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START DATE: April 2014


March 2016


Joint Management/Trade Union Consultative Committee




Consultative Committee


LOCATION: Human Resources / HR Polices


Stress Policy , Flexible Working Policy, Maternity Leave Policy, Health and Safety Policy , Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995

Disciplinary Policy and Procedure, Trust’s Procedure For Appeals Against Dismissal

Conduct, Capability Ill Health and Appeals Policies and Procedures For Medical Dental Practitioners

Recruitment and Retention of Staff with Disabilities AUTHOR/FURTHER INFORMATION: Rebecca Ryan, Human Resources Advisor


Joint Management/Trade Union Consultative Committee, Managers, Human Resources


Date Version

July 2008 1 Policy reviewed by at General Managers Meeting August 2008 2 Draft Policy to JMTUC

September 2008 3 Draft Policy to JMTUC (following amendments) January 2009 4 Policy reviewed at General Managers Meeting August 2009 5 Amendments to Policy (Agreed with Staffside)

November 2010 6 Amendments following review by Local Counter Fraud Service and updated Legislation - Equality Act 2010


November 2011 8 Updated design & reformatted Updated version to managers and staff side with endorsement received noting may be reviewed further in 2012 with Sickness QUIPP scheme


Managing Short Term Absence

Attendance record becomes a concern – trigger point reached.

Informal Meeting. Agree monitoring review date (normally within 12 weeks). Identify if referral to Occupational Health would be beneficial. Specify expected improvement.

Attendance improves – No Further Action.

Attendance remains a concern despite Informal Meeting.

Stage 1 – Formal Meeting convened, possible first written warning issued. Make further referral to OH if necessary. Ensure expectations for improvement are communicated and implications of not. Re-set monitoring period.

Attendance improves – No Further Action.

Attendance remains a concern despite Stage 1 – Formal Meeting.

Stage 2 – Formal Meeting convened, possible Final written warning issued. Arrange a further review with OH if appropriate.

Attendance improves – No Further Action

Stage 3 – Hearing convened, possible termination of contract.


Managing Long Term Absence

Absence is, or expected to be, 3 weeks or longer

Informal Stage: Manager maintains regular

contact with employee, makes OH referral Return to work known (within 5 weeks of absence

commencement) Hold Return to Work meeting & implement where reasonable, OH recommendations Return to work unclear/or likely to extend beyond

five weeks

Formal LTS Review Meeting arranged. OH referral made so that medical advice is available at the meeting.

Employee is signed fit to return to work by OH, return to existing post or suitable alternative post.

Return to work date established. Hold Return to Work meeting & implement where reasonable, any OH recommendations.

Employee is signed unfit to return to work by OH. Consider remaining options: temporary or permanent reduction in hours, redeployment, ill health retirement, flexible retirement or dismissal on the grounds of capability.


Dismissal on the ground of capability considered – Hearing arranged

Employee not fit for work but return in short term very likely. Monitoring period set and another Formal LTS Review Meeting scheduled

Fit with


Capability questioned Further recovery time



The Trust’s Sickness Absence Policy and Procedure provides definitions, triggers and details on the management of the overall sickness absence of staff. Both long and short term absences are categorised to help in identifying where absences occur which impact on service delivery. The sickness policy and procedure is aimed at managing and addressing the issue of attendance at work and not whether the absence is due to a genuine illness.

The procedural stages in managing absences are a series of meetings which are termed informal, formal, and one leading to a final written warning, ultimately leading to a dismissal meeting. The policy outlines the responsibilities of the individual staff member, manager, occupational health, human resources and that of union representatives and/or colleagues who may support the individual who is being managed. The policy outlines reporting requirements of an employee who falls ill, including contacting the line manager at the earliest possible opportunity before the employee starts work and during every day of the absence. Where the absence is longer than 3 calendar days, individuals are required to submit a “Fitness for Work Certificate”

The policies outlines a range of options for an employee returning to work, including phased returns, redeployment and where these options are not possible ill health retirement.

Appendices to the policy include a flowchart to assist in managing the process and the policy is also supported by a stand-alone guide for managers.

Key Points

Employees are expected to comply with reporting arrangements and provide statements of fitness for work certificates when required.

If sickness extends beyond 3 days, then a self-certificate must be submitted.

If sickness extends beyond 7 calendar days (including days off) then employees continue to provide a statement of fitness for work certificate promptly and continue to provide a doctors certificate promptly if period of sickness continues.



1.0 AIM 4

2.0 SCOPE 4


3.0.1 Sickness Absence Management 3.1 Short Term Sickness Absence 3.2 Long Term Absence

4.0 Disability Related Provisions 5


5.1 Role of The Occupational Health Department 5.2 Responsibilities of Managers

5.3 Responsibilities of Employees 5.4 Role of Human Resources 5.5 Role of Trade Unions

6.0 Reporting of Sickness Absence 9

7.0 Failure To Comply With Sickness Absence Reporting Procedures, 10 or Abuse of Trust Rules on Sickness Absence

8.0 Returning To Work After a Period of Absence 11

9.0 Managing Short Term Sickness Absence 11

9.1 Informal stage – Manager and Employee Discussion and Conduct 9.2 Formal Stages – Requirements

9.3 Stage 1 –Formal Meeting 9.4 Stage 2 - Formal Meeting

9.5 Stage 3 - Sickness Absence Hearing

10.0 Managing Long Term Sickness Absence 15

10.1 Informal Stage – Manager and Employee Discussion and Conduct 10.2 Formal Long Term Absence Review Meeting

11.0 Rehabilitation and Returning To Work 17

11.1 Phased Returns

11.2 Payment During Phased Return To Work 11.3 Redeployment

12.0 Ill Health Retirement 18

13.0 Long Term Sickness Absence Hearing 19

14.0 Medical Suspension 19

15.0 Accident at Work 19

16.0 Implementation and Dissemination of Policy 19

17.0 Monitoring & Review 19

18.0 Other Related Policies and Procedures 20



1 Return To Work Interview Guidance

2 Return To Work Form and Self Certificate Forms (SC2)

3 Occupational Health Management Referral Protocol


1.0 AIM

1.1 The Trust is committed to promoting the health, safety and welfare of all its employees with the

express aim of promoting arrangements for managing sickness absence in a manner which is fair and sensitive to staff, as well as minimising the effect of sickness absences on the operational requirements of the service.


2.1 This policy and procedure relates to all staff who are employed by Chelsea and Westminster

Hospital NHS Foundation Trust. Trust staff that become unwell are to be treated sympathetically and every effort will be made to assist recovery and their return to employment whilst managing sickness absence in accordance with this policy and procedure. It is recognised that any absence will impact on both the quality of the service delivered, in terms of work uncompleted and

additional pressure of colleagues to cover absences. The responsibility of managing sickness lies with the employee in correctly reporting any sickness absences from work and with the line managers in monitoring and controlling sickness absence, with support and advice from Human Resources and Occupational Health.

2.2 It may be in some cases that an individual’s sickness absence is related to a disability. Such

cases will be managed in accordance with the disability related legislation in accordance with the Equality Act 2010 and advice on specific cases can be sought from the Occupational Health Department in consultation with the HR Department.

2.3 The Trust will endeavour to support employees to return to work following long- term sickness absence by considering rehabilitation programmes and opportunities for temporary or permanent redeployment wherever possible on the medical advice of Occupational Health.


3.0.1 Sickness Absence Management

Decisions in the management of individuals sickness absence should be based on an employees

overall sickness absence levels, (i.e. the combination of both short term and long term absences)

taking into account the frequency and length of absences whether or not the absences are for the same or a number of different reasons normally within a twelve month period. However there may be occasions where longer periods are taken into account.

3.0.2 Where the management of episodes of sickness absences have not shown improvement following formal review periods or warnings, and within twelve months of any warning the level and frequency of absences are again a cause for concern the manager has the ability to re-enter the formal stages at any point without the requirement to begin again at the informal discussion.

3.0.3 Advice should be sought from Occupational Health / Human Resources and an assessment

undertaken of the impact of overall absence on the service and the continuation of the contract of employment.


3.1 Short Term Sickness Absence

3.1.1 This type of absence can often start with the odd day off sick. It may lead to a pattern whereby individuals regularly take days off sick.

The following should act as triggers for the manager to take action if he/she has not done so already.

3 or more episodes or 5 days of sickness absence within a 6 month period

a combination of odd days, longer periods of less than 3 weeks, or where patterns of absence exist which cause concern

Sickness absence is recorded as ‘Calendar Days Lost' which may include Saturdays, Sundays and public holidays as well as scheduled rest days, all of which count towards a continuous period of absence.

3.2 Long Term Absence

3.2.1 Long term sickness absence is defined as continuous absence through ill-health for a period of more than 3 weeks. It usually covers accidents, operations, long term illnesses or disability. It may also be for recurrent periods of time with a serious health problem and where an employee has returned to work but remains unfit to fulfil their full duties after a period of phased return.

3.2.2 Advice should be sought from Occupational Health in order for the manager to make an assessment of the impact of their absence on service delivery and a decision regarding the continuation of their contract of employment.


4.1 Terms and Definitions

4.1.1 Disability for the purposed of this policy is defined as mental or physical condition, which has a

substantial and long-term effect on the ability to carry out normal day to day activities.

4.1.2 Disability related sickness absence is defined as when an employee is off sick for a reason

relating to their disability. E.g. an employee with asthma is off unwell with an asthma attack. This type of leave is unplanned and has not been agreed in advance by the line manager. The

manager should record this on ESR absence returns.

4.1.3 Disability Leave is defined as a set amount of reasonable leave which has been agreed by the line manager in advance. For example, time off to go for a hospital appointment or treatment. The manager should record this on the ESR absence returns.

4.2 Managing Disability related leave

4.2.1 Where a disabled employee needs to take time off because of their disability for treatment, assessment or rehabilitation purposes, a reasonable amount of disability leave can be granted. The manager should consider and address this with the employee, and if necessary in conjunction with Human Resources or Occupational Health. Managers should record this on the Electronic Staff Record (ESR) Absence Form.


Any disability leave, disability related sickness absence or sickness absence must be recorded on the ESR Absence Form by the Line manager.

4.2.4 Under the Equality Act 2010 an employer has a duty to make reasonable adjustments to working conditions or the physical working environment where that would help overcome the practical effects of a disability.

4.2.5 The Occupational Health Department will advise managers, on request, if in their opinion an employee’s condition or impairment may meet the definition of Disability in accordance with the Equality Act as a result of their ongoing ill-health.

4.2.6 The Occupational Health Department will advise managers and staff on appropriate and suitable work, which may include adjustments or modification to existing hours on a temporary or permanent basis in an attempt to accommodate the medical condition

Reasonable adjustments are specific to individuals and might include: Making adjustments to premises, duties, working hours

Arranging training (and allowing time for the training) Acquiring or modifying equipment

If an adjustment is not feasible, suitable alternative employment will be sought through redeployment.

4.2.7 Adjustments to duties, working hours and meeting training needs will be the responsibility of the employee’s manager and would be agreed prior to a return to work. Managers should refer to the “Policy for Supporting the Recruitment and Retention of Staff with Disabilities” when considering any adjustments.


5.1 Role of the Occupational Health Department

5.1.1 The role of the Occupational Health (OH) Department is to provide managers and staff with advice regarding issues around fitness for work, including the Disability Discrimination Act (1995), if requested.

5.1.2 Managers can request an Occupational Health assessment by means of the Management Referral Form (Appendix 4). Managers should ensure that they have explained the reason for the referral to the employee prior to submitting the referral to the OH Department.

5.1.3 Advice given to managers by OH will be with regard to an employee’s fitness for work and may include recommendations regarding temporary or permanent modifications/adjustments to working hours and duties in order to facilitate rehabilitation after long term absence or to accommodate a medical condition in the workplace.

5.1.4 All reports from OH will be subject to the principles of the Access to Medical Reports Act, 1988 and employees will be given the option to see the report prior to it being sent to the manager so that they may correct any factual errors in the report and/or add their own comments. Reports will usually be copied to the employee.

5.1.5 Individual members of staff who have concerns about the impact of their work on their health or vice versa may seek advice from the OH. Independent approaches to the OH department will remain confidential, but managers will be advised regarding the employee’s fitness to work if these concerns regard their own health and safety or that of their patients.

5.2 Responsibilities of Managers


It is the responsibility of every manager to:

i) Abide by the requirements of this procedure, and ensure that all aspects of it are followed in

managing sickness absence and to record and monitor all sickness absence within their area, including reasons for absence.

ii) Complete and ensure submission by the 5th of each month attendance records for all staff in

their department to Human Resources for Trust wide reporting purposes whether they be paper records or electronic records. E.g.: MAPS Rostering System. Where this task is delegated to a supervisor or another person it is the managers’ responsibility to ensure that this is done accurately and on time. This information will be regularly monitored for absence trends. Ensuring that correct reporting is undertaken and is essential to enable correct payment for periods of sickness absence to be made.

ii) Ensure that satisfactory levels of attendance are met by all staff (satisfactory levels of attendance obviously depend on individual circumstances but Trust and national averages will be helpful in providing a benchmark).

iii) Ensure that there is a reporting system in place within the department /ward, and that the requirements of this procedure and the reporting systems are made known to all staff and especially to any new staff during their induction or where any changes to local procedures are made.

iv) Carry out return to work interviews for all staff when they return from their absence, and complete the Return to Work Form on each occasion however short the duration of the absence. Discuss the reason for absences and offer whatever help and support is appropriate in the circumstances.

v) Consider adjustments to hours or duties based on the advice on GP’s Statement of Fitness

for Work certificates or advice received from Occupational Health.

vi) Monitor absence levels within their own department/ward and take appropriate action on receipt of trigger reports as required and where necessary to refer employee to the Occupational Health Department in the agreed manner through the Management Referral Process.

vii) Recognise where there are concerns about the attendance levels of any employee that this

should be raised as early as possible with a member of the Human Resources Department for advice and guidance in conjunction with the Occupational Health Department.

viii) Undertake and / or initiate risk assessment in conjunction with the Occupational Health Department.

x) Take reasonable steps to ensure that employees work in a healthy and safe environment which has due regard to the Health and Safety at Work Act.

xi) Be aware of work related absences which may be related to bullying, harassment, stress and

other work related health conditions and take the necessary action to alleviate them. If absence is related to stress or depression to discuss this as appropriate with the Occupational Health Department/ Human Resources Department for advice and guidance. (Refer to Trust

Stress Management Policy)

5.2.2 Managers are responsible for determining if a member of staff should be sent home from duty.

5.3 Responsibilities of Employees

5.3.1 It is the responsibility of every employee to:

i) Ensure that they follow this policy and procedure for reporting sickness absence, including


keeping in regular contact, raising any issues at an early stage and attending meetings with line managers when requested.

ii) Undertake a Return to Work Interview and complete the Return to Work Form with the

manager on return from sickness absence.

iii) To attend Occupational Health appointments when referred by line managers and notify

managers when appointments have been booked (date & time) or rearranged so any arrangements to provide cover can be made.

iv) Be available to attend sickness absence meetings and appointments during their sickness

absence at times when they would normally have been at work. These are considered as reasonable management requests.

V) Obtain the explicit consent of their line manager, or the appropriate person responsible before

leaving the workplace for reasons of sickness during the working hours.

5.3.2 Failure of staff to co-operate with the sickness absence process (e.g. attending appointments, meetings, working elsewhere whilst declared unfit to work and where appropriate, accepting

reasonable offers of redeployment) will be viewed seriously and may lead to formal action being taken against them.

5.4 Role of Human Resources

5.4.1 The Divisional Human Resources teams can provide support, information and advice to managers and staff about this Policy and Procedure, as well as providing information on absence levels and training in applying these procedures.

5.4.2 The Divisional Human Resources teams can also attend any formal sickness review meeting on request from the line manager to provide advice and support.

5.4.3 The Divisional Human Resources Administrators will ask managers for a response to any nil sickness returns.

5.5 Role of Trade Unions

5.5.1 From the formal stages of this policy and procedure, employees may be accompanied to review meetings by a recognised trade union representative. This companion will be allowed to address formal review meetings in order to put forward the employee’s case, sum up the employee’s case and respond on the employee’s behalf to any view expressed at the meeting. This companion may also confer with the employee during the hearing, including asking questions, but may not answer questions on the employee’s behalf.

5.5.2 Alternatively employees may be accompanied by a workplace colleague, friend or partner not acting in an official capacity, but a companion who is not a trade union representative will not be allowed to address the meeting, sum up the employee’s case or respond on the employee’s behalf during the meeting.

5.5.3 It is the responsibility of the employee to contact his/her chosen companion and ensure that s/he is willing to act in that capacity. The employee must also inform the manager that s/he will be accompanied and must provide the name and contact details of the companion.



6.0.1 Employees are required to contact their line manager on the first day of absence to inform them that they will not be attending work. This should be done at the earliest possible opportunity before an employees expected starting time.

6.1 Employee Reporting Requirements

 Employees must telephone (text messages are not accepted) their manager, or deputy, and advise them of the following:

a) The reason for the absence and if possible anticipated length of absence plus details of any work which needs to be covered urgently.

b) Whether the employee intends to see a doctor and when c) Whether the condition is a result of an injury sustained at work

 Please note it is not sufficient just to leave a message on a voicemail, particularly out of hours, or with a colleague. Only in exceptional circumstances should a family member or friend telephone a manager, and where this is done, it is the employee’s responsibility to contact the manager as soon as possible thereafter. If the manager is unavailable, leave a message for them confirming how they can contact you.

 Should the employee be ready to return to work prior to their advised period of absence (specified on a current statement of fitness for work) the employee should notify and discuss this with their manager. It is advised that the employee will need to have confirmation from their GP or OH to confirm their fitness to return to work.

 During periods of absence the manager may need to contact the employee at home. This may be to obtain a current update on their progress or to invite them to meetings or Occupational Health appointments. It is the employees’ responsibility to keep their contact details up to date with their line manager and the Human Resources Department.

6.2 Statement of Fitness For Work Certificates

6.2.1 Employees are expected to comply with certification arrangements and provide statements of fitness for work certificates when required in a prompt and timely manner.

If Sickness Extends beyond 3 days

Provide a self-certificate promptly

If sickness extends beyond 7 calendar days (including days off)

Provide a statement of fitness for work certificate* promptly and continue to provide doctor's certificates promptly if period of sickness continues.

*certification by a registered medically qualified doctor only

6.2.2 Saturdays, Sundays, public holidays as well as scheduled rest days will count towards a continuous period of absence irrespective if the employee is not scheduled to work.


6.3.4 Repeat statements of fitness for work certificates should be provided within 3 calendar days of becoming due (i.e.: prior to the expiry of the previous certificate). Employees should contact their manager if they are aware of any delays in obtaining certificates. Repeat statements of fitness for work certificates must cover all calendar days of absence.

6.4.5 If relevant statements of fitness for work certificates are not provided at the appropriate time, the absence may be considered as unauthorised absence and therefore unpaid. Formal action may also be considered.

6.5.6 Where there is concern over the level of persistent short term absenteeism due to illness employees may be asked to provide a statements of fitness for work certificates confirming incapacity on the first day of each and subsequent absences. Guidance should be sought from Human Resources before doing so.


7.0.1 An employee who fails to comply with the Trust’s notification or certification procedures or who otherwise abuses Trust rules on sickness absence will be dealt with under the Trust’s Disciplinary Policy and Procedure.

7.0.2 Staff must not carry out any other paid employment, substantively or on the bank, either with the Trust or for any other employer, whether the NHS or not, whilst absent from the Trust due to sickness. Any such employment will be investigated in accordance with the Trust’s Disciplinary Policy and Procedure and will also be referred to the Local Counter Fraud Specialist and may result in disciplinary action and/or prosecution.

7.0.3 Failure to comply with the sickness absence procedure may result in the sickness absence being unauthorised and therefore unpaid for those periods of time where procedures and / or reporting arrangements were not followed. Payment of occupational sick pay is dependent on the employee providing the appropriate statements of fitness for work certificates and following the sickness absence procedure including any local arrangements. Reinstatement of pay will only be from the date when the employee complies with the procedure or specific management request and therefore may not be backdate. Managers should seek advice from the Human Resources Department before pay is stopped.

7.0.4 Employees may be required to undergo medical examinations by the Occupational Health

Department. If a member of staff does not cooperate in assisting the Trust to establish his/her true medical position, they should be advised in writing that a decision may have to be made upon the matter of his/her employment on the basis of the information otherwise available.

7.0.5 It is a contractual requirement for an employee to attend an appointment with the Occupational Health Department. When the employee who is absent from work due to sickness fails to attend without an acceptable reason, this will result in withdrawal of occupational sick pay until such time as they have attended an Occupational Health appointment. This should be instigated by the Line Manager seeking advice from a member of the HR team. Employees may appeal such a decision in line with the Trust’s Grievance policy.

7.0.6 Employees are also be advised that a refusal to attend Occupational Health, or not attending scheduled appointments for assessment may be regarded as failure to carry out a reasonable management request, which may result in disciplinary action. Where there is a justifiable reason for not attending an arranged appointment, it is the Employees responsibility to reschedule appointments to the next available time with OH.



should take place privately and confidentially. (Please refer to Appendix 1 and 2 for the Return to Work Guidance and Form.).

8.0.2 The return to work interview should be informal and helpful with its purpose being the opportunity

for the manager to ensure that the employee is fit to return to work as well as:

To update the employee on any relevant work issues, particularly on a return from long-term sickness absence

To allow the manager to discuss the particular period of sickness with the employee and the likelihood of re-occurrence and, if feasible, any steps that can be taken to prevent the absence occurring again.

An opportunity for the manager to review the employees sickness record

To enable the employee the opportunity to discuss, in confidence, any medical or other problems they may be encountering.


9.1 Informal Stage – Manager and Employee Discussion and Contact

9.1.1 In instances where the sickness absence of an employee is repeated (short term) for any reason, then monitoring mechanisms by managers and return to work interviews should indicate the next step will be a meeting to discuss and review the overall sickness absence record. The scope of the meeting will depend on the circumstances of the case and may not necessarily be limited to one session.

9.1.2 The time, date and venue of the meeting should be advised to the employee. The employee should receive a copy of their sickness absence record and this policy and procedure in advance of the meeting.

In cases of short term absences informal meetings should:

Establish the reasons for the sickness absences either individually or the pattern of absences. Explain the impact of the absence on the work of their ward/department

The employee should be given the opportunity to discuss any underlying reasons for the absences.

Identify any support or adjustments which could be offered and consider a referral to Occupational Health.

Set a monitoring period, depending on the level and pattern of absence. Typically the monitoring period should normally be no less than 4 weeks and no more than 12 weeks.

The manager should also consider whether undertaking any bank work has an effect on the sickness absence and whether it is appropriate that bank work is undertaken during the monitoring period. This must be decided on an individual case by case basis.

Advise the member of staff of expected improvements in attendance at work and the consequences of failure to improve.

A record of the discussion must be kept and the outcome of the meeting confirmed in writing. If the improvement has been achieved no further action should be taken.


9.2 Formal Stages - Requirements

9.2.1 During all formal stages of the management of sickness absence:

 The employee will be entitled to be accompanied by a recognised Trade Union Representative, friend or workplace colleague not acting in an official capacity. It is not reasonable for an employee to insist on being accompanied by a colleague whose presence would prejudice the meeting or who might have a conflict of interest.

 The manager will lead the meeting and will be responsible for writing to the employee following the meeting. The manager may be supported by a member of the Human Resources department or another management representative at the first formal meeting. A Human Resources representative is recommended to attend any subsequent formal meetings after the first formal meeting to provide advice and support.

9.2.2 Where an employee’s sickness absence is under formal review, they should be referred to the Occupational Health Department for review to obtain a medical opinion if there is an underlying medical condition which may have an affect on the employees’ ability to attend for work. In order to give this advice, Occupational Health may need to write to the individual’s GP and/or treating specialist with their written consent. Managers may also ask Occupational Health to assess immediate fitness for work and whether temporary or permanent adjustments/modifications to their duties/hours may be appropriate in order to maintain/improve their attendance at work.

9.2.3 It is the responsibility of managers to ensure that any relevant Occupational Health referral forms and documentation are completed prior to the appointment to assist in the assessment and completeness of the medical report. Upon receipt of the referral, the OH department will provide an appointment date to the manager to relay to the employee.

9.2.4 Once an OH report has been received, the manager will discuss the matter further with the employee. Depending on the circumstances:

It may be necessary to take further action because of the nature of the report (e.g. underlying medical conditions are identified or restrictions or adjustments have been advised)

Further discussions or an extension of any monitoring periods for the member of staff may be appropriate, or it may be necessary to proceed to the next formal stage of the procedure as appropriate.

9.3 Stage 1 – Formal Meeting

9.3.1 If the improvement in attendance outlined in the Informal Discussion has not been achieved the manager should seek the advice of Human Resources and arrange a Stage One Formal Meeting with the employee to discuss the attendance issue.

The following should be taken into consideration prior to setting up this meeting: Any previous monitoring periods and improvements required

Any Occupational Health report that may be available, any support or adjustments previously offered and / or put in place

The impact of the absences on the workload and other staff The employee’s overall health

Whether the absences are following an accident or industrial injury


include an updated sickness absence record and details of the Occupational Health report, if available. A member of Human Resources should be present.

9.3.3 During the meeting there should be a full discussion about the employee’s sickness absence record and any previous action that has already been taken and discussion about any Occupational Health recommendations that may have been suggested. Managers should clearly explain the effect of the employee’s absence, outline concerns and explore the reasons for the absence.

In summary the employee should be:

Advised of the improvement in attendance required.

Advised of the length of the monitoring period, and the likely consequences if attendance does not improve.

The manager should also consider whether undertaking any Staff Bank work has an effect on the sickness absence and whether it is appropriate that Bank work is undertaken during the monitoring period. This must be decided on an individual case by case basis. As a minimum the employee should not undertake any bank work for a period of 1 week from their date of return to their substantive post.

Referred or if necessary re- referred to Occupational Health for an opinion.

9.3.4 Following consideration of the facts, including underlying health issues and any other mitigating circumstances, the manager can continue to monitor over a specific period or a First Warning may be issued for poor attendance.

9.3.5 A First Warning will remain on file for a period of 6 months. The warning will include details of improvements to be achieved. Any monitoring period should normally be no less than 4 weeks and a maximum of 12 weeks.

9.3.6 Warnings given by managers under this procedure are not Disciplinary Warnings under the Disciplinary Policy and Procedure which are primarily warnings about conduct.

9.3.7 A letter confirming the warning for unacceptable attendance and confirming the improvements required should normally be sent to the employee within 7 working days of the meeting.

9.3.8 Where it is apparent that consistent improvement in attendance has not been demonstrated, the next stage in the process will be invoked. The next stage of the process can be invoked prior to the expiry of a warning previously given or the end of any monitoring period. Similarly if improvement is not sustained beyond a warning or monitoring period the next stage may be invoked in accordance with 3.0.2.

9.4 Stage 2 - Formal Meeting

9.4.1 If the required improvement in attendance has not been achieved by the end of the monitoring period set at the Stage One Formal Meeting and following a First Warning the manager should arrange a Stage Two Formal Meeting.

9.4.2 The employee should again be advised in writing of the meeting and his/her right to representation. The same format and principles that apply at the Stage One Formal Meeting will apply in arranging this meeting.

9.4.3 Following consideration of the facts, including underlying health issues and any other mitigating circumstances, the manager can continue to monitor over a specific period and set a review date, or a Final Warning may be issued for unacceptable attendance.

9.4.4 This Final Warning will remain on file for a period of 12 months. The warning will include details of improvements to be achieved. Any monitoring period set should normally be not less than 4 weeks and a maximum of 12 weeks.


of the employment contract on the grounds of capability. This hearing will be chaired by an appropriate manager who has the authority to make this decision. At this stage it may also be timely to request the employee to think about potential redeployment options and where appropriate make arrangements for them to be placed on the redeployment register, see section 11.3.

9.4.6 A letter confirming the Final Warning for unacceptable attendance and confirming the improvements required during the monitoring period will be sent to the employee normally within 7 working days of the meeting.

9.4.7 Where it is apparent that consistent improvement has not been demonstrated, the next stage in the process will be invoked. The next stage of the process can be invoked prior to the expiry of a warning previously given or the end of any monitoring period.

9.5 Stage 3 - Sickness Absence Hearing

9.5.1 If, having followed the previous stages, the nature, duration or frequency of absence continues, a Sickness Absence Hearing should be set up where continuation of the contract of employment is considered. This must be confirmed in writing to the employee. This meeting should be conducted by a manager with authority to dismiss and a Human Resources Representative must also be present.

9.5.2 The purpose of the hearing is to review all sickness absences since the commencement of any formal stages of managing the absences.

9.5.3 At this Sickness Absence Hearing, the employee has the right to be accompanied by a trade union representative, friend/colleague not acting in a professional capacity. He/she should be informed of this in writing and given 5 working days notice of the hearing. If representation is unavailable, the meeting will be rescheduled on no more than one occasion unless there are particular extenuating circumstances.

The notification of the hearing must include:

An accurate and up to date sickness absence report, this should include details of review periods and their outcomes.

Confirmation and details of any previous warnings given

A copy of the most recent Occupational Health report. This must be obtained prior to the meeting

Any other relevant medical advice that is relevant to the circumstances

Details of any previous support offered or adjustments made following advice from Occupational Health. This may include any adjustments in duties, hours or days worked. Details of any rehabilitation programmes and / or redeployment opportunities that have been

explored and their outcomes

9.5.4 The employee or the employees’ representative should be allowed to explain the absence record and

make representations at this meeting.

9.5.5 If following full discussion of the above, taking into account any mitigating circumstances, there is no evidence to indicate that a substantial improvement in attendance can be expected in the immediate future then the employee will be dismissed from the organisation. The reason for dismissal will be for an unacceptable level of attendance at work, which must be clearly identified

and demonstrated throughout this procedure.

9.5.6 Confirmation of the outcome will be provided to the employee normally within 7 working days of the hearing.



10.1 Informal Stage – Manager and Employee Discussion and Contact

10.1.1 Where an employee is, or is expected to be, absent for a period of 3 weeks or more, managers need to ensure that contact is established and continued with the employee in a sympathetic way. Maintenance of contact is important to ensure that members of staff do not feel isolated, to arrange for a referral to OH and to prepare for their return to work.

10.1.2 Both the manager and employee have a duty to keep in touch so progress can be properly monitored and any appropriate actions can be taken as necessary. Managers should as soon as possible, establish with employees mutually convenient times for them to be able to make contact on a regular basis. The frequency of contact should be agreed at the earliest opportunity.

10.1.3 Managers must involve OH and Human Resources at the earliest possible opportunity, so that appropriate advice may be obtained regarding the likely duration of the period of absence and so that a programme of rehabilitation may be planned once a likely return to work date is known. Managers must not make any decision about an employees return to work arrangements without consultation with the employee and OH.

10.1.4 Where an employee is due to return to work following a period of long term sickness absence they must provide their manager with reasonable notice of the date of return in order to allow for OH

appointments, amending cover arrangements or reasonable adjustments to be implemented etc.

Reasonable notice would normally be a minimum of one week, unless otherwise mutually agreed. 10.1.5 Where it is expected that the employee will make a return within 3 to 5 weeks of their absence

commencing, the manager should maintain contact via phone. On the employees return, a Return to Work meeting should be held see Appendix 1. At this meeting any recommendations for return to work arrangements from OH can be discussed and agreed.

10.1.6 Where it is believed, from speaking to the employee, that a return to work is not likely in the immediate future i.e. within 5 weeks of the absence commencing, then a referral to OH should be made and a Formal Meeting arranged – see next section.

10.2 Formal Long Term Absence Review Meeting

10.2.1 Where an employee’s long term absence extends beyond 3 weeks and a return is not planned

within 5 weeks, a Formal Long Term Absence Review Meeting should be held. In the event that

the employee is too ill to attend this meeting, the manager could write to obtain the information or consider visiting the home of the employee. This will need to be with the agreement of all parties. Only if an employee has failed to respond to all reasonable attempts to contact them should home visits be considered without prior arrangement.

10.2.3 The employee should be asked to attend the Occupational Health department for assessment,

prior to the Formal Long Term Absence Review Meeting, which may include enquiries to the employee's General Practitioner or Consultant, or examination, by a Medical Practitioner nominated by the Trust. The employee's written consent will be required for enquiries direct to their Medical Practitioner. In the event of the employee withholding consent any decision on subsequent action will, of necessity, be based on such information as is available or can be obtained by the Trust.


10.2.5 Before deciding on the appropriate course of action the manager will discuss with the employee and take into account:

the expected length of sickness absence the wishes of the employee

the opinion of the Occupational Health department on the fitness of the employee to undertake the work for which he/she is employed

the second medical opinion where appropriate

the needs of the service in terms of the capacity in which the individual is employed, the particular requirements of the department and the practicality of providing absence cover the length of service, previous health record and attendance record

potential for redeployment

10.2.6 If after consideration of the above, there is a positive prognosis and a return to work date is set for the near future (i.e. within 2 weeks), then the next step is to establish a return to work date in conjunction with advice from Occupational Health. If a return to work date is not anticipated within the immediate future, but is anticipated within the foreseeable future, or if clarification needs to be sought on any of the above points, then a further Formal Long Term Absence Review Meeting will be scheduled.

10.2.7 If after a Formal Long Term Absence Review Meeting the prevailing opinion is that the employee cannot be retained in the employment for which he/she is contracted then a Long Term Sickness Absence Hearing will be arranged (see 13.0).

10.2.8 Consideration should also be given to the availability of suitable alternative employment. There is however no duty on the Trust in these circumstances to create a post for the employee.

10.2.9 If the employee disagrees with the medical opinion expressed by the Occupational Health department, he/she may be given the option of obtaining a second opinion. Upon receipt of a second opinion, the case will be referred again to the Trust's Occupational Health department who will be asked to review the original advice in the light of any new information which has been produced and to report further.

10.2.9 Where there is mutual agreement, early retirement under the terms of the NHS Pension Scheme will be applied for on behalf of the employee, provided that the member of staff is party to that Scheme. (See Ill Health Retirement)


11.1 Phased Returns

11.1.1 In some circumstances, the member of staff may be advised by their own GP and / or Occupational Health to return to work gradually, i.e. fewer hours or light duties for a temporary period before resuming full duties and responsibilities of their job. Managers should consider making adjustments in line with advice. The temporary basis must be clearly identified at the beginning of a rehabilitation process.

Consideration should be given to:

The effect on others of implementing the recommendation (e.g. workload or hours where cover is required)

The feasibility of implementing the recommendations on a temporary basis The importance of the job and the needs of the service

During the rehabilitation period managers should:

Ensure sufficient rest breaks and agree reasonable time off to attend ongoing GP or hospital appointments


11.1.2 The failure of staff to reasonably co-operate with a rehabilitation process recommended by Occupational Health will be viewed seriously and may lead to formal action being taken against them.

11.1.3 A further referral to Occupational Health may be needed to ensure fitness before returning to full duties.

11.2 Payment during phased return to work

11.2.1 Managers should discuss with employees their pay entitlements during rehabilitation in advance of their return to work, or recommended adjustment of hours. Where a recommendation for reduced hours has been agreed managers will consider the payment of normal pay during this period for up to a maximum of four weeks.

11.2.2 Beyond four weeks, and where reduced hours are still required, employees will be paid for hours worked. Any subsequent phased returns for the same sickness episode will normally be paid for hours worked only. Employees will be encouraged to make up the hours lost using annual leave.

11.3 Redeployment

11.3.1 The Trust will endeavour to support employees to return to work following long-term sickness absence by considering opportunities for temporary or permanent redeployment wherever possible on the medical advice from the Occupational Health Department.

11.3.2 Temporary redeployment may include a temporary variation in job description and would be suitable for employees who were fit to return to work in some capacity but will need a period of transition before resuming the full duties of their substantive post. Temporary redeployment should be within the same department, or directorate or exceptional circumstances elsewhere in the Trust and may be offered to the employee for up to one month. During the temporary redeployment period the employee will continue to be paid by their substantive department.

11.3.3 Permanent redeployment is only appropriate where it is clear that the employee will not be able to return to their substantive post at any time in the future. Any move to a new post as permanent redeployment will be paid at the appropriate band for the job that they are redeployed to. Pay protection will not apply in these circumstances.

11.3.4 It is recommended that redeployment opportunities are sought for a period of 4 weeks although this can be extended in exceptional circumstances, but would not normally be expected to exceed 12 weeks. During this time the employee will be placed on the internal redeployment register and should receive copies of the Trust bulletin and details of any positions that may be considered as suitable. Attached with the post details will be a form for employees to complete and return outlining why it is, or is not, considered suitable.

11.3.5 Managers must ensure that individuals are suitable for new posts in consultation with the Occupational Health Department, who would where necessary, seek information from the relevant G.P. or Specialist. A trial period should be offered for a period of 4 weeks during which the employee will remain employed by their substantive department. During the trial period at least one review meeting should take place and a referral be made to Occupational Health. A final review should take place before the redeployment is confirmed as permanent.

11.3.6 If the trial is unsuccessful further opportunities for redeployment will be sought for a further period of 4 weeks. If during this period no suitable positions become available for redeployment then termination of employment will need to be considered.



Occupational Health have advised that they are permanently incapable of carrying out the duties of their post on the grounds of ill health.

12.0.2 Apply for Ill Health Retirement the employee will first complete an ill health application form with the Human Resources Department. The Human Resources Department will contact the Trusts Pensions Officer who will process the application form which also need to be completed by Occupational Health and the employees GP or Specialist as appropriate.

12.0.3 The decision to approve ill health retirement applications rests with the NHS Pensions Agency.


13.0.1 If after consideration of available medical advice and the recommendations of Occupational Health, it is determined that the service can not reasonably be expected to wait any longer for the employee to recover and return to their position, dismissal for reasons of capability will need to be considered.

13.0.2 In order to consider such a dismissal an appropriate manager who has the authority to make his decision, along with a Human Resources representative, will hold a sickness absence review meeting with the employee. A decision to dismiss may take place before the full period of Occupational Sick pay is exhausted.

13.0.3 If employment is terminated on the grounds of capability a letter confirming the termination will be sent to the employee within 7 working days of the hearing. In cases of dismissal on grounds of capability appropriate notice periods will be also be given in writing as indicated by the terms and conditions of employment.

13.0.4 Employees have the right of appeal against any decision to terminate their employment in accordance with the Trust's Procedure For Appeals Against Dismissal. Appeals Against Dismissal must be made in writing clearly stating the reason for appeal, and must addressed to the Director of Human Resources and received within 5 working days of the date of the letter confirming the

decision to dismiss. (Refer to Trust’s Procedure For Appeals Against Dismissal)


14.0.1 Situations may arise whereby it is considered unsafe for the employee to attend for work. These may be due to health and safety regulations, or medical guidance raising concerns about the employees fitness to carry out their job without causing harm to themselves or those around them. The manager should then contact the Human Resources Department for further guidance in these circumstances. Medical Suspension should be reviewed at regular intervals.


15.0.1 Injuries or accidents that occur whilst at work must be reported to your manager at the time that they occur or the earliest possible time thereafter, but no later than the end of that working day. The employee must complete an accident/ incident form.

15.0.2 If the employee is absent for three days or more as a result of the accident then RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995) will apply. The line manager should contact the Risk Manager’s Office without delay (Health and Safety Policy).

15.0.3 Employees who have injuries, disease or other health conditions that are wholly attributable to

their NHS employment, and have exhausted or reduced Occupational Sick Pay will be entitled to an injury allowance subject to the conditions and pay rates set out in Section 22 of AFC terms and conditions Handbook. The attribution of injury, illness or other health condition will be determined by the employer who will seek appropriate medical advice.




17.0.1 The following reports will be produced by the Human Resources Workforce team on a monthly and annual basis. They will be forwarded to the HR teams who will disseminate to line managers for review and follow up:

 Monthly Absence Trigger Report which will be circulated to Line Managers and HR teams  Monthly / Divisional KPI Report will be circulated to Performance Board

 Annual Absence Report will be forwarded to Trust Board.



Managing Sickness Absence

Additional Information for Managers and Staff


Subject to the needs and demands of the service, managers will be sympathetic to requests for occasional paid time off to attend hospital, doctors and dental appointments during work time where these cannot be arranged in an employee’s own time. Staff are required to discuss this with and be in a position to make available written confirmation of such appointments during work time well in advance of such appointments. Employees have a responsibility to arrange appointments with a view to creating the least disruption to the working day possible.

Where employees have an ongoing and continuous commitment to attend off site medical or dental appointments, excluding antenatal appointments, it may be necessary to review the arrangement including exploring flexible working, time off in lieu depending on the circumstances or alternatively taking unpaid time off. Managers should monitor the application of these arrangements to ensure equitable treatment of employees within their areas of responsibility.


An employee who attends work and who is sent home by their manager, will not normally be regarded as on sick leave for that day provided that:

● At least 3 hours have been worked prior to being sent home

● This is not the 3rd such occasion in a 6 month period

● Explicit permission has been given by the manager


To ensure that the employee has sufficient rest following a period of sickness absence the employee should not undertake any bank work for a period of 1 week from their date of return to their substantive post. In exceptional circumstances the employee may request and gain permission from their manager to undertake bank work.

Employees who are on a phased return to work rehabilitation programme will need to have returned to their full duties and contracted hours of work before undertaking any bank work.


The details of sick pay entitlements are set out in NHS Terms and Conditions. These entitlements may change from time to time and the application of the policy will reflect those changes as they occur.

Employees who are absent from work owing to incapacity due to sickness, accident or disablement not arising from or attributable to the employee’s own misconduct shall be entitled to the provision to receive payments under the Occupational Sick Pay Scheme within any period of 12 calendar months.

The table below gives examples of entitlements to Occupational Sick Pay

Length of Continuous NHS Service Recognised by the Trust

Occupational Sick

Full Pay

Pay Entitlement

Half Pay

During 1st year of service 1 month 2 months

During 2nd year of service 2 months 2 months

During 3rd year of service 4 months 4 months

During 4th and 5th year of service 5 months 5 months


The Trust has the discretion to take into account any period or periods of employment with employers outside the NHS where these are judged to be relevant to NHS employment

The rate of allowance and the period for which it will be paid will be set by the length of the employee’s service on the first day of absence and the aggregate of periods of absence due to illness during the twelve months immediately preceding the first day of absence.

Employees should note their entitlements to plan for when their pay may be affected. Payroll will

automatically adjust an employee’s pay in line with national guidance on occupational or statutory pay. If an employee has any queries about their entitlements please contact the HR department.


Where an employee is pregnant and becomes unwell, the absence should be dealt with in the same way as normal sickness absence, although account should be taken of the pregnancy in determining the reasons for the absence and in offering support. If the individual is still off sick 4 weeks prior to their expected week of confinement, their maternity leave will automatically commence on the fourth day of absence.


Sickness During Annual Leave

Employees who fall sick whilst on annual leave in the UK should inform their manager by telephone as quickly as possible and send in a statement of fitness for work from a doctor by first class post regardless of length of sickness. If this procedure is properly followed, the period of annual leave will be suspended whilst the employee is sick.

Employees who fall sick whilst abroad on annual leave should also contact their manager as quickly as possible, preferably by telephone or fax, or email, followed by a letter giving further details and the likely return date.

The employee is responsible for providing (and paying for) a statement of fitness for work covering the dates of illness, written by a registered medical practitioner and if written in a language other than English be accompanied by an authorised English translation. If the employee is unfit to work on return to the UK, he/she should visit their GP and obtain a statement of fitness for work in the normal way. If the documents are not produced, the annual leave will not be suspended and the employee will not be paid for any period longer than the agreed annual leave.

It is not normally expected that an employee will take annual leave immediately following a period of sickness. However, managers should consider this option on an individual basis.

Where an employee wishes to honour a pre- booked holiday or requests annual leave during a period of sickness absence they must seek permission from their line manager in advance of the requested dates and the usual methods of requesting and agreeing annual leave will apply. Where sickness absence review meetings or hearings have been arranged within the period that annual leave has been requested the manager has the right to refuse the annual leave request.

The manager may request information from Occupational Health and/ or request information from the GP about the fitness of the employee before giving their permission for annual leave. In these circumstances entitlement to sick pay will cease for the period of annual leave and recorded on MAPS and / or ESR accordingly. Once the annual leave period has been completed, and if the employee then remains off sick then entitlement to sick pay will recommence from the end of the annual leave period.

Accrual and Carry Over of Annual Leave During Sickness Absence


carried forward for reasons of long term sickness absence it is recommended that the excess above 5 days are:

Used as part of a phased return to work to help maintain pay during a rehabilitation period. (refer

to section on Rehabilitation, page 18)

and / or


Appendix 1


A return to work interview, particularly after short periods of absence, provides an opportunity for an open discussion about a member of staff’s sickness record. It also sends out a signal that managers are aware of the amount of time individuals are taking off work and, if conducted in the right manner, that they are interested in the well-being of their staff.

Many organisations have found that ‘return to work interviews’ have had a positive effect on reducing staff short term absence rates, whereas referrals to Occupational Health for these cases may be much less effective(and in some cases counter-productive).

However, it is suggested that a regular forum is set up so that managers may discuss specific cases with an experienced OH Adviser, who will be able to advise regarding case management and whether a formal referral would be appropriate.

The interview should take place as soon as possible after the absence, in a private area, where both manager and member of staff may speak freely. The interview should be structured as follows:

Welcome back

The interview should begin by welcoming back the member of staff and letting them know they have been missed

Enquire about health

A simple ‘How are you feeling now?’ may be enough to illicit the reasons for absence from the member of staff. Managers may ask reasonable questions about the sickness absence and are entitled to obtain at least the information which would have been written on the GP statement of fitness for work.

However, if they are reluctant to disclose any details at all, then they may be referred to Occupational Health for a confidential discussion.

The member of staff should be asked what steps have they taken to aid their recovery and if they think the absence is likely to re-occur. He/she should also be asked if they think there are any duties they won’t be able to do on their return to work, so that short/long term adjustments (e.g. reduced working hours) can be discussed.

The manager should ask whether the absence was work related and listen to any concerns the member of staff may have, exploring whether there is any support (e.g. training, review of duties; reduced hours; equipment; childcare support) which may be offered at this stage.

Any consequences of absence

The return to work interview is a good opportunity to point out the consequences of the staff member’s absence e.g. employing extra help; colleagues covering (although the latter point should not be laboured too heavily if the individual has spent much of their time covering for other colleagues’ absences!)

Any emerging patterns of absence should be discussed at this time, and whether there is any support available to help the staff member reduce their absences (see above)

Future action

In cases of persistent absences, the manager should explain to the staff member that continued periods of sickness absence could lead to formal action and refer them to the Trust’s Managing Sickness Absence policy.

If sickness is being monitored formally, then the member of staff should be informed that there will be a formal meeting with HR and an Occupational Health referral may also be appropriate at this point


The content of the interview should be documented along with any further action (e.g. formal action, case discussions with OH/formal OH referral, short/long term adjustments)


Appendix 2


To Be Completed in All Circumstances

Staff member’s name………...


I was ill/absent from (date)………to (date)………

Because (give details, symptoms etc)

……… ………

I returned to work on (date) ………..


Statement of Fitness for Work Certificate attached: Yes / No

Sickness/Absence in past 6 months (State number of days/episodes/reasons)

……… ………

Managers comments and Recommendations

………... ……… ………

Action to be taken ( Advice on GP’s fitness For Work Statement , Case discussion with OH; Formal referral to OH; adjustments in place; special equipment in place; date of review meeting;)

………... ……… ………


I understand that is an offence to carry out other paid employment either at my current employer or for another employer, NHS or private sector, whilst claiming sickness in this employment and I confirm by my signature that I have not worked anywhere else whilst on sick leave.

I also declare that all information given by me is correct and complete ant that any false information given by me may lead to disciplinary action and/ or criminal prosecution.

Signed (Manager)...Date:………






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