Policy into Practice: The Line Manager s Guide to the Management of Sickness Absence Click Here to Continue

Policy into Practice: The Line Manager s Guide to the Management of Sickness Absence Click Here to Continue 1

Contents Click on menu options for further information Introduction Responsibilities of the Line Manager Responsibilities of the Employee Responsibilities of HR Categories of Sickness Absence Arrangements for Reporting Sickness Absence Managing Absence Categories Short Term Absence Long Term Absence Holding a Health Review Meeting Employee Support Employees with disabilities Accidents at work Phased return to work Redeployment Non-return to work Disciplinary Action 2

Contents Introduction Quick Glance - Triggers and Scales of Allowances 3

Contents Arrangements for Reporting Sickness Absence Day 1 of absence Day 4 of absence Day 7 of absence Submitting Certificates Not Submitting Certificates Return to Work Process Monitoring and Following Up with Employees 4

Contents Short Term Absence One-off occasional absence Intermittent absence Intermittent absence (with underlying health problems) 5

Contents Long Term Absence Weeks 2 & 3 of absence Week 4 of absence Frequency of Contact Buddy System Meetings Medical Certificate 6

Contents Click on menu options for further information Employee support ICAS OHS 7

Contents Click on menu options for further information Non-return to work Determining Fitness to Work Dismissal on the Grounds of Capability Ill Health Retirement 8

Introduction The purpose of this guide is to provide practical advice and guidance to Line Managers in the management of sickness absence within their team. The guide takes into account relevant employment law and best practice and is also designed to complement the Management of Sickness Absence Policy and does not seek to replace the policy in any way. Line Managers are encouraged to attend the Management of Sickness Absence training courses to augment this guidance. Details of all corporate training courses are available on the NES intranet online booking system. work attendance. However, employees can be disciplined for their sickness absence. Employees can also be dismissed as a result of genuine sickness absence. Whilst being sensitive to employees who are unwell, it is the Line Manager s responsibility to be an effective and reasonable manager. Any Line Manager uncertain as to the application of any aspect of the policy or advice contained within this guide should in the first instance seek guidance from their HR Manager. Line Managers are advised to consider their approach when dealing with sickness absence within the team, as there may be a requirement to vary the management of individual cases. Whilst this guide attempts to give as comprehensive advice and practical guidance as possible in what can often be a challenging area of management, it should not be treated as the complete and authoritative guide to every possible circumstance which may arise. In most cases, employees are successfully managed through periods of sickness and resume regular 9

Quick Glance - Triggers and Scales of Allowances Triggers for closer management that Line Managers need to be aware of: 5 absences (self-certified and/or medically certified) or 10 working days within 12 months Any period of unauthorised absence Scales of Allowances Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec As stated in section 14.2 of the NHS Terms & Conditions of Service Handbook, employees absent from work due to illness will be entitled, subject to the conditions of this agreement, to receive sick pay in accordance with the scale below: Years of Service Full Pay Half Pay During the first year of service 1 month 2 months During the second year of service 2 months 2 months During the third year of service 4 months 4 months During the fourth and fifth years of service 5 months 5 months After completing five years of service 6 months 6 months * In the event of employment coming to an end, entitlement to sick pay ceases from the last day of employment More detailed information with regard to entitlement is available in the NHS Terms and Conditions of Service or from your HR Business Partner. 10

Responsibilities of the Line Manager As part of the overall responsibility of being a Line Manager, it is important to set standards of conduct, performance and attendance at work. This includes managing sickness absence within the team. If the situation is not managed appropriately absenteeism can develop into feelings of resentment, disinterest and discontent among employees, the perception being that absenteeism is acceptable. It is the Line Manager s responsibility to undertake the following: Ensure that employees have been given a copy of the policy and understand both the support available to them and their responsibilities. Attend the training sessions and actively apply the management skills developed, using a fair and equitable approach. On learning of an employee s absence, please notify as follows: Ensure that employees are aware of the online selfcertification form process and if there is a period of absence, that this form is completed as soon as possible on the return to work. The Line Manager should sign off the RTW1 form as acknowledgement of the individual s return to work and record any notes from the return to work discussion. Undertake return to work discussions with the employee and discuss the absence fully with that individual. This may be a quick informal discussion, or may require more in-depth discussion about an individual s health or workplace issue. The Line Manager may need to advise on NES facilities for support, e.g. OHS, ICAS. Enable employees to return to work after sick leave by providing reasonable support. Manage health and safety in the workplace and carry out risk assessments to prevent or reduce work-related health problems. Maintain contact with the employee on a regular basis throughout the absence, in line with the policy. Ensure compliance with equal opportunities legislation and, in particular, the Equality Act 2010. CO_ Continue Continue 11

Responsibilities of the Line Manager Consider whether the absence/absence pattern is due wholly or partly to disability and take this into account when considering what form any assistance should take. Ensure employee awareness of the Line Manager s responsibilities in monitoring, learning from and acting on sickness absence rates and absence patterns. If appropriate, meet with employees to discuss their absences and the potential consequences of persistent short- term absence or continuing long term absence. If the Line Manager believes that an employee s sick leave is not due to a genuine health problem, is not reported as required or does not comply with this policy and procedures in any other way, action may be required under the Disciplinary Policy. An employee with a disability can still be terminated if not turning up to work. The Line Manager may require additional support if the sick leave is attributable to: A disability Mental illness, e.g. depression Stress HIV or AIDS Alcohol, drugs or gambling addiction Pregnancy A notifiable infectious disease An accident at work Violence at work Bullying or harassment *It should be noted that some illnesses may be covered by the Equality Act 2010. 12

Responsibilities of the Employee Employees are responsible for the following: Reporting regularly to their Line Manager at the start and throughout any periods of sick leave. This means a phonecall to the Line Manager on Day 1 of the absence and maintaining contact on Day 4 and Day 7, if applicable and thereafter in line with the policy. Taking care of their health and attending work regularly Managing their work life balance effectively using the range of NES policies as required Submitting the RTW1 self-certification form and any medical certificates on time and in line with the policy Using sick leave for genuine sickness only Seeking and following medical advice, keeping the Line Manager informed Complying with their Line Managers request to obtain medical advice on their health, e.g. occupational health referrals Taking reasonable steps to resume work as soon as fit to do so Co-operating with any support or reasonable adjustments made by their Line Manager to enable them to return to work Reporting to the Line Manager any factors which may contribute to ill health such as health and safety, bullying and harassment etc. 13

Responsibilities of HR Occupational Health Service HR are available to provide professional guidance, advice and assistance to Line Managers on any matter relating to the management of sickness absence. They are also available to advise employees and staff representatives on the interpretation of the policy. If the Line Manager requires further support, HR should be informed and they will manage the medical referral to the Occupational Health Service (OHS) in conjunction with the Line Manager. They will continue to liaise with the Line Manager throughout until point of resolution. *See Employee Support Please see the intranet for details of who the HR Manager is for your Directorate: http://intranet.nes.scot.nhs.uk/hr/contacts/default.asp 14 Updated January 2014

Categories of Sickness Absence Although the policy addresses short term and long term absence separately, in practice the distinction is not always so clear. Line Managers are advised to exercise discretion when managing indiviudals and should take into account the individual s circumstances and take advice from HR. Short term absence - lasts up to 20 working days (or 28 days including weekends*). There are two types of short term absence: One-off occasional absence Short term intermittent absence this usually involves periods of short absence which occur intermittently over a period of months, or recurrent periods of short absence that form a pattern. Long term absence - lasts for more than 20 working days (or 28 days including weekends*). A Combination of Sickness Absence Categories In some circumstances a sickness absence pattern may not fall neatly into the categories previously described. There may be a pattern which is a combination of sickness absence categories, e.g. an underlying health issue and other intermittent unrelated sickness absences. If this situation arises, the Line Manager may need to consider this under conduct or capability. With regard to frequent short to long term absences, it is reasonable as an employer to expect employees to be able to sustain attendance at work. Where employees are unable to do so, it is reasonable to invoke the formal Capability Procedures at Appendix 2 of the Management of Sickness Absence Policy. http://intranet.nes.scot.nhs.uk/documents/ publications/classh/071108management_of_sicknessa bsence Policy.doc Unauthorised absence - If sick leave is not reported or is taken for reasons other than genuine ill health, it is regarded as unauthorised absence and can be classed as misconduct under the Disciplinary Policy. Where sick pay is claimed inappropriately, it can be regarded as gross misconduct and employees may be subject to disciplinary action. *Employees are paid for each of the 7 days of the week so, for sick leave purposes, every day is counted. If a decision is taken to go down either conduct or capability, the Line Manager should consult with their HR Business Partner about how to proceed and the implications of this. 15

Arrangements for Reporting Sickness Absence Day 1 of Absence Employees must notify their line manager of sickness absence as soon as possible on their first day of absence. The purpose of this contact is to notify NES formally that sick leave is starting. The employee needs to explain the reason for the sick leave the likely duration and any action being taken by the employee, e.g. going to the doctor. This discussion enables work to be re-distributed and for sick pay to start. If the employee is Full Time: Full time employees should telephone their line manager within normal office hours by 10am. If the employee is Part Time: Part time employees and anyone working non-standard hours (including home workers) should telephone their manager within one hour of their normal start time. If it seems likely that the employee will be off for a few more days, the Line Manager should remind them that they will need to phone again on Day 4 with an update. Where their Line Manager is unavailable during normal office hours, employees should notify another manager or leave a message. They should give their contact details so that their manager can call them back about their absence. In exceptional circumstances, employees may explain their reason for absence to a HR representative instead of their Line Manager. However, as the manager is responsible for managing absence, unless there is an exceptional circumstance, HR will be required to advise the Line Manager of the reason. *In such cases, employees still need to notify the Line Manager of the fact that they will be absent and their likely date of return, as outlined above. Once the Line Manager has been notified of any absence they should: Central Offices: email CO_Absence mailbox Regional Offices: Contact local HR Manager The Line Manager may need to check out any work related reasons for absence and deal with them promptly and appropriately, especially in relation to health and safety, pregnancy, or stress. 16

Arrangements for Reporting Sickness Absence Day 4 of Absence Mon Tues Wed Thurs Fri Sat Sun The employee must let their manager know when they can expect to return to work. Depending on the reason for absence, it can be difficult to anticipate when a full recovery will be made and so it will be assumed that this is an approximate date of return. The Line Manager should update their records and keep a note of the phone discussion. Employees should phone the Line Manager again. If the employee does not make contact, the Line Manager can call the individual to remind them of the procedures and for an update on the sickness absence. During the phonecall, the Line Manager should cover the following: health update how is the employee feeling now? further work implications arrangements for longer term cover, if needed and likely length of absence possible return date GP appointment do they plan to make an appointment? Advise the employee of the procedure for self-certification and/or obtaining medical certificates. If it seems likely that the employee will be off for a few more days, the Line Manager should remind them that they will need to phone again on Day 7 with an update. If there is a persistant lack of contact from the employee, the line manager should liaise with HR for advice about how best to proceed. 17

Arrangements for Reporting Sickness Absence Day 7 of Absence If they are not fit to return on the indicated date, employees must contact their manager again during working hours to discuss the matter further. This regular contact between employee and manager is essential as it enables the employee to remain connected to the workplace and helps the manager to plan the work programme and staffing requirements. Once Line Managers have put in place transitional arrangements to cover the employee s work commitments, managers will normally restrict their contact to reasonable enquiries about their employee s absence and not on-going work issues. Where the absence has the potential to become long term, there is evidence that this approach can also help employees achieve a successful return to their job earlier than would otherwise be possible. 18

Arrangements for Reporting Sickness Absence Submitting Certificates Absence lasting 7 days or less employees must complete and submit to their Line Manager the RTW1 self-certification form immediately on their return to work, using the form on the intranet. On this, they should outline the reason for their absence. Line Managers should sign this off following the return to work discussion and then forward as follows: *For sick pay purposes, every calendar day counts and must be recorded. e.g. A full time employee is ill on Friday, stays ill over the weekend, and is unwell on Monday. When s/he returns to work on Tuesday, 4 days should be recorded on the self-certificate. Normally if signed for longer than 7 days, the GP may state 1 month. In this instance, the GP will expect to see the employee again and issue a further medical certificate which states the date the employee can return to work. They may also stipulate any special conditions, such as a phased return. *Employees are paid for each of the 7 days of the week so, for sick leave purposes every day is counted. For part time, sick leave is calculated on a pro-rata basis. If line managers are unsure about whether an employee has reached one of the trigger points, they should contact their HR Business Partner. Managers should keep their HR Business Partner informed of the employees continuing absence and forward any medical certificates to central HR. Absence lasting more than 7 days employees MUST provide a medical certificate from their GP (or hospital, if they are an in-patient). This must be obtained promptly and sent to the Line Manager as close to Day 7 as possible. *Employees need to ensure that they have certificates to cover the whole period of their sick leave. They should arrange GP appointments before their certificate expires to either obtain a new one or be certified as fit for work. Cert CO_Absence or HR Manager (Regions) 19

Arrangements for Reporting Sickness Absence Not Submitting Certificates Employees who do not provide certificates promptly cannot be paid sick pay. In some instances, the period of absence may be regarded as unauthorised and may lead to disciplinary action. 20

Arrangements for Reporting Sickness Absence Return to Work Process Return to Work Discussion All employees are requested to complete the RTW1 self-certification form in preparation for the return to work discussion, regardless of whether they also have a medical certificate for the period of absence. Please note it is the responsibility of the employee to ensure the return to work process is fully completed. On every occasion following a period of absence (even if just for 1 day), the Line Manager should arrange to meet with the employee. This discussion should take place ideally the day of return from sickness absence and not later than 2 days following return to work. Please use the following prompts below to record any information discussed during the return to work discussion, ensuring that both the employee and Line Manager sign and date any information recorded. Explain the purpose of the meeting Establish that the employee feels better and is fit to be back at work Let them know how they were missed Identify the reason for the absence If a Medical Certificate has been submitted, is there a return to work date specified? Have any condition/s been stipulated by the GP? (e.g. less than full time, light duties etc.) Communicate any pertinent team/department/ organisation information that the employee may have missed Discuss how current workload will be managed Assess whether HR should be contacted regarding possible OHS intervention Have any trigger points been reached as a result of this absence? (Numbers of absences can be sourced from HR) Agree what has been discussed at this meeting This discussion may be formal or informal, and depending on the nature of the absence, may take only a few minutes. Line Managers should complete the return to work form with the employee. The RTW1 form can be found on the intranet. Any concerns should be noted and this may require the Line Manager to contact HR for further guidance and support, with a view to arranging a formal interview if appropriate. Formal Meetings these will be arranged with employees if absence is due to an accident, or whose absence history indicates the following: 5 absences (self-certified and/or medically certified) or 10 working days within 12 months Any period of unauthorised absence Meetings should be held at the earliest opportunity once it has been established that an employee s absence meets any of these criteria. This is to ensure that any necessary action can be implemented quickly. 21

Arrangements for Reporting Sickness Absence Monitoring and Following Up with Employees When a formal meeting has taken place, it is advisable to monitor the situation for a further period and then schedule a follow-up meeting. Ideally, this should take place no later than three months from the first formal meeting or earlier if appropriate. The meeting should be documented. The Line Manager should acknowledge if there has been an improvement in attendance and ensure that any necessary action has been implemented, to the satisfaction of the Line Manager. If the level of attendance is at an acceptable level, the employee should be encouraged to maintain this. If there has only been a slight improvement, the Line Manager should explore the reasons why this is the case and identify if any further assistance is required. The employee should be made aware that monitoring of their attendance will continue until an acceptable level has been reached. If the level of attendance has not improved, or has deteriorated, the Line Manager should contact HR to seek further guidance about how to proceed in managing the situation to the point of resolution. 22

Managing Absence Categories NES is sympathetic towards employees who fall ill from time to time. Employees may take reasonable time off when necessary. This can lead to an early recovery as well as ensuring that colleagues do not catch the colds and flu that can circulate in an office environment. Taking time off work on long term sick leave can be an anxious time for employees. NES is committed to providing reasonable support to enable employees to have the time they need to recover. It is generally understood that the longer an employee is off work, the harder they find it to return. Managers will look at creative ways to make a return to work possible within an acceptable time period and in ways that continue to support the recovery of employees. Employees should be aware that all absence is monitored. Line Managers are responsible for managing absence, having a duty of care for their employees and a responsibility to NES for proactively managing attendance. When considering their approach in the management of the different types of sickness absence, Line Managers may also need to take into account disability where appropriate. If an employee s short term absence is considered unacceptable, the Line Manager will work with them and support them to secure an improvement. In some instances, the reason for the sickness absence may give the Line Manager cause for concern because it may have the potential to become long term or re-current, or because of the implications for the workplace. Line Managers must manage absence actively and immediately being fair and firm, clear and consistent, and in line with the policy in all cases. At the start of the absence it is not always clear how long your employee will be off work. In all cases, you need to: record and report all absences check patterns and reasons for absence consider the impact of the workplace on employee health When considering a course of action, the Line Manager should take into account: the length of various sickness absence periods the periods of good health between them the reasons for the absences where applicable, the effect of the disability and/or underlying health problem on the employee s ability to carry out their current duties the business needs and workload of the employee, and the impact of the absences on other employees within the team 23

Short Term Absence One-off Occasional Absence *Please read this section in conjunction with Arrangements for Reporting Sickness Absence Line Managers will monitor the frequency, length and reason for all absence in order to determine whether there is regular attendance and acceptable levels of sickness, or the possibility of an underlying health problem or workplace issue (e.g. recurrent migraines, back strain), or an emerging pattern of absence (e.g. Fridays, Mondays, just before/after annual leave etc). Managing One-off Occasional Absence This is the most common and relates to occasional short bouts of unrelated ill health, where overall attendance remains at an acceptable level. It s the responsibility of the Line Manager to ensure employees understand the sickness absence procedures, to make them aware that they must keep in touch while they are on sick leave and undertake a return to work discussion when the employee returns to work. Short term absence can be the following: One-off occasional absence Periods of short absence, which occur intermittently over a period of months Recurrent periods of short absence that form a pattern 24

Short Term Absence Intermittent Absence Managing Short Term Intermittent Absence Short term intermittent absence is generally evidenced as more frequent absence which may or may not have an underlying health problem. It can sometimes be difficult to detect unless absence is routinely recorded and reviewed. As a guide, it should be classed as intermittent when the following trigger has been reached. 5 absences (self certificated and/or medically certificated) or 10 working days within 12 months. a pattern or is concerned, they should arrange a meeting with the employee to check whether there are any underlying problems. Causes of short term intermittent sickness can include: An underlying health problem Problems with job responsibilities malingering Workplace issues, such as bullying Personal problems outwith work An employee s sickness absence may show itself in patterns, such as: a higher incidence of absence on Fridays and Mondays absence before and after annual leave absence before particular work commitments (e.g. attendance at meetings, making presentations etc.) frequency of absence, e.g. 2 days off per month The Management of Sickness Absence Policy gives trigger points for calling a meeting with your employee. However, if the Line Manager notices 25

Short Term Absence Intermittent Absence (with Underlying Health Problems) Short Term Intermittent Absence (Underlying Health Problem) If a period of sickness absence takes place and an underlying health problem exists, it should be dealt with in a similar manner to that of long term absence. The Line Manager should record the employee s absence if it falls into this category. The absence should be closely monitored and regularly reviewed. The considerations/decisions as to how to manage the absence should be made in conjunction with HR and recorded. It is not appropriate to take disciplinary action if there is an underlying health problem and/ or disability which manifests itself as short term intermittent absences and the underlying health problem and/or disability has been confirmed by OHS. Where the prognosis is such that frequent or prolonged absences will be a continuing feature the case would require to be treated as one of lack of capability. 26

Long Term Absence Weeks 2 & 3 of Absence *Please read this section in conjunction with Arrangements for Reporting Sickness Absence Line Managers should involve their HR representative early on in cases of potential or actual long term sickness absence. The employee may not return to work and this is a complicated area of employment. Line Managers must take care to follow the policy and record all actions. Beyond Day 7 Weeks 2 & 3 of absence it is important that the Line Manager maintains contact with the employee throughout and maintains detailed notes of the discussions and any action taken in the employee s absence. Employees should phone the Line Manager again. If the employee does not make contact, the Line Manager can call the individual to remind them of the procedures and for an update on the sickness absence. During the phonecall, the Line Manager should cover the following: Discuss the GP appointment are any follow-up appointments required? Confirm what the new medical certificate covers Check longer term work implications Remind the employee to send in their medical certificate asap Remind the employee to make another GP appointment before the first one expires, if they continue to be unfit Make arrangements for the next telephone contact, taking into account that it may be easier for you to call them If it seems likely that the employee will be on sick leave for longer than four weeks, the Line Manager should alert the employee to the fact that they will need meet with them to discuss their health and ways to support their return to work The Line Manager should then undertake some follow-up action by contacting HR and updating them on progress. If the absence is likely to continue beyond Week 3, the Line Manager should discuss with HR, long term absence management. Medical Certificate - When the Line Manager receives the medical certificate, they should check the period of time covered, the reason for the absence and take account of any change from the original medical certificate. Continue 27

Long Term Absence Weeks 2 & 3 of Absence The Line Manager should seek HR advice if the medical certificate covers any of the areas below: A disability Stress Alcohol, drugs or gambling addiction A notifiable infectious disease Violence at work/home Mental illness HIV or AIDS Pregnancy An accident at work Bullying or harassment If the total length of the employee s absence is going to exceed 4 weeks, the Line Manager will normally need to arrange a health review meeting and liaise with HR so they can arrange an OHS referral. *See Holding a Health Review Meeting and Employee Support 28

Long Term Absence Week 4 of Absence Absence that exceeds 4 working weeks is considered to be long term. Whilst guidance is provided here and in the Management of Sickness Absence Policy, the individual circumstances of each case need to be taken into account. Once employees have reached week 4 of their absence and are likely to be off work for longer, Line Managers must seek case-specific advice from HR. Line Managers should make arrangements for a more in-depth health review with the employee. Depending on the circumstances, this will normally include one or more of the following: a meeting at work, at home or at a mutually convenient location, depending on the circumstances an occupational health referral forward any subsequent medical certificates to the local HR representative Employee s phonecall - During the Line Manager s normal contact phone call with the employee, they should seek to ascertain whether or not they are fit to return imminently. If they are not, the Line Manager should let them know that they will be arranging a time to meet with them to discuss their health in more detail, the likely length of their absence and any ways in which NES can assist with a return to work. This tends to be a sensitive area for staff, who sometimes interpret this as mistrust. The Line Manager should reassure the employee that, as the manager, they need to be able to plan ahead the manager needs advice on how long they can expect the employee to be off work and what steps the organisation can take to help them to return to work. *See Holding a Health Review Meeting 29

Long Term Absence Frequency of Contact Frequency and purpose of contact For longer term absence, which is likely to continue for an extended period, employees can reduce the frequency of contact to two-weekly intervals. However, the Line Manager also has the right to keep in contact with their employee and will be sensitive in this regard. Contact will normally be on an agreed basis and will not be excessive. Regular contact is essential as it enables the employee to remain connected to the workplace and helps the Line Manager to plan the work programme and staffing requirements. Line Managers will normally restrict their contact to reasonable enquiries about their employee s absence and not on-going work issues. The main purpose of this contact is to cover the following: To update the Line Manager on the employee s health status (especially after GP, OHS or hospital appointments) To update the Line Manager on the timing of a potential return to work To discuss any support that can be provided by NES To update the employee on any relevant developments in the workplace 30

Long Term Absence Buddy System If a return to work is not imminent, the Line Manager should encourage the employee to accept a buddy who can keep in touch with them during their absence. This is separate from the usual line management responsibilities and can be a valuable way of maintaining the social bond during an extended period of absence from the workplace. Their role would be to update the employee on informal matters, such as general news, shared interests, events, births, marriages etc. The Line Manager is responsible for ensuring that employees are sent any relevant corporate communications, e.g. vacancy bulletins, newsletters etc. The Line Manager should nominate an appropriate buddy, this may be a colleague who is close to the employee. The Line Manager should check that the buddy is happy to undertake this role before discussing with the employee who is absent. 31

Long Term Absence Meetings Although telephone contact is useful on an ongoing basis, from time to time employees will be required to attend meetings with their Line Manager. The Manager will be sensitive to the frequency and location of such meetings - they can be held at the workplace, at the employee s home or at another suitable venue as agreed. These meetings will normally involve HR and the employee is welcome to bring a staff representative or work colleague. The main purpose of these meetings is to cover the following: how NES can best support the employee during the period of absence whether the employee requires any support and/ or reasonable adjustments (if classed as disabled under the Disability Discrimination Act) to assist a return to work a potential date for a return to work arrangements for an appointment with OHS The reasons for absence and whether these have any implications for the workplace Meetings will be documented and a summary of the discussions provided to the employee in writing. Once the medical report has been received, a further meeting will normally be convened to discuss it and consider the implications for a return to work. 32 Updated January 2014

Long Term Absence Medical Certificate Once an employee is fit to return to work, the date of return to work must be completed on the medical certificate and passed to HR. Certificate Important for Line Managers Please refer to Appendix 4 Scottish Government CEL17 (2009), 30 April 2009, which discusses carry over of holiday entitlement during long term sick leave. Line Managers should be aware of the implications to an employee s annual leave entitlement during long term sick leave. Though a final ruling from House of Lords is still to be issued, the conditions outlined in the circular are applicable from 1 April 2009. * Part-time employees should be treated similarly as full-time employees, but on a pro-rata basis. If you require further advice when calculating any annual leave entitlement, please contact your local HR Manager. 01/11/10 33 Updated January 2014

Holding a Health Review Meeting The purpose of the meeting is to discuss the sickness absence of the employee, taking into account the individual s circumstances. The employee should be notified of the meeting in writing including the focus of the discussion, e.g. level of attendance, unauthorised absences etc. The employee may choose to be accompanied by a work colleague or staff representative. The Line Manager needs to be aware at the outset that the employee may not return to work, despite how unlikely that may seem at an early stage. As such, everything needs to be thorough and correct in order to ensure that there is a clear record of a fair and reasonable process and that it is in line with NES policy and procedures, NHS terms and conditions, and employment law. Remember: Follow the policy Be fair and reasonable at all times Seek medical advice Keep the employee s bond with NES strong Through the course of the meeting, the Line Manager should try to identify: how NES can best support the employee during the period of absence whether the employee requires any support and/ or reasonable adjustments (if classed as disabled under the DDA) to assist a return to work arrangments for an appointment with the Occupational Health Service (OHS) the reasons for absence and whether these have any implications for the workplace a potential date for a return to work Continue 34 Updated January 2014

Holding a Health Review Meeting Tips on Handling the Meeting In preparing for the meeting, if the Line Manager is unsure as to what action or form of assistance should be taken then they should seek further advice from HR. Be Sensitive - This meeting can be stressful for employees, particularly if it is their first one. Line Managers should be aware that it may be the first time that they been back in the workplace since taking going off sick, so the manager needs to be sensitive to this. Put the employee at ease and explain why the meeting is required. It is often the case that there is no doubt about the validity of the individual s reasons for sick leave and, as such, it can be helpful for Line Managers to mention this. Line Managers should attempt to obtain as much information as possible from the employee with regard to their health and explore any other relevant factors which may be impacting on the sickness absence level, e.g. problems at home, health concerns regarding another member of the family, caring difficulties, financial difficulties, relationships at home, relationships at work, problems in dealing with workload etc. to help improve the employee s sickness absence and/or facilitate a quicker return to work. Seek Medical Advice the Line Manager will normally require medical advice. However, if the Line Manager is a clinician, they need to remember that their role in this meeting is as the employer and therefore must access medical advice through the normal formal employment channels. Under the NHS Terms and Conditions, employees are required to attend the occupational health service as the OHS provides employers with important workplace advice. The OHS advice is useful in that it provides information which enables Line Managers to manage the case effectively and establish whether the employee will return to work and how they can be helped to do so. It is also essential to take into account any available medical advice, should the case progress to dismissal or ill health retirement. Continue One of the aims of this discussion is to mutually agree what forms of assistance may be appropriate Continue 35

Holding a Health Review Meeting At subsequent meetings, the occupational health physician s reports need to be discussed. Keep the Employee Committed - The longer that employees are off work, the harder it is for them to feel able to return it is the Line Manager s responsibility to help make it easier for them. If a return to work is not imminent, the Line Manager should encourage the employee to accept a buddy who can keep in touch with them during their absence. This is separate from the usual line management responsibilities and can be a valuable way of maintaining the social bond during an extended period of absence from the workplace. *See Monitoring and Following Up with Employees *See also Long Term Absence Buddy System 36

Employee Support ICAS During the managing sickness absence process, Line Managers should offer any assistance to the employees which may improve their attendance. It is also advisable to link in closely with the HR Manager. Independent Counselling & Advisor Services (ICAS) - All employees have free access to ICAS, the independent counselling service, which is a free and confidential service. It is available 24 hours a day, 365 days a year to employees and their immediate family members. As an employer, NES understands that maintaining a work-life balance is not always easy for staff. In order to provide support to employees, NES is pleased to provide Employee Assistance by ICAS to help achieve that balance. ICAS will provide counselling over the phone or in person, depending on the needs of the individual. NES encourages all employees to utilise this service for support, to help relieve pressures and/or to assist with personal problems. ICAS is available to help employees prevent problems building up by dealing with them earlier and more effectively. Further details of this 24 hour helpline are available on the intranet. http://intranet.nes.scot.nhs.uk/hr/icas/ 37 Updated January 2014

Employee Support OHS Occupational Health Service (OHS) Employees will normally meet with the OHS to discuss their health, their work and any other factors which may be having an adverse impact on their health. The OHS physician may wish to contact the employee s GP and hospital consultant for further information. Employees can request to see these reports and request amendments under the Medical Records Act. *See Responsibilities of HR decisions based on whatever information is otherwise available. This may negate their ability to explore reasonable options for work and may lead to termination of contract on the grounds of capability. *Employees can contact the Occupational Health Service direct with health problems on a confidential basis, whether or not they are on sick leave. This particularly relates to health problems affecting, or caused by, work. The purpose of the referral is normally for Line Managers to obtain advice on one or more of the following: the reasons for sick leave and its likely duration the impact of the workplace on the employee an employee s progress to recovery the support that can be offered to enable an employee to return to work safely recommendations for ill health retirement Under the NHS terms and conditions, employees are required to attend for a medical, if requested. The OHS medical report is important to NES as it under-pins the provision of support and informs decisions which may need to be made concerning an employee s work options or continued employment. Without this information, managers (in conjunction with HR) have to make 38

Employees with Disabilities NES is committed to supporting employees who are appointed with a disability or who develop a disability during their employment. Disability is defined in the Equality Act 2010 as being a physical or mental impairment which has a substantial and long term adverse effect on an individual s ability to carry out normal day to day activities. In the Act, substantial means more than minor or trivial. In addition, some long term conditions eg. cancer, HIV and multiple sclerosis are deemed disabilities under the Act from the point of diagnosis. Further details are contained within the NES Disability Policy. It is important to distinguish between general sickness absence and disability-related sickness absence. This helps to remove disadvantage experienced by disabled people and recognises that impairments and medical conditions may, at particular times, generate a greater level of sickness absence. When undertaking return to work interviews with disabled employees, the line managers will discuss the absence with the individual in order to ascertain if the absence was related to the disability, in such cases in may be appropriate to seek advice from occupational health. Particular attention should be given to determining if the disability is contributing to the absence. The aim is to ensure that the absence is recorded appropriately on the RTW1 Return to Work Discussion & Self Certification Form and personnel record as either sickness absence (e.g. where the absence was not as a result of the disability), or where it was an absence related to the disability (see Disability Policy.) Line Managers will actively work with employees and medical advisers to identify any reasonable adjustments which can be made to their jobs or to the workplace to assist their return to work and enable their regular attendance. Examples of reasonable adjustments can include: part time employment job sharing phased return to work allocation of duties to one or more other colleagues additional training or re-training time off for rehabilitation or treatment flexible working options (e.g. home working) redeployment acquiring or modifying equipment increasing supervision A government grant may be available to assist with any additional costs of making reasonable adjustments, as long as it is applied for before costs are Continue 39

Employees with Disabilities incurred. The Access to work scheme is managed by Jobcentre Plus and can provide whole or part-funding for up to three years to cover the additional costs of employing a person with disabilities. Employees with disabilities have a responsibility under the Equalities Act 2010 to co-operate with the reasonable adjustments proposed by NES. If redeployment is necessary the disabled employee will be viewed as a priority within the redeployment procedure. Where the post to which the disabled employee is redeployed is of lesser grade or salary, subject to the Executive Team approval, the employee s salary will normally be protected at the original salary during the trial period, after which he/she will be paid the salary for the new post. 40

Accidents at Work Where employees have an accident at work, they must report it in line with the Health and Safety Policy. Any sickness absence arising as a direct result of the injury may be treated differently from normal sick leave and employees should ensure that their Line Manager is advised accordingly. Line Managers should refer to the HR Business Partner who will give advice based on their interpretation of the NHS Terms and Conditions of Service. 41

Phased Return to Work Employees returning to work after a long break may require a phased re-integration to working life. This can result in employees being able to return to work earlier than would otherwise be possible, without adversely affecting their health. Line Managers should ideally meet and discuss with the employee a tailored induction package and/or training programme to re-orientate them to their job and to the organisation. Advice regarding the structure of any phased return arrangements must be sought from OHS. The Line Manager should consider the following options (and any others) as appropriate: working fewer days working reduced hours restricting job responsibilities working in a different location (perhaps working from home, or closer to home) job responsibilities and contractual working pattern. The Line Manager should meet regularly with the employee to monitor progress and continue to monitor medical reports. If an employee is unable to contribute fully to the workplace within a reasonable time frame, the Line Manager should consider whether the temporary arrangement can be made permanent. If it can, this will result in a new employment contract. If it cannot be accommodated, consideration will be given to redeployment or, regretfully, to ending the employment contract on grounds of capability. *At all times, the Line Manager should link in closely with HR. Although only employees with disabilities are entitled to consideration of reasonable adjustments under the Disability Discrimination Act (DDA), the Line Manager should be flexible in considering ways in which NES can reasonably assist an employee s return to work. The Line Manager should put in place a reasonable timeframe for an employee to resume their normal 42 Updated January 2014

Redeployment In some instances, employees may not be fit enough to return their original job. Further information can be found in the NES Organisational Change Policy and Procedures which includes the Redeployment Policy and Guidance. Further details are also contained in the NES Disability Policy. *At all times, the Line Manager should link in closely with HR. 43

Non-return to Work Determining Fitness for Work If circumstances deem that non-return to work must be considered, the Line Manager should liaise closely with their HR Business Partner and consider the following options: Determining fitness for work In a small number of cases, employees are unable to return to work within an acceptable time period. The formal capability procedures will be followed and all reasonable options will be considered before deciding that an employee s job cannot be held open for him/her any longer. It is not necessary for an employee s sick pay to have expired before consideration is given to ending the contract on the grounds of capability. It is, however, a last resort and, when considering dismissal, Line Managers must have: taken into account written medical advice and other factors consulted with the employee balanced the employee s likely future health against the organisation s needs considered offering redeployment explored other employment options and found these to be unavailable or impractical 44

Non-return to Work Dismissal on the Grounds of Capability See Appendix 2 in the Management of Sickness Absence Policy. The Line Manager and HR will normally meet with the employee several times to review medical reports, discuss progress, assistance with a return to work and, eventually, the possibility of dismissal if a return to work is not possible within an acceptable period. The decision to dismiss should never come as a surprise to affected employees. At all formal meetings, employees will be advised that they can bring a staff representative or work colleague with them. Before the final meeting, the employee will be sent a letter formally advising them that the outcome of the meeting might be dismissal on the grounds of capability. After the meeting, the employee will be advised in writing of the outcome and their right to appeal against the decision. *It is important to note that dismissal on these grounds does not mean that the sickness was not genuine. It does mean, however, that NES was unable to continue to hold the job open beyond an acceptable period and there were no alternatives which would have made an earlier return to work possible. 45