Sickness Absence Management Policy and Procedure

Sickness Absence Management Policy and Procedure (Reference No. HR020 0514) Version: Version 2, January 2015 Version Superseded: Version 1, September 2012 Ratified by: Joint Negotiating Committee Date ratified: 20 January 2015 Name and designation of originator/ author (Lead Officer): Name of responsible committee/ individual: Name of executive lead: Date issued: 27 January 2015 Review date: Target audience: Alison Ryder, Deputy Director of HR & OD Joint Negotiating Committee/ Alison Shelly, Director of HR & OD Alison Shelley, Director of HR & OD 3 years from date issued or earlier at discretion of the Executive Lead or Author All Hertfordshire Community Trust (HCT) staff Attendance Management Policy and Procedure HR020 0514 V.2 Page 1 of 47

Contents 1 Introduction... 4 2 Purpose... 4 3 Scope... 4 4 Explanation of Terms and Definitions... 5 5 Ownership, Roles and Responsibilities... 5 6 Principles... 7 7 Occupational Health... 7 8 Employees with Disabilities... 8 9 Sick Pay... 9 10 Sickness Absence Management and Reporting... 9 11 Recording and Monitoring Absence... 10 12 Procedure for Keeping in Touch... 10 13 Provision of Fit Notes... 10 14 Unauthorised Absence... 11 15 Return to Work Interviews... 11 16 The Management of Frequent Short Term Sickness Absence... 12 17 Bradford Score Calculations and Trigger points... 13 18 Informal Sickness Review Meeting... 14 19 Recurring Absence... 14 20 Formal Procedure Stage 1 First Written Warning... 15 21 Formal Procedure Stage 2 Final Written Warning... 16 22 Formal Procedure Stage 3 Dismissal... 17 23 The Management of Long Term Sickness Absence... 18 24 Alternative employment / redeployment... 21 25 Phased Return to Work following Sickness Absence... 22 26 Ill-Health Retirement (NHS Pension scheme members only)... 23 27 Terminal Illnesses... 23 28 Appeals... 24 29 Procedure for the Appeal... 24 30 Annual Leave and Sickness Absence... 25 31 Working (and Activities) While Absent for Ill Health... 25 32 Medical Appointments... 26 33 Self-Elected or Cosmetic Procedures... 26 34 Accidents and Incidents at Work... 26 35 Ratification of Absence Management Policy and Procedure... 27 Attendance Management Policy and Procedure HR020 0514 V.2 Page 2 of 47

36 Dissemination and Access to Ratified Policy... 27 37 Implementation and Training... 27 38 Monitoring Compliance and Effectiveness... 28 39 Review and Revision Arrangements... 28 40 Document Control and Archiving Arrangements... 28 41 Equality Impact Analyses (EIA)... 28 42 References... 29 43 Appendices... 29 Attendance Management Policy and Procedure HR020 0514 V.2 Page 3 of 47

1 Introduction 1.1 This document outlines Hertfordshire Community NHS Trust s (HCT) policy and procedure for reporting sickness absence and for managing sickness absence in a fair and consistent way. The policy reflects current legislation including the Social Security (Medical Evidence) and the Statutory Sick Pay (Medical Evidence) (Amendment) Regulations 2010 and the Equality Act 2010. 1.2 The Trust s approach to the management of sickness absence is supported by its staff health and wellbeing programme, as set out in the Trust s Staff Health and Wellbeing Strategy. The Trust is accredited under the Staying Healthy at Work scheme as an organisation which supports staff wellbeing. 1.3 This Policy should be read in conjunction with the following policies: Alcohol & Substance Abuse Policy Stress Policy Bullying and Harassment Standard Infection Prevention & Control Precautions and Isolation Policy Disciplinary Policy 1.4 This version supersedes any previous versions of this document. 1.5 This policy will be accessible to staff through the HCT Staff Intranet or by the issue of controlled paper copies where appropriate. 2 Purpose 2.1 The policy aims to promote, encourage and support all employees to achieve and maintain high standards of attendance through the application of a fair, effective and consistent approach when managing staff sickness. 2.2 This policy covers management of the full range of sickness absence from short term and relatively minor episodes to more serious illnesses. It also set out arrangements relating to the reporting and recording of sickness, sick pay, medical appointments and other related matters. 3 Scope 3.1. This policy applies to all Hertfordshire Community Trust employees. 3.2 The policy relates specifically to management of sickness absence, other forms of attendance management and performance issues will be dealt with under other Trust policies. Attendance Management Policy and Procedure HR020 0514 V.2 Page 4 of 47

4 Explanation of Terms and Definitions 4.1 An Episode of Sickness is defined as a minimum of a working day and can be of any duration. If a member of staff is unable to work for over half their daily hours because of sickness, this will be treated as one day. Where they are able to work for over half their daily hours this will not be included as part of any period of absence. 4.2 Short Term Sickness Absence - For the purposes of this policy, frequent shortterm sickness absence may be defined as a series of short-term absences, which may or may not relate to a single medical complaint. 4.3 Long Term Sickness Absence - For the purpose of this policy, long-term sickness absence may be defined as a continuous period of four working weeks or more of sickness absence. It may also apply to a number of episodes of related sickness punctuated by periods of return to work. 5 Ownership, Roles and Responsibilities 5.1 The generic statement of roles and responsibilities of The Trust Board, Designated Committee, The Executive Team, Chief Executive Officer, Lead Executive Director, Lead Officer, Deputy Directors/ General Managers, Line Managers, All Staffs, Policy Control Officer and Communication Lead applicable to all the HCT policies/ procedural documents are in line with the HCT (Trust) GR1 0114 V.3 and attached in Appendix 1. Roles and responsibilities specific to this particular policy are defined below. 5.2 Board Sub Committee (Designated Committee) Joint Negotiating Committee (JNC) is the Designated Committee for this policy. A Hertfordshire Community NHS Trust Committee (HCT) Structure with regards to Line of Accountability / Reporting is provided in Appendix 2. 5.3 Lead Executive Director The Director of HR & OD is the identified Lead Executive Director for this policy. 5.4 Lead Officer The identified Lead Officer for this policy is the Deputy Director of HR & OD. 5.5 Line Managers Managers responsibilities are: To provide a healthy and safe working environment. To treat all staff fairly, sensitively and ensure that any personal information, including medical diagnosis, is kept in complete confidence. To ensure that all staff are aware of the Trust s and the department s notification procedures for sickness absence. To monitor the attendance of their staff and manage their sickness absence To attend relevant training on managing sickness absence. Attendance Management Policy and Procedure HR020 0514 V.2 Page 5 of 47

To have a return to work discussion with the employee following each episode of absence. To ensure that accurate records of all sickness absence are recorded To refer the employee to Occupational Health, as appropriate. To consult with the HR Team if considering taking formal action. To keep in touch with employees on long-term sick leave To consider reviewing and changing current working patterns to support improved attendance or facilitate a return to work, liaising with Occupational Health and HR where necessary. To contact the Local Counter Fraud Specialists for advice if there is suspicion that an employee has taken sick leave dishonestly. 5.6 HR Department 5.6.1 The HR Department is responsible for advising management and staff on all aspects of these procedures. The manager concerned should involve the appropriate HR representative throughout the procedures. Staff with concerns regarding any aspect of this policy should seek advice from the HR Department. 5.6.2 The HR Department will provide, on a monthly basis, to each directorate details of their staff s sickness absence. 5.6.3 The HR Department will be responsible for providing on-going training on the application of this policy to managers. 5.7 All Staff 5.7.1 Staff responsibilities are: To obtain appropriate medical treatment and/or support or assistance if they are ill or suffering from any condition that may affect their work performance or make them unable to work. To ensure that they do not work excessive hours, particularly that they do not jeopardise their ability to attend their permanent post and function effectively by working excessive bank/nhsp or agency shifts. To telephone in person to notify their line manager of their sickness absence and to mutually agree on the regularity of updates. To provide a Statement of Fitness for Work (fit note) following continuous absence of more than 7 calendar days. To attend Occupational Health appointments and/or submit to a medical examination by any other registered medical practitioner nominated by the Trust at any time during employment when requested; and agree that any resulting reports may be provided to the Trust. To meet with their line manager on their return to work to discuss the absence. To take sick leave honestly and to understand that taking sick leave for reasons other than their own sickness may be deemed as fraud and treated as a disciplinary matter. Attendance Management Policy and Procedure HR020 0514 V.2 Page 6 of 47

6 Principles 6.1 Accurate sickness absence records will be maintained and all information received in relation to this policy will be dealt with in a confidential and sensitive manner. 6.2 Advice will be sought from the Occupational Health Department where appropriate in relation to intermittent short and long term sickness absence. 6.3 Managers will be responsible for monitoring absence levels within their teams in order to identify where these are high and develop systems of work which help to minimise absence. This may include appropriately designed jobs, good Health and Safety standards, proper recruitment, induction and training, effective communications and a healthy working environment. 6.4 Managers will have responsibility for the day to day management of absences and ensuring the fair and reasonable application of these policies in managing either frequent short term or long term sickness absence. 6.5 The same test of fairness applies under this procedure as in disciplinary cases. Managers will be required to demonstrate the staff member has been treated in a fair and consistent manner, had the opportunity to improve, and adequate warning has been given to ensure that they are fully aware of the eventual consequences of a failure to improve. 6.6 All staff will have access to the Sickness Management Policy via the Staff Intranet and must be familiar with their individual responsibilities under the policy. 6.7 This policy does not form part of any employee's contract of employment and may be amended from time to time. 7 Occupational Health 7.1 While the management of absence from work as a result of sickness is a management responsibility, the Occupational Health Service has an important role to play in providing the advice necessary to enable managers to fulfil their responsibility fairly and consistently. 7.2 The role of the Occupational Health Service is to give impartial advice to the employee, their manager and the Human Resources Department regarding the employee s fitness for work. It is the manager s responsibility with support from Human Resources to decide if any adjustments advised are reasonable and practical, and plan how they should be implemented. 7.3 Occupational Health cannot make management decisions, provide treatment nor influence the clinical judgement of those providing care to employees. However, Occupational Health can provide an opinion on the health status of an employee. With the employees written consent Occupational Health can collate information from the employee's General Practitioner and/or other medical specialists, interpreting its impact from a medical perspective within the workplace setting. Attendance Management Policy and Procedure HR020 0514 V.2 Page 7 of 47

7.4 The Manager and Human Resources Department may not be entitled to confidential medical information regarding the employee s health, but will be advised in terms of capability. 7.5 A referral to the Occupational Health Department may be appropriate in the following circumstances: Frequent short term sickness absence. Long term sickness absence. Where there are concerns about an employee s physical or mental fitness to carry out their role safely and effectively. If the absence is related to an injury or accident at work If the absence relates to pregnancy 7.6 Early referral by managers allows effective prioritisation and signposting to appropriate support services in order that individual employees can be given the best opportunity to either avoid an absence from work or facilitate their early return to work. 7.7 The manager must fully discuss all their concerns and the reason for the referral with the employee. The manager should seek the employee s agreement to the referral prior to sending the fully completed referral form to the Occupational Health Department. 7.8 At any stage in this policy, the Trust may require a member of staff to consent to a medical examination (normally with Occupational Health). The employee should be asked to agree that any report produced as a result may be disclosed to the Trust and that the Trust may discuss the report with its advisors and the medical expert who produced the report. 7.9. Where a member of staff does not consent to a medical examination referral, fails to attend the medical assessment appointments, and/or does not agree to any report produced being disclosed to the Trust, a decision on the next steps in the employee's sickness absence management (including the employee's future employment with the Trust) may need to be made based only on the information available to the Trust at the time and without reference to up to date medical advice. 8 Employees with Disabilities 8.1 The Trust is aware that sickness absence may result from an employee's disability. Disability is described by the Equality Act 2010 as a physical or mental impairment that has a substantial and long-term adverse effect on an individual s ability to carry out normal day-to-day activities. In such circumstances, managers are obliged at each stage of the procedure to make reasonable adjustments to the work place or the working environment to overcome the disadvantage and support the employee s return to work. 8.2 If an employee considers that they are affected by a disability or any medical condition that impacts on their ability to undertake their work, the employee should inform their manager. Attendance Management Policy and Procedure HR020 0514 V.2 Page 8 of 47

8.3 If a member of staff is off sick due to a disability or informs their manager that they believe that they are disabled, the employee's manager should seek advice from the HR Department and Occupational Health (see appendix 4). 9 Sick Pay 9.1 Employees absent from work owing to illness will be entitled to receive sick pay in line with the provisions set out in section 14 of the NHS Terms and Conditions Handbook (as amended from time to time). Subject to these provisions, sick pay is paid in accordance with the scale below: - during the first year of service one month s full pay and two months half pay; during the second year of service two months full pay and two months half pay; during the third year of service four months full pay and four months half pay; during the fourth and fifth years of service five months full pay and five months half pay; after completing five years of service six months full pay and six months half pay. 9.2. There is no requirement that an employee's sick pay entitlement should be exhausted prior to steps being taken under this policy. Managers should always seek to manage employee sickness absence in a timely manner without regard to whether the employee is in receipt of sick pay. 10 Sickness Absence Management and Reporting 10.1 Every member of staff who is not on annual leave/authorised absence has a responsibility to attend work unless prevented from doing so by illness. Where a member of staff is prevented from attending work due to illness, the procedure for reporting sickness absence must be followed and certificates provided where appropriate. 10.2 All managers have responsibility for defining local arrangements for reporting sickness absence and ensuring that these are communicated effectively to all staff. 10.3 Staff must report their sickness absence, including occasions when they have agreed to work outside their normal working week, to their immediate line manager or another designated manager verbally by telephone (not by text or email) at the earliest opportunity, before the start of their shift or working hours. This will normally be in person, but where genuine incapacity prevents this, it is the individual s responsibility to ask someone to do so on their behalf, and seek to personally contact their manager by telephone as soon as they are able. The employee should ascertain the name of the manager with whom the message was left. 10.4. When notifying absence, an individual should expect to give the reasons for and likely duration of their absence to their manager in order for necessary arrangements to be made to cover workload. Employees will normally be required to notify their manager on each day of absence (in accordance with local reporting procedures), Attendance Management Policy and Procedure HR020 0514 V.2 Page 9 of 47

unless expressly agreed otherwise with their manager. Employees likely to be absent for more than one day, should discuss and agree with their manager how they will notify their absence in respect of any further days absence. 10.5. It should be noted that late notification of sickness absence may, where there is no justification, result in disciplinary action and/or loss of pay. 11 Recording and Monitoring Absence 11.1 To manage sickness absence effectively, managers must have the ability to record and produce accurate information about an individual s attendance. 11.2 A copy of the weekly sickness and absence form must be forwarded to the Payroll Services Manager each Monday even if this is a nil return. The records will provide the basis for sickness management and are also required for the accurate payment of sick pay. 11.3 The HR Department will also provide absence reports. Managers should analyse the information contained in these and be consistent in their approach to staff. 12 Procedure for Keeping in Touch 12.1 During any period of sickness managers must keep in touch with their staff to see how they are progressing and, particularly where staff are off on long term sickness absence, to ensure they still feel in contact with the team. 12.2 It is also important that members of staff continue to maintain regular contact with their managers to discuss their progress and allow the necessary arrangements to be made to cover their workload. 13 Provision of Fit Notes 13.1 An individual who is prevented from working by illness is required to submit the following evidence of their incapacity: A self-certificate form will be required for absences lasting one to seven calendar days (appendix 6) Absences of more than seven calendar days duration must be supported by submission of an original medical fit note renewed as appropriate and sent to the manager. 13.2 Where fit notes are not provided in a timely manner, the Trust reserves the right to suspend an individual s pay until such times as a fit note is provided. Where an employee fails to provide the required evidence of their incapacity, the Trust may regard the absence as an unauthorised absence and accordingly reserves the right Attendance Management Policy and Procedure HR020 0514 V.2 Page 10 of 47

to withhold or deduct the employee's pay and regard the absence as a disciplinary matter. 13.3 The Trust may require a note to be submitted for periods of absence shorter than is normally required. Where this is requested, the cost will be reimbursed on production of a receipt. 13.4 A fit note may include information where a doctor has advised that an employee may be fit for work provided that measures can be taken to support their return, such as: Phased return to work - A doctor will recommend this where they believe that staff member employee may benefit from a gradual increase in the intensity of their work duties or their working hours. Altered hours - A doctor will recommend this where they believe that the staff member will benefit from a change to the hours that they work, in order for them to return to work. This does not necessarily mean working fewer hours, it may mean a revised working pattern. Amended duties - A doctor will recommend this where they believe the staff member may be able to return to work if their duties are amended to take account of their condition. 13.5 If an employee receives a certificate saying that they may be fit for work, the employee should inform their manager immediately. The Trust will discuss with the employee any additional measures that may be needed to facilitate their return to work taking account of their doctor's advice. If advice is required about the information on the fit note, then the manager should discuss this with Occupational Health. If appropriate measures cannot be taken to facilitate a return to work, the employee should remain on sick leave with a date set to review the situation. 13.6 Where a phased return is recommended, account will be taken of the needs of the service when considering whether or not this can be accommodated. This may involve undertaking a risk assessment. 13.7. If a period of sickness absence is as a result of a third party, in respect of which damages are or may be recoverable, the employee must immediately notify their line manager and any damages received will be set against sick pay. 14 Unauthorised Absence 14.1 Absence that has not been notified, or evidenced according to the sickness absence reporting procedure and certification requirements, will be treated as unauthorised absence. Cases of unauthorised absence will be dealt with under the Trust's Disciplinary Procedure. 15 Return to Work Interviews Attendance Management Policy and Procedure HR020 0514 V.2 Page 11 of 47

15.1 Return to work interviews are powerful tools in managing sickness absence consistently and fairly. They can also assist in reducing future occurrences of absence by providing an appropriate and timely opportunity for discussion about an employee s health and sickness absence record. 15.2 The purpose of any return to work interview is to be supportive and assist the employee, as far as possible, to avoid further sickness absence. It will be conducted on an informal, but private and confidential basis, after every period of absence. Managers should review the employee s Bradford score at every return to work interview. 15.3 The return to work interview will explore the reasons for the sickness absence, follow up any serious problems and suggest further assistance if required, including, for example, referral to Occupational Health or the Employee Assistance Programme /confidential counselling. 15.4 Staff must be given the opportunity to discuss any underlying problems either of a personal, domestic or work related nature, which may be the cause of the absence(s). Managers should support staff to develop a course of action to help them improve their sickness record. This may require consideration of possible adjustments to premises, equipment and/or duties, with consideration being given to any advice received from Occupational Health and/or the individual s own doctor. 15.5 Return to work interviews do not require the attendance of HR or union representatives. This meeting is held between the manager and the member of staff as good employment practice and as a supportive measure. 15.6 Further guidance for managers on return to work discussions is contained in Appendix 5. 16 The Management of Frequent Short Term Sickness Absence 16.1 It is essential that frequent short term periods of sickness absence, either medically or self-certified, are dealt with promptly and consistently, but also in a fair and sympathetic manner. The manager dealing with short term sickness absence should seek advice from a member of the HR team to discuss the steps to be taken. 16.2 A return to work interview must take place at the end of each period episode of sickness absence (see section 15) 16.3 An episode of sickness is defined as a minimum of a working day and can be of any duration. If a member of staff is unable to work for over half their daily hours because of sickness, this will be treated as one day. Where they are able to work for over half their daily hours this will not be included as part of any period of absence. However, if it becomes clear that there is a pattern of half day absences, this will be escalated and investigated in accordance with the short term sickness procedure. 16.4 Managers are expected to regularly review individual sickness records of their staff and take action as required. This includes identifying notable patterns e.g. absence prior to or after scheduled days off or a particular shift. Attendance Management Policy and Procedure HR020 0514 V.2 Page 12 of 47

16.5 A continuous absence of 4 weeks or more will be managed under the Long Term Sickness Absence procedure. 17 Bradford Score Calculations and Trigger points 17.1 Particular attention should be given by managers to any employee who has reached or exceeded a Bradford score of 125 in any rolling 12 month period or earlier than this if there appears to be an emerging pattern of sickness absence. 17.2 The Bradford Factor is a sickness absence tool used to ensure that sickness absence is measured consistently. A Bradford score is calculated by taking the number of absences and multiplying this number by itself and then by the total number of days' absence taken. The calculation is based on a rolling 52-week period. Bradford Score = S x S x D S = total number of spells of absence taken by an individual in the last 52 weeks D = total number of working days of absence taken by an individual in the last 52 weeks For example, for employees with a total of 14 days absence, the Bradford score can vary enormously, depending on the number of occasions involved. 1 absence of 14 days is 14 points (1 x 1 x 14) 14 absences of 1 day each is 2,744 points (14 x 14 x 14) 17.3 The only fully acceptable attendance is 100%, but is recognised that most people will occasionally be unable to come to work because they are prevented by illness or injury. Some absence is therefore inevitable. However, where in any rolling period of 12 months an individual s Bradford score reaches or exceeds 125, consideration will be given as to whether action under the policy is needed and the manager will meet with their staff member to discuss. 17.4 A high Bradford score will not always require formal action to be taken and each case will be looked at on an individual basis and discussed with HR, as appropriate. 17.5 It should be noted that the number of working days lost is not the same as the number of days recorded for workforce monitoring purposes, which counts the calendar week. If the employee is part time, their working pattern should be taken into account when analysing their sickness data and applying the Bradford factor. Attendance Management Policy and Procedure HR020 0514 V.2 Page 13 of 47

18 Informal Sickness Review Meeting 18.1 Once an employee has reached or exceeded a Bradford score of 125 (or earlier if there appears to be an emerging pattern of absence), the manager will invite the employee to an informal sickness review meeting. 18.2 The purpose of the sickness review meeting is to: Discuss with the employee the impact that the absences are having on their performance of the job and on the operation of the department. Give the staff member the opportunity to explain the reasons for their absence Discuss any existing Occupational Health reports or any other relevant documentation. If there has been no prior referral to Occupational Health, consider whether this would be useful to determine if there is an underlying medical condition. Establish any underlying difficulties or causes, particularly where these are contributed to by work issues. Give consideration to the employee s work or personal problems and review whether the manager can assist resolution. Advise the employee that their attendance level will continue to be monitored over a specified period of time - normally six months. Communicate any attendance targets being set for the individual. Indicate that, should the employee fail to reach and maintain the required level of attendance within the specified time period, they are liable to be subject to the formal stages of the policy. 18.3 Following the meeting, a letter will be sent to the employee confirming the targets set and the consequences of failing to reach the necessary improvement within the specified time period. 18.4 There will be a review at the end of the monitoring period to decide, dependant on the level of improvement, whether the monitoring period will continue to remain in force or not. The outcome of this should be confirmed in writing. 19 Recurring Absence 19.1 If an employee has been monitored under the short term absence procedure on a number of occasions, whether at an informal or formal stage, there may be concerns about a developing pattern of unacceptable absence. In such circumstances, it may be appropriate for the employee to be warned at the end of a successful monitoring period (at a review meeting) that if they trigger the short term absence management procedure again, any such further absences will be dealt with under stage 1 of this procedure without any further informal meetings. This should be confirmed in writing to the employee. 19.2 In circumstances where an employee has already been managed under the long term sickness absence procedure and, following their return to work, has a unacceptably high level of short term sickness absence within the next 12 month period, the Trust may decide to escalate the management of the short term absence to the formal stage of the short term sickness absence procedure. Attendance Management Policy and Procedure HR020 0514 V.2 Page 14 of 47

20 Formal Procedure Stage 1 First Written Warning 20.1 Where the employee fails to achieve a satisfactory improvement in their attendance levels, a meeting may be set up under the formal stages of the procedure. Managers should always consider the reasons for the employee's further episodes of sickness absence before the matter is escalated to stage 1. There is no requirement to wait until the end of the monitoring period to set up this meeting if the employee fails to meet the required improvement at an earlier stage 20.2 The employee should be given 7 calendar days notice in writing of the meeting and be informed that they may be represented by a trade union or professional association representative or work colleague. An HR representative will also be present. 20.3 At the meeting, the manager should: State the reason for the meeting. Set out the employee s sickness record and remind them of the previous action taken. Allow the employee and/or their representative to give reasons for their poor attendance and any mitigating circumstances. These should be fully considered before the manager considers whether it is necessary to issue a first written warning. Discuss the likelihood of further absences. Discuss the impact of absences on the employee's team/service. Discuss any assistance that will be given to improve attendance levels e.g. referral to Occupational Health. The employee should also be advised to seek help from their doctor and be advised of the Employee Assistance Programme. Having considered all the evidence, decide whether or not it is appropriate to issue a first written warning. 20.4 The manager s decision should be confirmed in writing to the employee within seven working days of the meeting. Where a first written warning is given, the manager must inform the employee that their attendance will be monitored during the period of the warning. The letter should also clearly state that, if a satisfactory level of attendance is not achieved, further action under the procedure will be taken and this may ultimately lead to dismissal. The warning shall remain in force for a set period - normally 12 months, after which time it will lapse. 20.5 The employee should be asked to sign a duplicate copy letter as confirmation that they have read and understood its contents. This signed copy should be filed in the employee s personal file. Any refusal by the employee to sign the letter will not, however, affect the validity of the warning. 20.6 If at the end of the monitoring period the employee has achieved a satisfactory level of attendance they should be informed both verbally and in writing, but reminded that the level must be sustained or further action under these procedures may be taken. 20.7 There may be occasions where an employee s sickness absence is satisfactory throughout the monitoring period, only to lapse very soon thereafter. This will be borne in mind when considering the length of future warnings and whether it is Attendance Management Policy and Procedure HR020 0514 V.2 Page 15 of 47

appropriate to escalate to stage 1 of the procedure if the employee's level of absence triggers this policy again (please see 'recurring absence' above). 21 Formal Procedure Stage 2 Final Written Warning 21.1 If, following a first written warning, a satisfactory level of attendance is not achieved and maintained during the monitoring period, a further formal meeting will be set up by the appropriate manager and in consultation with Human Resources. There is no requirement to wait until the end of the monitoring period to set up this meeting if the employee fails to meet the required improvement at an earlier stage. 21.2 The manager will normally refer the staff member to Occupational Health prior to this meeting to establish whether there are any underlying medical conditions not previously identified, and the likelihood of further absences. 21.3 The employee should be given 7 calendar days notice in writing of the meeting and be informed that they may be represented by a trade union or professional association representative or work colleague. An HR representative will also be present. 21.4 At the meeting, the manager should: State the reason for the meeting. Set out the employee s sickness record and remind them of the previous action taken under this policy. Discuss the contents of the Occupational Health report and any medical advice on the employee's health and whether further advice is required. Consider any underlying medical causes of the employee's absence and the employee's capability to carry out the role and whether any adjustments should be considered or whether redeployment might be appropriate. Discuss the likelihood of further absences. Discuss the impact of absences on the employee's team/service. Allow the employee and/or their representative to give reasons for their poor attendance and any mitigating circumstances. These should be fully considered before the manager considers whether a final written warning should be issued. Discuss any further assistance that will be given to improve attendance levels e.g. referral/reviews by Occupational Health. The employee should also be advised to seek help from their doctor and be advised of the Employee Assistance Programme. Having considered all the evidence, decide whether or not it is appropriate to issue a final written warning. 21.5 The manager s decision should be confirmed in writing to the employee within seven working days of the meeting. Where a warning is given, the manager must inform the employee that their attendance will be monitored during the period of the warning. The letter should also clearly state that, if a satisfactory level of attendance is not achieved, further action under the procedure will be taken and this may ultimately lead to dismissal. The warning shall remain in force for a set period - normally 12 months, after which time it will lapse. 21.6 The employee should be asked to sign a duplicate copy letter as confirmation that they have read and understood its contents. This signed copy by the employee Attendance Management Policy and Procedure HR020 0514 V.2 Page 16 of 47

should be filed in the employee s personal file. Any refusal by the employee to sign the letter will not, however, affect the validity of the warning. 21.7 If at the end of the monitoring period the employee has achieved the required level of attendance they should be informed both verbally and in writing, but reminded that the level must be sustained or further action under these procedures may be taken. 21.8 There may be occasions where an employee s sickness absence is satisfactory throughout the monitoring period, only to lapse very soon thereafter. This will be borne in mind when considering the length of future warnings and whether it is appropriate to invoke the formal procedure if the employee's level of absence triggers this policy again (please see section 19). 22 Formal Procedure Stage 3 Dismissal 22.1 If the required level of attendance is not achieved following a final written warning, a hearing should be convened to consider dismissal on the grounds of incapability due to ill health. The hearing will be chaired by a manager with the authority to dismiss (see Appendix 3) who has not been previously involved in the case, supported by a HR representative. 22.2 The manager will normally refer the staff member to Occupational Health prior to this meeting to establish whether there are any underlying medical conditions not previously identified, and the likelihood of further absences. 22.3 The employee will be given 14 calendar days notice of the hearing and will be advised that they may be represented by a trade union or professional association representative or work colleague. 22.4 If an employee is unable to attend the hearing for good reason, a further date will be arranged as soon as possible. This will normally be within 14 calendar days of the original hearing, but this may be extended by mutual agreement. 22.5 If the employee is unable to attend on the second hearing date, they will be advised they should provide a written submission. Unless there are exceptional circumstances, the hearing will normally take place in their absence. A trade union or professional association representative may attend on the employee s behalf. 22.6 At the meeting, the manager should: State the reason for the meeting. Review the previous meetings that have taken place under the procedure and the matters previously discussed with the employee Consider whether the sickness absence procedure has been followed and the employee has been given all possible assistance to achieve a satisfactory level of attendance. Discuss the contents of the Occupational Health report and any medical advice on the employee's health and whether further advice is required. Consider any underlying medical causes of the employee's absence and the employee's capability to carry out the role and whether any adjustments should be considered or whether redeployment might be appropriate. Attendance Management Policy and Procedure HR020 0514 V.2 Page 17 of 47

Review all the evidence presented by both management and the employee, and in particular, the impact of absences on the employee's team/service and any reasons given by the employee for their absence and any mitigating circumstances. Consider whether there is a reasonable likelihood of the employee achieving a desired level of attendance. 22.7 If the manager is satisfied that procedures have been followed and the employee has not achieved a satisfactory level of attendance they may dismiss the employee. If this is found not to be appropriate, the manager should make recommendations for further action. The manager will inform the employee both verbally and in writing of the decision. 22.8 In the case of dismissal, the employee should be informed of the reason for dismissal, the date of termination, including any notice period, and if they are required to work the notice period. They should also be informed of the appeals procedure. The letter should be sent by recorded delivery within seven calendar days of the panel s decision and a copy held on the employee s file. 23 The Management of Long Term Sickness Absence 23.1 Long term sickness is defined as continuous sickness absence of four working weeks or more. The manager dealing with a case of long term sickness absence should seek guidance from the HR department to discuss next steps to be taken. 23.1.2 Cases should be handled sensitively, fairly and on an individual basis. The Trust aims wherever possible to encourage the return of the member of staff to full normal duties. 23.1.3 It is of paramount importance that managers maintain contact with staff at regular intervals throughout any long period of sickness absence. Contact arrangements should be agreed at the start of the sickness absence, but the manager should normally be in contact with the employee at least fortnightly. The manager and member of staff may agree to meet informally during the period of absence as part of this contact. 23.2 Sickness Review Meetings 23.2.1 It is anticipated that over the course of any long term absence, and within the time span of the individual s sick pay entitlement, three sickness review meetings may be convened as set out below. It should be noted that the number of meetings and the timescale between each meeting are a guide and it may be necessary to accelerate and shorten the process depending on the circumstances of the individual case. 23.2.3 Should an employee, following a return to work after long term sickness absence, subsequently have a further period of long term sickness absence within a 12 month period: If the subsequent absence is for a different, unconnected health matter, the employee's absence will be managed at the stage previously reached. For Attendance Management Policy and Procedure HR020 0514 V.2 Page 18 of 47

example, an employee who manages a successful return to work after a stage 2 meeting will be requested to attend a new stage 2 meeting. If the subsequent absence is for the same or a connected health matter, the Trust may determine that the employee's return to work was not successful. In these cases, any absence will be treated as a continuation of the previous absence. For example, an employee who has previously had a stage 2 meeting will be required to have a stage 3 meeting. 23.2.4 Should the employee be too ill to attend meetings at work, the meeting may be held at their home or other venue convenient to them. Advice can be sought from Occupational Health as to a staff member s fitness to attend such meetings. If the staff member remains too ill to meet, consideration will be given to a telephone meeting or in exceptional cases the meeting may need to be held with a nominated representative, who may be a colleague, a trade union representative or in exceptional circumstances, with the agreement of the Trust, a family member (who should not be legally trained) in their absence. 23.3 Stage 1 Sickness absence review meeting 23.3.1 Where the member of staff is absent with no clear date for return, the manager will arrange a sickness review meeting with the individual. 23.3.2 Before setting up a review meeting, the individual should be referred to the Occupational Health Service to establish a current medical opinion on the state of their health. This advice will form the basis of the discussion at the meeting. If an employee refuses to give permission to obtain a medical report, management will proceed and make decisions on the basis of the information available at the time. 23.3.3 The first sickness review meeting will ideally be held within 8 weeks of the start of the absence and should follow receipt of advice from Occupational Health. 23.3.4 A member of the HR team may support the manager during the review meeting and the staff member will be informed that they may have their trade union or professional association representative or work colleague present. 23.3.5 The purpose of the sickness review meeting will be to seek to establish the reason for the absence and its likely duration and discuss the Occupational Health advice. This advice should be in line with one of the following options: The employee is fit to return to their present job, either immediately or in the near future The employee would be fit to return to their current job with temporary or permanent adjustments to their duties or working hours. The employee is not fit to return to their present job, but could work in a job that accommodated their health problem. The employee is unfit to return to work in the foreseeable future, in which case a timescale for a further review will be set. The employee is unfit to return to work in the foreseeable future and an ill health retirement is supported Attendance Management Policy and Procedure HR020 0514 V.2 Page 19 of 47

23.3.6 If the employee will shortly be fit to return to work, the manager will discuss arrangements for their return, including any additional support that they may need. A phased return may be considered please see section 25. 23.3.7 If the employee could return with adjustments, the manager will discuss the adjustments that could reasonably be accommodated (e.g. changes to duties or a shorter working week, etc.) and agree the period for which they will be put in place. 23.3.8 If the employee is not able to return to their current job, but could return to an alternative role, the options for this will be discussed and/or it will be agreed to set up a separate meeting to address this issue in more detail. Please see section 24. 23.3.9 The employee should be made aware that dismissal/retirement on the grounds of ill health may be the outcome should a return to work not prove possible within a reasonable timescale. 23.3.10 The outcome of the meeting will be confirmed to the employee in writing within 7 days. 23.4 Stage 2 Sickness Absence Review meeting 23.4.1 If the employee is unable to return to work following the stage 1 meeting, a second sickness review meeting will be convened, normally 6-8 weeks later (dependant on the review period agreed at the previous stage). 23.4.2 Further Occupational Health advice will normally be sought in advance of this meeting, unless it is clear that the prognosis remains unchanged. The meeting will follow the same outline as in stage 1 above. The employee shall be reminded again of the possible outcome of dismissal/ill-health retirement should a return to work not prove possible within a reasonable timescale and the outcome of the meeting will be confirmed to the employee in writing within 7 days. 23.5 Stage 3 Final Sickness Absence Review meeting 23.5.1 If the employee is still unable to return to work following the stage 2 review meeting, a stage 3 sickness absence review meeting will be scheduled. This will normally take place 6-8 weeks after the stage 2 meeting, dependant on the individual circumstances. 23.5.2 Before setting up a stage 3 meeting, the employee should be referred to the Occupational Health Service to establish a current medical opinion on the state of their health. If an employee refuses to give permission to obtain a medical report, the Trust will proceed on the basis of the information available at the time. 23.5.3 Having obtained further medical advice from Occupational Health and discussed the case with the Line Manager/HR representative, the appropriate manager with authority to dismiss will write to the employee informing them that a sickness absence meeting has been set up under the stage 3 of the long term absence procedure. 23.5.4 The employee will be given 14 calendar days notice of the meeting and will be advised that they may be represented by a trade union or professional association Attendance Management Policy and Procedure HR020 0514 V.2 Page 20 of 47

representative or work colleague. At the meeting, the employee will be informed that the Trust may consider terminating them on the grounds of incapacity. 23.5.5 If an employee is unable to attend the meeting for good reason, a further date will be arranged as soon as possible. This will normally be within 14 calendar days of the original meeting, but this may be extended by mutual agreement. 23.5.6 If the employee or representative is unable to attend on the second meeting date, they will be advised they should provide a written submission. Unless there are exceptional circumstances, the meeting will normally take place in their absence or may be held with their representative (see paragraph 23.2.4). 23.5.7 At the meeting, the line manager shall present a chronology of events and description of the efforts made to enable the person to return to work. A full account of previous meetings and available medical advice will be required. A member of the HR team may support the manager during the sickness absence meeting. 23.5.8 The employee shall have the right to respond to all of the information presented and to put forward any mitigation/alternative medical advice etc. 23.5.9 After investigation, consultation and consideration of other alternative posts, and where there is no reasonable prospect of the employee returning to work, the appropriate manager with delegated authority to take action will take a balanced view of the following factors when taking the decision to dismiss: The length of the absence to date and the likely length of the continuing absence The medical advice/prognosis The impact of the continuing absence on the rest of the team and service and difficulties in covering the absence 23.5.10 In line with section 14.17 of the NHS Terms and Conditions Handbook, the Trust has the option to terminate employment before the employee has reached the end of the contractual paid sickness absence period 23.5.11 If the manager s decision is to dismiss, the employee will be normally be informed of this verbally at the meeting (there may be an adjournment for the panel to consider their decision) and then this will be confirmed in writing within 7 days. If it is not possible to meet this timescale, the manager will inform the employee of the reason for the delay and the expected timescale for the decision to be communicated and/or letter to be produced. 23.5.12 Appropriate notice will be given and the individual will be informed of their right of appeal against the decision. 24 Alternative employment / redeployment 24.1 If, due to ill health or disability, it is apparent that the employee cannot continue in their current post and all applicable reasonable adjustments have been made, redeployment should be considered. This will involve the following steps: 24.2 Medical assessment of the employee s abilities and restrictions should be sought from Occupational Health. Should there be a disagreement between Occupational Attendance Management Policy and Procedure HR020 0514 V.2 Page 21 of 47