Trust Policy Human Resources

Trust Policy Human Resources Title: Managing Absence Author(s): Mandy Black, Senior HR Advisor Policy Lead: Isobel Clements, Acting Director of Human Resources Accepted by: Operational Partnership Forum Ratification: Policy Review Group November 2013 Applies to: All staff Active date: 16 th December 2013 Review date: 16 th December 2016 Exclusions: Bank staff with no substantive contract Purpose: The purpose of this policy is to set out a fair, supportive and effective process for managing absence. VERSION CONTROL - This document can only be considered current when viewed via the Policies and Guidance database via the Trust intranet. If this document is printed or saved to another location, you are advised to check that the version you use remains current and valid, with reference to the active date. Key Points: Absences that hit Short term triggers, which are either two occasions of absence in three months or three occasions of absence in a twelve month rolling year, will be managed in line with short term absence flow chart A1. (see section 5 of policy) Absences that hit the long term absence trigger, which is a period of absence lasting four continuous weeks or more, will be managed in line with the long term absence flow chart A2.(see section 6 of policy). When a manager identifies there is an unusual high level of absence, or have identified unusual patterns of absence, a review will be undertaken in line with the continual persistent absence flow chart A3.(see section 7 of policy) If an individual is covered by the Equality Act consideration will be given to adjusting the triggers and targets outlined in this policy. This must be done with advice from Human Resources and on the recommendation by Occupational Health Occupational Health can be involved at any time, via management referral, to support staff so that they can return to work and continue in employment.(see guidance note G) Case Conferences will be used in order to provide an opportunity to identify appropriate ways of supporting the employee to return to work at the earliest opportunity and also provides management to discuss with staff member current situation. (see guidance note H) Page 1 of 33

Managers and employees have a responsibility to follow the process as set out in this policy, fairly and appropriately. (See guidance note B & C). The requirements under this policy for ensuring that all staff sickness is managed fairly and consistently will be monitoring under the policy performance monitoring framework. Page 2 of 33

SHORT TERM ABSENCE On 2 nd occasion of absence in 3 months Or 3 rd occasion of absence in 12 month rolling year Stage One Return to Work Interview held On next occasion of absence- 3 rd occasion in 3 months or 4 th Occasion in 12 months Stage Two Meeting Set monitoring targets 1 occasion in 3 months. Review meeting held at month 2. Return to work interviews after every absence Send outcome letter 1 or no occasions of absence during three month monitoring period. Meet to advise and send completion letter. Further absence hits a trigger within 0-3 months. Proceed to stage 3 send invite letter and manager to complete checking sheet Further absence hits a trigger within 3-6 months. Back in at stage 2 send invite letter 2 or less occasions of absence during 6 month monitoring period Return to work interview and written invitation to Stage 2 2 nd Occasion of absence during three month monitoring period. Meeting to discuss a breach in monitoring targets and agree to move to next stage of policy. Manager to complete checking sheet and written invitation sent for Stage 3 Stage Three Meeting- At stage two however HR Advisor present at meeting. Offer OH referral. Set monitoring targets 2 occasions in 6 months. Send outcome letter At least bi-monthly review meetings and return to work interviews after every absence 3 rd occasion of absence during six month monitoring period Meeting to conclude the monitoring period and send completion letter. Confirm that absence must stay within Trust limits. Meeting to discuss a breach in monitoring targets and agree to move to next stage of policy. Further absence hits a trigger within 0-3 months. Proceed to stage 4 send invite letter Further absence hits a trigger within 3-6 months. Back in at stage 3 send invite letter Written invitation to stage 4 sent Stage Four Final Review Final Review meeting to consider further monitoring period, redeployment or termination of employment Page 3 of 33

LONG TERM ABSENCE 4 Weeks plus Declined Manager to document Offer OH referral Agree regular contact plan minimum contact every 2 weeks Accept complete O/H referral form & forward to HR Keep written record of contact and sickness notes Following appointment Occupational Health report will be sent to the Manager & copied to HR Return to work stated Yes Return to work interview Arrange a case conference with HR support, discussing report No Discuss; Long Term prognosis Timescales Report from O/H RTW/Redeployment Consider reasonable adjustments Send outcome letter Return to work date set Yes Return to work interview Possible further case conference. Discuss way forward. No Returning to work complete RTW interview No return to work date within 4 months absence obtain new occupational health report and arrange Final Formal meeting Final Formal 4 month final meeting Return to work date within 2 months of Final Formal Yes Return to work interview No return to work date within 6 months Further Final Formal Meeting Hold at 6 month. Decision taken re-employment Page 4 of 33

OVERALL HIGH LEVELS OF PERSISTENT ABSENCE / PATTERNS OF ABSENCE Identified by Manager Produces evidence and background information of employee s absence. Contact HR advisor to discuss case history and high % of absence rate. Manager writes to individual with 7 days notice advising of the need to hold a meeting to discuss absence history. Invite letter persistent absence review meeting. Outcome letter sent following meeting. Advising that senior manager will be in contact to arrange a Final Formal meeting. Outcome letter persistent absence review meeting Offer O/H referral No Manager to document Yes contact HR for referral form Obtain Occupational Health report and hearing manager invite to Formal Review meeting. Invite to Formal Review Meeting letter. Final Formal Meeting held to review absence history and decision taken to continue with employment or termination of contract due to high absence rate. Page 5 of 33

1. Introduction 1.1 The policy is to ensure all staff are supported during periods of health related absence, to provide staff with the appropriate support to return to work, as soon as possible and to ensure that they are able to fulfil their contractual obligations. 1.2 This policy applies to all staff with a substantive contract with Taunton and Somerset NHS Foundation Trust. 1.3 This policy does not differentiate between genuine and non genuine absence, as it is assumed that every episode of sickness reported by an employee is genuine. All sickness absence, including surgery, will contribute to monitoring under this policy, unless the policy specifically excludes it, or following discussions with HR allows the absence to be counted as a reasonable adjustment as the condition falls under the Equality Act. 1.4 This policy has been produced and agreed in partnership between management and Trade Union representatives of the Trust to ensure all employees are treated equitably when their attendance fails to meet the expected standards set within the Trust. 2. Definitions 2.1 Short term triggers are either two occasions of absence in three months or three occasions of absence in a twelve month rolling year. 2.2 The long term absence trigger is a period of absence lasting four continuous weeks or more. 2.3 Continual persistent absence is when a manager identifies that there is an unusual high level of absence, or they have identified unusual patterns of absence which does not fall under either two of the above and a review is therefore required. 3. Policy principles 3.1 When a period of absence falls under any of the definitions above the manager must ensure the appropriate stages /process of the policy is being followed. 3.2 The short term process incorporates four levels of review. The long term absence requires a Final meeting at four months and a persistent absence meeting can be undertaken at any time that a manager feels there is a significant high level of absence that falls outside the Trust sickness targets. The final meetings can result in Page 6 of 33

dismissal on the grounds of failure to meet the required levels of attendance in line with the Trust s Managing Absence Policy without reverting to the Disciplinary Policy. 3.3 The policy must be followed stage by stage. It is not possible to progress to a further stage until the initial processes have been adhered to. 3.4 All periods of absence must be reported at the earliest possible opportunity to their appropriate manager who will keep a full record of all absences. This includes individuals who are not due to be in work as they are not rostered, are on annual leave, or working from home/alternative work base. There is no expectation that individuals will undertake any work related activity whilst absent from work due to ill health, unless advised by Occupational Health, or on advice from the individual s GP with the presentation of a suitable fit note. 3.5 It is the employee s responsibility to ensure they provide a Fit note from a doctor after 7 days of absence or longer. The employee must ensure that this is provided to the manager as soon as possible, and no longer than after the 10th day of absence. For continuing absence the employee must obtain and submit their Fit note certificate no later than two days after the last day covered by the previous certificate. Failure to do so may lead to the non-payment of salary 3.6 Every period of absence, full and part shifts must be discussed at a return to work interview. The manager must complete the appropriate return to work form, discussing with the individual the reason for the absence, and whether any further support is required. 3.7 Special consideration will be given to those employees who potentially receive protection under the Equality Act 2010. In circumstances where an individual has a long term condition, potentially covered by the Equality Act, which impacts on their attendance at work or the ability to undertake their role, consideration will be given to adjusting the triggers and targets outlined in this policy. This must be done with advice from Human Resources and on the recommendation by Occupational Health. Each case will be treated individually. 3.8 The Trust must ensure that all reasonable adjustments are considered. This could include change to the working environment, hours, triggers and targets. It may also be of benefit to involve outside agencies such as a disability advisor or access to work for advice if needed. Page 7 of 33

3.9 When an employee falls pregnant, or as a result of IVF, any sickness which is related to the pregnancy or IVF will not be included for monitoring purposes. However a return to work form must be completed. 3.10 It is essential that all managers ensure a safe working environment, which includes the awareness that stress can lead to short and long term absence. 3.11 When an employee is absent due to stress, the manager or agreed third party should contact the individual to offer an immediate referral to Occupational Health. The contents of this referral must be agreed by the individual prior to this being sent to HR for action. 3.12 At the formal stages within the policy the employee will have the right to be accompanied by a Trade Union Representative or work colleague, this does not extend to the right of legal representation, partners, and family members 3.13 If an employee is absent and as a consequence has been unable to take the statutory annual leave entitlement under the Working Time Directive within the current leave year, permission to carry forward the remainder into the new leave year will be based on prevailing legislation. Please contact HR for further clarification. 3.14 If an employee falls ill whilst on annual leave, they will be required to report their sickness following the normal locally determined procedure. It may be possible to credit the annual leave for the period in question only if the sickness would affect their capacity to do their job annual leave does not get credited if the sickness meant they just couldn t enjoy their holiday. A doctor s fit note will be required. 3.15 Employees will not be entitled to an additional day off if sick on a statutory holiday. 3.16 All forms of employment, both paid and unpaid should be declared to the Trust. Staff should not undertake any paid or unpaid employment elsewhere whilst absent from the Trust, unless this has been discussed with HR. Any concerns should be reported immediately to the Trust s Local Counter Fraud Department. 3.17 Dismissal may only be authorised by an appropriate level of manager. Those authorised to dismiss may delegate the power of dismissal, in writing prior to the meeting, to another manager at a senior level. 3.18 When arranging the final meeting of any of the absence processes laid out, individuals will be given at least seven days prior notice. In the event of the need to reschedule every effort should be taken to ensure a reasonable time frame is met. Page 8 of 33

Should individuals fail to attend this re-arranged meeting, the Trust may decide to hold the meeting in the employee s absence. 4. Duties/Responsibilities Human Resources The HR team is available to provide advice and guidance regarding managing absence. HR involvement is required from Stage 3 in line with the short term process. HR advisors will support managers during long term cases, as well as providing support when a persistent absence case is highlighted. Managers Managers are expected to follow the process as set out in this policy, fairly and appropriately. It is essential that the manager is able to demonstrate that a fair process has been followed. Guidance note B sets out the responsibilities of the manager when managing absence. Employees Guidance C sets out the responsibilities of the employee when absent. 5. Process Short Term Absence Process 5.1 When an employee hits one of the short term triggers being either two occasions of absence in three months, or three occasions of absence in a twelve month rolling year. This process will be instigated. See short term absence flow chart. If an individual is covered by the Equality Act 2010 consideration will be given to adjusting the triggers and targets outlined in this policy. This must be done with advice from Human Resources and on the recommendation by Occupational Health. Each case will be treated individually Episodes of absence where an employee has left work early (at any time during their shift) due to being unwell will be counted as a part shift. If the individual has not commenced work this will be counted as a full days absent. Page 9 of 33

If three part days occur in a twelve month rolling year, this will count as one occasion of absence towards monitoring. A return to work interview will be required to be completed after each part shift. 5.2 Stage One The Stage One acts as an indicator to employees that their absence is causing concern and that monitoring could commence on the next occasion of absence. The aim is to try and prevent any further absence by identifying and addressing issues and consider any support required as part of the return to work interview. The standard return to work interview form is completed by the line manager however it is recorded that this is a Stage One return to work interview by ticking the appropriate box at the top of the form and recording that the stage one interview has taken place. Guidance note E 5.3 Stage Two This stage takes place when an employee has another period of absence following the Stage 1 return to work interview, and hits the triggers which will mean the absence is the third occasion within three months or the fourth occasion within a twelve month rolling year. On their return from the absence the manager will carry out a return to work interview with the employee and during this inform them that a further meeting will be arranged to discuss their absence. This will be the Stage Two meeting. If the employee is happy to proceed with the Stage Two meeting during the return to work interview this can be undertaken by the manager at the same time. This must be clearly documented in the outcome letter following the meeting stating that the employee was happy to proceed. Should the employee wish to have the Stage Two meeting at a later date, the manager will write to the employee inviting them to the meeting, giving seven days notice, and explaining that they have the right to representation and provide a copy of the managing absence policy. This meeting, where possible, will be held within 14 days of the employee s date of return. The aim of the meeting is to: Discuss the episodes and reasons for the absence and ensure that the employee is aware of the absence triggers that they have hit; Page 10 of 33

Assess the possibility of an underlying medical condition by referring to Occupational Health; Inform the employee that continued absence periods are unacceptable and state that the employees continued employment could be at risk (dismissal due to failure to meet the required levels of attendance in line with the Trust s Managing Absence Policy); Consideration is to be given to any personal problems or worries with discussion on the ways in which they may be resolved and any support that can be provided. Advise that the employee s attendance will be monitored for a period of three months, setting a target of no more than one occasion of absence during the monitoring period, which will commence from the date of the meeting. Consideration should be given to adjusting the monitoring targets where an employee is covered by the Equality Act as their condition may expect unusual levels of absence. If the post cannot support adjusted targets consideration should be given to redeployment; Inform the employee that there will be a mid way review meeting during the monitoring period. Details following the meeting must be confirmed in writing to the employee. A review meeting will be held at the end of the agreed monitoring period, if satisfactory improvement has been achieved and sustained during the monitoring period no further action will be taken. The employee must be written to and informed that they have been taken off monitoring and that they need to keep their absence rate below the Trust target levels. If an absence trigger is hit the policy can be invoked again at the next stage if it is within three months of completing monitoring or the stage which had previously been reached if it is between three and six months of completing monitoring. If during the monitoring period the employee exceeds the targets set, then they will be informed at their return to work interview that there has been no satisfactory improvement and it is therefore necessary to proceed to the next stage of the policy. If an employee is absent for four continuous weeks or more during a monitoring period, the monitoring period will be extended. The extension will depend on what length of time was remaining on the monitoring period. Any employee who is being monitored under Stage Two of the Policy and wishes to undertake additional shift/hours including on the Trust s Bank must have a conversation with their manager to obtain agreement. This must be documented in the employees file. Taking into account the medical reasons the manager has the Page 11 of 33

right to decline this request should they feel that extra work would have a detrimental effect on the staff member s attendance or health. 5.4 Stage Three This can occur when; When the targets set in Stage Two are not met An individual successfully completes Stage Two but then has a further occasion of absence within the 0-3 months and hits the triggers An individual successfully completes Stage Three, but has a further occasion of absence within the 3-6 months and hits the triggers When this happens a Stage Three meeting will be arranged with the employee s manager and an HR Advisor. Prior to the meeting the manager will complete the checking sheet and forward to HR together with the personal file to ensure triggers are being hit and the process has been followed. This must be confirmed in writing giving seven days notice and providing the right to representation, where possible, this will be held within 14 days of the employee s date of return. The meeting format should follow the same process as for Stage Two, however the employee should be advised that the monitoring period will be for six months with a target of no more than two occasions of absence. There will be regular review meetings which will take place bi monthly. The stage 3 monitoring period will commence from the date of the meeting. The consequences of not reaching the given targets must be clearly indicated, this will involve consideration of termination of employment. The meeting will be summarised in writing to the employee including what will happen if these targets are not met. A final review meeting will be held at the end of the agreed monitoring period, if satisfactory improvement was achieved and sustained during the monitoring period no further action will be taken. The employee is taken off monitoring and advised that they need to keep their absence rate below the Trust trigger levels. If an absence trigger is hit the policy can be invoked again at the next stage if it is within three months of completing monitoring or the stage which had previously been reached if between three and six months of completing monitoring. If during the monitoring period the employee exceeds the targets set, then they will be informed at their return to work interview that there has been no satisfactory improvement and it is therefore necessary to proceed to the next stage of the policy. Page 12 of 33

If an employee is off absent for four continuous weeks or more during a monitoring period, the monitoring period will be extended. The extension will depend on what length of time was remaining on the monitoring period. Any employee who is being monitored under Stage Three will not be permitted to work any additional shifts/hours, including on the Trust s Bank it is the responsibility of the Manager to notify the Bank of this. In addition, a review of any secondary employment arrangements should be undertaken and a decision made as to whether those arrangements can continue under the circumstances. Individuals will continue their contractual commitment to on-call. 5.5 Stage Four When the targets set on Stage Three, are not met or an individual is absent following completion of Stage Three which hits a trigger within 0-3 months a review meeting will be arranged. The Manager will write to the individual inviting them to this meeting advising that they have the right to be accompanied at this meeting. The purpose of this meeting will be to advise the employee of the reasons why they are proceeding to a stage four. Following this meeting the Stage Four meeting will be arranged. The meeting will be arranged and conducted by a senior manager with the authority to dismiss and a senior member of the HR team. Also present will be the employee s manager who maybe supported by an HR Advisor. The employee must be informed of the Stage Four final review meeting date in writing by the chair of the panel, and that termination of their contract due to failure to meet the required levels of attendance in line with the Trust s Managing Sickness Policy may occur. Employees must be reminded of their right to representation. The employee must be provided with a copy of all the paperwork relevant to the meeting at least seven days in advance of the meeting. This could include the following documentation: A complete sickness record including a summary of reasons for absence; Copies of all letters sent throughout the process; Copies of all return to work interview records; Copy of the formal return to work interview record; A copy of all Occupational Health and/or specialist medical reports; A time plan which sets out the key dates for the whole process; Any other information as deemed relevant. Page 13 of 33

If the individual is covered by the Equality Act any reasonable adjustments that may have been made to the role, targets or triggers that are set out in the process will need to be clearly visible. Any new information given at the meeting regarding ill health or a change in the nature of the sickness is to be assessed with a referral to Serco Occupational Health, which may result in the review meeting being adjourned. The termination of the employee s contract should not be considered unless a recent assessment by Occupational Health has occurred. However, if an employee does not wish to be referred or fails to attend the OH appointment without an explanation that is satisfactory to the Trust, the meeting will proceed and a decision will be taken on the information that is available. Having considered the employee s mitigation the possibility of terminating the employee s contract could be considered. If dismissed the employee has the right to appeal against the dismissal. 6. Long Term Absence Procedure When an employee hits the long term absence trigger of four continuous weeks the long term absence procedure must be followed. Long term process 6.1 Managers must offer an employee a referral to Occupational Health when they hit the long term absence trigger. This referral should be made as soon as the manager is aware that the absence will be for four weeks or more. Guidance note G sets out the Occupational Health referral process and expectations. 6.2 Managers are required to maintain contact with employees on an agreed basis, but not less than fortnightly. If the employee is not happy for the manager to be their point of contact then they can request for an agreed third party to maintain contact. However the manager must be kept up to date at all times and a written record of all contact must be kept in the employee s personal file. 6.3 Once a referral has been made to Occupational Health, all long term absence cases can be discussed and monitored via the Case Conference system as appropriate. This will provide an opportunity to identify appropriate ways of supporting the employee to return to work at the earliest opportunity. Guidance note H provides detailed information regarding the case conference approach and the expectations for all parties. Page 14 of 33

Special consideration will be given to those employees who potentially receive protection under the Equality Act 2010. In circumstances where an individual has a long term condition, potentially covered by the Equality Act, which impacts on their attendance at work or the ability to undertake their role, consideration will be given to those circumstances will be given to any reasonable adjustments. All cases will be treated on individual merit. 6.4 When an employee returns to work after a prolonged period of absence the manager should arrange an initial return to work interview and then ensure that follow up discussions occur as necessary. An induction programme should also be considered where appropriate. 6.5 In some cases, usually following advice from Occupational Health, the employee may require a sheltered return to work. A sheltered return is suitable for employees where there is a realistic expectation that they will be able to return to their current post, hours and full duties. The sheltered return will be for either a period of part time work or a post with alternative duties or less demanding duties and is a temporary change. 6.6 A Fit note is given to the employee by their GP stating what adjustments are required in order for the individual to return during the sheltered return to work period. A Manager can agree a sheltered return with the employee for a period of no more than two weeks. If a longer sheltered return is required this needs to be through Occupational Health, The maximum amount of time that an employee can have on sheltered return where they are paid their contractual hours, is four weeks within a 12 month rolling year. 6.7 If after this period the employee is still not able to fulfil their substantive post, their pay will reflect what they are currently doing in the new adjusted role/hours, even if this is a temporary arrangement. Alternatively holiday can be used in addition rather than an employees pay being reduced. In addition a review will need to take place on whether the employee will be able to return to their substantive post. Managers will need to meet and review the employee on a weekly basis; if there is no improvement then they will need to refer the employee back to Occupational Health. 6.8 The Equality Act place an onus on the employers to ensure that they make reasonable adjustments in the workplace or the duties of a post to ensure that an individual with a disability is not at a disadvantage in comparison with employees who are not disabled. It may be beneficial to involve outside agencies such as the job centre disability advisor or access to work for advice if needed. For further information please refer to the HR team. Page 15 of 33

6.9 Whilst it is always the hope that the individual will be able to resume their normal duties, if this is not the case in the foreseeable future, the manager, in line with the advice from Occupational Health and a HR Advisor will need to consider the options available as part of a Final Review. 6.10 The Final Review Process When it is identified that the employee will be unable to return to work, or at the very latest when they have had four months of absence from work, the manager must arrange a final review meeting where a decision can be made on the appropriate way forward. The employee must be informed of the final review meeting date in writing giving at least seven days notice, reminding them of their right to representation and that termination of their contract due to ill health may occur. The review meeting will be chaired by a senior manager with the authority to dismiss. During this final review the senior manager, with HR support must consider what, if any, reasonable adjustments could be implemented to support the employee returning. The manager will make all reasonable attempts to have an up to date Occupational Health report to determine whether a return to work is likely within the next two months. If a return to work is not possible at this time or within the next two months the following options must be considered if appropriate: Redeployment: On the advice of Occupational Health, redeployment can be considered on the grounds of ill health. For more information on the process of this see the Redeployment Policy. Flexible Working This should be an option that is considered to support the employee returning to work. For more information on this see the Flexible working Policy Career Break This is an option that can be discussed at the meeting, but will need authorisation from the Directorate Manager. Information on Career Breaks can be found in the Special leave Policy Termination of Contract: Where an employee is not able to return to work within reasonable timescales despite all of the above being considered, then termination of their contract on the grounds of Page 16 of 33

capability due to ill health will be considered. In order for this decision to be made, the report from Occupational Health must state the following information: Up to date medical evidence; Treatment Plans The prospects of a likely return to the substantive post, with or without adjustments within 2 months; A sheltered return with or without adjustments; Redeployment; The possibility of a successful ill health retirement application. The employee must be given the opportunity to bring to the meeting any new medical evidence, which may alter the decision. When looking to terminate the employee s contract the manager must have written a letter informing them that at the meeting termination of contract will potentially be discussed. There will be occasions when individuals that remain in employment following the 4 month Final meeting and are still absent from work at six months. At this stage a Further Final Meeting will be held. The employee must be informed of the meeting date in writing, reminding them of their right to representation and that termination of their contract due to ill health may occur. The second review meeting will be chaired by the same senior manager and member of the HR team. The meeting format should follow the same process with the same considerations. A decision will be made at this meeting regarding continued employment. If an employee refuses to attend case conferences or a final review meeting without an explanation that is satisfactory to the Trust, the process will proceed in their absence and a decision will be taken on the information that is available. The employee will be informed of any outcome in writing 7. Continual Persistent Absence Each case that is managed in line with this process will be treated on an individual basis and the principles below will apply. To ensure a fair approach is being considered in the management of these cases robust monitoring arrangements have been made which are in Section 9 of the Policy. If a manager identifies that an individual has a significant high level of reoccurring absence, which is not hitting any short term trigger but is giving cause for concern, the manager should contact a HR Advisor to discuss the case. This can be managed through the continual persistent absence route to ensure appropriate action is taken. Persistent absence flowchart. Page 17 of 33

When reviewing the case with an HR advisor, the manager is required to state the facts as to why a case review is required, produce the absence history of the employee and the pattern of the absence. Special consideration will be given to those employees who potentially receive protection under the Equality Act 2010. Once the case has been reviewed with the HR advisor, the manager will arrange for a meeting with the individual. This meeting must be confirmed in writing giving seven days notice and providing the right to representation. At this meeting the HR Advisor will be present and the manager will discuss with the employee the purpose of the meeting. The manager will explain that due to the individuals high percentage or pattern of absence compared to the Trust levels, they are required to attend a Formal Review meeting. The employee must be informed of the final review meeting date in writing giving at least seven days notice, reminding them of their right to representation and that termination of their contract due to absence rates may occur following a review of the case history. The employee must be provided with a copy of all the relevant paperwork that will be discussed at the meeting at least seven days in advance of the meeting. This could include the following documentation: A complete sickness record including a summary of reasons for absence; Copies of all letters sent throughout; Copies of all return to work interview records; A copy of all Occupational Health and/or specialist medical reports; Any other information as deemed relevant. The employee must be given the opportunity to bring to the meeting any new medical evidence, which may alter the decision. When looking to terminate the employee s contract the manager must have written a letter informing them that at the meeting termination of contract will potentially be discussed. The review will be chaired by a senior manager with the authority to dismiss. The senior manager must have an up to date Occupational Health report in order to make a final decision. However, if an employee does not wish to be referred or fails to attend an appointment without an explanation that is satisfactory to the Trust, the meeting will proceed and a decision will be taken on the information that is available. Page 18 of 33

8. Appeal Rights An employee may appeal against dismissal at Stage Four of the short term absence procedure, against dismissal under the long term absence procedure or against dismissal under continual persistent absence, as set out in this policy. The right of appeal must be exercised within 14 calendar days of the date of the letter confirming the outcome of the meeting. The appeal letter must clearly state the specific reasons for appeal and should be addressed to the named manager stated in the outcome letter. 9. Policy Review This Policy will be reviewed three years after its implementation, or earlier at the initiative of either side of the Partnership Forum or following legislative changes. 10. Performance Monitoring The requirements under this policy for ensuring that all staff sickness is managed fairly and consistently shall be monitoring according to the arrangements set out in the Policy Performance Monitoring Framework see below. 11. Equality Impact Assessment This policy has been subject to Equality Impact screening. This assessment identified no impact on any specific group equality group, with the exception of disability, for which a positive impact was identified. This recognises the provision made for adjustments to the processes for staff with disabilities. A full assessment has not been undertaken as no negative impact is evident from the screening. Page 19 of 33

Policy Performance Monitoring Framework Managing Absence Policy Element of policy for monitoring Monitoring method - Information source (eg audit)/ Measure / performance standard Item Lead Monitoring frequency / reporting frequency and route Arrangements for responding to shortcomings and tracking delivery of planned actions Arrangement for ensuring learning Staged process as set out in the Absence flow charts chart- Short term Long term Overall High Levels of persistent absence. Cases that reach Stage Four under the short term process and those cases that reach a Final Formal Meeting under both long term and overall high levels of persistent absence will be recorded on the Monitoring Database by the HR Advisor leading on the case. All details of where a case should have proceeded to a stage four hearing, or a final hearing, and advise has been given from a HR Advisor not to proceed will be recorded on the database The nominated Lead within the HR Team Monitoring reported to the HR Governance Committee, six monthly. If the HR Committee identifies a concern they will oversee the development of an action plan or escalate as appropriate to the Director of HR. The Operational Management structure will be the primary route for communicating any learning / changes required. On an annual basis the HR Advisor team will carry out an audit of all the cases that have not proceeded to the final stages, to identify any common themes or trends which need resolving through either direct one to one support, training, or policy changes. A sample of 10 departments across the Trust which will include clinical and nonclinical departments and across directorates will be six monthly audited. If during these audits scores fall below the agreed HR Governance Committee scoring criteria the department will be re-audited. Timescales for re-audits are dependent on level of scoring. The HR Advisor Team will review the cases that fall under the Continual Persistent Absence section of the policy. These finding will then be fed into the HR Governance Committee to ensure fair application of the policy. Bi monthly to the HR Governance Committee via a report, unless it is nil return which will be reported verbally. Page 20 of 33

Managing Sickness Guidance Notes The following standard documents have been written to assist managers and HR staff in the delivery of a consistent approach in accordance with the Trust s Managing Sickness Policy. DOCUMENTS A1 Short Term Absence Flowchart Page 2 A2 Long Term Absence Flowchart Page 3 A3 Continual Persistent Absence Flowchart Page 4 B Managers responsibilities Page 22 C Employees responsibilities Page 24 D Return to Work Interviews Page 25 E Return to Work Interview Record Page 26 F Short Term Absence Definition Page 28 G Staff Occupational Health Page 29 H Case Conferences Page 32 I Hospital Acquired Infections Page 33 Page 21 of 33

Guidance Note B Managers responsibilities Managers are required to appropriately document all action taken under this policy. This includes telephone conversations that they may have when an individual is on a period of long term sickness leave. It is the manager s responsibility to record every absence and the practice of carrying out documented return to work interviews is a measure to ensure that all absences are discussed to ascertain whether there are regular patterns emerging, including part shift absences. A consistent approach to return to work interviews ensures that sickness absences are acknowledged. Guidance note D sets out the process for carrying out a return to work interview. It is recognised that it is not always possible for some areas, e.g. wards to carryout out the return to work interview on the first day back and therefore it should take place ideally no later than 48 hours after they return in line with policy. In these cases the delay and reasons must be documented on the return to work interview record form. Where there are regular patterns of absence emerging the manager should contact HR to discuss the case in line with the continual persistent absence process. It is the manager s responsibility to ensure that any accident at work should be recorded on an incident form as set out in the Trust Incident policy. Sickness absence following an incident must be discussed with Human Resources in order to determine whether the absence will be excluded for monitoring purposes. For information on Temporary Injury Allowance the manager must contact the HR Advisor Team. Managers are responsible for ensuring they attend the Trust training on this policy, and keep updated with any changes. Managers are also required to ensure that their staff are aware of any changes within the Policy. Managers must ensure that their staff are aware of and understand the Trust s Managing Absence Policy. Managers should also ensure that their staff are aware of their responsibilities under Health & Safety legislation and that these are followed. Managers must give their support in finding suitable alternative employment for any staff that require redeployment on health grounds in co-operation with Occupational Health and Human Resources. Page 22 of 33

Managers are responsible for proactively managing their staff, and where possible considering what support is required to reduce an employee s absence. Managers should consider offering Occupational Health referrals or getting advice before an employee is absent from work. Managers should seek advice from Occupational Health and HR as appropriate. Page 23 of 33

Appendix C- Employees responsibilities It is the employee s responsibility that they follow the departments local reporting procedure at the earliest opportunity if they are unable to attend work, providing the reason for the absence and their likely return date. This procedure must also be followed when an employee is unwell at weekends, on a non-working day, or during a period of annual leave. Failure to correctly follow this process could result in the absence being treated as unauthorised and unpaid. Employees are required to notify their manager once they are fit to return to work, even if this falls on a weekend, a non-working day or annual leave. Failure to do so will extend the recorded length of the absence. Employees have a responsibility to be familiar with the Trust s Managing Absence Policy and to co-operate with managers in its implementation. All employees are expected to attend work and carry out their duties only when fit to do so. It is the employee s responsibility to ensure they provide a Fit note from a doctor after 7 days of absence or longer. The employee must ensure that this is provided to the manager as soon as possible, and no longer than after the 10 th day of absence. For continuing absence the employee must obtain and submit their Fit note certificate no later than two days after the last day covered by the previous certificate. Failure to do so may lead to the non-payment of salary Upon the employee s return they will attend a return to work interview where possible on the day they return from their absence. Employees must notify their managers as soon as possible, when they expect to return to work. If a member of staff is fit to return to work, but is on a day off or annual leave they also need to inform their manager that they are well enough to return, otherwise the sickness will continue to be counted. Employees must be honest and open about their reason for absence so that support can be given as necessary. Employees have a responsibility to co-operate in managing their absence and return to work to ensure that managers have all the necessary information to support them. Failure to follow this policy or local absence processes may result in disciplinary action being taken. Page 24 of 33

Appendix D Return to work Interviews. A return to work interview provides the manager with the opportunity to see the employee on their return from absence and to express their concerns about their health problems, let them know they were missed and make arrangements to update them on any information they may have missed while away. It is during these discussions that underlying problems maybe identified. Special attention should be drawn to those who have frequent absence following days off, annual leave or weekends. The manager must ensure that they check the employee s periods of absence are not related to anything else apart from sickness. If any medical condition is identified at this stage, which is likely to affect the employee carrying out their job, a referral to Occupational Health must be completed with the employee s consent. This is a mechanism to support the employee in carrying out their job. Guidance note G sets out the process of how to make a referral. The return to work interview form must be completed in full; this includes ticking the relevant box at the top of the form and being signed by both the manager and the employee. The return to work record form must be filed in the employees personnel file. Page 25 of 33

Guidance note E- Return to Work Form RETURN TO WORK INTERVIEW RECORD Return to Work Interview Stage 1 (2nd occasion in 3 months, or 3 rd occasion in 12 months) Name & Address State reason why you were unfit for work Department I now declare I am fit for work Yes Job Title No Have you consulted a doctor or visited hospital? First day of absence from work: Please tick if left part way through shift: Is there any support or adaptations that need to be put in place? (e.g. O/H referral) First day sickness reported [if earlier]: Last day absence reported: Date of return to work: Was absence due to an accident at work? YES/NO If yes, has accident/incident been reported on Trust Incident Reporting form/system? YES/NO (If No, give reasons below) Was the illness related to Ward closure? Yes/No Is the absence counted for monitoring? Yes/No State Incident Number: IF No, reasons why? Absence notified on: Date:.. Was your absence related to your long term condition? Reported to:.. Page 26 of 33

Notes of any additional discussion during return to work interview Employee I declare that the information as discussed at my return to work interview is true and that I did not undertake paid or unpaid employment during this period of absence. Signature:.. Date:.. Giving false information may result in criminal and disciplinary action and or the loss of sick pay benefits. Manager Signature:.. Date:.. This section is to be completed by line manager/supervisor as a result of any comments or action taken, following the return to work interview. Comments/Action taken following Return to Work Interview: Signature: Name:. Department: Date: Page 27 of 33

Guidance Note F Short Term Absence Definition Short Term Absence can be defined as periods of absence of less than four weeks, usually odd single days or a few days at a time, through-out the year. This sickness may be covered by a Fit Note, although these periods tend to have no particular trend related to medical conditions. If a trend does occur where there are several occasions with the same reason it may be that the manager needs to look at meeting with the individual & discuss whether a referral to Occupational Health is appropriate. This can be discussed with an HR Advisor. Managers must remember that although all absence may be genuine, when collated together it may constitute a bad attendance record. Should this result in a high overall unacceptable level of attendance, this can be managed through the high level of persistent absence route. In exceptional circumstances when absence is found not to be genuine i.e. deceit is suspected/proved, the Disciplinary Procedure should be used. Page 28 of 33

Guidance Note G Occupational Health Service Occupational health is a distinct branch of medicine concerned with how a worker s health can affect his or her ability to do the job and how work and the work environment can affect an employee s health. Occupational health is about the effect work has on health and about making sure employees are fit for the work that they do. As a result of a referral occupational health can provide advice to managers and aim to assist employees with health problems. When an Occupational Health referral is required, the manager must contact the HR team to discuss the referral and obtain a referral form. The HR team will email the form to the manager. The manager will complete the details and then email back to HR, after the individual has agreed with the content of the referral. The email address is HR@tst.nhs.uk. A copy of the referral form is then kept in the individuals file. It is important that the occupational health adviser is made aware of all relevant facts about a case to ensure that objective advice is given, based on a full understanding of the issues of concern to the referring manager. The Occupational Health Referral Form is designed to help managers provide sufficient information and specify the type of advice they are seeking when making a referral. Occupational Health will then; Review the information provided by the manager. Elicit further information from the employee Carry out any appropriate examination s relevant to the employee s health problems. Subject to the employee s written consent, obtain, if necessary, further medical information from the employee s own General Practitioner or Hospital Specialist. Determine the advice that will be offered to the manager and advise the employee of this. Arrange a follow-up appointment if required. Advice given to the manager will not contain confidential medical detail, but is concerned with matters of employment and fitness and will contain the following: Whether or not the employee is suffering from a health problem which will have an impact upon their fitness to carry out their duties. Where there is no medical evidence or any medical problem to account for an employee s absence record, then this will be clearly stated; The potential effects of the problem on current and future performance or attendance; Page 29 of 33