communication, for example, if they are hospitalised/undergoing treatment. 2.4. All written communication should be copied to Human Resources and the employee s trade union/professional organisation representative, if one is involved. On occasion it may be relevant to communicate with an employee s partner/relative/carer. The employee s right to confidentiality should be maintained unless they or others may be at risk. 2.5. Where any periods of sickness absence are related to domestic violence or if the line manager believes the employee is at risk of domestic violence, the Page 9 of 25

guidance within the Domestic Violence Policy should be followed and advice sought from Human Resources and/or the Chief Nurse. 2.6. Where communication from a partner/relative/carer is received on behalf of the employee and the inference is that communication with the employee is not welcomed, this should be confirmed in writing to the employee. The opportunity for the employee to contact the line manager should remain open during these instances. The employee should be asked to provide a named contact for correspondence. 2.7. Whilst it is recognised that services will have to be covered it is not appropriate for a line manager to ask an employee to make contact on each day of absence if the employee has indicated a likely period of absence. If, however, the employee expects to be absent for a period longer than originally communicated they must notify their line manager as soon as possible and no longer than one hour after their normal start time on the day that they would have been returning to work. 2.8. Where an employee is absent for more than seven calendar days they must submit a fitness to work certificate from their GP. If the employee is hospitalised the certificate will be issued by the medical staff of the hospital. Medical certification must be sent promptly to the line manager. The line manager should forward the medical certificate to the Sickness Absence Administrator who will ensure that the Electronic Staff Record System is updated. The medical certificate will then be forwarded to Human Resources for retention on the employee s personal file. 2.9. Where an employee has reached a trigger point for formal monitoring of their attendance or where there is cause to question the validity of the period of sickness absence the CCG reserves the right to refer the employee to Occupational Health and if required seek further information from the employee s GP. Any costs associated with this will be met by the CCG. 2.10. Where an employee without good and acceptable reason fails to report their absence due to sickness or fails to submit medical certificates on time this may result in a loss of pay as the employee will be regarded as absent without authorised leave. If after further discussion there appears to be no justifiable reason for the absence disciplinary proceedings may apply. It is recognised that in extreme circumstances it may not be possible for an employee to fulfil these requirements if they do not have immediate access to the relevant facilities and this should be borne in mind when deciding on any further action to take. 3. Return to Work Interview 3.1. Employees should contact their line manager on the first day of their return to work. Where their first day of fitness to work falls on a non-working day the employee should contact their line manager on the first day they attend for Page 10 of 25

duty advising of the actual fit to return date. Consideration should be given to any requirements for a phased return to work. 3.2. The line manager should ensure that they inform the Sickness Absence Administrator that the employee has returned to work in order that the sickness absence period entered in to the Electronic Staff Record system can be closed. Failure to close the sickness absence period will result in the employee entering half or no pay. 3.3. On an employee s return to work the line manager must make arrangements with the employee to conduct a return to work interview to discuss their absence. Normally this should be undertaken within the first day of returning to duty. Where this is not possible the return to work interview should take place as soon as possible. 3.4. The return to work interview should take place in a confidential environment. The discussion should aim to ascertain if any support is required by the employee with regard to their absence or return to work. Where there is a need for further action to be taken in terms of managing the employee s sickness absence these discussions should be held in a face to face situation rather than over the telephone. The sickness absence return to work form (Appendix 1) should be completed in full and a copy should be given to the employee and a copy forwarded to Sickness Administrator. 3.5. The Sickness Absence Administrator will ensure that the details contained on the sickness absence return to work form are entered into the Electronic Staff Record before sending the form to Human Resources for retention on the employee s personal file. 4. Domestic / Personal Issues / Work Related Stress 4.1. Where the employee has indicated that the reason for absence may be due to domestic circumstances or is of a personal/sensitive nature, care should be taken to ensure the matter is dealt with appropriately and confidentially. 4.2. If the employee is unwilling and/or unable to discuss such circumstances with their immediate line manager and opportunity must be given for the employee to discuss their concerns with a person other than their line manager, e.g. Human Resources, Trade Union/Professional organisation representative. 4.3. If during the discussion with the line manager or third party it is apparent that some form of flexible working pattern, or taking carer s leave, may assist the employee, these forms of assistance should be explored further and guidance given as to how to proceed. Further details are contained within the Flexible Working Policy. 4.4. Where the employee s absence may be connected to any form of bullying, harassment or intimidation, the employee should be offered support and Page 11 of 25

made aware of the facilities available as outlined in the Bullying and Harassment Policy. 4.5. Where an employee s absence is stress related or if the line manager identifies that the employee may be at risk of developing a stress related illness the line manager should follow the guidance set down in the Management of Stress Policy and the employee should be offered the supporting suggested therein. 4.6. Whilst recognising the need to maintain confidentiality the employee should be encouraged to give their line manager a reasonable explanation for their absence, however, managers must not coerce an employee to provide details where the employee has stated they would prefer not to. 4.7. Similarly, where the Occupational Health Service believe the employee to be at risk on health and safety grounds a reasonable explanation must be given to the line manager regarding the absence or the need to continue to be absent. This may not however give specific details at this stage. The Occupational Physician should indicate to the line manager a timescale which they believe to be reasonable when further information will be available to indicate when the employee may be able to return to work and this may include the arrangement of a case conference. Should this be the case the conference will be between the employee, their trade union/professional organisation representative/colleague, line manager, Human Resources representative and the Occupational Health Physician. The purpose of the case conference will be to agree decisions regarding the return, or not, of an employee to work. 5. Monitoring and Recording of Sickness Absence 5.1. The purpose of monitoring sickness is to pay attention to an employee s absence and therefore capability to maintain a level of fitness/attendance in order to fulfil their duties. The nature of an employee s illness should also be borne in mind when considering what course of action to take, if any. 5.2. Regular attendance is a requirement that is embodied in all contracts of employment so that services can be sustained. It is important, therefore, for the CCG to maintain a systematic review of an individual s absence to provide support and to identify as early as possible potential problems. 5.3. Line managers are required, therefore, to ensure that all absences are recorded and analysed to take into account both the number of days lost and the number of separate occasions. The triggers for monitoring and action will, therefore, be as follows: 3 separate occasions in 4 months or 20 days in total 5 separate occasions in 12 months or 20 days in total Long Term Absence, i.e. 4 weeks or more continuous sickness absence Page 12 of 25

Planned sickness absence for a known medical condition where medical advice may be required prior to planned return to work An occasion is one period of sickness absence regardless of the number of days absent. 5.4. It is a line manager s responsibility to maintain accurate sickness absence records to highlight when an employee has reached a trigger point. However, Human Resources will utilise the ESR system to identify employees who have reached the trigger points and will contact the line manager to request an update on how the employee absence levels are being managed. 5.5. Actions to be taken be a line manager at this stage of monitoring may include the following: Formally notifying the employee of concerns regarding sickness absence levels Formally notifying the employee that the Managing Performance Policy will be invoked Formally notifying the employee that the formal action will be invoked due to previous incidents/occupational Health advice given Referral to Occupational Health for medical advice The line manager should liaise with Human Resources and ensure correspondence is conducted in a sensitive manner. 5.6. The application of formal triggers may not always be appropriate and managers are advised to use their discretion, for example where an employee had a known long term condition or disability that may impact on their ability to attend work from time to time, where the sickness absence is pregnancy related, as a result of a work related injury or due to bereavement. 6. Managing Sickness 6.1. Whilst each case of sickness absence will be different and will require individual consideration dependent upon the nature of the absence, generally sickness absence can be divided into four categories as follows: Long term absence (i.e. 4 weeks or more) with little or no prospect of return to work Long term absence with a distinct possibility of return to work Intermittent related absence Short term intermittent unrelated absence 6.2. Short Term Intermittent Unrelated Sickness Absence Page 13 of 25

6.2.1. Where the number of occasions of sickness absence is in excess of 3 over the previous 4 months period or 5 over the previous 12 months period, the line manager should arrange to investigate the circumstances surrounding the absence with the employee via an informal meeting. Dependent upon the nature of the absence or should there be any particular concerns, Human Resources will provide support to line managers with their investigations. The discussion should include: Details of the absence record and the reasons for absence Any patterns of absence that seem to be emerging Whether the employee has any problems which contribute to or cause the absence (these may not all be health related) Whether a referral to Occupational Health Service may be helpful at this stage Where appropriate the offer of assistance to overcome any underlying problems, this may include referral to other agencies for specialist assistance Assistance in looking at flexible working options Reinforcing the requirement to attend work on a regular basis The detrimental impact to colleagues/services of the absence Informing the employee that their record is under review and to indicate when the next review will take place If it emerges during discussion that the individual may have an alcohol or substance misuse problem the appropriate policy should be invoked 6.2.2. A summary of the discussions should be recorded on the sickness absence notification form. If necessary additional file notes should be recorded and a copy given to the employee and a copy placed on the personal file. Where a file note contains information which the employee has been asked about but the employee denies any problems with, the employee should be advised during the meeting that the contents of the discussion will be mentioned in the file note. 6.2.3. Where the line manager is satisfied that there is no cause for concern no further action will be taken. 6.2.4. Where the line manager believes there is cause for concern one of the following options should be followed: Where an employee s explanation for absence appears to indicate the likelihood of an underlying medical problem a referral to Occupational Health Services should be made. Where periods of sickness absence appear to be unconnected, formal monitoring should commence. Where the line manager is not satisfied that the reason for absence is acceptable, the employee should be informed of the line manager s expectations regarding attendance and the standards that the employee needs to achieve and maintain. Page 14 of 25

6.2.5. The line manager should inform the employee of what formal action may be taken if the standards are not achieved after a further 3 months period of monitoring in accordance with the stages contained within this procedure. 6.3. Short Term Intermittent Unrelated Sickness Formal Monitoring of Absence Stage 1 If during a monitoring period the employee s levels of absence are breached, a meeting must be arranged with the employee and their representative at which the employee should be advised that their absence record is in excess of the attendance standard required and that their attendance record will be monitored for improvement during a review period. It is recommended that the review period is 12 weeks. The employee should be advised that failure to meet the future levels of conduct and performance required will result in formal proceedings being started in accordance with the Managing Performance Policy. This should be confirmed in writing to the employee. Stage 2 Following the review period, if the employee has failed to meet the standard required and there is still no underlying medical condition, the employee must be informed in writing that the formal action will be invoked and a review meeting will be convened. If a sanction is imposed the employee must be advised that their attendance level will continue to be monitored over a further review period and that further action may result if the employee fails to meet the standards required. Stage 3 Any further lapses in sickness absence levels will result in Further action being taken which may include dismissal if previously all reasonable steps have been taken. Request for a Fitness to Work Certificate Where short term absence is being monitored a line manager reserves the right to request that a fitness to work certificate be produced to cover absence of less than 8 days. The CCG will be responsible for meeting any costs associated with this. Requests for fitness to work notes from the line manager should be made in writing to the employee. Advice may be sought from Human Resources. Where the employee has attempted to comply with this request but their GP has refused to issue the certificate, the employee should notify the line manager of this in writing. The line manager will then be responsible for pursuing this matter with the GP if considered appropriate and advice may be sought from Occupational Health Services. Page 15 of 25

6.4. Long Term Sickness 6.4.1. Long term absence may be defined as: 4 weeks or more continuous sickness absence or where the absence level of an employee would appear to be more long term than originally anticipated. Or Where there is a known reason for the absence and a likely future return date was given but the employee remains absent after this date. In cases of long term sickness absence the line manager should contact the employee with a view to arranging a meeting with the employee to investigate the circumstances surrounding the absence and/or to advise them of the next steps to be taken. This should normally be undertaken at the beginning of the 5 th week of absence. At the conclusion of this meeting a referral to Occupational Health Services should be considered. 6.4.2. If appropriate reasonable adjustments to the workplace/duties may be considered. 6.4.3. In very exceptional circumstances it may be considered inappropriate for meetings to be arranged as this may not be conducive to improvements in the employee s wellbeing. In these circumstances the employee should be kept informed of alterations in pay entitlements and communication channels kept open for the employee to make contact. 6.4.4. If at the end of an 8 week period of absence an employee has not been referred to Occupational Health Services a referral must be made unless there are exceptional circumstances which should be discussed with Human Resources and the Occupational Health Physician. 6.4.5. The employee should be given the opportunity to have the formal meeting at home or at a neutral venue if they feel unable to attend the CCG headquarters. The employee should still be advised of their right to be represented or accompanied at the meeting. As part of the formal meeting it will be important to consider the following: The current known duration of absence The length of any periods of absence and attendance at work The relationship between the working environment from a health and safety aspect and the employee s health The requirement of the CCG for the work of the employee to be done Page 16 of 25

The outcome of the meeting should be followed up in writing and a date for the next review meeting agreed. 6.4.6. Referral to Occupational Health Services Having concluded at the formal meeting that there may be an underlying medical problem the line manager must refer the employee to the Occupational Health Service. The line manager must explain to the employee why they are being referred to Occupational Health and the process for referral. The employee must be informed that Occupational Health have the right to request that they are enabled to contact the employee s GP/Specialist Consultant to gain further information if required before concluding their findings. Should any costs be incurred in obtaining such further medical opinion/documentation this will be met by the CCG. The employee should be advised that declining consent to Occupational Health to such information may result in Occupational Health having to base any decision making on the evidence they have to hand. In exceptional circumstances the Occupational Health Service may be asked to conduct their review with the employee at a place other than the on-site Occupational Health Service, for example at the employee s home, GP practice, or other acceptable venue. 6.4.7. Follow Up Meeting On receipt of medical advice from the Occupational Health Service the line manager should arrange a formal meeting with the employee to discuss the advice and any course of action proposed, taking into account the options detailed in paragraph 6.4.11. Any judgement which is made should be based on the employee s fitness/capability to carry out the duties of the job they are employed to do. Consideration must also be given at this stage to any reasonable adjustments/alterations to the employee s duties and responsibilities. The employee should be kept fully informed if their employment is at risk in any way and all formal discussions should be followed up in writing. 6.4.8. Information regarding Sickness Pay Entitlements It is essential that line managers advise employees as soon as reasonably possible before their full pay expires that they are to enter half pay and that a meeting with the employee is arranged at least one month before the employee s sickness payment expires altogether. This notification will be sent to the Line Manager by the Pay Services Department. In cases of employees who have been continuously absent due to sickness for more than 12 months, pay should be reinstated at half pay in the following circumstances: Page 17 of 25

For employees with more than 5 years reckonable service sick pay will be reinstated if sick pay entitlement has been exhausted before a final review meeting has taken place. For employees with less than 5 years reckonable service sick pay will be reinstated if sick pay entitlement has been exhausted before a final review meeting does not take place within 12 months of the start of the sickness absence. Reinstatement of sick pay should continue until the final review meeting has taken place. Reinstatement of pay is not retrospective for any period of zero pay in the preceding 12 months of sickness absence. These conditions will only apply where the failure to undertake the final review meeting is due to a delay by the employer and will not apply where the review is delayed for any other reasons. A final review meeting is classified as the meeting at which it is determined that the likelihood of termination of employment is discussed and when the employee is made aware that this will be recommended to the relevant Officer with delegated authority to dismiss, who will make the final decision. 6.4.9. Pension Benefits Employees should be advised to seek advice from the Pensions team within Pay Services on the impact on their pension benefits of reducing their hours or termination of their contract of employment. 6.4.10. Options Available The action taken by the line manager will be dependent on the medical advice received. The table below outlines the action to be taken on the advice provided. Advice Received The employee will be fit to return to work in the near future and a date has been identified. Action(s) to be taken No further action is required other than maintaining regular contact with the employee and ensuring they do return to work. In the event of a failure to return to work on the date indicated contact should be made by the line manager to ascertain the reason for non- attendance. If the reason is a reoccurrence of the illness the employee should be re- referred to Occupational Health. In the event of a new or other reason for absence, the stages in this procedure should recommence. The employee will It will be necessary to explore with Occupational Health Page 18 of 25

Advice Received recover sufficiently to return to work but not be able to undertake the full range of duties immediately. Action(s) to be taken and the employee a phased return to work with a view to enabling the employee to fulfil all their duties and responsibilities in the near future. A phased return may include interim flexible working arrangements during which the employee will receive full pay. The situation should be regularly reviewed by the line manager and the employee, seeking further Occupational Health advice as necessary. A reasonable timescale for a return to full duties should be established. Phased returns are usually over a period of 1 to 3 months although this may be longer dependent upon the nature of the sickness absence. If during the phased return it becomes apparent that the restrictions to duties are unsustainable a decision should be taken by the line manager, taking into account Occupational Health advice, as to the long term prospects for the employee. Further action in accordance with this procedure should be considered. The employee will recover sufficiently to return to work but not to undertake the full duties and responsibilities of their substantive post. Advice should be sought from Occupational Health as to what type of work the employee will be able to undertake and consideration given to this. The line manager should meet with the employee and their representative to discuss the advice received and the alternative opportunities that the CCG can offer. The Management of Change Policy will apply. The employee should be given 3 months to seek suitable alternative employment and then the situation should be reviewed and consideration given to a further 3 months being given. In the event that redeployment is not successful and all available options have been exhausted the issue of continued employment with the CCG should be discussed together with the possibility of pursuing illhealth retirement. Where termination of the employee s contract is the only option this will be undertaken in accordance with the Disciplinary Policy. The employee will The line manager should arrange to meet with the Page 19 of 25

Advice Received be unable to return to work in any capacity in the foreseeable future. Action(s) to be taken employee to discuss the advice given. If the advice support ill health retirement and where the employee is part of the NHS pension scheme, this should be pursued and further detailed advice should be sought from Human Resources and the Pensions Team within the Payroll Services. If the advice supports termination of employment due to capability the matter will dealt with in accordance with the Disciplinary Policy in terms of process however a clear distinction is made between the dismissal being as a result of capability due to ill health rather than any form of misconduct and will be handled sensitively. In these cases the employee should be given notice and will have the right of appeal. If the appeal is successful and the employee is reinstated they will be entitled to pay from the effective date of termination to the date of reinstatement. 6.5 Intermittent Related Absence 6.5.1. Employees who have either a long term condition, disability or underlying medical condition may experience periods of time when they are unfit to undertake their duties as a result of their individual condition. Such periods of absence will be regarded as intermittent related absence. 6.5.2. Employees should disclose the nature of their condition to their line manager and advice should be sought from Occupational Health Services regarding the likely impact upon the employee s attendance and ability to undertake their duties. 6.5.3. Advice may be provided by Occupational Health in relation to reasonable adjustments to enable the employee to attend work and it may be necessary to undertake work station assessments. This will be arranged via Human Resources and a Health and Safety Representative. 6.5.4. The application of trigger points will apply to employees with intermittent related absence in order to ensure attendance is managed appropriately and that any changes/deterioration to the employees condition are taken into account. 6.5.5. Where the formal trigger points are continually breached over a sustained period of time advice should be sought from Occupational Health regarding the likelihood of improved attendance. Where this is considered unlikely a formal review meeting will be invoked and the viability of the employee s employment on the ground of capability due to ill health will be considered. 7. Occupational Sickness Pay Entitlements Page 20 of 25

7.1. During periods of sickness absence, subject to the conditions of this policy, employees will be entitled to receive occupational sick pay as detailed in the table below. Length of Reckonable Service Less than 12 months Between 1 and 2 years Between 2 and 3 years Between 3 and 5 years Over 5 years Entitlement 1 months full pay and 2 months half pay 2 months full pay and 2 months half pay 4 months full pay and 4 months half pay 5 months fully pay and 5 months half pay 6 months full pay and 6 months half pay 7.2. For details of how payments are calculated and what the definition of full pay includes reference should be made to Section 14(a) of the NHS Terms and Conditions of Service Handbook. 7.3. Employees will not be entitled to an additional day off if sick on a statutory holiday. 7.4. Line managers will have the discretion to extend the period of sick pay on half or full pay where there is the expectation of a return to work in the short term and an extension would materially support a return to work and or assist recovery. Particular consideration should be given to those staff without full sick pay entitlements or in other circumstances the line manager considers to be exceptional. 8. Working Whilst Sick 8.1. Employees should not engage in any other form of employment whilst absent due to sickness from their CCG employment without notifying their line manager and Human Resources. Dependent upon the reason for illness it may be that certain work could be undertaken, however, it would be unacceptable for work undertaken to be akin or similar in nature to that which they are ordinarily employed. Engaging in paid work of such a nature could be considered a fraudulent act and may be subject to an investigation which may result in disciplinary, civil or criminal proceedings. 9. Third Party Compensation 9.1. Where the reason for absence is due to an accident caused by a third party and compensation is sought there is a statutory obligation for employees to reimburse their employer with any element in the compensation award that was for loss of pay. This process will be handled in accordance with paragraph 14.16 of the NHS Terms and Conditions of Service Handbook. Page 21 of 25

Failure to advise the CCG of circumstances such as these and the retention of any money received for loss of earnings where no loss has been incurred, could be considered a fraudulent act and may be subject to investigation and result in disciplinary, civil or criminal proceedings. If employees have any doubt regarding this they should contact their line manager or Human Resources. 10. Medical Evidence 10.1. The CCG is entitled to rely upon the medical evidence provided by the Occupational Health Service with regard to an employee s fitness to undertake the duties and responsibilities for which they are contracted. However, an employee may provide evidence that is contrary to that provided by Occupational Health. In such circumstances Occupational Health would be asked to consider the evidence provided by the employee and consider whether their opinion would be altered. The CCG may decide to seek independent medical advice and any costs associated with this will be met by the CCG. 11. Workplace Assessments 11.1. Where an employee has been off sick as a result of an injury, work related stress, illness which may affect their ability to undertake their full range of duties or where a phased return is recommended, a workplace assessment should be undertaken. The line manager should seek advice from Occupational Health and support from the Health and Safety Representative to undertake the relevant assessment. The assessment will inform, in conjunction with other advice received, the management of the employee s sickness absence and safe return to work. 12. Terms and Conditions of Service during Sickness Absence 12.1. Sickness absence payments will be made in accordance with the NHS Terms and Conditions of Service Handbook. During all periods of sickness absence the employee will continue to accrue annual leave entitlement. Where an employee is likely to be absent from work towards the end of the annual leave year period the line manager should discuss with the employee the possibility of taking or carrying forward annual leave. 13. Access to Work Assistance 13.1. Where an employee has an impairment or disability either prior to or as a result of a period of sickness absence external assistance may be available to support the employee back to/and in work. Assistance may take the form of adaptations or adjustments to equipment where the working environment can Page 22 of 25

support this, supply of equipment, financial assistance with transportation to and from work etc. Advice from Human Resources is available. Page 23 of 25

Appendix 1 Page 24 of 25

Page 25 of 25