Sickness Absence Management Policy

Sickness Absence Management Policy Policy: HR05 Version: 2 Ratified by: Executive Management Team Date ratified: 13/10/2010 Name of originator/author: Andrew Stewart Name of responsible Senior HR Advisor, HR Department committee/individual: Date issued: November 2010 Review date: 31 March 2012 Target audience: All Staff 1

Version Control Sheet Version Date Who Status Comment No. 1.0 24/09/09 Rebecca Shore Final Approved by PSPF 1.1 23/11/09 Rebecca Shore Final Approved by IGC 2.0 13/10/10 Andrew Stewart Final Approved by EMT 2

Promoting equality, valuing diversity and ensuring fairness within NHS Northamptonshire NHS Northamptonshire aims to design and implement business functions, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage. This policy was originally produced in consultation with staff side representatives and approved by the Provider Services Partnership Forum and NHS Northamptonshire s Executive Management Team. The policy will be applied fairly and consistently and those responsible for its implementation towards individual staff or groups of staff will ensure that their behaviour and actions are non-discriminatory and are in line with the Requirements of: Equality Act, (2010) The Race Relations (Amendment) Act, (2000) The Civil Partnership Act, (2004) The Public Sector Gender Equality Duty (2007) The Disability Discrimination Act, (1995, 2005) Employment Equality (Age) Regulations (2006) In addition Equality Impact Assessment has been performed as part of the public sector duty to: Eliminate unlawful discrimination Promote equal opportunities Promote good relations between people from different backgrounds In addition, the Equality Impact Assessment has considered the following aspects of potential discrimination, which are age, gender, sexual orientation, disability, ethnicity, religion and belief. In order for this policy to be effective, NHS Northamptonshire believe that it is important for all employees to be aware of the processes, and that managers are trained in their use. Monitoring information will be produced on an annual basis to ensure policy is effective in the way it is applied. Action to ensure this will be as follows: Copies of the full policy and procedure will be available on the intranet. Copies will also be available from the Human Resources Department and managers. Managers must explain the provisions to new employees as part of the induction process. Special attention must be paid to individuals whose first language is not English, or who have a sensory impairment or some other disability. Monitoring information will be produced on an annual basis to ensure policy is effective 3

Title Page Number 1. PURPOSE OF THE POLICY 6 2. POLICY STATEMENT 6 3. SCOPE 6 4. RESPONSIBILITIES 7 4.1. TRUST 7 4.2. MANAGERS 7 4.3. STAFF 7 5. INTRODUCTION 8 6. ENTITLEMENT TO OCCUPATIONAL SICK PAY 8 7. ACCOMPANIMENT 9 8. PRE-EMPLOYMENT SCREENING AND CAPABILITY 9 9. SICKNESS ABSENCE PROCEDURE REPORTING ABSENCE 9 10. UNAUTHORISED ABSENCE 10 11. MEDICAL SUSPENSION 10 12. SICKNESS ABSENCE DUE TO DRUG OR ALCOHOL RELATED PROBLEMS 10 13. SICKNESS ABSENCE REPORTING 10 14. RETURN TO WORK 11 15. AVAILABILITY WHILST ABSENT THROUGH SICKNESS 11 16. MANAGEMENT OF PERSISTENT SHORT TERM ABSENCE 12 16.1. INFORMAL ACTION 13 16.2. FORMAL ACTION 14 16.2.1. STAGE 1: ABSENCE REVIEW MEETING 14 16.2.2. STAGE 2: SECOND REVIEW MEETING 14 16.2.3. STAGE 3: DISMISSAL 15 16.2.4. APPEAL HEARING 15 4

17. LONG TERM SICKNESS ABSENCE 15 17.1. DEFINITION 15 17.1.1. STAGE 1: INITIAL DISCUSSION 16 17.1.2. STAGE 2: REFERRAL TO OCCUPATIONAL HEALTH 16 17.1.3. STAGE 3: ALTERNATIVE EMPLOYMENT 16 17.1.4. STAGE 4: DISMISSAL: INCAPABILITY DUE TO ILL HEALTH / EARLY RETIREMENT 16 17.1.5. APPEAL HEARING 17 18. UNDERLYING LONG-TERM MEDICAL CONDITION / REHABILITATION FOLLOWING SURGICAL PROCEDURES 17 18.1. Disability Discrimination 18 19. REPEATED EPISODES OF LONG-TERM AND/OR SHORT-TERM SICKNESS ABSENCE 18 20. SICKNESS ABSENCE AND ANNUAL LEAVE 18 21. THE NHS INJURY BENEFIT SCHEME 18 22. REFERAL TO OCCUPATIONAL HEALTH 19 22.1. INTRODUCTION 19 22.2. OCCUPATIONAL HEALTH REFERRAL 20 22.3. OCCUPATIONAL HEALTH ADVICE 20 22.4. Phased Return 20 23. EARLY RETIREMENT 21 24. CREATING A HEALTHY AND SAFE PLACE TO WORK 22 25. COUNSELLING SERVICES 23 26. COSMETIC SURGERY 23 27. APPENDIX A - Return to Work Following Sickness Absence Interview 24 28. APPENDIX B - Management Referral to Occupational Health 24 29. APPENDIX C - A summary of your principal rights under the terms of the Access to Medical Reports Act 1988 29 30. APPENDIX D Self Certification for Absence due to Illness 30 5

Where absence is due to medically certified illness the issue becomes one of capability and employers should take a sympathetic and considerate approach ACAS code of practice 2000 1. PURPOSE OF THE POLICY To set out the policy and the procedures to follow in the following circumstances: when staff are absent from work due to sickness in the short term where there is a poor level of work performance for reasons related to repeated periods of short/medium term sickness absence where staff are absent from work due to long term sickness (i.e. sickness that is in excess of 4 weeks certified absence) The emphasis within this policy is to provide the necessary support to staff to facilitate their return to work following sickness absence and to ensure that their working environment is conducive to healthy working. 2. POLICY STATEMENT It is the policy of NHS Northamptonshire to ensure the fair, reasonable and just treatment of all employees who are absent from work as a result of injury or ill health. This policy assists in supporting staff when they have unavoidable illness and describes a fair method for ensuring that NHS Northamptonshire is enabled to staff the services it offers appropriately when staff sickness becomes problematic. NHS Northamptonshire seeks to ensure that employees do not suffer undue hardship as a result of such absence and that management acts in accordance with legislation and has regard to sound human resource practices. It is recognised that all situations involving sickness absence will vary and therefore require individual consideration. NHS Northamptonshire recognises its own responsibilities for ensuring that the workplace is a healthy and safe place to be, and Trust will conform to the Health and Safety At Work Act 1974, The Data Protection Act 1998 and other relevant legislation and good practice guidelines. 3. SCOPE This policy and procedure applies to all permanent and temporary employees working under a NHS Northamptonshire contract of employment, excluding bank staff. (It does not apply to medical and dental staff, where there is statutory provision for issues relating to ill health). This policy should be read in conjunction with the NHS Northamptonshire policy relating to the employment of people with a disability, available via the intranet. 6

4. RESPONSIBILITIES 4.1. TRUST It is the responsibility of NHS Northamptonshire to ensure that: The policy is implemented. Systems are in place that are fair and evenly administered for the monitoring of sickness absence. That NHS Northamptonshire meets national, regional, and locally agreed targets. 4.2. MANAGERS All managers have a responsibility for the health, safety and welfare of their staff and sickness absence is one aspect which requires particular attention. Managers should ensure that: 4.3. STAFF Arrangements are in place to comply with this policy. The sickness absence of staff is monitored and, where necessary, appropriate action is initiated. Records of staff sickness absence are maintained as required by the Trust and compliance with section 13 of this policy. Plans are in place for their service or department that will, year on year, show a reduction in the level of sickness absence and create a healthier workplace. Staff have a responsibility to adhere to this policy and to ensure that they are aware of the contact arrangements for the first day of sickness absence as set out in the plan or procedure for their service or department. The minimum contact requirement for the first day of sickness absence is given below, however this is explained in more detail at section 9 of this policy: The likely duration of the illness / reason for absence and when the member of staff is likely to return to work. The employee should also state if the absence has employment implications e.g. a skin complaint or infectious disease or if the reason for the absence is due to a work related injury. Whenever possible the sick employee should state what is the outstanding work or urgent appointments or duties that need to be carried out in his / her absence. Manager and employee to determine frequency of contact. If duration of sickness is likely to be more than 7 days, in exceptional circumstances e.g. a serious incident, contact with the employee outside the agreed times may be made. Employees to ensure that GP certificates are compatible with the absences(s). 7

5. INTRODUCTION All managers have a responsibility for the health, safety and welfare of their staff, and sickness absence is one aspect that requires particular attention. Managers should monitor the sickness absence of their staff and, where necessary must initiate appropriate remedial action. When a Manager is considering taking action in respect of an individual with an unacceptable level of sickness absence, the following will be taken into account: the length of the individual s employment with NHS Northamptonshire/the NHS the nature of their job the nature, length and effect of the illness the need for the work to be done the need for any replacement employee A HR Department must be involved in consideration of an individual s sickness absence record prior to any formal interview being arranged and will participate in any such interview. Absence, whether certified or not, which is found to be due to deceit or record falsification is not incapability - it is misconduct and will be dealt with by using the NHS Northamptonshire Disciplinary Procedure, available via the intranet. 6. ENTITLEMENT TO OCCUPATIONAL SICK PAY An employee s entitlement to Occupational Sick Pay is calculated based on continuous length of service with any NHS employer. An employee can count previous service with other NHS Employers, where there has been a break or breaks in service of 12 months or less. Entitlement is subject to the employee s compliance with NHS Northamptonshire policy and procedure on reporting sickness absence. In line with Agenda for Change Terms and Conditions employees will be entitled to receive sick pay in accordance with the scale below: In any twelve month period: - During first year of service one month at full and 2 months at half pay During the second year of service 2 months full and 2 months half pay During the third year of service 4 months full and 4 months half pay During the fourth and fifth years of service 5 months full pay and 5 months half pay After 5 years service 6 months full pay and 6 months half pay. The definition of full pay includes regularly paid supplements including any recruitment and retention premia, payments for work outside of normal hours and high cost area supplements. Sick pay is calculated on what the employee would have received had they been in work based on an average of 12 weeks of work immediately preceding the absence. 8

Occupational sick pay will be reduced as necessary so that it, together with statutory sick pay and any benefit received from the Department of Social Security for the period in question, does not exceed in total your normal basic pay for the period. The period during which sick pay should be paid, and the rate of sick pay for any period of absence is calculated by deducting from the employee s entitlement on the first day of sickness (based on reckonable service) the aggregate periods of paid sickness absence during the 12 months immediately preceding that date. 7. ACCOMPANIMENT Although the issues covered by this policy are not disciplinary matters, they may nonetheless result in dismissal. As such, employees may be accompanied by a companion at any of the formal stages. This person / companion may be a certified representative of a trade union/professional organisation or a work colleague not acting in a legal capacity. 8. PRE-EMPLOYMENT SCREENING AND CAPABILITY Provision is made for the pre-employment screening of all new employees and employees transferring to another post within NHS Northamptonshire. It is essential that their capability for a particular type of employment is verified prior to commencement. Capability for posts will be considered in line with the Disability Discrimination Act 1995 and the Two Ticks Disability Symbol for which NHS Northamptonshire NHS Northamptonshire is recognised to show ongoing commitment to employing disabled people. 9. SICKNESS ABSENCE PROCEDURE REPORTING ABSENCE The employee, or their representative, should contact their line manager as soon as possible on their first day of absence, ideally within one hour of their normal start time. This will enable the manager to make any necessary arrangements to cover the employee s work commitments. The employee, or their representative, should advise their line manager of the reason for the absence and, where possible, give some indication of when they expect to return. This will enable the line manager to plan how to cover the employee s absence. If the employee is going to be absent for longer than originally predicted they should make further contact with their line manager to advise them of the situation. If the absence continues for more than 3 calendar days the employee will be required to complete a self-certificate upon their return to work. If the employee is going to be absent for a period of time exceeding 5 days then the line manager should agree an appropriate communication channel (e.g. telephone contact) with the employee. This is to ensure that the employee receives a suitable level of support from NHS Northamptonshire during their absence. 9

If the absence extends beyond 7 calendar days the employee will be required to submit a medical certificate, issued by their doctor, to their line manager within 2 working days of receipt of the certificate from their GP. For certification purposes absence calculations are based on consecutive days of absence, including weekends and non-working days. For guidance surrounding the provision for medical appointments, please refer to NHS Northamptonshire Special Leave Policy, available via the intranet. 10. UNAUTHORISED ABSENCE Unauthorised absence occurs when an employee fails to report their absence for one or more days as outlined in section 9. Unauthorised absence may also occur if certification for a sickness absence is not provided as outlined in section 9.6. Any period of unauthorised absence will be investigated by the Line Manager and may result in Occupational Sick Pay being withheld and in disciplinary action being taken in accordance with NHS Northamptonshire Disciplinary Policy, available via the intranet. 11. MEDICAL SUSPENSION If an employee displays symptoms of a serious illness which could impact on the Health and Safety of themselves, colleagues, and the care of clients, the employee may be suspended from work on medical grounds. Medical suspension is a neutral action to allow NHS Northamptonshire to investigate the nature of the health issue, during which a referral to Occupational Health will be made for the employee to determine their capability to work. During periods of medical suspension, the employee will receive full pay. Continuation of medical suspension should be reviewed at 10 day intervals and the employee should be kept informed about the progress of the investigation at each interval. 12. SICKNESS ABSENCE DUE TO DRUG OR ALCOHOL RELATED PROBLEMS In some cases, sickness absence may be caused by a drug or alcohol related problem. Where this is identified and accepted by the employee, use of this procedure may be inappropriate. Please see NHS Northamptonshire Drug and Alcohol Misuse Policy for information on how to manage these situations. 13. SICKNESS ABSENCE REPORTING Managers are required to maintain sickness absence records, and as a minimum to report employee sickness absence issues to the HR Department for advice on management of the situation. Anonymised absence data and trends are reported to management and NHS Northamptonshire Operational Management Board meetings, this includes any RIDDOR reportable absences. 10

14. RETURN TO WORK When the employee returns to work following sickness absence the line manager should conduct a return to work interview as a matter of course. The purpose of this is firstly to ensure that the employee is fully recovered and fit to return and secondly to establish if there are any changes required to their environment or working conditions to facilitate their return. It is also an opportunity to establish if their work has in any way created the cause of absence in the first place. It is not designed, and should not be seen, as a way to check up on individuals but as a support mechanism for the employee and the team based on Health and Safety at Work and NHS Northamptonshire Duty of Care. If the absence has been for less than 5 days the interview may take the form of an informal chat. However, for absences of 5 or more days then the line manager should complete a return to work form (Appendix E). This form will help to ensure that the line manager has considered all the issues relating to the employee and that any necessary action is highlighted. From the employee s perspective they will be able to see that their absence and well-being are taken seriously. If the employee s absence is for more than 3 and less than 8 days then they can self certificate their absence. They must complete a self-certificate (Appendix H) upon their return and this should be passed to the line manager during the return to work interview. Certificates should be kept on the employee s sickness file. If the employee s absence exceeds 7 days then a doctor s medical certificate(s) should be provided covering the eighth day of sickness to the date of return. Certificates should be passed to the line manager as soon as possible and not saved until the employee returns to work as outlined in section 9.6. The certificate should be retained on the employee s sickness file. All sickness absence should be recorded on the PCF3 Weekly Absence Return and sent to McKesson to ensure that appropriate Occupational and Statutory Sick Pay can be calculated and paid to the employee. 15. AVAILABILITY WHILST ABSENT THROUGH SICKNESS It is important that an employee maintains contact with their manager whilst on sick leave. This will ensure that the manager can provide them with the appropriate support whilst ensuring that the work commitments are suitably covered. However, it is recognised that the level of support required will be different for individuals, and will also be dependent on the nature of their illness. As such the line manager should discuss and agree an appropriate communication channel with the employee, particularly in cases of long-term sickness. It is acknowledged that in certain cases, such as stress, the employee may find it difficult to maintain contact with their manager, and so extra sensitivity is required when discussing and agreeing the channel of communication. For example, it might be more appropriate to communicate directly with a family member in the early stages of the absence. 11

If an employee is on long-term sick leave (i.e. for four weeks or more) they will be required to attend an Occupational Health appointment and / or a meeting with their line manager and Human Resources. The employee should make themselves available for such appointments. If they are too unwell to attend then the line manager should make arrangements for the employee to be seen at home or at an alternative convenient venue. 16. MANAGEMENT OF PERSISTENT SHORT TERM ABSENCE As a matter of routine, managers will review the sickness absence record of their staff on a regular basis, and as a minimum at least once per annum. The maintenance of records will enable managers to monitor the absences of all employees. Where it becomes evident that an employee is having frequent short absences, whether or not the absences are covered by a medical certificate or selfcertified, it is the responsibility of the manager to monitor the situation. For any of their staff who, in a rolling 12 month period: Have three episodes of sickness absence (any duration) within any 3 month period OR Have accrued a cumulative total of 15 working days sickness absence (pro rata for part-time staff) in 3 or more episodes their situation will be reviewed on its own merits and the manager will decide whether or not it is necessary/ appropriate to apply the formal stages of the procedure. A manager will consider the following: The frequency and duration of the absences and the reason given for absences. Whether or not the absences are covered by a medical certificate. Whether or not they reflect a morale, personal or domestic problem which could be rectified or improved by managerial support, or in certain cases, by support from someone other than the manager, for example a Senior HR Advisor. Whether the absence is due to other employment. The effect that such absences are having on the individual s work performance and that of their workplace, particularly the contract to deliver high quality patient care and the health and safety of other employees. The extent to which the absences constitute a problem which management cannot continue to contain. In cases of absence which is causing management concern, which may be certified or uncertified, management action may take the following form on an incremental basis: Informal action Formal action leading to first formal stage following a meeting with the member of staff concerned, his/her representative, the line manager and a Senior HR Advisor. 12

Formal action leading to second formal stage following a meeting with the member of staff concerned, his/her representative, the line manager and a Senior HR Advisor.. Dismissal this will involve invoking the Disciplinary Policy and Procedure (available via the intranet) and a panel hearing. 16.1. INFORMAL ACTION There may be occasions when an employee's sickness absence is greater than the required and expected standards. If this should happen, the manager will react promptly to establish why this has occurred and determine, with the employee, how the attendance level can be improved on an immediate and sustained basis. In most cases this type of guidance and corrective discussion will be all that is needed to secure an acceptable improvement. The management of persistent short term absence will require sensitive handling through an informal discussion with a view to setting before the member of staff the concerns of the manager, together with the need to maintain levels of service through all employees fulfilling their contractual responsibilities. A Senior HR Advisor may be present at this informal discussion. The member of staff may be accompanied by a trade union representative or a work colleague not acting in a legal capacity. As a matter of good practice, the appropriate line manager or supervisor must, where reasonably practical, see members of staff following any episode of sickness to enquire about their well-being. Immediately following 3 absences in a 3 month period, or a cumulative 15 days absence during 3 episodes, or any other reasonable cause for concern, an informal discussion will be held by the appropriate manager or supervisor regarding the absence record and the individual advised that he/she may be referred to the Occupational Health Department for health assessment. In certain circumstances, it may be more appropriate for the formal process to be handled by an alternative appropriate manager rather than the employee s line manager. In the event of a referral to the Occupational Health Department for health assessment, the manager will write to the Occupational Department sending confidential detailed information as required in the Management Referral Form (Appendix F). This will normally be signed by the employee unless there are reasonable (usually medical) grounds for not doing so. The Occupational Health Advisor may with the written consent of the individual, seek to obtain further information from their General Practitioner. Once the Occupational Health Advisor or Physician has given his/her opinion on the capability of the individual to continue working, together with any recommendations about modification of the working environment, the manager and employee together should discuss a return to full working and implement any changes deemed necessary. Where this approach does not work or where the absence level is too serious the following formal procedure will be used. 13

16.2. FORMAL ACTION The manager is responsible for arranging meetings, which the employee will be required to attend at stages 1, 2 and 3 of the formal procedure. The employee will be given prior written notice of each meeting and this will include a brief outline of the matters that will be considered and the right to be accompanied. The objective of each meeting will be to review the employee s level(s) of sickness absence, explore the reasons and set out a timed action plan to reduce/ stop the absence. After each meeting the employee will receive a written summary of the conclusions reached which will include: clarification of the standard expected the ways in which the absence falls short of the standard required the support and assistance to be offered to improve attendance/ reduce sickness absence including the involvement of Occupational Health any monitoring (or close monitoring) arrangements the time period during which an improvement is expected the date for next stage of formal meeting 16.2.1. STAGE 1: ABSENCE REVIEW MEETING If the initial discussion does not result in any significant improvement in attendance, the manager will discuss the situation with a Senior HR Advisor with a view to arranging a formal meeting with the employee concerned. At the meeting, the difficulties caused by the absence(s) will be explained and the employee will be encouraged to identify any new problems that might be contributing to their level of sickness absence. If there is no satisfactory explanation, the manager will advise the employee of the improvements required during a specified period of normally not more than 3 months. The employee must understand that their attendance record will be kept under close review. 16.2.2. STAGE 2: SECOND REVIEW MEETING If the employee s sickness absence level continues to be unacceptable, taking into account the outcome of the earlier meeting at Stage 1, the employee will be interviewed again by their manager, together with a Senior HR Advisor. At the meeting, the manager will advise the employee that their sickness absence level is still unacceptable, seek an explanation for the level of absence, and offer whatever reasonable assistance necessary to produce a significant and sustained improvement. If there is no satisfactory explanation, the manager will advise the employee of the improvement required during the following period of up to a maximum of 3 months. The written confirmation of the outcome of the interview must state that, unless there is a significant and sustained improvement, the employee will be dismissed. Referral to Occupational Health may be considered appropriate at any of the previous stages and MUST be made before proceeding to Stage 3. (See Section 22 Referral to Occupational Health) 14

16.2.3. STAGE 3: DISMISSAL If the nature, duration and frequency of absence continues, the employee will be called to a further and final meeting, which will be conducted by the manager with authority to dismiss the employee in accordance with the scheme of delegation contained within NHS Northamptonshire Disciplinary Procedure, available via the intranet. The purpose of the meeting will be to consider the continuation of the individual s employment. If no important mitigating circumstances are put forward to explain the absence levels, the employee will be dismissed on the grounds of incapability due to ill health. The written confirmation of the outcome of the meeting will include the right to appeal against the decision to dismiss. 16.2.4. APPEAL HEARING Employees have a right of appeal against dismissal, which will be conducted in accordance with the NHS Northamptonshire Disciplinary Procedure, but their level of absence will not be treated as a disciplinary matter. 17. LONG TERM SICKNESS ABSENCE To use a fair approach when dealing with employees who are absent for long periods due to ill health and to ensure that: Regular communication is maintained between the employee, their manager and the Human Resources Department. The nature of the illness and its managerial consequences are investigated by Occupational Health and that no decision about an employee s continued employment is made without an Occupational Health opinion. To encourage, wherever possible, the return of the employee to full normal duties for which he/she is employed. 17.1. DEFINITION For the purpose of this policy, long-term sickness absence is that which continues after 4 weeks of continuous sickness absence, inclusive of self-certified and certified episode/s. This may be one single absence or comprise of shorter periods of absence for the same medical reason. The nature of the health problem will determine the action to be taken, if any, and will vary according to the individual situation. Depending on the reasons for the sickness absence but well before the employee s entitlement to full sick pay has expired, the following procedure must be adopted. The principle to be adopted is that appropriate action should be determined as soon as sufficient data is available to facilitate reasonable decisions. 15

17.1.1. STAGE 1: INITIAL DISCUSSION The manager should contact the employee to arrange an initial discussion to discover when a return to work can be expected. The response will determine the next stage in the process, as the options could vary from an early return to work to early retirement. If the employee is too ill to attend this meeting in person the manager should consider visiting the home of the employee (subject to their prior agreement). If this is not appropriate then they should write to the employee to obtain the necessary information. The employee has the right to be accompanied at this meeting by a trade union representative or a work colleague not acting in a legal capacity. A Senior HR Advisor may also attend this meeting. 17.1.2. STAGE 2: REFERRAL TO OCCUPATIONAL HEALTH If at the 4 week point a date for return to work within an acceptable timeframe cannot be established, the employee should be asked to attend an Occupational Health appointment. The purpose of this is to establish an appropriate course of action to facilitate the employee s absence and possible return to work. In some instances it may be appropriate to refer an employee to Occupational Health before 4 weeks absence has been reached. Occupational Health referral should always be made prior to an employee returning to work following long term sickness to ensure that they are fit to return and to establish if any changes should be made on either a temporary or permanent basis to facilitate their safe return to work (see section 22 on Referral to Occupational Health for further information). 17.1.3. STAGE 3: ALTERNATIVE EMPLOYMENT If the Occupational health report indicates that the employee is incapable of carrying out the duties of their current post but may be able to perform alternative duties, NHS Northamptonshire will attempt to identify such employment. However, it must be stressed that this may not always be possible (see section on Referral to Occupational Health for further information). 17.1.4. STAGE 4: DISMISSAL: INCAPABILITY DUE TO ILL HEALTH / EARLY RETIREMENT In the event that the Occupational Health Physician recommends that the employee is incapable of work in the foreseeable future, or where suitable alternative employment cannot be found, the employee should be interviewed in order to consider the implications of the Occupational Health Physician s report. If the employee is a member of the NHS Pension Scheme, an application for early retirement under the terms of that Scheme can be made. It must be recognised however, that even with the full support of NHS Northamptonshire, the immediate payment of any pension benefits will depend upon the NHS Pension Scheme approving the application for ill health retirement. If the employee unreasonably refuses offers of alternative employment, then following discussion with them, their contract of employment will be terminated, either 16

on the grounds of incapability due to ill health or through a successful application for early retirement. If there is no suitable alternative employment, or early retirement on the grounds of ill health is inappropriate, the employee will be dismissed on the grounds of incapability due to ill health. It is a managerial decision whether to dismiss or to follow another course of action. The decision to dismiss will be taken by the manager with the authority to dismiss in accordance with the scheme of delegation contained within the Trust s Disciplinary Procedure, available via the intranet. An individual who is dismissed in this way will receive their contractual notice, paid in lieu and will have the right to appeal against the decision. If an employee disagrees with the medical opinion expressed by Occupational Health, they will be given the opportunity of obtaining a second opinion. Upon receipt of a second opinion, the case will be referred again to Occupational Health who will be asked to review the original advice in light of any new information that has been produced. The manager will take into account information arising from the second opinion in making any decision about the future employment of the employee. 17.1.5. APPEAL HEARING Employees have a right of appeal against dismissal, which will be conducted in accordance with the Trust s Disciplinary Procedure, but their level of absence will not be treated as a disciplinary matter. 18. UNDERLYING LONG-TERM MEDICAL CONDITION / REHABILITATION FOLLOWING SURGICAL PROCEDURES Where an employee s sickness is caused by a long term underlying medical condition their case will be treated sensitively and the following will be considered before determining any course of action: The likely period before an improvement can be expected and whether the employee is likely to return to full fitness. The impact of the absence on the department. Whether reasonable adjustments and/or temporary or permanent redeployment to another area of work would eliminate the need for the employee to incur sickness absence. Where an employee is fit to return to work, but where the phased return provisions outlined in section 22 are unlikely to allow sufficient rehabilitation for the employee, consideration should be given to a temporary or permanent reduction in the employees working hours, which may require review at regular intervals. In this instance, the employee would receive pay pro rata to the hours worked, following completion of the phased return period. Where an employees health prevents them from returning to their role on a temporary basis, but where it is likely that they will be fit to return to their role in the foreseeable future, consideration should be given to temporary redeployment to allow the employee to contribute safely to the workplace. Further advice on the length of 17

time that an employee may take to become fit and the suitability for any role should be sought from Occupational Health. 18.1. Disability Discrimination In the event that an employee becomes disabled and is unable to continue in their current post, NHS Northamptonshire recognises its duty under Disability Discrimination legislation to make reasonable adjustments. 19. REPEATED EPISODES OF LONG-TERM AND/OR SHORT-TERM SICKNESS ABSENCE Repeated episodes may consist of absences ranging in length from days to several months separated from periods at work where the provisions outlined in sections 16 and 17 do not apply. If a pattern is identified where a manager becomes concerned about the cumulative amount of absence over a period of time, the manager will arrange an informal meeting to discuss the situation. The manager may involve Occupational Health in order to obtain a medical opinion. If there is no improvement in the levels of sickness absence, consideration should be given by the manager to formal action as outlined in section 16. Where absences have shown patterns of improvement and then deterioration after an improved level of absence for a full 12 months period following a sickness absence review, the review procedure outlined in section 16 can be resumed at any previous stage. It is not necessary to recommence the process at the informal stage. 20. SICKNESS ABSENCE AND ANNUAL LEAVE Where an employee is due to take annual leave whilst on sick leave they should make contact with their line manager prior to the annual leave dates to discuss how absence during this time will be recorded. Where an employee falls sick during a period of annual leave that is medically certified, the episode of absence will be treated as sick leave, allowing the employee to take the annual leave at another time. In these circumstances self-certification is not acceptable. In the case of long-term sickness, annual leave will continue to be accrued during the episode of sickness absence and can be taken on the employee s return to work, or in the event of dismissal, the value of the leave will be paid to the employee. If the episode of long-term sickness spans across more than one annual leave year, the employee will be entitled to carry the annual leave into the proceeding annual leave year. Arrangements should be made by the employee with their manager on their return to work to take the annual leave, in accordance with NHS Northamptonshire Annual Leave Guidance, available via the intranet. 21. THE NHS INJURY BENEFIT SCHEME The purpose of the NHS Injury Benefit Scheme (the Scheme) is to guarantee an income to an employee who suffers a temporary loss of NHS earnings, or a permanent loss of earnings, resulting from an injury or disease wholly or mainly attributable to the duties of their NHS employment. The Scheme may also pay 18

benefits to the spouse and dependants of an NHS employee whose death has been caused, or hastened by, their NHS duties. There are 3 types of benefit payable from the Scheme. These are: Temporary Injury Allowance Permanent Injury Benefit Death Benefit Almost all staff employed in the NHS are covered by the Scheme from their first until their last day of employment and they do not have to be a member of the NHS Pension Scheme. GP practice staff, GP co-operative staff, dental practice staff, APMS staff, freelance GP and dental locums, Direction employees, reservists, and staff working for a private or public limited company that provides a service to the NHS (ie agency staff) are not covered by the Scheme. It is the manager s responsibility to make their staff aware of the Scheme and to discuss it with their staff during their sickness absence. Advice should be sought from a member of the HR team in such cases, and indeed, the monthly sickness absence reports will alert managers and act as a prompt to discuss the Scheme with staff if a RIDDOR reportable absence has been recorded. Further information about the Scheme can be obtained from www.nhspa.gov.uk or by contacting the Pensions Officer at McKesson on 01926 475521 or pensions@mckesson.co.uk 22. REFERAL TO OCCUPATIONAL HEALTH 22.1. INTRODUCTION The Trust s Occupational Health Service plays an important role in cases involving sickness absence. It provides advice and guidance both to managers and to members of staff but it does not have any executive authority. A decision about the continued employment of an employee will be taken by the appropriate manager, who will reach a decision with the benefit of advice from both Occupational Health and Human Resources. Referrals to Occupational Health on sickness absence issues should normally be made with the advice of a Senior HR Advisor to ensure that a referral is appropriate and complies with the NHS Northamptonshire procedures. In cases of serious illness, advice should be sought from Human Resources on whether it is appropriate to refer to Occupational Health. NHS Northamptonshire may require an employee to submit to a medical examination by a practitioner of its choosing if at any time the employee is unable to perform their duties because of ill health. In addition, an employee can be asked to attend for a medical examination even though not on sick leave. In such circumstances if an employee refuses to attend, the individual concerned will be notified in writing that, in 19

the absence of a medical report, a managerial decision about their continued employment will be taken on the information available. 22.2. OCCUPATIONAL HEALTH REFERRAL A referral form should be completed by the line manager, usually in conjunction with the employee, which must be signed by the employee before submission unless this is not practical. The form provides information that will be used to assess who the appointment should be with (i.e. an advisor or a physician) and gives the employee s consent for this information to be sent to the Occupational Health Service provider. At the Occupational Health appointment the employee will be able to discuss their situation in confidence with a trained professional. Any recommendations and further courses of action (e.g. obtaining a GP report, referral to another professional) will be discussed and agreed between the individual and the advisor / physician. Following the appointment a report will be produced for the employee s line manager advising on the agreed way forward. This will provide sufficient information to enable appropriate management action to be initiated but may not divulge details of an individual s specific condition. The line manager will discuss the report with the employee, who may choose to be accompanied in accordance with the conditions set out in section 7, in order to establish the way forward. 22.3. OCCUPATIONAL HEALTH ADVICE The recommendations from Occupational Health will normally fall under one of the following categories: a) Fit to continue in present job If a manager is advised that an employee is capable to continue in their current job, they should contact the employee and arrange an interview so that the medical report can be discussed. Any temporary or permanent changes to facilitate their return will be discussed and implementation agreed. If appropriate, the employee will be advised that their sickness absence record will continue to be monitored and reviewed at regular intervals. The manager will confirm this outcome in writing. 22.4. Phased Return In some circumstances it may be beneficial for an employee to return to work on a phased basis. This would involve a resumption of duties on an agreed part time basis increasing to normal contractual hours over a period of time that should not normally exceed 4 weeks. In these situations the employee would receive full pay. b) Unfit to continue in present job consider alternative employment Whilst the Trust is under no specific obligation to create a job for an employee who, through sickness or injury becomes permanently unfit to undertake their normal duties, every effort will be made to find suitable alternative employment which is compatible with the employee s medical limitations. The employee s manager and a Senior HR Advisor will interview the employee so that the possibility of alternative employment can be explored. Thereafter, appropriate vacancies will be bought to the attention of the employee. This will 20

normally continue for a period of 4 weeks, or such other period as the manager considers to be appropriate bearing in mind the nature of the work required and the turnover of staff vacancies. Where an employee expresses an interest in a post, which both parties regard as representing suitable alternative employment, the employee will be interviewed by the relevant manager who will be encouraged to consider them for appointment as a priority over recruitment processes. A referral will be made to Occupational Health to ensure the employee is fit for the post prior to employing them on trial for a period of four weeks. At the end of the four week trial, the employee will be either be appointed substantively or in circumstances where an employee is not offered the post, written reasons for non-selection will be provided to the employee. If no suitable alternative employment can be found or if the employee refuses offers of suitable alternative employment, it will then be necessary to terminate the employee s contract. Prior to this, it may be appropriate to re-submit the case to the Occupational Health Physician for further guidance. c) Incapable of any work in the foreseeable future Assuming that the employee is fit to do so, she/he should be asked to attend an interview with the manager with the authority to dismiss (in accordance with the scheme of delegation contained in NHS Northamptonshire Disciplinary Procedure, available via the intranet) where the medical report will be discussed. The employee may either be dismissed or an application for ill health retirement made (see Section 5 Early retirement). The employee may seek a second opinion and in such circumstances, the process outlined in Section 3 of this procedure will be applied. In accordance with The Access to Medical Report Act (see appendix G), the employee has the right to see any medical report made about them. An employee must be seen by Occupational Health Physician to establish if they are unfit to continue either in their present job or any employment offered by NHS Northamptonshire. An Occupational Health Advisor or Line Manager cannot make this medical decision. 23. EARLY RETIREMENT Early retirement on the grounds of ill health may occur in two ways: a) when an employee indicates that she/he wishes to retire in advance of her/his normal age-retirement date because of ill health This will occur solely at the request of the employee concerned and may not be as a result of a referral to the Occupational Health Department. If there are rights to enhancements to pension, the relevant documentation will be given to the individual for completion. 21

b) when a decision is taken to dismiss an employee following advice from Occupational Health Providing that the individual has rights to an enhanced pension, the relevant documentation will be provided to the individual, one part of which will be completed by the Occupational Health Physician. Further information on Early Retirement and Pension Rights can be obtained from: McKesson Payroll Services telephone:01248 672316 email pensions@mckesson.co.uk or The NHS Pensions Agency 01253 774774 or Website: www.nhspa.gov.uk 24. CREATING A HEALTHY AND SAFE PLACE TO WORK Further measures that the manager should take to meet targets in respect of Improving Working Lives and Standards For Better Health, is to develop plans that will year on year, show a reduction in the level of sickness absence. The plan should be based on good employment practice and have been discussed with staff. The plan should include at least the following: Training / awareness for staff on the Sickness Absence Management Policy. Agreed contact and reporting arrangements during sickness, as failure to adhere to these may result in suspension of pay. Mechanisms for informing the department of the absence of the member of staff and responsibility for completing relevant paperwork to record the absence etc. Introduction of return to work interviews or arrangements for welcoming staff back to work following their absence. Arrangements for all staff to have an annual appraisal and a personal development plan. Ensure that the service has a range of family friendly policies and practices in place to encourage a healthy balance between work and commitments outside of work in accordance with NHS Northamptonshire Flexible Working and Retirement policies, available via the intranet. Early referrals to the Occupational Health Department and NHS Northamptonshire independent counselling service so that staff can seek professional help early, for example, stress related illness. Training to equip staff with the techniques to help them implement their service plan. Robust procedures for recruitment and selection and induction, please see relevant NHS Northamptonshire policies for guidance. 22

25. COUNSELLING SERVICES The PCT offers a free and confidential counselling service for all employees. Employees can obtain support from this service by contacting the following: Changing Minds Centre Website: www.changingmindscentre.co.uk Telephone: 01604 893461 26. COSMETIC SURGERY Employees who choose to have cosmetic surgery for reasons other than for physical or mental health requirements will not be entitled to take time off as sickness absence. Annual leave should be arranged to accommodate this type of absence. 23

27. APPENDIX A - Return to Work Following Sickness Absence Interview Return to Work Following Sickness Absence Interview Preparation Review absence record to date (inc. copies of correspondence, sick notes etc) Establish if there is a pattern of sickness Arrange a suitable time and private location for the interview Purpose of the Interview To clarify the reason for absence To confirm that the employee is now fit to return to work To establish if there are any underlying health issues To identify any temporary / permanent changes required To highlight any ways that the Trust can support the employee further Employee Line Manager Date of Interview Reason for Absence Absence Dates Current Level of Fitness Adjustments to work required? Is the problem likely to reoccur? Was the health problem work related? (please give details) Number of days absent in rolling 3,6 & 12 month period Further action? Total Days Number of absences in rolling 12 month period Manager s Signature: Employee s Signature: 24