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Sickness Absence Policy by jizhen1947


									                   Sickness Absence Policy

Date approved by the BCH Committee: 13th November 2008

             Date of Implementation: 14th November 2008

             Date of Review:         November 2011

Signed ………………………………………..Date…………………………………..
Managing Director, Bristol Community Health on behalf of Bristol PCT

Signed ……………………………………….Date………………………………..
Chair of Joint Union Committee


 1 Introduction
 2 Aims and Purpose
 3 Roles and Responsibilities
    3.1 The PCT Board
    3.2 The Human Resources Department
    3.3 Occupational Health
    3.4 Managers
    3.5 Trade Union Representatives
    3.6 Employees

 4 Sick Pay
 5 Sickness Monitoring and Return to Work Interviews
    5.1 Sickness Monitoring
    5.2 Return to Work Interviews

 6 Short and Frequent Sickness
    6.1 Formal Reviews and Stage 1
    6.2 Stage 2
    6.3 Stage 3
    6.4 Conducting a Stage Three Meeting
    6.5 Removal from the Policy

 7 Managing Long Term Absence
    7.1 Termination of Employment

 8 Management Support Measures
    8.1 Phased Return to Work Programmes
    8.2 Return to Part-Time Working
    8.3 Alternative Employment/Redeployment
    8.4 Ill-Health Retirement

 9 Disability Discrimination
    9.1 Reasonable Adjustments
    9.2 Disability Related Sickness
    9.3 Disability Related Sickness and Sick Pay

10 Industrial Injury/Incident
11 Industrial Injury Benefit
12 Abuse of the Policy
13 Review of Policy

1.0   Introduction

Bristol PCT recognises the importance of a positive approach to the
management of sickness absence to enable the organisation to operate
effectively, to provide the necessary support to employees and to ensure that
all employees are treated in a consistent and equitable manner.

As a good employer, the PCT recognises and fully accepts its responsibility to
maintain the health, safety and welfare of its employees and to ensure that the
working environment is safe and that conditions of employment are conducive
to promoting health and well being.

The management of sickness absence is important for the organisation, not
only for continuity of care provided to service users, but also in relation to the
effective management of the PCT.

Staff members are the PCT‟s most valued resource and the quality of the
services delivered to our clients depends upon the full participation and
contribution of all staff. If levels of employee non-attendance due to sickness
are high, this inevitably has a negative impact on both the scope and quality of
services provided and may place staff who are left to maintain services, under
undue pressure.

2.0   Aims and Purpose

The purpose of this policy is to assist managers and staff to maintain an
optimum level of attendance at work. It also ensures that non-attendance due
to sickness is managed effectively and that staff who are absent due to illness
are treated fairly and sensitively.

This document clarifies the roles and responsibilities of both managers and
staff, and highlights the consequences of failing to follow the procedures
included in the policy.

The aims of the policy are:

         To promote health and well-being of the workforce
         To ensure that staff are treated fairly, consistently and sensitively.
         To positively support staff who are absent due to sickness or
         To provide managers with a framework for dealing with sickness
         To ensure that all staff are fully aware of their obligations (including
          reporting requirements) both under the provisions of this policy and
          their terms and conditions of employment.
         To ensure that non-attendance due to sickness has minimum impact
          on the Trust‟s overall performance.

3.0   Roles and Responsibilities

All those who have access to personal information relating to sickness absence
have a general responsibility to ensure that this information is treated in a
confidential manner in accordance with the Data Protection Act 1998.

3.1   The PCT Board

         The PCT Board has a strategic responsibility to ensure that
          appropriate conditions at work exist to ensure the health and safety
          of the workforce and to ensure that employees are able to maintain
          regular attendance.

3.2   The Human Resources Department

         Will oversee the introduction, operation and monitoring of the policy
          and will report on sickness absence levels on a regular basis
         Will ensure the provision of training, guidance and support for
          Managers on the operation of the policy.
         Will ensure the provision of regular and accurate information on
          sickness absence levels/trends to line management.
         Will provide advice and guidance to managers on the Sickness
          Absence Policy and its application.
         Will assist Managers in the handling of sickness absence issues.
         Will monitor sickness absence data, and will assist in identifying
          problem areas and appropriate solutions.
         Will assist and provide appropriate support and information to
          employees who are applying for Ill-Health retirement and other
          aspects of early retirement.

3.3   Occupational Health

         Will provide a reporting service for Managers in respect of employees
          with sickness absence issues following a management referral.
         Will offer advice on appropriate help and support to employee‟s to
          improve attendance levels, improve employee's health and assist
          their return to work where appropriate.
         Will assess the need for re-deployment and /or rehabilitation of
          employees with health problems and provide the necessary advice
          guidance and support.
         Will advise managers on what reasonable adjustments might be
          necessary to facilitate a return to work and/or comply with the
          Disability Discrimination Act (DDA).
         Will assess the likely return to work date of an absent employee.
         Will provide medical support, as appropriate, to employees who are
          retiring on health grounds.
         Will advise on the need to exclude employees from duty due to
          contact with a notifiable and/or infectious disease.

3.4    Managers

The control and management of absenteeism is a management function, and
one by which they will be measured. Each manager is responsible for
managing absenteeism for the staff that are accountable to them, and for
treating employees who are ill in a sensitive, fair and consistent manner.

Managers will, therefore:

         Identify early warning signs at work that might prevent sickness (i.e.
          stress, incidents at work).
         Implement adjustments recommended by HR and Occupational
          health that are feasible and reasonable in view of service delivery,
          into the work place to help individuals attend work and review them
          as and when required.
         Apply the principles of Sickness Absence Policy fairly and sensitively.
         Ensure that staff fully understand the departmental notification of
          sickness absence procedures.
         Ensure that the importance of this policy is emphasised and that all
          staff are made fully aware of the policy and their obligations under it.
         Ensure, in conjunction with the Health and Safety Department, that
          acceptable physical working conditions are in place and that health
          and safety standards are properly maintained.
         Ensure that where a member of the team is absent on long-term
          sickness, they will maintain informal contact and offer possible
          support appropriate to the individual circumstances.
         Monitor the attendance of members of staff for whom they have
         Maintain accurate records of sickness absence locally and return
          attendance information to payroll and HR as required.
         Ensure that sickness absence is never ignored.
         Endeavour to find out the cause of absences, but only in general
         Managers will carry out regular return to work interviews as part of
          sickness absence management.
         Keep the HR Department well informed of those who are on long
          term sick or who have a large amount of short term sickness periods
         Ensure a final review meeting always takes place before a member
          of staff is due to entre nil pay.

3.5   Trade Union Representatives

         Will support the fair and equitable application of this policy and
          represent their members at any stage of the formal procedure if
         Will support appropriate efforts for a successful return to work of
          those employees who have been absent due to sickness.

3.6   Employees

Employees are expected to demonstrate a commitment to the Trust, and to
effectively discharge the obligations of their contract of employment, by regular
attendance at work.

Employees are, therefore expected to:

          Ensure that they have read and have fully understood the provisions
           of this policy.
          Take all reasonable steps to keep themselves in a good standard of
           general health and to comply with the Trust's Health and Safety
          Not attend work if unwell or unfit if in so doing they would affect their
           health and/or the health of others.
          Make sure they know who to contact when reporting their sickness
          Ensure that, where appropriate, absences are covered by a
           self/medical certificate and ensure that such certificates are
           submitted on time and cover the whole period of absence
          Whilst off sick, refrain from any activity (e.g. domestic, social or
           sporting) that may be prejudicial to recovery.
          Attend and actively participate in return to work interviews and
           sickness review meetings when required to do so.
          Attend work and perform the duties of their post unless they have an
           authorised absence, for example - sickness absence, parental leave
           or annual leave.
          Notify the correct manager or nominated person of sickness
           absence, keep in touch with them and attend meetings as
           appropriate and as agreed throughout the sickness absence.
          Immediately inform the relevant manager or nominated person if they
           think their sickness absence is work related, for example: as a result
           of an incident or accident at work or if you have come in to contact
           with an infectious disease. They should also complete an incident
          Attend an Occupational Health appointment if reasonably requested
           by the relevant manager. This may be whilst they are off sick or at
           any time if the manager is sufficiently concerned about their well
          Follow the advice and support measures given by Occupational
           Health, the relevant manager and the HR Department, which will
           facilitate a return to work.
          Employees must not falsely claim occupational or statutory sick pay
           and any false claim maybe construed as fraudulent activity and
           investigated by the Local Counter Fraud Service.
          Employees must make themselves aware of the implications of sick
           leave and secondary employment. Please refer to the Secondary
           Employment Policy for further information.

4. Sick Pay

These arrangements are intended to supplement statutory sick pay to provide
additional payment during absence due to illness, injury or disability.

There are certain conditions attached to the payment of contractual sick pay
and these can be located in the national agenda for change handbook section

Your sick pay is calculated according to your NHS Continuous length of
service. If you are absent from work owing to illness you will be entitled to
receive sick pay in accordance with the scale below:-

      During the first year of service – one months‟ full pay and two months‟
       half pay in a rolling 12 month period.

      During the second year of service – two months‟ full pay and two
       months‟ half pay in a rolling 12 month period.

      During the third year of service – four months‟ full pay and four months‟
       half pay in a rolling 12 month period.

      During the fourth and fifth years of service – five months‟ full pay and
       five months‟ half pay in a rolling 12 month period.

      After completion of five years service – six months‟ full pay and six
       months‟ half pay (maximum entitlement) in a rolling 12 month period.

Occupational sick pay will not be paid for cosmetic surgery unless it is deemed
necessary on medical grounds by Occupational Health or a GP. Evidence of
this is required before occupational sick pay will be issued. Types of evidence
that would be acceptable would be a letter from a GP outlining the surgery is
due to medical grounds or confirmation of NHS funding. Statutory sick pay will
be issued if a sickness certificate is provided regardless of the reason for the
cosmetic surgery. Consideration to grant annual leave or unpaid leave should
be given by the manager when the surgery is not due to medical grounds.
Statutory sick pay and annual leave cannot be paid in conjunction with each
other. In the unfortunate event that there are complications after the cosmetic
surgery resulting in the member of staff being unfit for work for longer than
normal (i.e. post surgery infection) then normal occupational sick pay will apply
for the excess recovery period.

Employees unreasonably failing to discharge their responsibilities under this
policy may lose their entitlement to occupational sick pay and/or be subject to
disciplinary action in accordance with the provisions of the Trust‟s Disciplinary

5.    Sickness Monitoring and Return to Work Interviews
Sickness monitoring and return to work interviews form a critical part of
managing sickness effectively.

5.1 Sickness Monitoring

Your manager/nominated person systematically monitors all sickness absence.
Details of your sickness absence will be noted on your sickness absence
record which is kept in the strictest of confidence. Sickness absence dates are
also entered onto a computer database within the payroll department to ensure
correct salary/wages payments are made.

Monitoring sickness absence helps your manager to identify any work related
health problems and other concerns in order that they may create a healthy
workplace and manage your department efficiently for you and others.

Current Department of Health requirements are in place to monitor the levels of
sickness absence in the Health Service and co-ordinate this data across
England. Only true sickness absence should be recorded. If you have a
problem such as a child, family member who is sick, etc, then you should refer
to the Trusts Work Life Balance Policy and take the appropriate leave. Your
manager/HR can help advise with this. Claiming statutory or Occupational Sick
pay inappropriately can result in disciplinary action and maybe deemed as
fraudulent activity by the Local Counter Fraud Service.

5.2 Return to Work Interviews

On an employees return to work after a period absence a return to work
interview should take place between the employee and the manager. This
should take place at the earliest convenient time following the employees
return. Afterward complete the Return to Work Form (appendix 2) and ask the
employee to complete a self certificate form if required. Return all paperwork to
the HR Department. Guidelines on conducting a return to work interview can be
found in Appendix 4.

6. Short and Frequent Sickness Absence

The following procedure is designed to manage circumstances where
individuals are experiencing frequent episodes of absences due to sickness.
The duration of any one of these episodes can vary from one or two days to
several weeks/months, and can be for a variety of reasons.

Whilst the procedure is designed to be supportive and aims, where possible, to
help individuals to achieve regular attendance at work, it also provides a
mechanism for dealing with individuals whose levels of sickness remain
unacceptably high in spite of the management support made available.

Staff being managed under a formal sickness process may be removed from
the bank register on a temporary basis until the sickness management process
is completed.

6.1 Formal Reviews and Stage 1

Where a member of staff has had levels of sickness absence that the Trust
deems unacceptable they may be referred for a formal review meeting. The
Trust‟s aim is to support staff in attending working and a formal process is
aimed to be a supportive mechanism that also meets the needs of the

A Human Resources Representative may attend the meeting and the employee
should be given the opportunity to be represented by a Trade Union
Representative or fellow worker.

Prior to the meeting the manager may decide to refer the employee to the
Occupational Health Department as part of the investigation process.

They should then invite the employee to a formal review meeting.

During the meeting the Manager (or equivalent) will:

         Discuss the issues surrounding the level/frequency of sickness
          absence and allow the employee to respond accordingly.
         Explore the way in which the Trust can support the employee to
          sustain regular attendance (e.g. refer to Occupational Health,
          adjustments to working arrangements etc).
         Keep a record of the interview, including any advice or actions taken
          and confirm this in writing to the employee.
         Clearly inform the employee that their level of absence exceeds the
          parameters of what is deemed acceptable and that efforts need to be
          made to improve their future level of attendance.
         Ensure that the various stages of the Managing Attendance Policy
          are fully understood.
         If appropriate, place the employee on Stage One of the Managing
          Attendance Policy. The employee should be informed of what levels
          of absence are deemed as unacceptable for the employee and agree
          a period over which to review the employee attendance (normally
          three-six months).
         If the decision to move to stage one of the formal process is taken
          the employee should be issued with a first formal warning and this
          should be confirmed in writing.

          If placed on Stage One, the manager will arrange a follow up review
          at the end of the review period. At the follow up review meeting, the
          manager may consider the following options:

         Extend Stage One for a further period.
         Remove the employee from Stage One.
         If the Manager considers that the employee‟s absence continues to
          give cause for concern, they may consider moving to Stage Two of
          the procedure.

6.2 Stage Two

Depending on the individual circumstances a further referral to the
Occupational Health Department may be beneficial before the review meeting.

If the decision is taken to move to stage two during the review meeting at the
end of stage one the manager will:

         Outline why it has been necessary to invoke stage two of the process
          and allow the employee and/or their representative to respond to
          these findings.
         Explore any other support that could be put in place to help the
          member of staff decrease their sickness levels
         Keep a record of the interview, including any advice or actions taken
          and confirm this in writing to the employee
         Set a period, normally three-six months, after which the levels of
          sickness will be reviewed and outline what is deemed as an
          acceptable absence rate for that employee.
         The employee will also be issued with a final warning which will be
          confirmed in writing.

         It should be clearly outline to the employee that failure to approve
          their attendance levels may result in their dismissal.

If placed on Stage Two, the manager will arrange a follow up review as part of
the monitoring process.

At the review meeting the manager may consider the following options:

         Sign the employee off the formal sickness process.
         Extend the Stage Two monitoring period
         Consider referring the matter to Stage Three of the Sickness
          Absence Policy.

6.3 Stage Three

A result of the stage 3 meeting could be termination of employment capability
due to ill health.

After the review meeting at the end of stage two if the manager recommends
the matter is referred to stage three of the process the manager, with support
from the HR Department, will submit a report to a relevant senior manager with
delegated dismissing authority (usually Associate Director or equivalent). The
report will outline the process which has been followed and other relevant
information related to the management of absence for the individual in question
and any personal circumstances that need to be taken into consideration. The
senior manager can recommend two courses of action at this stage:

           1. A formal stage 3 meeting should take place
           2. The review period in stage two is extended.

The report should also include any Occupational Health advice that has been
received to date. It may also be beneficial, if appropriate, for another
occupation health referral to be made prior to submitting the final report.

If a hearing is convened, its purpose is to make a decision regarding the
continued employment of the individual concerned.

6.4   Conducting a Stage Three Meeting

Panel Members should include:

       1. A Senior Manager with delegated authority to dismiss
       2. Senior HR Representative or a similar specialist

A third panel member may also attend who would be a senior manager or
professional advisor.

Stage Three hearings will be conducted in accordance with the procedure
outlined in Appendix 5. After discussing with the Human Resources
representative and the employee‟s representative, managers may use their
discretion to adapt the procedure as appropriate.

Actions taken by the panel can include:

         Dismissal on the grounds of capability due to ill health
         A further review period to be put in place and the decision of dismissal
          deferred until the end of that review period. The panel may also make
          recommendations of further support that can be put in place to support
          the member of staff during this review period.

The outcome of the hearing will be followed up in writing. A member of staff will
be given the right to appeal any decision of dismissal inline with the Trust‟s
Appeal Policy.

6.5       Removal from the Policy

Staff who successfully complete the sickness absence process, but over the
following 12 months after successful completion of the process once again
have absence levels which give cause for concern, will return to the beginning
of the stage that they were signed off at.

7.        Managing long term absence

Long-term sickness is defined as continuous absence in excess of four weeks.

When dealing with long-term absence, although each situation will be different
in nature and circumstances, managers should be aware of their duty to act
reasonably and consistently, with the emphasis being on providing support of
the individual.

It is important for the effective management of long-term sickness absence that
both managers and employees communicate during the period of absence.
This approach will help both parties, (i.e. employees will be able to raise any
concerns, and managers will be able to establish the likely duration of the
absence to inform decisions about planning services).

When managers become aware that an employee is likely to be absent on
long-term sickness, they should make a management referral to the
Occupational Health Department.

During a period of long-term sickness the manager should conduct regular
reviews. During such reviews employees will have the right to be represented
by a Trade Union Representative or a fellow worker. A HR Representative may
also attend. These reviews should take into account any updated information
made available from the Occupational Health Department.

During the reviews, discussion should take place with regards to the likely
duration of the sickness absence, any treatment/medication that has been
prescribed together with any support that might be put in place to assist the
employee on their return to work at the earliest possible opportunity.

When employees are ready to return to work from a period of long-term
sickness consideration should be given to the adoption of a phased return to
work if recommended by the Occupational Health Department.

Where medical opinion indicates that a return to work is unlikely in the
foreseeable future, consideration should be given to retirement on the grounds
of ill-health or termination of employment on the grounds of capability. This is
always a last resort and it needs to be demonstrated by the manager that a
review meetings have taken place, medical advice has been sought and all
other options such as reasonable adjustments and redeployment have been full
explored. A final review meeting should take place before an employee enters
nil pay.

7.1    Termination of Employment

Termination of employment on health grounds may be appropriate where it
unlikely an employee will be able to return to work within the foreseeable future
and all other options have been fully explored. This will normally be supported
by Occupational Health and/or a GP/Medical Officer who has confirmed that
the employee is no longer fit to carry out the duties for which they are employed
and reasonable adjustments have been explored and where no suitable
alternative employment is identified under the redeployment procedure.

A decision to terminate employment should be made irrespective of any
considerations around application for ill health retirement i.e. it is not necessary
to await the outcome of an application before giving the employee notice of

It should be made clear to the employee at the final review meeting that
termination of employment on health grounds is a possibility and this should be
confirmed in writing.

The manager should produce a report summarising the situation to date and all
actions that have been taken and explored to support the employee in returning
to work. An up to date occupational health report or medical advice should also
normally be attached as an appendix to the report. The report should then be
submitted to the relevant senior manager with delegated dismissing authority
for consideration. A copy should also be sent to the employee.

The employee should then be invited to a meeting with the Senior Manager and
a Senior HR Representative. The employee should be given at least 5 working
days notice of this meeting and will have the right to be accompanied by a work
colleague or a Trade Union Representative. If the employee‟s representative
cannot make the meeting date, the PCT should suggest another date so long
as it is reasonable and not more than five working days after the date originally
proposed by the manager. This five day limit may be extended by mutual
agreement. Reasonable adjustments should be implemented to help an
employee attend the meeting.

The purpose of the meeting is to make a justified decision on the future of their
employment. Should it not be possible for the employee or someone acting on
their behalf to be able to attend the meeting the employee should be given the
opportunity to submit a written statement to be considered at the meeting.

If the decision to terminate employment on health grounds is taken, any unused
outstanding sickness entitlements will be paid in full to the employee and
payment in lieu of the contractual notice will be paid subject to any outstanding
monies owed to the PCT (i.e. any over payments).

Employees will have the right of appeal against a decision to terminate their
employment on health grounds in accordance with the PCT Appeal Procedure,
and will be advised of this in writing.

8.     Management support measures

Where rehabilitation to work is considered appropriate by the manager,
employee, HR and Occupational Health and the nature of the illness precludes
the employee, either on a temporary or permanent basis from returning to their
original job, a range of options may be available to support their return.

8.1    Phased return to work programmes

An example of a phased return to work may be for the employee to gradually
build up their working hours over a reasonable period of time, with a view to
eventually returning to their normal hours of duty. Occupational Health can give
advice on a tailor phased return to work programme for staff.

During a phased return to work programme employees can receive full pay until
the time that their sick pay provisions would have expired as long as the
phased return to work programme being undertaken is supported by
Occupational Health.

Staff returning to work who are already in a nil pay situation or would have had
less than 1 months sick pay entitlement left before they return may be entitled
to a maximum of 1 months full pay during their phased return to work if the
phased return to work programme is supported by Occupational Health. This is
at managerial discretion and is not a contractual right. When deciding to invoke
this, managers should take in to consideration all the factors including length of
service and previous attendance records before awarding this benefit.

After phased return to work paid allowance periods expire staff will only be paid
for the hours that they work but can have the option of using their annual leave
to cover the shortfall should they wish. Staff will not be eligible for “bank work”
during the phased return period and should not undertake any other secondary
employment if it is felt detrimental to their recovery (Please refer to the
Secondary Employment Policy)

8.2    Return to Part-Time Working

If an employee is able to return to their existing post although not on their
former hours either on a temporary or permanent basis, consideration should
be given to allow them to reduce their hours.

8.3   Alternative Employment/Redeployment
Should it be appropriate to redeploy a member of staff due to health problems
the PCT Redeployment procedure will be followed.

8.4    Ill-Health Retirement

Where the employee wishes to retire on health grounds, and this is supported
by Occupational Health and/or the individual's G.P (if they have access to the

relevant guidance) managers, with support from the HR Department will assist
staff to apply for ill health retirement. Employees, who pay into the NHS
Pensions Scheme and have been a member for at least two years, may apply
for the benefits of ill health retirement. Applications for ill health are subject to
approval by the medical advisors to the Pensions Agency. There is now a two
tier ill health retirement system. Further details on ill health retirement are
available from the NHS Pensions Agency or the HR Department.

9. Disability Discrimination

The Disability Discrimination Acts 1995 and 2005 (DDA) make it unlawful for an
employer to discriminate against current or prospective employees who have or
have had a disability. Discrimination can occur when for a reason which relates
to a person's disability the employer treats that disabled person less favourably
than they would treat others and they cannot show that this treatment is

Particular care should be taken when considering action under this procedure.
The definition of Disability under the Act is very broad and many ill-health
problems may fall into this category. Managers have an obligation to explore
options for making reasonable adjustments to the working environment to
assist employees to remain in work if they acquire a disability. The advice of
the Occupational Health Department should be sought where such issues

Employees may be dismissed but the process must be fair deemed as

9.1 Reasonable Adjustments

The employer has a duty to make reasonable adjustments to its premises and
practices to accommodate a disabled person where any arrangements or
physical features of the premises cause a substantial disadvantage to them
compared to a non-disabled person. Steps must be taken where reasonable to
take into account all the circumstances in order to prevent that disadvantage.
Examples of reasonable adjustments are as follows: -

          Re-allocation of duties
          Transfer to other work where a vacancy exists
          Change in working arrangements, place of work
          Time off for rehabilitation, assessment and treatment
          Providing or arranging training
          Acquiring or modifying equipment
          Adjustments to premises

Managers must make sure that the disabled employee is included in
conversations regarding reasonable adjustments and to ask them what
adjustments they think they need. Managers should not however expect
disabled people to be experts on the adjustments they need. If the person has
been working recently they might have a good idea about what works for them.
If, however, the person has a newly acquired disability or hasn't been in work

recently they are unlikely to know what is available or possible in the
workplace. Remember, advances in technology may mean that adjustments
are possible now that were not available only a few years ago. Advice should
always be sought form Occupational Health in the first instance when
discussing reasonable adjustments. Further advice could also be sought from
the Health and Safety and Human Resources Departments. Human Resources
will also be able to arrange an Access to Work workplace assessment to get
expert advice if required. Access to Work is a government funding scheme for
disabled people run by Jobcentre Plus. It provides financial assistance towards
the extra costs of employing someone with a disability. It is available to
unemployed, employed and self-employed people and can apply to any job,
full-time or part-time, permanent or temporary.

Further guidance concerning the application of the Disability Discrimination Act
is available from the Human Resources Directorate and Occupational Health

9.2 Disability Related Sickness

In some cases occupational health may advise that an employee with a
disability is likely to need more time off sick than someone without their
disability either generally throughout the year or at certain times of year. For
example, cold or damp weather might exacerbate MS or arthritis and poor air
quality during a hot summer might make asthma worse. In these circumstances
you could consider:

        allowing the person to work from home if they find it difficult to come into
         work but are well enough to do some work
        allowing the person to work overtime and "bank" extra hours to take
         when they are feeling unwell


        You could decide that it would be a reasonable adjustment to allow the
         person a few more days off sick than someone without their disability
         before an attendance review meeting is triggered. Remember that these
         are only suggestions for reasonable adjustments. Not all of them will be
         reasonable in every case.

Line managers need to consider what is reasonable for that particular
employee in their job in the organisation after taking advice when appropriate.

 Reasonable adjustments can include accommodating more time off sick than
you would for someone without that disability but only if it is reasonable and
possible to do so and if the reason for absence is directly linked to the

If it is not reasonable to accommodate more absences in a particular job further
reasonable adjustment such as redeploying the person into another more
suitable job should be considered if other reasonable adjustment have been
exhausted. This would be managed under the PCT Redeployment policy.

Any absence directly due to a disability should be discounted when considering
a member of staff for promotion, training opportunities and redundancy.
9.3 Disability Related Sickness and Sick Pay

Sickness absence due to a persons disability is classed as sickness absence
for the provision of an employees sick pay. However, if an employee is unable
to return to work in any capacity as there is a delay in implementing a
reasonable adjustment recommended that can be implemented this will not be
classed as sickness absence the employee will receive full pay until the
adjustment is implemented.

10.    Industrial Injury/Incident

An industrial injury is an accident or incident that has occurred at or as a result
of your work. You must always report an industrial injury and complete a
Incident Form if you have been injured at work. Incident/ Accident Report
Forms are available to you within your department.

If you believe your sickness absence is as a result of an injury or incident at
work, then you must let your manager or nominated person know. They will
advise and help you and will carry out any necessary investigations and take
appropriate action to prevent such an incident from occurring again.

Your manager may refer you to Occupational Health for advice.

11.    Industrial Injury Benefit

Industrial Injury Benefit is a scheme which provides a guaranteed level of
earnings for an individual suffering from an industrial injury which has resulted
in a temporary or permanent drop in earnings. Almost all NHS employees are
covered by the NHS Industrial Injury Benefit Scheme. Further information on
Industrial Injury Benefit can be obtained form the HR Department.

12. Abuse of the Policy

Unless there is a satisfactory reason, if you fail to notify your nominated person
of your absence or fail to provide a Medical Certificate you will not be paid for
those days of absence and your absence will be recorded as „unauthorised‟.
Unauthorised absence (without good reason) constitutes a breach of contract.
Backdated certificates will not be accepted unless in exceptional

Unless there are exceptional circumstances, if you abuse this policy or fail to
follow these and any local guidelines, your Manager will investigate the reasons
and where necessary disciplinary action will be taken under the Trust‟s
Disciplinary Policy and Procedure. Falsely claiming Occupational Sick Pay or
Statutory Sick pay may be considered to be fraudulent activity and investigated
by the Local Counter Fraud Service.

13. Review of Policy

This policy will be reviewed every 2 years but can be reviewed at any time if the
PCT deems it necessary to do so or a review is requested by the Joint Union

                                                                    APPENDIX 1


This is intended to be an example of a notification of sickness procedure and
maybe adjusted locally to suit different services and departments. Employees
should make themselves aware of their local report procedure and if in doubt
should follow the procedure below until clarification is sought from their
manager at the earliest opportunity.

When you need to be absent from work due to sickness, your manager needs
to be informed as early as possible in order to make arrangements, where
appropriate, to cover your work.

Under the provisions of this policy you have an obligation to comply with the
notification procedures given below. Unreasonably failing to comply with
these procedures may lead to non-payment of Occupational Sick Pay
and/or disciplinary action

Your manager must ensure that you are fully aware of what action to take when
you are unable to attend work due to sickness. If you are unclear about this
procedure, you should contact your manager immediately.

If you are unfit to attend work due to ill health you must notify your manager (or
nominated person) as early as possible on the first day of absence. If your
manager is not available at the time you call, you must try to speak to the
designated senior member of staff nominated by your manager to receive such
calls. Notification should be by telephone and always to a person senior to you.
Note: it is not acceptable to leave a message on an answer machine, with a
colleague or a junior member of staff nor is it acceptable to give notification by
text or e-mail .

The following timescales will apply:

          Morning shift/day shift

           Employees must notify their manager no later than 30 minutes
           after the normal shift start time.

          Afternoon/night shift

           Employees must notify their manager no later than two hours
           before the normal shift start time.

During this initial contact you must provide information on the general nature of
your illness and, where possible, some indication of the expected duration of
the illness. If you continue to be absent beyond this initial period of time, you
are expected to contact your manager again to advise of a new anticipated
date when you will be able to return to work.

Certification of Sickness

All certificates of sickness that may be required must be submitted to your
manager in a timely manner.

If you are absent for up to 7 days, you will be required to complete a self-
certificate on your return to work. The self certificate form can be located in
appendix 3 of this policy. If you are absent for over 7 consecutive days
(including Saturdays and Sundays) you must submit a medical (i.e. a doctor‟s)
certificate. Further medical certificates will be required if your absence
continues. Subsequent medical certificates must be submitted at the
appropriate time to cover the absence where it extends beyond the period
covered by the initial certificate. Please note that if you are absent on certified
sick leave, it is your responsibility to ensure that the absence is covered by a
current medical certificate at all times. Unreasonably failing to submit medical
certificates in a timely and regular manner may result in the non-payment of
Occupational Sick Pay and/or disciplinary action being taken

Sickness during Annual Leave

If an employee is unwell on annual leave the annual leave will be reimbursed if
the sickness procedure has been followed correctly. If you fall sick during a
period of annual leave, you must contact your manager on your first day of
sickness in accordance with the normal notification of sickness procedure. You
must also produce on your return a self-certificate. That certificate will cover
the first and any subsequent days of sickness up to and including the seventh
calendar day of sickness. Medical certificates should be submitted to cover the
eighth and subsequent calendar days of sickness, where appropriate on and
after the 8th day of absence and should be provided to the PCT on a recurring
basis to cover a continued period of sickness..

                                                                                               APPENDIX 1

                                   RETURN TO WORK PRO-FORMA
When an employee has been absent through sickness their Manager must conduct a return to work
interview using this form. For guidance on return to work interviews, and other useful information please
consult the Trust‟s Sickness Absence Policy. This is available on the intranet site under Policies.
NAME     …………………………………………                            DEPT/SERVICE …………..………………………………
DATE OF INTERVIEW ……………………………………………………………………………………………….
PERIOD OF ABSENCE             FROM ………..………………….…                        TO ……………..………………………
NO OF DAYS ABSENCE IN PREVIOUS 12 MONTHS …………………………….……………………………

1.     REASON FOR ABSENCE:                      Was the Absence Disability Related: YES/NO
       (see reverse for code/category)

2.     CERTIFICATION (tick appropriate box):

                                                     Self certificate                 GP certificate
3.     Did you see your GP/hospital doctor?          YES/NO (please delete as appropriate)
       If YES, what have they advised?
4.     Are you fit to carry out all your normal duties?                 YES/NO
       If NO, please specify.
5.     Are you receiving any ongoing treatment or support?
6.     What support might we be able to provide to help you?
7.     What can we do to avoid further absences?
Please continue on a separate sheet if necessary

Signed ………………………………………….… (Manager)                                     Date ……………………..…………...….

Signed …………………………………………… (Employee)                                     Date ………………………………..……
1.     Is a referral to Occupational Health appropriate?                     YES/NO
       If YES has it been actioned?                                          YES/NO
                           NOW SEND THIS FORM TO HUMAN RESOURCES


  CODE                           CATEGORY

   01      INJURY AT WORK - Assault
   02      INJURY AT WORK - Musculoskeletal
   03      INJURY AT WORK - Other
   04      WORK related – upper limb disorder
   05      Sharps injury
   06      Arthritis or Orthopaedic problems
   07      Back or neck problems
   08      Broken limbs
   09      Cold / sore throat / influenza
   10      Infection or virus
   11      Migraine / sinusitis
   12      Stomach / gastric problem (e.g. Diarrhoea / vomiting)
   13      Gynaecological problems
   14      Heart complaint (e.g. Angina)
   15      Respiratory tract (e.g. Asthma)
   16      Post-operative care
   17      MRSA
   18      Pregnancy-related sickness
   19      Depression or mental health problem
   20      Stress
   21      Other – please specify

           Please highlight any sickness relating to a road traffic

                                                                   Appendix 3
This form should be completed following one day or more of sickness absence
(including part shift if you went home) up to your 7th day of consecutive
absence, and should be returned to your manager. If you are absent for more
than 1 calendar week a medical certificate from your GP be required from your
8th day of consecutive absence (includes weekends).
 Job title……………………………………….
 Which days do you normally work? Mon Tue Wed Thu Fri Sat Sun

 Date sickness absence commenced……………………………………………
 Date of return to work……………………………………………..
 Details of sickness/injury …………………………………………………

 Was the absence directly related to a disability? Yes/No

INDUSTRIAL INJURY If injured at work give details of accident.
 When did the accident happen? Date………………………… Time…………….
 Where did the accident happen?………………………………………………………
 What happened? …………………………………………………………………..
  Has an Incident Form been completed? YES/NO
 If NO then accident must be reported immediately


 Signed……………………………………………………. Date……………………..

 Recorded on monthly sickness return and individuals sickness record held locally
 Signed………………………                          Date……………..
 (To be completed by departments sickness administrator)

 I confirm that the appropriate action has been taken to notify payroll, and any other
                                                                     Appendix 4
 as necessary in accordance with the sickness absence policy including a return to
 work interview.   Guidelines on Return to Work Interviews

 Signed………………………………….                       Date………………………

      To welcome the employee back to work
      To ensure the employee is fully fit to return to work
      To identify the reason for the absence and confirm the length of absence
      To identify and address any problem (work-related or otherwise) that
       may be causing or contributing to the absence
      To discuss and/or identify any adjustments to the workplace/hours/duties
       that may reduce/eliminate absences
      To agree the priorities for the post absence period and to up-date the

The interview must be held in private and must be handled in a sensitive,
professional and competent manner.


      Ensure you have the right information available
      Check records for both current and previous absences
      Be prepared to discuss any trends or patterns of absence
      Remember THIS IS NOT A DISCIPLINARY HEARING - you are trying to
       establish facts.
      Approach the meeting with an open mind and no prejudgments.


      The core of this process is to discuss the absence
      Try to determine the cause of the absence
      Listen to what is being said
      Is the cause work related?
      Was the absence directly linked to a disability?(See section 12)
      Could adjustments to the workplace/hours/duties reduce/eliminate
      Are there any other problems contributing to the absence
      Place current absence in the context of previous absences
      Be sensitive to employees feelings where personal problems and
       illnesses are involved
      Establish if an occupational health referral would be beneficial
      Where there is conflicting evidence/statements, ask for an explanation
      Discuss the effect of the absence on the employee's work colleagues
      If appropriate inform the employee that frequent intermittent absence
       may trigger the formal sickness procedure.

                                                                    Appendix 5
                       Procedure of a Stage 3 Meeting

         Introductions

The manager hearing the case should introduce all present, explain the
purpose of the meeting and explain how the meeting will be conducted.

       Statement of Concern

The manager will present their findings and concerns about the employee‟s
ability to fulfil their employment contract due to health problems. Any
statements/evidence to support their concerns will have been circulated prior to
the meeting in good time.

         Employee’s reply

The employee should be given the opportunity to state their case, including the
tabling of any previously circulated statements/evidence.

         Summing Up

After general questioning and discussion, both parties should be given the
opportunity to summarise their main points, with the employee having the right
to go last.

         Adjournment

The Panel conducting the hearing should consider their decision in private. If it
is necessary to recall one of the parties to clear any point of uncertainty on
evidence already given, then both parties should be invited to return.

         The Decision

Factors to be considered by the panel when making a decision may include:

         The magnitude of the level of sickness absence.
         The employee‟s general employment record and, in particular their
          previous sickness record.
         The fairness, consistency and merits of the information presented
         The efforts made by the employee to improve their attendance.
         The extent to which the employee may have contributed towards
          their level of absence.
         The requirements of employment legislation, which stipulate that the
          employer acts reasonably having regard for the equity and merits of
          each case.

The employee and their companion should be invited to return to hear the
manager‟s decision, which will subsequently be confirmed in writing within a
reasonable timescale of the hearing.


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