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Produced By:                             Elizabeth Webber
Date                                     February 2004
Ratified By:
The PCT Remuneration and Human Resources Management Committee 4 February
The PCT Board on 29 April 2004
The Joint Consultative Committee on February 2004

CEO Signature: ……………..              Chair JCC Signature: ………….

Policy last reviewed on:       February 2004

Policy to be reviewed on:      February 2006

Policy to be reviewed by: Director of Human Resources and Organisational
Policy to be used in conjunction with:

Whitley Council Agreements

Capability Policy and Procedure

Disciplinary Policy and Procedure

Special Leave Policy

Annual Leave Policy

Maternity Leave Policy
     Sickness Absence Policy and Procedure

     1.    Purpose and Scope

     1.1   This policy is designed to encourage and assist employees to achieve and maintain
           standards of attendance.

     1.2   This policy and procedure applies to all staff employed by Hounslow Primary Care
           Trust and should be used in conjunction with the appropriate Whitley Council

     1.3   This policy sets out the steps management should take to resolve what are often
           complex problems, each needing to be considered on its individual merits and to
           enable staff to know how they should expect to be treated.

     1.4   Genuine sickness absence is not a disciplinary issue and where employees are unable
           to perform their duties because of illness they will be subject to the Capability Policy
           and Procedure.

     1.5   Employees are required to complete the appropriate documentation and/ or certificates
           in relation to sickness. Where employees are unwilling or unable to substantiate their
           absence from work on grounds of sickness, or there is evidence to suggest that their
           recorded absence due to sickness is not genuine, or their attendance record shows an
           unacceptable level of frequent short-term absence, the Disciplinary Policy and
           Procedure may be invoked.

     1.6   Employees who require time off to attend to domestic emergencies and family illness
           should refer to the Special Leave and/or Annual Leave Policy.

     1.7   Employees who are unwell as a result of maternity should refer to the Maternity Leave

2.   Principles

     2.1   The aim of the Sickness Absence Policy and Procedure is to give both management
           and staff a framework in which to address sickness absence issues in a sympathetic
           and supportive manner whilst accepting the necessity to provide an efficient service.

           To facilitate this, the PCT seeks to:

              •   ensure that employees are counselled and assisted when symptoms of ill health
              •   treat employees sympathetically in cases of illness or disability and to make any
                  reasonable adjustments to the work or workplace to enable them to fulfil their
                  duties in accordance with the Equal Opportunities in Employment and Disability
                  Awareness Policies

          •   provide arrangements to enable employees to take time off to respond to
              domestic crises and parental responsibilities in accordance with the Special
              Leave Policy
          •   provide a fair procedure for tackling frequent short-term or long term sickness

2.2    Most instances of sickness absence will be handled in an informal interview between
       the manager and the member of staff and will take the form of counselling.

2.3    This policy will be applied fairly and consistently to all staff employed by the PCT in
       accordance with the PCT’s Equal Opportunities in Employment Policy

2.4    Employees with disabilities will be given the opportunity, time and support to request
       and receive any appropriate facilities they need in order to participate fully in formal

2.5    If an employee fails to attend or is unable to attend an interview at any stage under this
       procedure the Manager shall decide, after considering the circumstances, including the
       number of times the date of the interview has been set, whether the interview should
       be postponed to a new date, or be continued in the employee’s absence.

2.6    Referrals to Occupational Health will only take place when it is necessary to obtain
       medical advice. When the PCT seeks medical advice it will conform to the
       requirements of the Access to Medical Reports Act 1988 and employees should be
       fully advised of their rights under The Act.

2.7    Redeployment will always be considered when existing duties are established, through
       medical evidence, to be contributing to the employees’ ill health, and/or the employee
       is unable to continue to carry out the duties and/or responsibilities of the past due to
       medical reasons.

2.8    Rehabilitation, as advised on medical guidance will always be addressed as part of the
       sickness absence policy and procedure.

2.9    Employees do not have to agree to a medical report being requested from their GP or
       medical specialist, but in these circumstances, decisions will be made on the state of
       the employee’s health based on the facts known at that time.

2.10   All employees will have the right to appeal against formal action taken under the
       Disciplinary or Capability procedure as a result of the application of this policy.

2.11   All employees are entitled to be represented by a trade union representative or a friend
       employed by the PCT, not acting in a legal capacity, during the formal stages of this

2.12   A Human Resources representative will be consulted and be present at all formal
       stages of this procedure.

2.13   Throughout the management of absence the need to maintain confidentiality is of
       paramount importance. This must be considered in all forms of communication.
       Disclosures of confidential information may result in disciplinary action being taken. All
       staff, including managers, need to be reminded of the consequences of disclosing such
       information and if necessary managers should remind staff of the consequences of
       disclosing such information. Advice and assistance on dealing with confidential issues
       should be sought from Human Resources.

3.     Types of Absence

3.1    Authorised Absence

       Authorised absence occurs if:

       •   absence from work is due to personal sickness or injury which has been
           appropriately notified in accordance with the reporting procedure
       •   the absence was authorised in advance by the line manager
       •   the absence is due to a genuine reason(s) outside the employee’s control which is
           acceptable to the line manager, in accordance with the PCT’s Special Leave Policy

3.2    Unauthorised Absence

       Unauthorised absence occurs when an employee is absent from his/her place of work
       for one or more days without fulfilling the criteria laid down as Authorise Absence.
       Unauthorised absence may also occur when certification arrangements such as
       providing documentation relating to absence have not been carried out.

       Any period of unauthorised absence should be investigated and depending upon the
       circumstances may result in disciplinary action being taken against the employee. The
       period of unauthorised absence may not be paid.

3.3    Short-Term Sickness Absence

       These absences generally present as a pattern of unrelated explanations for absence.

       As a guideline the following will normally be regarded as unsatisfactory absence
       behaviour and will trigger this procedure

       •   Four or more periods of absence in a 12 month period or less
       •   Regular absence on certain days, e.g. Mondays or Fridays, known busy days etc.
       •   Where a combination of odd days, longer periods and patterns of absence exists
           which causes the manager concern.

3.4    Long-Term Sickness Absence

           Long-term sickness may be defined as continuous absence through ill-health covering
           a prolonged period of 4 weeks1 or more during a 12 month period. Any absence of
           over 4 weeks will automatically be referred by the manager to occupational health and
           the employee may not return until such time as occupational health have declared the
           employee fit to resume their duties.

4.         Procedure

4.1        Reporting Sickness Absence

           It is the employee’s responsibility to contact his/her line manager within one hour of
           their normal starting time or as soon as is reasonably practicable if they need to take
           sickness absence leave. If the manager is unavailable the employee should speak
           with another designated manager. It is not acceptable to leave a message on an
           answer phone, send a text message or e-mail. If no one is available in the relevant
           department then Human Resources can be contacted to pass the message on.

           Employees may nominate another person to make the initial phone call where they are
           unable to do so themselves but it remains their responsibility to ensure that this takes

           During the initial contact the following points should be covered:

           •   The nature of the absence (unless confidential)
           •   Whether the absence is due to an industrial injury
           •   When the employee thinks he/she is likely to return to work
           •   Handover information from the employee to the manager
           •   Any support the organisation can offer to assist the employee

           On the fourth day of absence, including any non-working day, employees or their
           nominated person must again telephone their manager within one hour of their normal
           starting time or as soon as is reasonably practicable informing them of their continued
           ill- health. They should also inform the manager of a likely return date.

           On the eighth day of absence, including any non-working day, the employee must see
           his/her doctor (if they have not done so previously), obtain a medical certificate and
           submit this immediately to their manager. The certificate should either be handed to
           the manager or sent by post marked private and confidential to the manager (staff are
           advised to take a photocopy). From this point medical certificates must be submitted to
           cover any further periods of absence.

           Part-time staff are required to count non-working days for the purposes of reporting
           sickness absence although only the working days will be recorded on their sickness
           record as is the case for full time employees. Absence in respect of part-time and job
           share employees working less than five days a week will be considered on a pro-rata

    As defined in Managing Ill Health Retirement in the NHS (June 2000)

      During periods of long-term sickness managers and employees should agree a method
      of regular communication which results in contact being made at least every two

4.2   Employees with disabilities may need to make alternative arrangements with their
      manager if these contact times are difficult as a result of their disability.

4.3   Where an employee has failed to report a sickness absence, the manager should
      consider such factors as the nature of the illness, whether or not the person has a
      telephone, lives alone etc before deciding what action to take. Failure to supply
      regular sickness certificates covering periods of sick leave over seven days may be
      regarded as unauthorised absence and result in the suspension of pay and the
      initiation of disciplinary action under the Disciplinary procedure.

4.4   All injuries, accidents, illnesses or diseases arising from work activity must be reported,
      regardless of severity, to the employee’s manager as soon as possible after the
      incident in accordance with the PCT’s Health and Safety Policy. Failure to properly
      record the incident could result in loss of benefit. The employee must sign the incident
      form, and a copy should be made available for the employee. Absence lasting more
      the three days must be notified by the manager to the Occupational Health Manager
      and Health and Safety Officer on the fourth day.

4.5   Leaving the UK/ holidaying in the UK whilst on Sickness Absence Leave

      It is the responsibility of the employee to consult their GP and seek their advice prior to
      informing their manager that they intend to leave the UK whilst on periods of sick pay.
      Failure to do so could result in suspension of sick pay and possible action under the
      disciplinary procedure.

      If an employee intends to take a holiday in the UK, the advice of their GP should also
      be sought prior to informing their manager. Dependent upon the circumstances the line
      manager may request the employee to attend an assessment at the Occupational
      Health Department prior to his/her departure from/ holiday in the UK. The aim of this
      assessment will be to ensure the compatibility between the nature of the illness and
      the travel planned.

4.6   Returning to Work

      At the end of periods of sickness absence the employee should telephone his/her
      manager to inform him/her of the date of his/her return.

      As soon as possible after returning to work the employee and manager must arrange a
      suitable time to meet for a discussion and to sign the sickness absence form (Appendix
      1). It is essential that in all cases the reasons for the absence are discussed between
      the employee and the manager. This discussion should be informal and helpful to the

      During this discussion the manager must:

       •   Establish the reasons for the absence and as far as is reasonably practicable and
           satisfy himself/herself that the reason for absence was due to sickness
       •   Check that the employee is ready to work normally, considering, if it was sought,
           any medical advice received from occupational health regarding modifications.
       •   Endeavour to determine whether or not an underlying medical condition exists
           which is related to, or causing, the absence and future capability of the employee
       •   Establish if the illness is likely to recur and if further time-off (e.g. for treatment) may
           be necessary
       •   Seek advice from the Occupational Health Service if necessary.
       •   Establish whether the employee requires any further advice or counselling
       •   Ensure that the employee is aware of and understands the PCT’s Sickness
           Absence Policy and Procedure
       •   Make the employee aware of any changes that have occurred during his/her

4.7    There may be occasions where the normal first line manager is unavailable and a
       colleague undertakes the discussion on his/her behalf. Where this occurs the
       employee’s views should be respected if, owing the confidential nature of the absence,
       he/she only wishes to speak with the line manager or another appropriate manager of
       the same gender. In certain very sensitive circumstances the discussion may take
       place with the Human Resources Manager. In all such circumstances the line
       manager should be informed of any action taken.

4.8    An employee must complete a Hounslow PCT self certificate for all absences which
       are seven days or less (enclosed at back of policy). This may be completed at the back
       to work interview or the first day back to work, whichever is more appropriate.

4.9    The manager will then keep the certificate for their records.

4.10   If an employee is off for more than 7 consecutive days (including weekends) they will
       have to obtain a medical certificate to cover the period of sickness.

5.     Short-term Sickness Absence

5.1    Counselling

       When an employee is frequently absent for short periods the following procedure
       should be followed:

       •   The employee’s pattern of absence should be identified as being unsatisfactory,
           after consultation with Human Resources. Accurate records of both certificated and
           uncertificated absence will be maintained and monitored by the employees

      •   Where the pattern of absence causes concern, the manager must discuss this
          informally with the employee and seek the employee’s views about the state of
          his/her health in the light of the sickness record.

      •   Managers should ensure that all staff are dealt with in a consistent manner.

5.2   It is important for the manager to ascertain whether there are any underlying work-
      related or domestic welfare difficulties affecting the employee’s performance and
      whether any additional support is required e.g. annual leave, special leave.

5.3   The manager should explain the difficulties that arise for colleagues and management
      in meeting service commitments because of the employee’s level of absence and set a
      review date.

5.4   Where the manager feels that an employee is nearing the stage where formal stages
      of the procedure may have to be used he/she should draw it to the employee’s
      attention, both verbally and in writing.

5.5   A record of the meeting should be kept on the employee’s record and a copy given to
      the employee.

5.6   It may be appropriate to discuss the case with Occupational Health staff or to refer the
      employee, with his/her agreement to the Occupational Health Department. The
      Occupational Health Physician may medically assess the employee and/or obtain (with
      the written permission of the employee) a report from the employee’s General
      Practitioner or Hospital Consultant in accordance with the Medical Reports Act 1988

6.    Formal Procedure

6.1   If there is no improvement by the specified review date, the manager should discuss
      the matter with Human Resources. Depending on the results of these discussions and
      in the light of medical advice received, the manager will need to assess whether the
      employee is able to undertake the duties of his/her job satisfactorily and whether to
      invoke the formal procedure.

6.2   Once the manager has established with Human Resources that frequent short-term
      absences have occurred a first formal interview will be arranged.

6.3   The employee will be given at least three working days’ written notice of the interview,
      advised of its purpose and of his/her right to representation. A copy of this policy and
      procedure should also be attached.

6.4   The manager should consider any request by the employee for a deferment to enable
      him/her to be represented.

6.5   The employee is expected to attend the interview unless confined to his/her home or
      hospital by incapacity.

6.6   The purpose of the formal interview will be as follows:

      •   To review the attendance record of the employee and relevant information provided
          by Human Resources
      •   To provide the employee with the opportunity to discuss the reasons for his/her
          periods of absence
      •   To review any previous efforts to assist the employee and discuss any further
          assistance that may be possible to help reduce the level of absence
      •   To explain to the employee the difficulties for colleagues and for management
          arising from his/her absence, in providing services
      •   To establish the standards of attendance required
      •   To set a review date

6.7   After taking the above into consideration the manager should inform the employee that
      failure to improve will result in a further formal interview under the Disciplinary policy
      and procedure or the Capability policy and procedure as appropriate.

7.    Work Performance Affected by Ill-Health

7.1   When an employee’s performance falls below the acceptable standard and this
      appears to be due to ill health, despite there being no identified short or long-term
      sickness absence problem, the above procedure or those under the Capability Policy
      and Procedure should be followed as appropriate.

8.    Long-Term Sickness

8.1   Where an employee is on long-term sickness absence the manager should discuss the
      case with Human Resources having regard to the known sickness record, the
      employee’s post, the effect of the post on the employee’s health and the effect of
      his/her continued absence on the work of the department.

8.2   Throughout the period of incapacity the employee and his/her line manager should
      maintain contact and review the situation at appropriate intervals. If the employee
      agrees this may involve a visit to his/her home, by the line manager and/or a
      representative from Human Resources, in order to obtain up-to-date information on the
      employee’s state of health, to keep him/her involved with news of what is happening at
      work, and to offer help and support.

8.3   The manager may discuss the case with Occupational Health staff or refer the
      employee to the Occupational Health Department. All absences equal to or longer
      than a 3 week continuous period will be referred to Occupational Health to ensure that
      the staff member is fit to return to work.

      The Occupational Health Physician may medically assess the employee and/or obtain
      (with the written permission of the employee) a report from the employee’s General
      Practitioner or Hospital Consultant in accordance with the Medical Reports Act 1988.
      This referral to Occupational Health may be made whilst the employee is still off sick,
      and the employee will be expected to attend a mutually convenient appointment or
      allow Occupational Health staff to visit at home.

8.4    The Occupational Health service is responsible for:

       •   Assessing the nature of the condition, the current and possible treatment and its
           likely effects and the likely prognosis of the condition
       •   The likely duration of sickness absence
       •   Whether or not the individual will be fit to return to their own job without modification
           or rehabilitation
       •   Whether job modification or rehabilitation in the short term would facilitate an earlier
           return to work
       •   Whether job modification or redeployment may be necessary indefinitely on return
           to work
       •   Whether the employee will be permanently incapable of carrying out their duties
           however modified
       •   Making recommendations on whether the member of staff is fit to carry out their
           normal duties or advise on modifications, long term or short term, to the job which
           would allow them to return to work
       •   Whether the employee should return on a phased basis

8.5    On receipt of this information the manager will identify, whether it is possible to make
       the suggested modifications to an employees post or will identify if there are suitable
       alternative posts, whilst at all times complying with the provisions as laid out in the
       Disability Discrimination Act 1995 (if applicable)

8.6    Following discussions with the employee and Human Resources, and bearing in mind
       any medical advice received, a formal meeting should be arranged with the employee
       to discuss the situation.

8.7     If the employee is unable to visit the work-place at the time of the review meeting the
       option of a home visit should be considered.

8.8    The manager will write to the employee and confirm the meeting is being conducted
       under the sickness absence policy and procedure. The employee will also be advised
       of his/her right to representation.

8.9    The meeting should be used to discuss:

       •   The impact of the absence on the service
       •   The possibility of the employee’s return to work
       •   Whether short-term changes to terms and condition would facilitate a more speedy
       •   The use of Occupational Health or a report from the employee’s physician to
           determine the employee’s health situation if this has not already taken place
       •   The possibility of either ill-health or early retirement if applicable

8.10   A review date will be set and details of this meeting and any subsequent review agreed
       (if appropriate) will be confirmed in writing.

8.11   Where an employee is unable to attend a review meeting he/she must be made aware
       of any action being taken in connection with his/her long-term sickness and of his/her
       right to be represented. He/she should also be given the opportunity to discuss the
       matter with the manager and/or Human Resources.

9.     Dismissal and Ill-Health Retirement

9.1    Where an employee is to be dismissed on grounds of long-term ill-health the
       termination can be made at any stage (i.e. Full pay and half pay entitlements do not
       have to be exhausted). However, employees will not be dismissed automatically at the
       end of their entitlement to paid sick leave without these procedures having been

9.2    The notice of termination must be the maximum amount due in accordance with the
       stated notice period in the employee’s contract.

10.    Ill-Health Retirement

10.1   Early retirements on grounds of ill health may occur in two situations:

       (a)      Medical advice is received that the employee is permanently unfit to carry out
                their duties in their existing post and redeployment into other suitable
                employment has not been possible

       (b)      Where both the employer and employee agree that ill-health retirement is the
                most appropriate course of action in the circumstances. Occupational Sick Pay
                does not necessarily have to be exhausted before a decision to pursue ill-health
                retirement is made.

10.2   Following a formal decision to pursue ill-health retirement a meeting should be
       arranged with the line manager, employee and Human Resources representative. The
       employee is entitled to representation at this meeting.

10.3   The meeting should be used to:

       •     confirm the decision that the employee is to apply to leave on ill-health retirement
       •     discuss the process for effecting the decision
       •     confirm the medical information requirements
       •     ensure the necessary documentation is completed

10.4   The outcome of the meeting should be confirmed in writing.

10.5   Once the NHS Pensions Agency has reached a decision about the application a
       meeting should be arranged between all parties concerned.

10.6   If the Agency has agreed the ill-health retirement the meeting should be used to:

       •     confirm the decision reached by the Agency

       •   mutually agree a date the contract of employment will end
       •   determine how outstanding leave will be dealt with

10.7   The outcome of the meeting should be confirmed in writing.

10.8   If the NHS Pensions Agency rejects the application (which the employee can appeal
       against) the procedure for termination of contract on grounds of ill-health may be

11.    Medical Suspension

11.1   If an employee either arrives at work with symptoms of serious illness (or develops
       them over a period of time) which could impact on the care of clients, the health and
       safety of colleagues or the long term health of him/herself, the employee may be
       suspended from work on medical grounds.

11.2   Medical suspension is not a punitive measure and should only be used to allow the
       organisation to investigate a particular health issue. During periods of medical
       suspension the employee should receive normal sick pay entitlement.

11.3   Immediately upon suspension a referral to the Occupational Health Department should
       be made for an assessment as to the employee’s capability of to work. The
       suspended employee should be kept informed of the outcomes of the referral. At
       future meetings following the suspension the employee has the right to representation.

11.4   Continued Medical Suspension should be reviewed at 10 day intervals.

12.    Role of the Employee

12.1   Employees are expected to take measures to keep lateness and absence from work to
       a minimum. Among such measures should be:

       •   Maintaining reasonable standards of health and taking reasonable precautions
           against illness and accidents at work and elsewhere
       •   Attending to personal affairs, including medical appointments, at times outside
           working hours or with minimal disruption to working hours where possible

12.2   Employees are responsible for ensuring that they follow the reporting procedure as
       contained in this policy and ensure that management are aware of any underlying
       health problem which may affect attendance.

13.    Role of the Manager

13.1   Managers are responsible for ensuring that they attend training on sickness
       management, complying with the principles and procedures outlined in this document
       and ensuring that their staff are aware of this policy and procedure.

13.2   Managers should treat employees who are suffering from illness sympathetically and
       ascertain the causes of their illness, offer help and support whilst taking into
       consideration the needs of the service.

13.3   Managers are required to maintain contact with employees who are sick, at agreed
       intervals, ensure they are kept informed of service developments and ensure that the
       appropriate return to work interviews and review meetings with employees take place.

13.4   It is the manager’s responsibility to ensure that accurate records are kept of
       employees’ periods of sickness absence and that this information is regularly

13.5   Should managers identify either a pattern or underlying problem they should take
       appropriate action to address the situation.

13.6   Managers need to ensure that any appropriate documentation is given to employees.

13.7   Managers must ensure that they treat all staff in a consistent manner.

14.    Role of the Human Resources Department

14.1   The Human Resources Department is responsible for providing advice and guidance
       on the management of sickness absence.

       Its services are available to managers and employees and their representatives who
       wish to seek clarification of the policy and procedure outlined in this document. It is
       also available to employees who wish to confidentially discuss matters affecting their
       attendance at work e.g. alcohol/drug dependency, bereavement, stress etc.

14.2   The Human Resources Department and Managers are responsible for producing
       accurate sickness absence reports, ensuring that these reports are distributed to
       relevant groups such as the Board, Executive Directors Team, JCC etc., setting targets
       for reduction, assisting in the management of absence and ensuring consistency in the
       application of this policy and procedure.

15.    Role of the Occupational Health Service

       The Occupational Health Service provides two main functions:

       (a)   for an individual employee it can provide confidential advice around ill-health
       (b)   for management it provides a referral service for both the continued health of
             employees and an assessment as to their fitness for work.

16.    Role of the Employee’s Representative

16.1   The representative’s role is to provide support, advice and representation, as
       appropriate, to the employee during the whole of the Sickness Absence Policy and

16.2   He/she shall be afforded the rights outlined in the Disciplinary Policy and Procedure.

17.    Appeals

       Appeals shall be conducted in accordance with the PCT’s Appeals Policy

18.    Review

       This policy and procedure will be reviewed two years following agreement and
       thereafter every two years to ensure that it is operating fairly and effectively

Appendix 1

                     HOUNSLOW PRIMARY CARE TRUST

Name                                             Department

                        First day of Sickness

                        Last day of Sickness

                       Date returned to work

                Doctors certificate provided?                     YES/ NO
Absence as a result of: (please tick boxes that apply)
Sickness                                         Accident/
                                                 Injury at
Accident                                         Other
involving 3rd                                    (please state)
Reason for absence (please give as much detail as possible)

Managers’ signature …………………………….                     Date ……………………………

Please print full name (Manager) ………………………………………………………

Signed by member of staff ………………………                  Date ……………………………


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