Supporting Attendance Policy

Full text

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Document name: Supporting Attendance Policy Ref.: 117

Issue date: 16 November 2015 Status: Final

Author: Gayle Williams – Deputy HR Business Partner Page 1 of 32

Supporting Attendance Policy

Reference Number: 117

Author & Title: Gayle Williams

Deputy HR Business Partner

Responsible Director: Director of HR

Review Date: 05 November 2018

Ratified by: Director of HR and

Strategic Workforce Committee

Date Ratified: 05 November 2015

Version: 8.1

Related Policies and Guidelines

 Appraisal Policy

 Employee Code of Expectations

 Managing Conduct Policy

 Managing Performance Policy

 Maternity Leave Policy

 Smoke Free Policy

 Substance Misuse Policy

 Managing Stress Policy

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Document name: Supporting Attendance Policy Ref.: 117

Issue date: 16 November 2015 Status: Final

Author: Gayle Williams – Deputy HR Business Partner Page 2 of 32

Index:

1. Policy Summary _______________________________________________ 4 2. Policy Statements _____________________________________________ 4 3. Definition of Terms Used _______________________________________ 5 4. Duties and Responsibilities _____________________________________ 6

4.1. Employee responsibilities __________________________________________ 6 4.2. Behaviours whilst absent __________________________________________ 7 4.3. Annual leave whilst on sick leave ____________________________________ 7 4.4. Sickness during annual leave _______________________________________ 8 4.5. Managers’ responsibilities _________________________________________ 8 4.6. Role of Human Resources __________________________________________ 9 4.7. Role of the Representative _________________________________________ 9 4.8. Role of Occupational Health ________________________________________ 9 4.9. Failure to attend an Occupational Health appointment _________________ 11 4.10. Case Conferences ___________________________________________ 12 4.11. Payroll Department __________________________________________ 12

5. Procedure for Dealing with Frequent Sickness Absence – Procedure A 12

5.1. Manager’s discretion and patterns of absence ________________________ 13 5.2. Stage 1: First formal sickness meeting ______________________________ 14 5.3. Stage 2: Second formal sickness meeting ___________________________ 15 5.4. Stage 3: Formal sickness hearing __________________________________ 16 5.5. Final written warning _____________________________________________ 17 5.6. Dismissal_______________________________________________________ 17 6. Procedure for Managing Long Term Sickness or an on-going Medical Condition – Procedure B ___________________________________________ 18

6.1. Planned sickness absence ________________________________________ 18 6.2. If an employee is too unwell to attend meetings _______________________ 18 6.3. Early interventions _______________________________________________ 18 6.4. Return to work after long-term absence _____________________________ 19 6.5. Employee unable to return to work _________________________________ 20 7. Suspension on Medical Grounds ________________________________ 22 8. Time off for Appointments/Treatments ___________________________ 22

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Document name: Supporting Attendance Policy Ref.: 117

Issue date: 16 November 2015 Status: Final

Author: Gayle Williams – Deputy HR Business Partner Page 3 of 32

9. Notifiable and Other Infectious Diseases _________________________ 24

9.1. D&V reporting ___________________________________________________ 24 9.2. Accidents at work________________________________________________ 24 10. Monitoring Compliance ________________________________________ 25 11. Review _____________________________________________________ 26 12. Training _____________________________________________________ 26 13. References __________________________________________________ 26 Appendix 1: Frequent Absence Flow Chart __________________________ 27 Appendix 2: Long Term Absence Flow Chart ________________________ 28 Appendix 3: Return to Work Interview Form _________________________ 29 Document Control Information ______________________________________ 30

Ratification Assurance Statement _____________________________________ 30 Consultation Schedule _______________________________________________ 31 Equality Impact: (A) Assessment Screening ____________________________ 32

Amendment History

Issue Status Date Reason for Change Authorised

4.0 Approved January 2010

Planned Review TCNC Policy Sub Group 5.0 Approved 18th March

2013

Planned Review, Formatted

Lynn Vaughan, Director of HR

6.0 Approved 6th June 2013

Accidents at Work revised

Lynn Vaughan, Director of HR

7.0 Approved 8th May 2014

Planned Review TCNC Policy Sub Group & Strategic Workforce committee

8.0 Approved 30th April 2015

Planned 6 month policy review – trigger and targets revised

TCNC Policy Sub Group

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Document name: Supporting Attendance Policy Ref.: 117

Issue date: 16 November 2015 Status: Final

Author: Gayle Williams – Deputy HR Business Partner Page 4 of 32

1.

Policy Summary

Throughout this policy the Royal United Hospitals, Bath NHS Foundation Trust is referred to as “the Trust”.

This policy covers the management of health and sickness issues in all Trust employees, including junior doctors and those with honorary contracts.

The Trust is committed to providing and delivering the highest quality health care for patients as assessed by patient safety and clinical outcomes and evidenced by patient surveys. We have a stable and highly committed workforce, which we seek to support and develop. We recognise that staff are our most valuable asset and by offering attractive and fair conditions of employment, flexible working opportunities, a healthy environment and, above all encouragement to all members of staff to “own” their organisation, we hope they will play active roles in its future. The key to our success lies in the motivation, competence and capability of the people we employ. High attendance rates are essential for delivery of service. The management of attendance is an integral part of performance management. A positive and proactive approach to the management of absence is required in order to optimise attendance rates and enable the Trust to move forward to achieve its goals.

This Policy and Procedure supersedes all previous policies and procedures in relation to managing health and sickness in the Trust.

2.

Policy Statements

The policy of the Trust is to encourage positive action to be taken in the event of sickness absence.

The purpose of this policy is to:-

 Clarify expectations for both management and all members of staff.

 Harmonise the Trust's approach to the management of attendance.

 Enable a consistent standard to be applied to all members of staff within the Trust.

 Optimise attendance and minimise absence through standard setting, monitoring and where required intervention.

 Support, protect and promote the interests of those who are genuinely incapacitated.

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Issue date: 16 November 2015 Status: Final

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3.

Definition of Terms Used

Within this policy, a distinction will be drawn between sickness absence without an underlying health cause and sickness absence with an underlying health cause. Sickness absence without an underlying health cause - This is a period of sickness for which Occupational Health advise that 'there is no underlying health condition causing the individual's sickness absence'. This will normally present itself as short term sickness which may be described as relatively minor, self-limiting illness or injury that requires little or no medical intervention. A medical fit note is often not required.

Sickness with an underlying health cause – this can be either an isolated period of absence or on-going absences for which Occupational Health advise there is an underlying health condition

Long term Sickness - This is an episode of sickness absence that lasts for 4 weeks or more.

Phased Return - A phased return is a return to work on reduced hours and/or days for a specified period of time, usually no longer than four weeks, this may be

extended with Occupational Health advice. Advice will be sought from Occupational Health prior to the start of a phased return.

Adjustments to the Workplace - The Line Manager should consider whether the recommended adjustments can be accommodated and may seek further advice from Occupational Health.

Altered Hours or Duties and Temporary Placements - The employee should not be disadvantaged through being at work on a fit note when compared to being signed off as sick. Therefore when a fit note recommends restricted duties or hours the employee will be paid as if they were at work i.e. at the same grade and the same hours as their substantive contract.

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Document name: Supporting Attendance Policy Ref.: 117

Issue date: 16 November 2015 Status: Final

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4.

Duties and Responsibilities

A member of staff who is absent from work due to illness should rightly feel that the organisation is concerned for his/her well-being and will provide appropriate support prior to and following a return to work.

In the majority of cases absence will be manageable because it is short in duration and/or non-recurring. Occasionally however, individual cases arise where

attendance falls outside “normal” expectations. Managers expect and plan for “normal” levels of attendance based on the general health of the majority of staff. Where attendance falls outside such expectations, pressure is placed on the service and team to continue to perform to the level of output planned and contracted for. In some cases it may not be immediately clear whether some issues, for example, poor performance or persistent short-term sickness absence, fall into the scope of the Managing Performance Policy, the Conduct Policy, or the Supporting Attendance Policy. Line Managers should take advice from HR and decide which is the more appropriate after weighing up all the circumstances. However, it may be necessary to move from one policy to another as circumstances dictate. The Line Manager will explain the reasons for their decision to the member of staff. The member of staff will be told which Trust procedure is being followed.

Staff should be aware of the policies and procedures regarding sickness and governing attendance. Procedures must be followed to ensure consistency and fairness.

The management of attendance is the responsibility of Line Managers. The role of Human Resources and Occupational Health Services is advisory and supportive.

4.1.

Employee responsibilities

Every member of staff is expected to attend work when fit to do so, and is required to fulfil their contractual working hours, as agreed with their Line Manager. The Trust does not expect members of staff to work when they are unfit to work.

Staff may be unfit for their normal role but fit to attend work in another capacity for a temporary period if suitable work can be found. In these circumstances staff will be expected to return to work on their normal pay, or on rehabilitation under the terms described in Section 6. Unjustified refusal to return to work may be dealt with under the Trust’s Conduct Policy.

Members of staff, who require time off for routine/on-going medical/dental

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It is recognised by the Trust that there are occasions when a member of staff is unable to attend work due to sickness absence. In such instances, the member of staff's responsibility is to:-

 Report their absence in accordance with the agreed local procedure. Members of staff are expected to make reasonable efforts to contact their Manager directly and not to notify their absence through messages with colleagues, text message, voice mail or answer phones unless this is the procedure agreed for that particular department, in which case the Line Manager will contact the member of staff on receipt of the message.

 Provide a self-certificate or medical certificate (fit note) as soon as possible to their Manager following a period of sickness or during sickness absence if prolonged in order for sick pay to be paid correctly. Late certification of sickness absence can result in incorrect sick pay being paid to staff, particularly those near to a half or no pay situation.

 Provide a reason for the absence (although this may not necessarily include a medical diagnosis). Estimate the anticipated length of absence and agree with the Manager when he/she will contact the Manager next if the absence is expected to last more than a day. If contact with the immediate Line Manager is not possible the member of staff will be expected to contact the Deputising Manager of the department.

4.2.

Behaviours whilst absent

In all cases of sickness or injury that necessitate taking time off work, it is expected that the employee will do their utmost to facilitate a speedy return to fitness and to work. In this regard, employees are expected to act sensibly and honestly, for example

- not to undertake heavy manual work i.e. DIY/gardening with a back injury. - not to undertake any other employment whether paid or unpaid. The Trust

expects employees to do everything to aid a speedy recovery, and working whilst absent on sick leave may be classed as an act of gross misconduct, may be investigated by Counter Fraud and may lead to dismissal under the Managing Conduct Policy.

4.3.

Annual leave whilst on sick leave

Employees are not normally expected to go away on holiday during a period of sickness absence. However, when a member of staff wishes to honour a pre-booked holiday they should inform their Line Manager in advance. The Line

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4.4.

Sickness during annual leave

If an employee is sick during a period of annual leave, they can request sick leave to be granted instead of annual leave, so long as they contact their Manager in line with normal reporting arrangements for sickness absence. Staff will be required to inform their Manager on the first day of absence and provide either a self-certificate or medical certificate as appropriate verifying the sickness. Staff returning from annual leave and requesting retrospective sick leave will not generally have their request granted if the accepted reporting arrangements for sickness have not been followed.

4.5.

Managers’ responsibilities

As part of a member of staff's induction, Managers are to ensure that the Trust's policy on sickness absence and the local reporting guidelines relating to absence from the workplace are discussed and that the member of staff is clear about the local reporting arrangements. This is to ensure that members of staff are aware of the Trust's standards of attendance and the requirements of this policy. The

member of staff should be provided with a copy of the local reporting guidelines. At this time both parties should come to an agreement about how the member of staff may be contacted at home by the Manager if there is an unexpected failure to attend work.

Managers should forward any sickness certification (self-certificated or medically certified) as soon as possible to payroll for processing. Late receipt of sick notes can result in staff receiving the incorrect sick pay and being over/underpaid.

Managers are also responsible for keeping accurate documentation relating to absence, and monitoring levels of attendance. Records should be reviewed

regularly and appropriate management action taken for those members of staff who have been identified with a poor attendance record. Members of staff should be informed that such records are being kept and given a copy of any such record on request.

Regardless of whether sickness is self-certified, or medically certified, Managers should undertake a review of a member of staff's attendance record. Managers should seek advice from HR whenever an individual's attendance record gives rise for concern.

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If a Line Manager identifies that a member of staff's sickness is reaching the trigger points, (see Procedures for dealing with frequent sickness absence Section 6), a sickness management meeting with the member of staff should be arranged, to encourage discussion at an early stage, of any problems that may have arisen and to provide support or advice before matters escalate. The Line Manager will also outline their reasons if they exercise the option to refer members of staff to

Occupational Health. Any medical diagnosis if offered to the Line Manager should be kept in confidence.

Managers will distinguish between reported sickness absence and unauthorised absence where the absence is not reported in line with the procedure and

acceptable explanation is given. Unauthorised absence will be managed through the conduct policy.

4.6.

Role of Human Resources

The role of the HR Department is to provide specialist advice, to support Managers at all stages of the Supporting Attendance Policy, and to attend meetings at

informal/formal stages as required. HR will also support Managers in identifying sickness absence trends through the monthly sickness absence reports and provide training in the management of attendance.

4.7.

Role of the Representative

At all formal stages of the procedure, members of staff have the right to be represented by their Trade Union representative or work colleague.

The Trust encourages the involvement of representatives, as they will be able to advise the member of staff and where appropriate encourage them to seek further medical or other advice. The representative will also seek to ensure that the

member of staff fully understands the options that are available to them and also the consequences of further sickness absence or inconsistent attendance at work.

4.8.

Role of Occupational Health

Occupational Health offers a range of confidential services, which promote the health, and well-being of staff through:-

 Pre-employment assessment of fitness to work

 Provision of a workplace immunisation programme

 Sickness/absence referral

 Counselling service

 Physiotherapy service

 Health education/promotion/well being

 Case conferences

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When a member of staff's level of absence becomes a concern or has reached the trigger points set out in section 6 the Manager in discussion with the member of staff may decide to make a referral to Occupational Health. It is essential that the

member of staff and the Occupational Health Advisor and/or Physician are informed and understand the reason(s) for the referral. All referrals must be in writing and signed by the referring Line Manager. These referrals must be timely and received in Occupational Health prior to the appointment date.

The Occupational Health referral should contain all information to prevent any delay and Managers should ensure that the information is accurate. The employee will be contacted by Occupational health and informed of their appointment. If telephone contact has not been possible a letter will be sent to the employee. Other than short notice appointments the Manager can expect to receive a copy of the appointment letter.

Management Referrals

The Manager will discuss and agree the referral with the member of staff and will make arrangements for attendance. The member of staff should be advised that a report relating to an assessment of their capacity to undertake their full range of duties would be forwarded to the Manager, the member of staff and the relevant HR Advisor if appropriate.

Managers are required to provide Occupational Health with full details of attendance record and any relevant background information. This may include details of the work environment to aid the Occupational Health Physician in assessing what adjustments may be needed.

Following the referral, Occupational Health will be able to provide a medical opinion on the member of staff's fitness to work, and in long term sickness cases, the

expected timescale for a return to work. The Occupational Health Advisor or Physician will be able to advise Line Managers on whether any restrictions on activities in the workplace need to be made to facilitate the member of staff's return to work. The assessment will indicate the length of the rehabilitation period, if any. Line Managers working closely with Occupational Health Department will seek effective and successful resolutions to any sickness absence cases.

Occupational Health gives advice to both members of staff and Line Managers alike, often assisting the member of staff to understand an illness and minimise its impact on his/her life, and providing Line Managers with general information, which may help them to plan and manage their team effectively during a member of staff's illness. The member of staff has a right to patient confidentiality and this right will be adhered to at all times.

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Manager concerned to take further appropriate action, following advice from their HR Advisor.

If a Line Manager receives a ‘statement of fitness to work’ that advises that the member of staff may be fit to return to work subject to temporary workplace adjustments a referral should be made to occupational health prior to an agreed return date. The member of staff may be required to attend an occupational health appointment or partake in a telephone appointment. All advice from occupational health will be followed up in writing/by e-mail to the Manager

It is inappropriate for advice on employment or medical condition to be sought from or provided by the member of staff's GP or Medical Specialist direct to the Line Manager. Information on the clinical management of a member of staff's illness may, however, be sought with written consent of the member of staff from their doctor(s) by the Occupational Health Department to enable a full assessment to take place, and relevant advice to be given to Line Managers.

Line Managers may at any time require a member of staff who is absent from work due to illness to attend an appointment with Occupational Health. Furthermore, staff do not need to be off sick to be referred to the Occupational Health Department or for a further medical assessment. The Manager will meet the cost of any medical examination resulting from such a referral from their departmental or directorate budget.

- Self-Referrals

Self-referral to the Occupational Health Doctor for further advice is a service offered to staff. No report will be forwarded to management unless there are extenuating circumstances. If a report is required this will be discussed first with the member of staff to obtain his/her consent. Staff can self-refer for work related conditions. For other issues that are not work related staff should make an appointment with their GP.

4.9.

Failure to attend an Occupational Health

appointment

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4.10. Case Conferences

There may be occasions when it will be necessary to hold a “case conference” to discuss a member of staff's condition, its impact and possible limitations on their ability to discharge their duties, in more detail. Case conferences are arranged with a view to looking at a constructive way forward for both the service and member of staff.

The aim of the conference will be to identify ways to support the staff member to return to work from long-term sickness, or increase their level of attendance if they have frequent sickness absence.

Case conferences can take place at any stage of the procedure, either with or

without the member of staff being present. The member of staff will receive a written invitation to the case conference and be reminded that they are entitled to bring along a representative or work colleague.

4.11. Payroll Department

The Payroll Department are expected to:

 Accurately enter sickness absence dates and causes of absences in to ESR;

 Ensure the HR department, the Line Manager and the employee are notified in a timely manner when the employee’s pay status is due to change;

 Ensure that employee’s sick pay is correctly and accurately administered;

 Withhold payment if absence has not been certificated.

5.

Procedure for Dealing with Frequent Sickness

Absence – Procedure A

Frequent intermittent absence is defined as sickness absence that results in a staff member being unable to attend work for any of the following:

 3 or more episodes in a 6 month period,

 5 episodes of sickness in a 12 month period.

 Have sickness absence equating to a total of 4 or more of their working weeks in a 6 month period.

 A pattern of absence that is a cause for concern or that falls below 95%

 A level of absence that is unsustainable for the service

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Likewise if an attendance target has been set and an episode of long term sickness occurs during the target period, this should be counted. Where there are frequent episodes of short and long term absence then one attendance target will be set for both forms of absence.

Where an employee has triggered formal sickness absence management, Managers are required to consider the pattern of the sickness to date. If the sickness absence days are intermittent or are a cause for concern owing to their frequency, Managers will be required to manage the employee under the formal procedure.

5.1.

Manager’s discretion and patterns of absence

Where the Manager recognises that the sickness absence is for a specific reason e.g. a broken wrist and the employee will be absent for a clearly defined period of time before returning to work or there is no history of intermittent sickness, or discernible pattern in sickness Managers are advised to take a pragmatic approach to the application of the trigger.

Where a pattern of sickness is identified that is of cause for concern the Manager will arrange to meet with the employee under the first formal stage of the sickness

absence procedure.

Some examples of unusual patterns of absence are listed below. This is not an exhaustive list and it is important to note that one off occurrences are unlikely to constitute a pattern. For instance taking sick leave immediately prior to or following annual leave on one occasion would not usually require formal management of attendance, unless it contributed to other episodes of sickness. However if there was a repeated incidence of this, the Manager may want to consider formal absence management.

Additional guidance on the use of discretion is available by contacting the operational HR team.

Examples of patterns could be:

 Recurrent days of absence that fall on the same day or same shift (i.e. always on a Monday or when the staff member is due to work a night shift)

 Taking sick days immediately prior or after annual leave

 Taking sick leave routinely but not enough to trigger formal management.

 Taking sick leave immediately following/at the end of a period of formal management

Once the employee has hit a trigger as part of the return to work interview, a

“Frequent Absence and Referral to Occupational Health” form should be completed with the employee to ascertain whether a referral to Occupational Health is

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If a referral to Occupational Health is necessary, they will be able to offer advice on the impact an underlying health condition is likely to have on the employee’s

attendance.

Pregnancy related sickness should not be considered as part of any sickness absence management process.

5.2.

Stage 1: First formal sickness meeting

The Manager should arrange a formal sickness meeting with the employee as soon as reasonably possible. The purpose of the meeting is to inform the employee of the results of the Occupational Health assessment if a referral has been made and to discuss how the employee can achieve an acceptable level of attendance. The employee may be accompanied by a colleague or union representative at this meeting and should be invited to do so in the invite letter.

If Occupational Health advice has been sought and has confirmed that the recurrent absences are due to an underlying health condition, the Line Manager should seek further advice on what level of sickness absence they can reasonably expect. They should then consider what reasonable adjustments can be made to facilitate the employee’s attendance target. This could include:

 Change in working patterns

 Reduction in hours

 Alteration of duties

The attendance target will run for 6 months. During this time the employee will be set a target of:

 No more than two episodes of sickness absence or combined absences that exceed 4 or more working weeks.

 And, no more than 5% absence in 6 months.

This should be confirmed to the employee in writing following the meeting. Guidance on how to conduct this meeting can be found on the HR intranet site.

If the employee makes the required improvement, after six months the formal process will stop. The employee’s attendance will continue to be monitored as with all other employees.

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Setting adjusted targets

In exceptional circumstances the Line Manager may consider adjusting the expected attendance target in light of an underlying health condition in question, (i.e. decrease the level of attendance the employee is expected to achieve).

In the case of a member of staff with an underlying condition an attendance target based on a percentage may be more appropriate. A calculator for working out a percentage attendance is available on the Intranet. The percentage target should also be set over a 6 month period from the date of the sickness meeting.

In deciding what an acceptable level of attendance would be, advice from HR and Occupational Health should be sought to ensure a consistent and equitable

approach is being taken across the Trust.

5.3.

Stage 2: Second formal sickness meeting

Should the target set in the Stage 1 meeting be breached, a second formal sickness meeting should be set up as soon as possible after this breach. In advance of the meeting the employee will be offered a referral to Occupational Health.

The purpose of the meeting is to advise the employee that they have breached their attendance targets, to inform them of the results of the Occupational Health

assessment, (if one has been carried out) and to discuss how the employee can achieve an acceptable level of attendance.

If an Occupational Health referral reveals there is an underlying health condition causing the short term recurrent absences, adjustments should be considered and discussed, including setting a target based on percentage attendance

At the meeting a further attendance target will be set. Again this target will be no more than two episodes of sickness absence, or combined absences that last 4 working weeks or more over the course of six months from the date of the meeting and no more than 5% absence. The employee will be given a formal written warning that if they fail to achieve this attendance target during the second review period there will be a further meeting at which their employment may be terminated. This warning will remain current on their file for 24 months.

The issuing of the warning and the contents of the meeting should be confirmed to the employee in writing following the meeting. Guidance on how to conduct this meeting and a template letter can be found on the HR intranet site.

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Author: Gayle Williams – Deputy HR Business Partner Page 16 of 32 If there is a repeated breach of the attendance targets while the formal written warning remains live, the formal procedure will recommence at stage 3, following further Occupational Health advice if appropriate.

The contents of the meeting should be confirmed to the employee in writing following the meeting. Guidance on how to conduct the meeting and a template letter can be found on the HR intranet site.

5.4.

Stage 3: Formal sickness hearing

Should the target set in the Stage 2 meeting not be met, or the staff member trigger the absence triggers whilst a formal written warning is live the Line Manager should refer the matter to the Head of Nursing, or Deputy/Divisional Manager for the

employee concerned, who will seek support from the HR Department.

A Stage 3 Formal Hearing should be set up by the Senior Manager as soon as possible after the target breach, to which the affected employee and Line Manager should be invited.

The Senior Manager will chair the meeting, with support from a HR representative and an independent Manager as a third panel member. The Line Manager, also supported by a representative from HR, will present a management case detailing:

 The sickness absence history of the employee

 The meetings held with the employee

 Advice received from Occupational Health

The employee will be encouraged to be represented in the meeting by a work colleague or an accredited trade union or professional association representative. It is the employee’s responsibility to arrange representation.

If the Occupational Health advice reveals there is an underlying health condition causing the short term recurrent absences, adjustments should be considered and discussed.

In considering whether to issue a final written warning or dismiss the employee the panel should consider the following:

 Whether it is reasonable to conclude that the level of absence will not improve in the foreseeable future.

 Whether the level of absence had a serious adverse effect(s) on service provision.

 Whether all reasonable steps to reduce the level of absence have been exhausted.

Whether other alternatives such as redeployment, and those described in the Equalities Act are appropriate or available.

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5.5.

Final written warning

If the Senior Manager concludes that there are exceptional circumstances which mean that sufficient reasonable opportunity has not been given to the employee, a final attendance target of no more than 2 episodes of sickness/4 working weeks absence and 5% or less absence in a 6 month period will be set.

The employee will be given a final written warning that if they fail to meet this target during this third review period the Stage 3 Formal Hearing will be reconvened at which their employment may be terminated. This final written warning will remain live and current on the employees file for 24 months after the date of the hearing. The contents of the meeting should be confirmed to the employee in writing following the meeting. Guidance on how to conduct this meeting and a template letter can be found on the HR intranet site.

If the employee makes the required improvement, a formal review meeting should be arranged between Line Manager and employee and the employee advised that the formal process will now stop. The employee’s attendance will continue to be

monitored as with all other employees.

However if there is a repeated breach of the attendance targets stipulated while the final written warning remains live, the formal procedure will recommence at stage 3, following further Occupational Health advice if appropriate.

If there is a repeated breach of the attendance targets stipulated after the expiry of the final written warning, the formal procedure will recommence at stage 1.

5.6.

Dismissal

If the Senior Manager concludes that the employee and the process have been managed fairly, they will confirm that the employee’s employment has been terminated with the appropriate notice for failure to meet an acceptable level of attendance.

The main details discussed during the meeting and its outcome will be confirmed in writing to the employee and if applicable their representative.

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6.

Procedure for Managing Long Term Sickness or

an on-going Medical Condition – Procedure B

If an employee has been absent, or is due to be absent for more than 4 weeks then procedure B should be followed.

Long term sickness absence is defined as a period of continuous absence of 4 weeks or more. As soon as it is apparent that sickness absence will be for four weeks or more, the Line Manager should seek advice from Occupational Health.

6.1.

Planned sickness absence

If it is known in advance that an employee is going to be taking sick leave, for

instance due to planned surgery, then the Manager will make arrangements with the employee, prior to their absence, to make future contact with them on an agreed date.

The purpose of the Manager making contact at this time is to determine how the employee is and when the likely return to work will be. The Manager should

consider making a referral to Occupational Health (OH) for a health assessment prior to a return to work following surgery. This will involve discussing any suitable work adjustments and their implementation.

6.2.

If an employee is too unwell to attend meetings

If, due to their illness, an employee is unable to attend meetings held under this policy, then a letter from the GP or consultant or Occupational Health will be required to confirm this. The Line Manager should consider how meetings may proceed in such circumstances such as organising transport for the employee, making a home visit or holding the conversation by telephone.

If the employee is seriously ill, the Line Manager may have to have these

discussions through the next-of-kin, representative or proceed in the employee’s absence.

6.3.

Early interventions

If a member of staff has been absent from work, or is currently at work but struggling due to:

A Musculoskeletal reason (i.e. back pain) the Line Manager should refer the individual to Occupational Health immediately for early intervention via the Trust’s Physiotherapist; or

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referral to Occupational Health. In addition they should notify the member of staff of the support they can access from the Trust’s counselling services, the Employee Assistance Programme (EAP).

Any contact with the Trust’s EAP service is confidential and will not be passed back to the Line Manager. The service is there to provide staff with psychological support and intervention where appropriate.

The Trust’s Stress Management Policy should also be consulted when a member of staff is absent due to work related stress

Following receipt of a report from Occupational Health, the employee should be invited to meet with the Manager. The employee should be advised in writing that this is a formal meeting and of their rights to representation by a work colleague or trade union representative as recognised by the Trust. The purpose of the meeting will be to discuss:

 how long the employee is likely to be off work/what support can be given to enable them to remain in work.

 whether there are any steps that can be taken to support to sustain

attendance at work or a return to work if they are absent(e.g. adjustment of hours or duties)

 advice from Occupational Health, the GP, specialist consultant.

Other options to be considered in the event that the employee is unable to return to work are outlined later in the policy.

Managers should note that many cases of long term sickness absence may well relate to disabilities as defined by the Equality Act 2010. In any case, the Trust will meet the standards of the Act, in order that the situation is managed consistently and fairly.

6.4.

Return to work after long-term absence

Following a return to work after a long absence, management will need to ensure appropriate reviews to check on an employee’s progress. The number of reviews and the timescales will depend on the employee’s needs and the reason for and length of the absence.

Alternative Options for the employee to return to work – During discussions with the employee and in consideration of Occupational Health and GP advice (from the medical certificate), it may become apparent that the employee is not able to

undertake the duties of their substantive role in the same way as they had done previously. In such circumstances the following options could be considered:

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and the employee regarding what would be suitable/reasonable hours and duties in line with service requirements. Occupational Health will be able to advise on the suggested length of time of the adjustment and the maximum number of hours to be worked.

The arrangement should be put in writing. A phased return is usually supported for a period of four weeks or less and the Trust will grant full pay for a rehabilitation

programme for this period. Regular reviews by the Manager should take place during rehabilitation period to ensure that the arrangement continues to work for the

employee and the service. Occupational Health can advise if a medical review of the employee is required, including advice and support from the rehabilitation nurse. If the programme extends beyond four weeks, other options such as a temporary reduction in contractual hours or use of accrued annual leave should be explored. Reasonable adjustments (temporary or permanent) - If there is an underlying medical condition contributing to sickness absence, management will need to consider whether there are adjustments that could be made to the job. These could be to change the physical environment, the employee’s attendance target, to adjust job content and/or to reduce hours.

Adjustments may also be recommended by Occupational Health or by the GP on the medical certificate, and management will need to consider if these adjustments are reasonable and practical in terms of the needs of the department, the cost, the impact on colleagues, and whether the adjustments can be made permanently or for a limited period only.

Where adjustments are made, management will inform all necessary parties, e.g. supervisors/colleagues to ensure the department continues to support the employee with their return to work. Management will need to ensure when informing colleagues of the reasonable adjustments, that they do not breach confidentiality (e.g. disclosing the reason for absence or underlying condition). Managers should discuss and agree with returning members of staff what will be shared with their team members upon their return to work.

6.5.

Employee unable to return to work

When all other options have been explored and exhausted, and if the long term sickness absence continues, management will need to consider the overall absence in its entirety. If there is no indication that the employee is able to return to work within a reasonable timeframe, having due consideration to the needs of the service, a recommendation for dismissal on grounds of capability will be made. Ill health retirement may also be a consideration at this stage.

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Ill-health retirement – If the employee, in agreement with Occupational Health, decides they wish to apply for ill health retirement on the basis they are not fit to carry out their role then they will be dismissed under the grounds of ill health / capability.

Employees who have been contributing to the NHS Pension Scheme for at least two years may put forward their application for ill health retirement.

To begin the process the employee needs to discuss his/her intention to apply for ill health retirement with his/her Manager, in conjunction with the occupational health advice received. The Manager will then contact payroll to obtain the AW33(E) form. Completing the form requires the support of a doctor, usually from Occupational Health, alternatively the employee’s GP could complete the relevant part. The

completed form needs to be sent back to Human Resources in the first instance and will then be forwarded to the Trust’s Pension Officer, and subsequently the NHS Pensions Agency. The decision to grant ill health retirement is external to the Trust. For information on Ill Health Retirement conditions visit NHS Pension website. Further information regarding the ill health retirement process will be provided by the member of the Workforce Relations Team supporting the Manager

Terminal illnesses – There are special provisions in the Pension Scheme for terminal illnesses, which are designed to make a person’s circumstances as comfortable as possible in such difficult times. Staff may be able to opt to convert their pension benefits (annual pension and lump sum) into a larger one off lump sum, known as commutation.

Therefore early advice should be sought from the Pensions Department and information is available from: http://www.nhsbsa.nhs.uk/Pensions/IllHealth.aspx

Termination of Contract by mutual agreement: There may be some instances where the nature of the employee’s illness is such that they do not wish to proceed with a formal meeting or hearing, or are too unwell to do so. In such a circumstance the Manager may agree with the employee the most appropriate way to manage the employee leaving the Trust. For example a discussion might take place with the employee and Manager, ideally in person, but if not then over the telephone and the decision confirmed in writing rather than holding a full hearing. The employee will still have the right to appeal the decision.

Formal Meeting: Should the employee not wish to mutually agree their dismissal, a formal meeting will be arranged with the employee who has the right to be

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7.

Suspension on Medical Grounds

Suspension on medical grounds is intended to help ensure safety of staff and

patients. It seeks to make sure staff do not work when it is not safe for them to do so. Under certain circumstances – listed below – the Line Manager is authorised to suspend the member of staff on medical grounds. Clearly this is not in any way connected with disciplinary action and this should be made clear to the member of staff.

 This form of absence will be paid at full pay for an initial period of up to 2 weeks, and subsequently reviewed weekly by the Line Manager to ensure that it is appropriate to maintain the suspension.

 Suspension on medical grounds should only be chosen in order to seek initial or further medical opinion including advice from the Occupational Health Service.

 Suspension on medical grounds will be for short periods only and should, in case of any doubt, be decided on after discussion with the HR Manager.

 Circumstances when suspension on medical grounds can be used include:- o If any member of staff returns to work after sickness absence and the Line Manager has doubts about their ability to perform the full range of their duties in a safe way and prior to an Occupational Health

Assessment.

o If the member of staff is unwell or has a condition which causes the Line Manager concern and might present a risk to him/her or to others. In cases involving medical and dental staff, the advice of the Medical Director must be sought at the earliest opportunity.

8.

Time off for Appointments/Treatments

8.1.

Routine Dental/GP/Hospital appointments

Staff should arrange to attend routine GP, dental and hospital appointments that are off site in their own time e.g. day off, at beginning or end of the working day/shift to minimise disruption to the service. Staff should provide reasonable notice to their Line Manager when making a request to attend an appointment off site and agree how they will make up the time owed.

Where this is not possible, either annual leave, unpaid leave, time off in lieu, or a combination of these, will need to be negotiated, prior to taking the leave, which will be subject to the needs of the service. (NB all antenatal appointments are covered under the Trust's Maternity Leave Policy).

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It is anticipated that a member of staff will not require more than two routine dental appointments per year. However, there may be occasions where a member of staff is required to attend for a course of dental treatment, hospital appointments or undergo a series of tests on a frequent basis. In such instances, a full discussion should take place between the Line Manager and the member of staff in order to agree the most appropriate way for this time to be granted (paid, unpaid, annual leave, time off in lieu). The Trust will endeavour to provide as much flexibility and support to members of staff as possible within service constraints.

8.2.

Time off for other appointments/treatments

Staff may require time off for other appointments during the course of their

employment. Some examples are provided below, but this is not an exhaustive list.

 Time off related to In Vitro Fertilisation (IVF)

Time off related to In Vitro Fertilisation (IVF) treatment only will be considered by the Trust as sick leave. When scheduling IVF appointments, if at any time there is any scope to plan the absence from the department, staff are expected to discuss this in advance with their Line Manager.

 Routine appointments for staff with a disability who require regular treatment/reviews of their condition

Under the Equalities Act 2010 provision is made for staff with a disability that may require time off for routine on-going rehabilitation, hospital treatment or counselling. These are considered “reasonable adjustments” which Managers are required to grant. Time off relating to this treatment is to be negotiated with the Line Manager beforehand.

 Time off for staff undergoing gender reassignment

In the event that a member of staff intends to undergo gender reassignment surgery and may require time off to achieve the change without unnecessarily compromising their physical and mental health, the amount of time off will depend on the member of staff’s needs. The member of staff should make every effort to procure treatment outside office hours but there will be occasions when this is not possible and it would be reasonable to allow some time off for appointments.

Any reasonable absence due to the effects of treatment for gender reassignment should not normally be taken into account for purposes of formal action for

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9.

Notifiable and Other Infectious Diseases

Following contact with an infectious disease (refer to the Trust’s Infection Control policy), staff and their Managers should promptly seek advice from the Occupational Health Department.

Where an employee is unable to attend work due to restrictions placed on them following contact with an infectious disease (as detailed in the Infection Control policy), their absence will be recorded, however, Managers will take advice from a member of the HR Operational Team before any formal management action is taken.

9.1.

D&V reporting

Managers must call the D&V hot line immediately if staff call in sick with D&V. Name, role, area, date symptoms first started should be left on the answerphone. During an outbreak the hot line is checked daily by Occupational Health.

Please note that diarrhoea and vomiting (D&V) is not in itself a notifiable

disease. However, some notifiable diseases will have symptoms of D&V such as salmonella and dysentery. Recurrent episodes of diarrhoea will result in a confirmed diagnosis being required and Occupational Health should be contacted to provide further advice.

Staff who have been absent from work due to diarrhoea should remain off work for 48 hours after the symptoms have subsided, in line with the Infection Control policy. Staff with symptoms of D&V likely or confirmed to be due to Norovirus should remain off work for 48 hours after the symptoms have subsided.

These periods of 48 hours enforced absence will be recorded as paid special leave, under the Work Life Balance Policy, where the diagnosis is confirmed. The days on which an employee is ill will be recorded as sickness absence, and be included within an employee’s overall sickness absence record for purposes of absence management (in line with this procedure).

If a medical certificate confirming the diagnosis is required within the 7 days self-certification period, and a charge is incurred, the Trust will meet the cost.

9.2.

Accidents at work

If an employee is injured whilst on duty, this must be reported to management as soon as possible, but no later than the end of the working day.

All work related injuries must be reported to the individual’s line manager, or

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An incident reporting form must be completed and the appropriate Trust procedure should be followed, for example in cases of needle stick injury, advice should be sought from Occupational Health.

Work related injury, that causes sickness absence and a reduction in pay, may be eligible for NHS Injury Benefits known as Injury Allowance, (IA). Eligible staff should notify their Manager. Managers should then contact Human Resources for advice on how to determine whether the staff member is eligible to receive IA.

In the first instance, Managers should indicate injury related sickness on their payroll return and the employee on their self-certificate.

If staff are absent for 7 days or more after the day of the accident or unable to perform their normal duties (but at work) for this period, as a result of an accident at work, then this must be reported under the Reporting of Incidents Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013.

The Trust has a statutory duty to report notifiable incidents within set timescales. Failure to report correctly could adversely affect the Trust’s reputation in relation to Health and Safety and could result in a fine.

Occupational Health is able to provide advice and support to Managers and the employee regarding follow up action after an accident at work, and the Staff Counselling Service is available to all employees.

10.

Monitoring Compliance

The implementation of and compliance with this policy and procedure will be monitored using the following key performance indicators:

 Sickness within each department does not exceed the target.

 Line Managers have received training on the contents of this policy within the last 24 months;

 Those featuring on trigger reports are being actively managed and there is documentary evidence of this;

 Terminations of contract for health related reasons have been fair and in line with policy, and have not been successfully challenged by the employee. Monitoring will be performed by Divisional Managers, supported by HR. Although the sickness absence rates will be monitored on a monthly basis, formal monitoring of the implementation of the policy will occur quarterly.

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Should the monitoring uncover any shortfalls in the implementation of the policy, the Divisional Manager and HR will work with the relevant Departmental Manager to draw up an action plan for improvement. This action plan may include:

 Additional training for the Line Manager;

 A risk assessment within the area of work;

 A review of departmental reporting processes;

 A review of the number of individuals within the department responsible for sickness absence management.

An organisational-wide report on the results of the monitoring exercise will be produced by the HR department which will capture any themes in reasons for non-compliance and make recommendations to the organisation on whether any cross-divisional steps can be taken to bring about improvement.

11.

Review

This policy will be subject to a planned review every three years as part of the Trust’s Policy Review Process. It will be reviewed after 6 months and again prior to the third anniversary of the policy. It is recognised however that there may be updates

required in the interim arising from amendments or release of new regulations, Codes of Practice or statutory provisions or guidance from the Department of Health or professional bodies. These updates will be made as soon as practicable to reflect and inform the Trust’s revised policy and practise.

12.

Training

Staff will receive advice and information regarding the effective management of sickness absence from a number of sources:

 Trust Policies

 Line Manager

 HR Team

 Other communication methods (e.g. team brief, team meetings)

Staff should refer to the staff development pages available on the intranet, to identify what training in relation to managing sickness absence is available.

13.

References

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Appendix 1: Frequent Absence Flow Chart

Long term

Frequent sickness absence triggers hit

Stage 1 1st Formal Meeting

Set attendance target for 6 months

Stage 3 Formal Hearing

Attendance target not achieved in 6 months Progress to Stage 2

Repeated absences over 12 month period

Progress to Stage 2

Attendance target achieved Formal process stops

Attendance target not achieved in 6 months Progress to Stage 3

Final written warning

Attendance target for 6 months Employment

Terminated

Attendance target not achieved in 6 months or whilst written warning is live

Return to Stage 3

Appeal Process Trigger Points, (Pg13) Reached

(Refer to Occ. Health if appropriate) Long term sickness See appendix 2 Attendance target achieved Formal process stops

Stage 2

2nd Formal Meeting

Issue formal written warning (current for 24 months)

Set attendance target for 6 months

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Appendix 2: Long Term Absence Flow Chart

Appeal Process Staff member is absent or plans

to be absent for 4 weeks or more. Refer to Occupational Health

Staff Member is signed off with musculoskeletal problems or stress

Agree with the staff member how and with what frequency you are going to keep in contact. Arrange Health and Sickness Meeting

At the meeting discuss whether any of the following can be applied to enable the employee to return to work:

• Adjustments to the workplace

• Adjustments to working pattern (hours/shifts)

• Redeployment (temporary or permanent)

• Ill health Retirement

This step may need to be repeated if treatment is on-going or a diagnosis is still being made.

1. Redeployment 12 weeks Posts are ring fenced for employee.

2. A post is found and OH declares the post suitable. Interview for the post takes place to ascertain that the staff member has the skills to undertake the role

Adjustments are made (temporary or permanent) and staff member returns

to work.

Ill health retirement is applied for.

Or

Staff member resigns

Redeployment is successful

3. Redeployment is unsuccessful & the staff member remains unfit for work. Staff member goes back into redeployment (2). A final trial period can take place if a post is found.

Final Sickness Hearing takes place.

Redeployment is successful

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Appendix 3: Return to Work Interview Form

Employee’s Details:

Name: ……… Role: ……….……….. Department: ……….. Start of Absence: ………..…….… End of Absence: …………..………. Number of Days Absent (including part days) ……….

Checklist

Self-Certificate Received? Work Related Injury? OH Referral?

Medical Certificate Received?

If so, incident form completed?

Secondary Employment?

Record of Discussion

A copy of this discussion will be retained in the employee’s file held by the Line Manager

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Document Control Information

Ratification Assurance Statement

Dear Strategic Workforce Committee

Please review the following information to support the ratification of the below named document.

Name of document: Supporting Attendance Policy Name of author: Gayle Williams

Job Title: Deputy HR Business Partner I, the above named author confirm that:

 The Policy presented for ratification meets all legislative, best practice and other guidance issued and known to me at the time of development of the Policy;

 I am not aware of any omissions to the Policy, and I will bring to the attention of the Executive Director any information which may affect the validity of the Policy presented as soon as this becomes known;

 The Policy meets the requirements as outlined in the document entitled Trust-wide Policy for the Development and Management of Policies (v4.0);

 The Policy meets the requirements of the NHSLA Risk Management Standards to achieve as a minimum level 2 compliance, where applicable;

 I have undertaken appropriate and thorough consultation on this Policy and I have documented the names of those individuals who responded as part of the

consultation within the document. I have also fed back to responders to the consultation on the changes made to the Policy following consultation;

 I will send the Policy and signed ratification checklist to the Policy Coordinator for publication at my earliest opportunity following ratification;

 I will keep this Policy under review and ensure that it is reviewed prior to the review date.

Signature of Author: Gayle Williams Date:

Name of Person

Ratifying this policy: Claire Buchanan

Job Title: Director of Human Resources

Signature: Date:

05 November 2015

To the person approving this policy:

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Document name: Supporting Attendance Policy Ref.: 117

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Consultation Schedule

Name and Title of Individual Date Consulted

HR Operational Team 18th November 2013

28th November 2013 Occupational Health Team 18th November 2013 28th November 2013 Staff Side Representatives 18th December 2013

Specialty Managers 18th December 2013

Matrons and Ward/Departmental Managers 28th November 2013 18th December 2013

Department Managers 18th December 2013

6 month review

HR Operational Team 8th October 2014

Occupational Health Team 8th October 2014 Staff Side Representatives 8th October 2014

Specialty Managers 8th October 2014

Matrons and Ward/Departmental Managers 8th October 2014

The following people have submitted responses to the consultation process:

Name and Title of Individual Date Responded

HR Operational Team November 2014, February & April 2015

Occupational Health Team October & November 2014 Matrons and Ward/Departmental Managers November 2014

Name of Committee/s (if applicable) Date of Committee

TCNC Policy Sub Group 30th October 2014

TCNC Policy Sub Group 27th November 2014

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Equality Impact: (A) Assessment Screening

To be completed when submitted to the appropriate Executive Director for consideration and approval.

Person responsible for the assessment:

Name: Gayle Williams

Job Title: Deputy HR Business Partner

Does the document/guidance affect one group less or more favourably than another on the basis of:

Yes/No Comments

Race Yes No

Ethnic origins (including gypsies and travellers) Yes No

Nationality Yes No

Gender (including gender reassignment) Yes No

Culture Yes No

Religion or belief Yes No

Sexual orientation Yes No

Age Yes No

Disability

(learning disabilities, physical disability, sensory impairment and

mental health problems) Yes No

Is there any evidence that some groups are affected

differently? Yes No

If you have identified potential discrimination, are there

any valid exceptions, legal and/or justifiable? Yes No

Is the impact of the document/guidance likely to be

negative? Yes No

If so, can the impact be avoided? Yes No

What alternative is there to achieving the

document/guidance without the impact? Yes No

Can we reduce the impact by taking different action? Yes No

If you answered NO to all the above questions, the assessment is now complete, and no further action is required.

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