To present the new management of absence policy for ratification.

Report to Trust Board Date 6 May 2008 Agenda Item P10 Title Sickness Absence Management Policy Sponsor Catherine Oliver, Director of Human Resources Prepared by Catherine Oliver, Director of Human Resources Presented by Catherine Oliver, Director of Human Resources 1 Purpose and Key Issues To present the new management of absence policy for ratification. 2 Equality and Diversity Implications The changes made to the document will continue to support the organisation s delivery of the equality and diversity agenda. The policy may have an adverse impact on: People with disabilities or long term health conditions may be adversely affected by this policy, in respect of the trigger points for managing short term absence issues. Impact can be avoided if the policy is followed appropriately and advice sought from HR and Occupational Health, e.g. use of long term absence management policy where underlying medical conditions exist rather than the short term policy/employment Review Procedure and active use of return to work programmes. 3 Legal Implications This policy complies with current legislation. 4 Patient, Public and Staff Involvement Staff Side were involved in the development of this policy. 5 Controls and Assurances This policy has been agreed by the Policy Group, Joint Negotiation and Consultative Committee and the Clinical Services Executive Committee. 6 Cost Implications The proactive management of absence will reduce spend on sick pay and temporary staffing. 7 Potential risk to the organisation This policy will tighten absence management processes. Without this it is likely that absence levels will continue to increase. 8 Recommendations The Board is asked to RATIFY the policy. Best Care, Highest Standards, Right Place

Strategic Objectives Ten strategic objectives were agreed by the Trust Board in May 2007 to support the Trust s mission statement Best Care, Highest Standards, Right Place. The strategic objectives have been developed to ensure there is a shared understanding and common purpose throughout the organisation about the Trust s strategic direction and what needs to be delivered. X Patient Safety Efficient & Effective X High Quality Services Strategic Partnerships Listening and responding to the needs of patients Modern and Effective Infrastructure Deliver Care in the most appropriate setting Public Health Integrate Health and Social Care Robust and Sustainable Standards for Better Health The Core and Developmental Standards for Better Health have been developed by the Healthcare Commission. Compliance with the Standards throughout the year form a part of the Trust s Annual Health Check. C1a Incident Reporting X C7e Equality & Diversity C16 Patient Information C1b Safety Alerts C8a Whistle blowing C17 C2 Child Protection C8b C3 NICE Interventional procedures Personal Development Programmes C18 C9 Records Management C19 C4a Infection Control C10a Employment Checks C20a C4b Medical Devices C10b Professional Codes of Conduct C20b Patient & Public Involvement Access to Services Equality & Choice Access to Services Emergency care Security and Health & Safety Patient Privacy & Confidentiality C4c Decontamination C11a Recruitment C21 Hospital Cleanliness C4d Medicine Management C11b Mandatory Training C22a C4e Waste Management C11c C5a C5b C5c NICE Technology appraisals Clinical Supervision & Leadership Clinical Professional Development C5d Clinical Audit C13c C6 Healthcare bodies cooperating together C7a Corporate Governance C14b X C7b Finance & Probity C14c Professional Development C22b C12 Research & Development C22c C13a Dignity & Respect C23 C13b Consent to treatment C24 Use of Confidential Information D1 C14a Complaints - Information D2a Complaints Nondiscrimination Complaints Service improvements C7c Clinical Governance C15a Patient Food Standards C7d Performance C15b Patient dietary requirements D13a D13b Public Health Health inequalities Public Health D of PH report Public Health - Working with partners Public Health Health promotion Major Incident Planning Patient Safety Risk reduction Clinical Effectiveness Best practice Public Health Health inequalities Public Health National guidance Human Resources Directorate Page 2 of 33

Document Control Report Title: Sickness Absence Management Policy Author: Catherine Oliver, Director of Human Resources Version Date Status Comment Issued 2 25/1/08 draft for agreement at JNCC 3/3/08 Main Contact Catherine Oliver Director of HR Tel: Direct Dial 01271 311 511 Tel: Internal 3511 Fax: Email: catherine.oliver@ndevon.swest.nhs.uk Lead Director: Catherine Oliver, Director of HR Document Class Policy Target Audience All staff Non-Executives Distribution List Distribution Method Senior Management TarkaNet Superseded Documents NDHT Sickness Absence Management policy (version 1) NDHT Absence Management Policy Issue Date tbc Archive Reference Path Filename Review Date 3 years Human Resources Directorate Page 3 of 33

Contents Section Page 1 Introduction 5 2 Purpose 5 3 Definitions 5 3.1 Definition of frequent and persistent short term absence: 5 3.2 Definition of long term sickness absence: 5 4 Responsibilities 5 4.1 Management Responsibilities 5 4.2 Employee Responsibilities 6 4.3 Role of Human Resources 6 4.4 Role of Occupational Health 6 4.5 Role of Staffside Representatives 7 5 Calling in Sick 8 6 Keeping in Touch 8 7 Attendance at GP / Dentist Appointments 8 8 Working whilst of sick 8 9 Medical Certificates and Documentation 9 9.1 Self Certification 9 9.2 Medical Certificates 9 10 Sickness and Annual Leave 9 10.1 Sickness Whilst on Annual Leave 9 10.2 Annual Leave Whilst on Sickness Leave 9 11 Referral to Occupational Health 9 11.1 Management Referral 9 11.2 Employee Referral 10 12 Return to Work Interviews 10 13 Short Term Absence Management Process 11 13.1 Definition of frequent and persistent short term absence: 11 13.2 Managing Short Term Absence Step by Step Guide 11 14 Managing Long Term Absence 12 14.1 Definition of long term sickness absence: 12 14.2 Managing Long Term Absence: Step by Step Guide 12 Human Resources Directorate Page 4 of 33

Section Page 15 The Options 14 15.1 Return to work before sick pay expires 14 15.2 Return to work but not before sick pay expires 14 15.3 Phased return to work 14 15.4 Alternative employment 15 15.5 Termination of Employment on the Grounds of Capability 15 15.6 Ill Health Retirement 15 15.7 Consultation 15 16 Sickness absence and pay/career progression 15 16.1 Knowledge and Skills Framework 15 17 Appeals 16 18 The Development of the Policy 16 18.1 Prioritisation of Work 16 18.2 Document Development Process 16 18.3 Equality Impact Assessment 16 19 Consultation, Approval and Ratification Process 16 19.1 Consultation Process 16 19.2 Policy Approval Process 16 19.3 Ratification Process 16 20 Review and Revision Arrangements including Document Control 16 20.1 Process for Reviewing the Policy 16 20.2 Process for Revising the Policy 16 20.3 Document Control 17 21 Dissemination and Implementation 17 21.1 Dissemination of the Policy 17 21.2 Implementation of the Policy 17 22 Document Control including Archiving Arrangements 17 22.1 Library of Procedural Documents 17 22.2 Archiving Arrangements 17 22.3 Process for Retrieving Archived Policy 17 23 Monitoring Compliance With and the Effectiveness of the Policy 17 23.1 Process for Monitoring Compliance and Effectiveness 17 23.2 Standards/Key Performance Indicators 17 Human Resources Directorate Page 5 of 33

Section Page Appendices A Record of Absence and Return to Work Form 18 B Absence Record Form for Personnel Record 20 C Occupational Health Management Referral Form 21 D Self Certified Sickness Return 24 E Employee Short Term Absence Discussion Record Form 25 F Equality Impact Assessment Screening 27 Human Resources Directorate Page 6 of 33

1. Introduction 1.1 The Trust recognises and values the contribution every employee to providing health care services and aims to ensure that all employees are able to fulfill their contractual duties. 1.2 Nevertheless, the Trust fully accepts that there are times when sickness absence is unavoidable. The Trust aims to ensure that all employees are treated fairly and with concern, both for employee welfare and also for the effective delivery of healthcare services. 2 Purpose 2.1 The procedure outlined in this policy is intended to support managers when dealing with the various types of sickness absence encountered. It aims to ensure a fair and uniform approach, taking due account of both the interests of the employee and the interests of the Trust. 2.2 Although the policy is detailed, there will still be many variations that can occur in individual cases, and managers are encouraged to obtain advice from the HR Department if in any doubt. 2.3 This polices applies to all employees of Northern Devon Healthcare Trust. 3 Definitions 3.1 Definition of frequent and persistent short term absence: Frequent absences of short duration, either certified or uncertified, over periods of time, which significantly impair the effectiveness of the employee and the department. The absences may be for unconnected reasons or ailments. 3.2 Definition of long term sickness absence: is defined as absence for a prolonged period of time, or recurrent periods of time, due to serious / significant health problem. It should last 4 weeks or more. Each case of long term sickness absence must be considered individually and treated sympathetically and fairly. 4 Responsibilities 4.1 Management Responsibilities It is the responsibility of managers to:- ensure that staff are made aware of the procedure for reporting absences and that keep a record of all reported absence, when a member of staff calls in, on the part 2 of the Record of Absence and Return to Work Interview Form (Appendix A) keep accurate comprehensive records of each employee s absence / attendance to enable them to identify sickness absence patterns at an early stage. All individual absences should be summarised on the Absence Record Form (see Appendix B). monitor the absence of all staff for whom he / she is responsible and for taking appropriate action on an individual basis when this is required. Each case of absence will be different and should therefore be judged on its merits. ensure that every member of his / her staff is informed of the standards expected of him / her. Each member of staff must also be made aware of the consequences of not reporting sickness absence i.e. that loss of pay and / or disciplinary action may result. highlight sickness absence statistics at departmental meetings to emphasize how absence affects the department and the service, and emphasize to all members of staff the problems sickness absence causes, encouraging them to take responsibility for these problems by keeping sickness absence to a minimum. maintain regular and frequent contact with staff off sick, keeping them informed of Human Resources Directorate Page 7 of 33

developments within the Trust and the team. monitor the sick pay entitlements of staff who are off sick, informing them when their pay is due to decrease to half pay and nil pay. This information must be given prior to the change in sick pay status. conduct return to work interviews on each occasion of sickness absence be prepared to follow up sickness absence issues with staff refer staff to the Occupational Health Service whenever necessary or appropriate, ensuring that this is discussed with the individual prior to referral where applicable, use the Trust s Disciplinary Procedure to resolve persistent short term absence problems. take positive action to resolve long term sickness absence through phased return, alternative employment, early retirement on the grounds of ill health or termination of employment on the grounds of capability due to ill health, where appropriate. maintain accurate written records to record actions taken at each stage of the management of absence procedure ensure that decisions about an individual on long term sick leave will be made and implemented prior to the expiry of his / her sick pay entitlement. reduce and maintain sickness absence below the Trust s rate of an average of 2.5% (rolling 12 month period). 4.2 Employee Responsibilities Employees who are sick and unable to attend for work are responsible for notifying their manager, as soon as possible, of their sickness absence. They must normally telephone their manager prior to commencement of duty where possible or the within 1 hour of the start of duty at the latest, in accordance with the general rules relating to sickness absence (see section 9 below) and the specific rules relating to their department or professional group. Failure to notify a manager in accordance with the rules may result in the employees absence being treated as unauthorized leave and may result in loss of pay and / or disciplinary action being taken. If the employee does not return to work on the date expected, or is sick for any length of time, it is his / her responsibility to keep his / her manager informed as to progress and his / her intentions to return to work. Where an employee is employed on a rota or shift system, and / or in accordance with his / her department s policy, he / she may be required to give 24 hours notice of intention to return to work. Failure to do so may, at the manager s discretion, result in the employee being sent home without pay. 4.3 Role of Human Resources As with other management issues, both managers and employees may request advice from Human Resources advisers in relation to sickness absence. When managing absence, Human Resources advisers will be able to advise managers on the options available and procedure that should be followed, depending on whether the issue is persistent short term or long term absence. In such circumstances, a full discussion will take place, but the decision as to what action is taken lies with the manager. It is anticipated that the majority of this support will be in advance of any meetings. It is not expected that Human Resources advisers will attend routine management Human Resources Directorate Page 8 of 33

of absence interviews. 4.4 Role of Occupational Health Both managers and employees may request advice from Occupational Health advisers in relation to sickness absence. This can be through either self or management referral. Following a management referral (See Appendix C Management Referral Form), Occupational Health advisers will be able to advise managers on:- the nature of the employees condition, the possible effects of the employee s duties on his / her condition, the prognosis for the future and whether the employee is likely to be able to return to work and the range or type of work the individual might be able to undertake, if he / she is unable to return to his / her substantive role. Following a management referral an occupational health report will be forwarded to the manager and subsequent discussion can take place. However, the decision as to what action is taken lies with the manager. Where the Occupational Health professional feels it necessary, he / she will share the referral document with the individual concerned. 4.5 Role of Staffside Representatives It is acknowledged that members of staff may wish to have their staffside representative present during a management of absence interview. The role of the staffside representative in this process will be to provide support to the member of staff, to ensure due process is being followed and to take notes on behalf of the member of staff in particularly complex or difficult situations. 5 Calling in Sick 5.1 All staff are responsible for notifying their manager, prior to commencement of duty where possible or the within 1 hour of the start of duty at the latest, of their sickness absence if they are unable to attend work (see Employee Responsibilities, section 3.2 below). When speaking to their manager, the individual must let the manager know why he / she is off work, the nature of the illness and give an indication of when he / she is expecting to return to work. When notified of a period of absence the manager will record the following details, using part 1 of the Record of Absence and Return to Work Interview Form (see Appendix A) :- 1. Name: 2. Unit and Department: 3. Job Title: 4. To whom was absence first reported? 5. Date reported: 6. First day of absence: 7. Reason for absence: 8. Expected date of return: 9. Is absence due to an injury at work? 10. If accident at work, has an accident form been completed? 11. Incident report number: 12. Was this absence due to work induced diarrhoea and vomiting? 13. Has a doctor been consulted? Human Resources Directorate Page 9 of 33

Where a message is left for the manager either via an answerphone or a colleague, the member of staff must leave his / her contact number so the manager can call the individual back. When contacting a member of staff who is off sick, care must be taken to ensure that any conversation is reasonable, sensitive, appropriate and not intrusive, with the aims of seeing how the individual is and if any support is needed. The manager should keep a record of this conversation on the part 2 of the Record of Absence and Return to Work Interview Form (Appendix A) Where a member of staff is off work with a stress related illness or other mental health condition, advice must be sought from Occupational Health regarding the most appropriate way of making contact with the member of staff. NOTE If a member of staff fails to make contact, the manager will follow this up by telephone, initially and if necessary, in writing. Failure to notify your manager of any absence may lead to the absence being considered as unauthorised absence and may result in loss of pay and disciplinary action being taken. 6 Keeping in Touch 6.1 It is important for line managers and staff to keep in contact during periods of absence. Line managers need to be kept informed of a member of staff s progress in order to try to ensure appropriate support, organise work and maintain service delivery and being off work for pro-longed periods of time can leave staff feeling isolated, unsupported and out of touch. It is the responsibility of individual members of staff to keep their manager informed of progress and when they are likely to be fit to return to work. When keeping in touch with a member of staff who is off sick, care must be taken to ensure that any conversation is reasonable, sensitive, appropriate and not intrusive with the aim of seeing how the individual is, seeing if any further support is needed and keeping the member of staff informed of developments within the Trust and the team. The manager should keep a record of all keep in touch conversations on the part 2 of the Record of Absence and Return to Work Interview Form (see Appendix A). 7 Attendance at GP / Dentist Appointments 7.1 It is acknowledged that staff may need to attend a GP / Dentist appointment during working hours. All staff are encouraged to make such appointments at the start or end of their working day, or during their lunch break, to minimise disruption to service delivery. Where appointments are arranged during working time, the member of staff MUST inform their manager in advance and obtain approval to attend the appointment in work time. Where appointments are attended during work time, the time lost should come out of any time owing or be worked back within an agreed period of time. For information regarding Ante-natal appointments, please refer to the Maternity Leave Policy / Guidelines. 8 Working whilst of sick 8.1 The general principle is that staff who are off sick from work at the Trust must not undertake any paid or voluntary work for any employer for the period of their absence. It is however, acknowledged that for some individuals, working during a period of recovery may have a positive therapeutic effect. Human Resources Directorate Page 10 of 33

Where a member of staff is considering undertaking any paid or voluntary work whilst off sick they must put this request in writing to their line manager for approval, prior to commencing the activity. The manager will take the necessary advice from HR and Occupational Health prior to confirming whether this activity is acceptable. The manager will then confirm this in writing to the individual, keeping a copy of the letter on the individual s personal file. Note failure to obtain prior permission to undertake any paid or voluntary work whilst off sick may result in investigation by the NHS Counter-Fraud team and / or disciplinary action being taken. 9 Medical Certificates and Documentation 9.1 Self Certification (see Appendix D Self Certificate Form) Certification is not normally required for sickness absence of up to 3 days. Employees who are absent through sickness for four to seven consecutive days must complete a Trust Self-Certification Form, preferably in the presence of his / her manager. Self-certificates will be retained on the employees personal file, but the self certified absence must be recorded on time sheets and monthly returns. 9.2 Medical Certificates Employees who are absent through sickness for eight or more consecutive days must obtain a medical certificate from their GP and submit it to their manager at the earliest opportunity. The medical certificate must be retained on the employees personal file. Where a medical certificate is surrendered to the Benefits Agency, in order for supplementary benefits to be considered, a photocopy of the medical certificate must be retained on the personal file. Employees must ensure that subsequent certificates are provided to ensure continuous cover. Manager should monitor each case. Where, as a consequence of frequent and persistent short term sickness absence disciplinary action has to be taken, an employee may be required to provide a medical certificate(s) for each occasion of sickness absence for a specified time. NOTE: It is the responsibility of the individual manager to monitor directly sickness absence levels within their department and to take any necessary related action. Managers should use the Absence Record Form (Appendix B) to log any sickness absence as it occurs and keep a copy of this on the individuals Personnel File. 10 Sickness and Annual Leave 10.1 Sickness Whilst on Annual Leave Where an employee falls sick whilst on annual leave, the annual leave days lost to sickness can only be reclaimed if the absence is covered by a medical certificate and this is submitted as soon as the employee returns to work. Employees will not be entitled to an additional day off if they are sick on a Bank/Public holiday that they would otherwise have been required to work as part of their basic week. 10.2 Annual Leave Whilst on Sickness Leave Employees on long term sick leave may go on holiday, including oversees and this is not deducted from their annual leave entitlement. Annual leave will accrue for the duration of all paid sick leave. Should an employee take a holiday that appears to indicate that he / she may be fit to return to work or which contradicts the reason for his / her absence, for example, someone who is off sick with a bad back going skiing or surfing, this will be addressed by the line manager and where necessary, referred to NHS Counter- Human Resources Directorate Page 11 of 33

fraud for review. Advice will be available from Occupational Health to support this discussion. On returning to work, the employee will be encouraged to take their annual leave in accordance with the annual leave policy. Only 5 days annual leave may be carried forward to the following year. 11 Referral to Occupational Health 11.1 Management Referral It is a condition of employment that the Trust has the right to refer staff for medical examination during the course of their employment. Occupational Health Services may examine the member of staff and will normally investigate all possible reasons for the absence, taking into account psychological and personal factors, in order to ascertain whether or not there are legitimate reasons for the absence. Referral to Occupational Health Services must be discussed with the member of staff, either in person or by telephone, prior to the referral being completed and sent to Occupational Health.. Occupational Health Services may, with the employee s consent, seek information from the employee s GP or Consultant. Independent medical reports may also be obtained with their consent. When referring a member of staff to Occupational Health Services, the manager must complete the Management Referral Form in full (See Appendix C Management Referral Form),. Any missing information may result in the referral being returned to the manager for completion. In the case of persistent short term sickness, Occupational Health Services will be required to state whether the employee is fit to carry out his / her duties and what, if any, management action should be considered. In the case of long term sickness, Occupational Health Services will be required to indicate how long the illness is likely to continue, and whether, and for how long the employee will, or is likely to be, unfit for work. In both cases Occupational Health Services will be asked to advise on the type of alternative work, if any, that the employee is capable of undertaking should he / she be unfit to continue in their present employment. 11.2 Employee Referral Employees may contact Occupational Health Services directly for advice or assistance. This contact and any subsequent appointments(s) is / are confidential and there is no requirement for the manager to receive a written report. The manager must be made aware of the self referral by the member of staff so that time off work to attend the necessary appointments can be agreed. 12 Return to Work Interviews 12.1 It is Trust policy that employees be interviewed by their manager on each occasion they return to work after an episode of sickness absence using the Record of Absence and Return to Work Interview Form (see Appendix A) This is NOT a disciplinary interview, but the opportunity for the manager to : ensure the employee is fit to return to work establish, in general terms, the cause(s) for the absence complete relevant documentation update the employee as to relevant information or changes so as to ensure a Human Resources Directorate Page 12 of 33

smooth return to work. 12.2 Since sickness absence can be a sensitive issue, it is important to get the tone of the interview right. It is recommended that managers:- conduct the interview in privacy acquaint themselves with the individual s sickness absence record welcome the individual back to work enquire as to the reasons for the absence enquire as to how he / she is feeling on returning to work and ask about their general health reinforce the importance of his / her contribution to the Directorate / Department / Ward s work, and how and why he / she was missed confirm the interview in writing The interview is also the opportunity for the manger to demonstrate, through care and concern, that the individual does matter and is valued and to offer help and support if needed. 13 Short Term Absence Management Process 13.1 Definition of frequent and persistent short term absence: Frequent absences of short duration, either certified or uncertified, over periods of time, which significantly impair the effectiveness of the employee and the department. The absences may be for unconnected reasons or ailments. Human Resources Directorate Page 13 of 33

13.2 Managing Short Term Absence Step by Step Guide Step 1 : Gather your facts accurate sickness records patterns and trends Where an individual s absence record shows:- 3 episodes or more of sickness absence OR 10 days or more of sickness absence within the last 12 months a Counselling Interview should be held see Step 2 below. Step 2 : Counselling Interview 1 ascertain the nature / causes of the illness(es) / absence(s) discuss any personal / background reasons affecting the absence discuss the effect his / her absence is having on the performance of the Directorate / Department / Wards consider whether referral to the Occupational Health Service is appropriate. consider what further support could be offered and how. NOTE : such referral should not be done automatically at this stage, but only if the manager feels that there is a real underlying health problem which may be causing the absences. set clear standards for improvement and a review date Detailed notes must be made of the Counselling Interview and confirmed in writing to the employee using the Employee Short Term Attendance Record Form (appendix E). If, following the counselling interview, the absences continue then the manager must meet with the individual, discuss the issues and refer the employee to Occupational Health. Step 3 : Refer to Occupational Health Step 4 : Counselling Interview 2 When making a referral to Occupational Health the individual must be informed of the referral prior to its submission. Once a report is received from Occupation Health, the employee should be interviewed again. The referral to Occupational Health identifies an underlying medical condition or problem the employee should be offered appropriat to obtain the necessary treatment. Should the problem or condition persist, the need to be dealt with in the same manner a illness problem. Where no medical condition or problem is identified which would indicate an underlying unfitness for work. clearly state the standards of attendance required of the employee in the future provide an adequate time period for the individual to demonstrate that improvement, together with a review date. The employee should also be advised that if the absence record does not improve, then disciplinary action may be taken against them. Detailed notes must be made of the Counselling Interview and confirmed in writing to the employee using the Employee Short Term Attendance Record Form (appendix E). Human Resources Directorate Page 14 of 33

Where the same pattern of illness(es) / absence(s) persist and no improvement results from the Counselling interview process, the manager must meet with the individual and invoke the Employment Review Procedure. Step 5 : Interview the Employee and Invoke the Employment Review Procedure Meet with the employee and inform them that the matter of the individual s conduct (i.e. poor attendance record) will now be dealt with in accordance with the Employment Review Procedure. The disciplinary action should be taken, based on the employees conduct (i.e. poor attendance record), NOT on the sickness / illness itself. The Trust s Employment Review Procedure must be used. 14 Managing Long Term Absence 14.1 Definition of long term sickness absence: is defined as absence for a prolonged period of time, or recurrent periods of time, due to serious / significant health problem. It should last 4 weeks or more. Each case of long term sickness absence must be considered individually and treated sympathetically and fairly. 14.2 Managing Long Term Absence: Step by Step Guide Step 1 : Keep in Touch at least monthly keep the employee informed and updated about matters affecting the Trust, Directorate and department / ward. ascertain the true medical position. discuss fully with the employee the prospect of a return to work and in what capacity. Minutes of team meetings, copies of the Chief Execs Bulletin, Staff Express and Pulse should be forwarded to the employee. Where the employee is unable to attend meetings at the workplace, the manager should arrange home visits, accompanied by an Occupational Health or Human Resources Adviser if this is appropriate and resources allow. Step 2 : Refer to Occupational Health NOTE: where staff are off for over 20 days for planned surgery, with no complications, referral to Occ. Health may not be necessary. Step 3 : Long Term Sickness Meeting after one month, where appropriate he / she should be referred to the Occupational Health Service. The individual must be informed of the referral prior to its submission. referrals can be made sooner, depending on the circumstances. referrals should then be made on a regular basis, throughout the period of absence. where a full recovery is doubtful, or is likely to be a lengthy process the manager should request update reports from Occupational Health, with the aim of establishing:- the employee s fitness to return to work, his / her fitness to continue in his / her current post / occupation, and / or fitness for other employment. Once a report is received from Occupation Health, the employee should be interviewed again. Human Resources Directorate Page 15 of 33

discuss the individuals sick pay status and advise them of when changes to half pay and nil pay are due to take place discuss the feedback from Occupational Health discuss the options available to the employee see section 15 below. agree a date for a follow up meeting detailed notes must be taken throughout the meeting and the outcomes confirmed in writing to the employee. If Ill Health Retirement is being considered, a full application process should be followed, including the appeal stage, if necessary. For the duration of this process, other than keeping in touch, no further action is required by the manager. If the Ill Health Retirement process in unsuccessful, the steps shown below should be followed. If the employee is deemed unfit to perform his / her current duties, but is capable of other work, then. Step 4 : Long Term Sickness Follow Up Meeting discuss the individuals sick pay status and advise them of when changes to half pay and nil pay are due to take place discuss the feedback from Occupational Health and that the individual in not able to return to their post but could return to other duties see the Trust s Redeployment Policy. discuss what these other duties could be, what skills and experience the individual has. agree the nature of jobs to be looked for, as suitable alternative employment. inform the individual that any possible suitable alternative jobs will be cleared by Occupational Health before any further action is taken. agree a timescale for looking for alternative work inform the employee that the Trust is not obliged to create a job and that in the event that an alternative job is not found, there may be no other option that to terminate the employee s contract on the grounds of capability due to ill health. (note terminations cannot take place whilst the individual is still receiving sick pay) agree dates for review meetings. detailed notes must be taken throughout the meeting and the outcomes confirmed in writing to the employee. If alternative employment is found, no further action need be taken If alternative employment has not been found, then. Step 5 : Review Meetings discuss any expected changes in sick pay status discuss any new feedback from Occupational Health. discuss any options for alternative employment that have been considered and why they were not considered suitable discuss new options for alternative employment remind the employee of the agreed timescale for looking for alternative work, and that in the event that an alternative job is not found, there may be no other option that to terminate the employees contract on the grounds of capability due to ill health (note - terminations cannot take place whilst the individual is still receiving sick pay). confirm dates for review meetings. detailed notes must be taken throughout the meeting and the outcomes confirmed in writing to the employee. Human Resources Directorate Page 16 of 33

If alternative employment is found, no further action need be taken If the employee is unfit / unable to return to work in the foreseeable future or either no alternative work has been found in the timescale agreed, or the employee declines an offer of alternative employment, then.. Step 6 : Giving Notice The manager may request a representative from HR and / or Occupational Health to be present in these meetings. discuss any new feedback from Occupational Health. discuss any options for alternative employment that have been considered and why they were not considered suitable remind the employee of the agreed timescale for looking for alternative work, and that in the event that an alternative job is not found, there may be no other option that to terminate the employees contract on the grounds of capability due to ill health. confirm that the timescale has expired and that no alternative employment has been found. explain that as a consequence, there is no alternative than to terminate their employment on the grounds of capability. confirm that you are therefore giving them notice of the termination of employment (ensure that the notice period you state is in accordance with legal requirements) confirm the date of the last day of service inform the employee that they have the right to appeal where dismissal is the course of action to be taken confirm that you will continue to look for alternative employment for the duration of the notice period. discuss any new options for alternative employment detailed notes must be taken throughout the meeting and the outcomes confirmed in writing to the employee. If alternative employment is found, no further action need be taken If no alternative work has been found in the notice period or the employee declines an offer of alternative employment then.. Step 7: Confirmation of Termination of Employment confirm that no alternative employment has been found that the termination of employment will take place as set out in the letter of inform the employee that they have the right to appeal where dismissal is the decision. detailed notes must be taken throughout the meeting and the outcomes confirmed in writing to the employee 15 The Options 15.1 Return to work before sick pay expires The employee will be fit for work in the near future and before his / her entitlement to sick pay expires. This will need to be closely monitored and, under normal circumstances, no further action should be required. 15.2 Return to work but not before sick pay expires The employee will be fit to return to work in the near future but not before their entitlement to sick pay expires. This will need to be closely monitored and, under normal circumstances, no further action should be required. The agreement should be in writing and a copy submitted to occupational health for their records. Human Resources Directorate Page 17 of 33

15.3 Phased return to work The employee is deemed unfit to perform their current duties in full but could resume work on a phased re-entry basis, e.g. part-time, light duties only, for a specified and short period of time. It would be expected that the employee would be fit to undertake their full role at the end of the phased return basis. In this instance, the manager must, with advice from Occupational Health, meet with the employee to agree the phased return arrangements. The agreement should be in writing and a copy submitted to Occupational Health for their records. The phased return must be closely monitored by the manager and must include reviews by Occupational Health. Depending on the status of the individual s sick pay at the point of the return-to-work programme commencing, the basis on which the individual will be paid during the return to work programme must be clarified and confirmed in writing, for example:- If a member of staff is still in full sick pay, the time not at work would be taken as full pay sick pay, annual leave or unpaid leave. If a member of staff is still in half sick pay, the time not at work would be taken as half pay sick pay, annual leave or unpaid leave. If a member of staff is in nil pay, the time not at work would be taken as nil pay or annual leave. The basis of the individual s pay for the phased return to work programme must be clearly set out on a Change of Circumstances form and sent to the Payroll Department. If an extended return to work program was required the arrangements for this would need to be negotiated by the manager, individual and occupational health and different pay / annual leave arrangements may apply as necessary. 15.4 Alternative employment The employee is deemed unfit to perform his / her current duties, but is capable of other work. In this case alternative employment should be considered and a reasonable period of time should be agreed to pursue this option. The manager with advice from HR and Occupational Health will determine, in consultation with the employee what possibilities exist for alternative employment, both within the department and / or the Trust. There is no onus on the Trust to create a job. Please refer to the Trust s Redeployment Policy. NOTE: Pay Protection arrangement do not apply to alternative employment in these circumstances. 15.5 Termination of Employment on the Grounds of Capability The employee is unfit / unable to return to work in the foreseeable future or either no alternative work has been found in the timescale agreed, or the employee declines an offer of alternative employment. In these circumstances the employee must be retired on the grounds of Ill Health or dismissed on the grounds of capability. 15.6 Ill Health Retirement This only applies to NHS pension scheme members. It will only take place on the recommendation of a medical practitioner and final approval rests with a Medical Advisor at the NHS Pensions Agency. To qualify for ill health retirement, an employee must have contributed to the NHS pension scheme for a minimum of two years. To receive enhanced benefits, the employee must have completed 5 years reckonable service. Processing applications can take 2 3 months or longer, thus early discussions with the employee regarding this option should be undertaken. 15.7 Consultation Whatever option is considered, it is a legal requirement that the employee is properly consulted throughout the process and about the possible options available BEFORE any decision is taken. Human Resources Directorate Page 18 of 33

It is the manager s responsibility to ensure that such consultation takes place. 16 Sickness absence and pay/career progression 16.1 Knowledge and Skills Framework KSF Gateway Reviews should be scheduled well in advance of the normal incremental date to ensure that the review can take place and normal pay progression occur in accordance with the arrangements detailed in the Agenda for Change: NHS Terms and Conditions of Employment Handbook. Exceptionally it may be necessary to defer KSF gateway pay progression in cases where long-term sickness absence prevents a manager from being able to complete a satisfactory review of the employees performance. In such cases the Manager must seek advice from the HR Department and ensure that the employee is informed of any proposed course of action. 17 Appeals 17.1 Staff have the right to appeal the termination of their employment on the grounds of Capability due to Ill Health. To exercise this right staff must write to the Director of Human Resources, within 21 days of the date of the letter confirming the termination of employment. 18 The Development of the Policy 18.1 Prioritisation of Work Following vertical integration of the community services from the North Devon Primary Care Trust with the acute services, a requirement was identified to harmonise the two organisations policies for the management of absence. It addition, following a strengthened process, piloted in Midwifery, the policy was further developed to strengthen calling in procedures, recording of absence and return to work interviews. 18.2 Document Development Process As the author, the Director of Human Resources is responsible for developing the policy and for ensuring stakeholders were consulted with. This policy was discussed with the Unions via the Policy Group during its development and draft copies were circulated for comment before approval was sought from the relevant committees. 18.3 Equality Impact Assessment The Trust aims to design and implement services, policies and measures that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. An Equality Impact Assessment Screening has been undertaken and there are any adverse impacts are addressed. (Appendix F) 19 Consultation, Approval and Ratification Process 19.1 Consultation Process The author consulted widely with stakeholders, including: Policy Group JNCC Consultation took the form of a request for comments and feedback and via discussion. 19.1 Policy Approval Process Initial approval of the policy will be sought from the JNCC on 3 rd March 2008. Final approval will be sought from the Clinical Services Executive Committee. 19.2 Ratification Process The policy will be ratified by the Board. 20 Review and Revision Arrangements including Document Control 20.1 Process for Reviewing the Policy The policy will be reviewed every three years. The author will be sent a reminder by the Tarkanet Support Officer four months before the due review date. The author will be responsible for ensuring the policy is reviewed in a timely manner and that the reviewed policy is initially approved by JNCC given final approval by the Clinical Services Executive Committee and ratified by the Trust Board. All reviews will be recorded by the author in the document control report. Human Resources Directorate Page 19 of 33

20.2 Process for Revising the Policy In order to ensure the policy is up-to-date, the author may be required to make a number of revisions, e.g. committee changes or amendments to individuals responsibilities. Where the revisions are minor and do not change the overall policy, the author will present the revised version to the JNCC for approval. Significant revisions will require final approval by the Clinical Services Executive Committee and ratification by the Board. All revisions will be recorded by the author in the document control report. 20.3 Document Control The author will comply with the Trust s agreed version control process, as described in the organisation-wide Guidance for Document Control. 21 Dissemination and Implementation 21.1 Dissemination of the Policy After ratification by the Trust Board, the author will provide a copy of the policy to the Tarkanet Support Officer to have it placed on the Trust s intranet. The policy will be referenced on the home page as a latest news release. Information will also be included in the weekly Chief Executive s Bulletin which is circulated electronically to all staff. An email will be sent to senior management to make them aware of the policy and they will be responsible for cascading the information to their staff. In addition, staff will be informed that this policy replaces any previous versions. 21.2 Implementation of the Policy Line managers are responsible for ensuring this policy is implemented across their area of work. Support for the implementation of this policy will be provided by the HR department. 22 Document Control including Archiving Arrangements 22.1 Library of Procedural Documents The author is responsible for recording, storing and controlling this policy. Once the final version has been ratified, the author will provide a copy of the current policy to the Tarkanet Support Officer so that it can be placed on Tarkanet. Any future revised copies will be provided to ensure the most up-to-date version is available on Tarkanet. 22.2 Archiving Arrangements All versions of this policy will be archived in electronic format within the HR Team policy archive. Archiving will take place by the PA to the Director of HR once the final version of the policy has been issued. Revisions to the final document will be recorded on the document control report. Revised versions will be added to the policy archive held by the HR Team. 22.3 Process for Retrieving Archived Policy To obtain a copy of the archived policy, contact should be made with the HR Team. 23 Monitoring Compliance With and the Effectiveness of the Policy 23.1 Process for Monitoring Compliance and Effectiveness Monitoring compliance with this policy will be the responsibility of all Managers and Directors, for their own areas. Where non-compliance is identified, support and advice will be provided by the HR Team to improve practice. 23.2 Standards/Key Performance Indicators As set out in section 4.1 above, it is the Trust s target to achieve a 2.5% average absence level (rolling 12 month period). Human Resources Directorate Page 20 of 33

Appendix A - Record of Absence and Return to Work Interview Form (2 pages) This form should be used to record the Notification of Absence, Keeping in Touch and the Return to Work Interview held between the line manager and employee, in accordance with the Sickness Absence Management Policy. The return to work interview should be held the same day as the individual's return to work. Part 1: Record of Notification of Absence 1. Name: 2. Unit and Department: 3. Job Title: 4. Date reported: 5. To whom was absence first reported? 6. First day of absence: 7. Expected date of return to work: 8. Reason for absence: 9. Is this absence work related? YES/ NO 10. Is absence due to an injury at work? YES/ NO 11. If accident at work, has an accident form been completed? YES/NO 12. Incident report number: 13. Was this absence due to work induced diarrhoea and vomiting? YES/NO* 14. Has a doctor been consulted? YES/NO* Delete as applicable* Part 2: Record of Keeping in Touch Please summarise all discussion with the member of staff off sick, including date, time, nature of conversation, etc. Please continue on a separate sheet if necessary. Human Resources Directorate Page 21 of 33

Part 3: Record of Return to Work Interview SECTION 1: For completion by the Line Manager Employee name: Job title: Department: First day of absence: Date returned to work: Total days absent from work: Reason for absence: Was this absence notified correctly? YES/ NO (If no, feedback to individual and clarify process) Is absence due to an injury at work? YES/ NO If accident at work, has an accident form been completed? YES/NO Incident report number: SECTION 2: RTW DISCUSSION RECORD NOTE - FOR COMPLETION BY LINE MANAGER Is employee fit to return to work? Number of episodes of sickness absence in the last 12 months: Number of day s absence in the last 12 months: Have the Trust trigger points been exceeded (3 episodes or more of sickness absence or 10 days or more sickness absence within the last 12 months): If trigger points exceeded, confirm action to be taken in accordance with the Sickness Absence Management Policy: Update employee on relevant information or changes to ensure smooth return to work: Remind employee to complete self certification form or provide doctors note as appropriate I confirm that the above notes represent an accurate record of the issues discussed and the actions undertaken/recommended Name: Department: Signature: Date: SECTION 3: FOR COMPLETION BY INDIVIDUAL RESUMING FROM SICK LEAVE I confirm that the attached sickness summary is an accurate record of my absence history and that the interview notes above are an accurate record of the issues discussed. In addition, I wish to comment as follows: Name: Department: Have you seen a doctor? YES/ NO Signature: Date: Medical certificates attached? YES/NO Data Protection: The Northern Devon Healthcare Trust processes the information provided on this form and on medical certificates for the purposes of meeting its legal obligations. In particular, individual data is disclosed to line managers for the purpose of responding appropriately and fairly to an individual's overall level of sickness absence and for the appropriate management of their health and safety at work. This form should be kept in the employee s personal file and a copy sent to the individual. Human Resources Directorate Page 22 of 33