Attendance Management Policy and

Transcription

NHS FORTH VALLEY
Attendance Management Policy and Procedure
Date of First Issue
01 / 10 / 2006
Approved
17 / 04 / 2009
Current Issue Date
01 / 05 / 2015
Review Date
01 / 10 / 2015
Version
V3.11
EQIA
Yes
01 / 05 / 2008
Author / Contact
Staff Governance Team, 01786 431184
Group Committee – Area Partnership Forum
Final Approval
This document can, on request, be made available in alternative formats
Version 3.11
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UNCONTROLLED WHEN PRINTED
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Consultation and Change Record – for ALL documents
Contributing Authors:
Staff Governance Team
Consultation Process:
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Distribution:
NHSFV Intranet
Change Record
Date
Author
Change
17.04.09
Area Policy
Steering
Group
Policy revised following review process
01.10.09
Staff
Appendix 7 – Location for appointment
Governance changed from Menstrie to Clackmannanshire
Community Healthcare Centre.
14.10.10
Human
Resources
Version 3.11
Version
Policy amended to reflect:

Clarification on line manager’s role

Recognition of periods of absence which
require to be recorded but would not
count towards a period of 4 absences
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
Clarification on duration of monitoring
periods

Clarification on HR/Staff-side attendance
at first meeting
30.12.2010
EH
NHSFV template applied to previously
published document
V3.01
23.11.2011
EH
APF agreed policy extended to 1.4.2012
V3.02
01.09.2012
Human
Resources
Policy amended to reflect:
V3.03
Employees responsibilities – to co-operate with
Attendance Management policy; participate in
meetings
Line managers – make timely referrals
Definition of long term absence – period of
absence lasting 3 weeks or more
Information regarding fit notes
Short-term procedure – change to combine
Return to Work Meeting with 4 in 12, informal
1:1 meeting. Only move to formal meeting with
HR and staff-side if necessary.
Remove short-term absence table and
streamline.
Occupational Health Referral – refer to OHS
after 3 weeks or as soon as absence is
identified as long term.
Clarify final review process to comply with CEL
Clarify termination process
Update information on Support to Work
Guidelines – renamed – previously Phased
Return
01.08.2013
Staff
Appendices updated in line with Absence
Governance Management documentation review
Team
V3.04
09.08.2013
Staff
10.2 Short-Term/Persistent Absence Procedure
Governance updated
Team
V3.05
16.08.2013
Staff
Document updated to correct page numbers
Governance
Team
V3.06
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24.09.2013
01.12.2013
Appendix 3 Persistent Absence Model Meeting
Staff
Governance Letter removed to reflect updated process
Team
Policy updated to include an additional “trigger”
Staff
Governance point of 9 or more cumulative days short-term
Team
absence over 3 episodes within a 12 month
V3.07
V3.08
rolling period.
01.01.2015
Staff
Governance Section 8: Attendance Records updated.
Team
V3.09
13.02.2015
Section 7, paragraph 3 updated to include longStaff
Governance term absence.
Team
V3.10
01.05.2015
Staff
Governance Policy review date extended in line with the
Team
release of the Promoting Attendance and
V3.11
Managing Health at Work PIN Policies.
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CONTENTS
1.
POLICY STATEMENT
2.
SCOPE
3.
KEY PRINCIPLES
4.
ROLES, RIGHTS & RESPONSIBILITIES
4.1 EMPLOYEE RESPONSIBILITIES
4.2 EMPLOYEES HAVE THE RIGHT:
4.3 LINE MANAGERS
4.4 OCCUPATIONAL HEALTH SERVICE
4.5 HUMAN RESOURCES
4.6 STAFF SIDE REPRESENTATIVES
5.
DEFINITIONS OF ABSENCE
6.
ATTENDANCE MANAGEMENT PROCEDURES
6.1 NOTIFYING ABSENCE
6.2 MEDICAL EVIDENCE
6.3 KEEPING IN TOUCH
7.
RETURN TO WORK DISCUSSION
8.
ATTENDANCE RECORDS
9.
OCCUPATIONAL HEALTH SERVICE ADVICE
10.
PROCEDURE FOR UNSATISFACTORY ATTENDANCE
10.1 TRIGGER POINT
10.2 PERSISTENT ABSENCE
10.3 LONG TERM ABSENCE PROCEDURE
10.4 OCCUPATIONAL HEALTH REFERRAL
11.
REVIEW PROCESS, CASE MANAGEMENT, PEER REVIEW
12.
TERMINATION OF EMPLOYMENT ON THE GROUNDS OF ILL HEALTH
13.
PREMATURE RETIREMENT ON THE GROUNDS OF ILL HEALTH
14.
REVIEW OF POLICY AND PROCEDURE
LIST OF APPENDICES
Appendix 1
First Call Absence Checklist and Return to Work Booklet
Appendix 2
Self Certificate Form
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Appendix 3
Long Term Absence Model Meeting Letter
Appendix 4
Post Absence Model Meeting Letter
Appendix 5
Breach of Monitoring Period Model Letter
Appendix 6
Breach of Monitoring Meeting Outcome Model Letter
Appendix 7
Occupational Health Referral Form
Appendix 8
Sick Pay Entitlement Chart
Appendix 9
Support to Work Guidelines
Appendix 10
A Guide for Staff and Managers (Procedural Flow Chart)
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1.
POLICY STATEMENT
This policy was revised in 2012 and will be continually monitored. The principles of
this review conducted in partnership include:
NHS Forth Valley is committed to promoting the health, safety and wellbeing of its
workforce. Employees are expected to attend work in accordance with their
contractual arrangements unless ill health prevents this. This Attendance
Management Policy reflects this position and aims to provide a supportive framework
which is fair and consistent for all. That commitment to staff includes having in place
support mechanisms and procedures to support those who are absent due to ill
health, and help them return to work.
This Policy aims to establish and reinforce a culture of attendance at work. It details
the rights and responsibilities of individual staff; line managers; Human Resources
(HR) and the Occupational Health Service (OHS) in dealing with absences from work
because of ill-health.
The Equality Act (2010) requires NHS Forth Valley to put in place reasonable
adjustments to working practices and procedures to allow employees with a disability
to remain in employment.
This policy has been developed in partnership with staff side organisations and
reflects best practice identified in the guidance on Managing Health at Work
produced by the Partnership Information Network (PIN) Board in 2003. The Policy
also reflects relevant employment legislation including The Equality Act and the
Employment Rights Act 1999. The policy has also been assessed against current
NICE guidance on absence
This policy and procedure is endorsed by the Board, Senior Management and the
Area Partnership Forum and will be communicated to all staff.
2. SCOPE
This Policy and Procedures replaces any previous guidance on Managing
Attendance and applies to all staff employed by NHS Forth Valley, but does not apply
to independent contractors working on a contract of services.
3.
KEY PRINCIPLES
The Principles, Values and Codes of Behaviour set out in the NHS Forth Valley
Partnership Agreement 2008 and the Dignity at Work Policy both underpin this policy.
These documents can be found via the intranet or through HR. In addition, NHS
Forth Valley commits to act as a reasonable employer at all times in its dealings with
employees who suffer illness or incapacity, whether temporary or on a permanent
basis.
All employees will be treated as individuals and their needs and individual
circumstances will be taken into account.
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4.
ROLES, RIGHTS AND RESPONSIBILITIES
4.1 Employee Responsibilities
NHS Forth Valley recognises that the majority of employees attend work regularly.
However it also recognises that people will, on occasion; need to take time off work
when they are ill. When this happens employees are expected to:

notify their line manager on the first day of absence if they are too ill to
come to work, and in line with this policy, continue to stay in touch with
their line manager, keeping them up to date on their progress and
expected return to work date;

provide a self certificate or fit note (see 6.2 medical evidence) for all
periods of sick absence;

take an active part in the Return to Work discussion;

attend and participate in all meetings; and appointments relating to the
absence framework;

manage their work life balance effectively using the range of NHS Forth
Valley policies as required;

co-operate with any support or reasonable adjustments made by their Line
Manager to enable them to return to work;

report to the Line Manager any factors which may contribute to ill health
such as health and safety, bullying and harassment etc.

make use of Occupational Health Service and any appropriate supportive
services that are provided, and to attend any meetings to which they are
invited.
4.2 Employees have the right:

to be given the opportunity to improve their attendance

not to have action taken against them unless their absence has reached or
exceeded the trigger points

to have the full circumstances of their case considered before formal
action is taken;

to be told if their level of absence is putting their job at risk;

to have reasonable adjustments considered and made, where appropriate,
when they have an underlying health condition or disability;
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
to be accompanied and represented by a Staff Side Representative or
colleague throughout the attendance procedure;

to state their case before any decision is made;

to confidentiality;

to be supported in their rehabilitation back to work

to self-refer to the Occupational Health Service.
4.3 Line Managers
Line Managers roles and responsibilities in relation to the policy and procedure are
to:

manage the attendance of staff acting at all times in accordance with the
roles and responsibilities set out in the NHS Forth Valley Partnership
Agreement whilst fully implementing this policy and its procedures within
their area;

ensure that all members of their team are fully aware of the contents of
this policy, and that everyone who works within their area knows who they
should contact if they are ill and the time by which contact is expected;

keep in touch with people who are off work ill; and make appropriate and
timely referrals to the Occupational Health Service on their behalf;

complete Return to Work Interviews with employees within 3 working days
of their return, during which they must discuss with the employee any
underlying medical condition or disability and seek occupational health
advice if appropriate;

liaise with the OHS, HR and other agencies with regard to the
management of attendance at the points agreed within the policy;

ensure that all records and documentation in relation to the management
of attendance are kept in accordance with the Data Protection Act 1998;

keep information regarding an individual’s health confidential;

record and submit the relevant attendance management monitoring
information in the format and within the timescales agreed by payroll and
HR;

Line Managers are advised to consider their approach when dealing with
sickness absence within the team, as there may be a requirement to vary
the management of individual cases. Whilst this guide attempts to give as
comprehensive advice and practical guidance as possible in what can
often be a challenging area of management, it should not be treated as the
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complete and authoritative guide to every possible circumstance which
may arise. The advice of HR staff should be fully utilised;

whilst being sensitive to employees who are unwell, it is the Line
Manager’s responsibility to be an effective and reasonable manager. Any
Line Manager uncertain as to the application of any aspect of the policy or
advice contained within this guide should in the first instance seek
guidance from their HR Manager;

lead discussions at any case management review meetings;

facilitate as early return as possible following advice from Occupational
Health or the advice contained in the Fit Note from the GP which could
include a phased return to work, altered hours, amended duties or workplace
adaption (see Appendix Rehabilitation to Work Procedure).
4.4 Occupational Health Service
The ethos of the Occupational Health Service is to support health and wellbeing in
facilitating full recovery and capability and where feasible, an early return to work. In
some circumstance advice will also be provided to help prevent absence occurring in
the first place.
In addition, Occupational Health Service roles and responsibilities in relation to the
policy and procedure are to:

liaise with General Practitioners and other agencies, as appropriate, to
provide expert advice to the line manager on the impact the employee’s
medical condition may have on their ability to perform their current or any
future role; this covers advice on the Equality Act

provide advice on returning to work on a phased return basis,
redeployment or retirement due to ill health;

advise managers on whether there is any common link or underlying
health reason for recurring absences;

provide expert advice and support to employees who are suffering health
problems;

proactively work with line managers to encourage early intervention and
develop solutions to long-term health issues;

make onward referrals to any of the supportive services which NHS FV
provides eg Staff Physiotherapy, Staff Psychology, Employee Counselling.
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4.5
Human Resources
Human Resources’ roles and responsibilities in relation to the policy and procedure
are to:
4.6

provide support and guidance to managers, individuals and staff
representatives in the interpretation of the policy and procedure;

support the ongoing implementation of the policy by training managers,
employees and staff side representatives in its contents and by assisting
in the development of the skills necessary to manage attendance
effectively;

put processes in place to monitor the effectiveness and efficiency of the
policy.
Staff Side Representatives
The Staff Side Representative’s role and responsibility in relation to the policy and
procedure are to:
5.

provide advice, support and guidance to the employee throughout the
attendance management process and procedure;

to act in the interests of the employee and the wider workforce;

to ensure that their member is aware of all the supportive services
available to them as an employee of NHS Forth Valley.
DEFINITIONS OF ABSENCE
Long Term
Any continuous period of absence from work because of ill health lasting three weeks
or more will be deemed as long term sickness, or alternatively if the cause of
absence is known to be one that will undoubtedly last more than three weeks, eg
fractured femur.
Short Term
This is defined as absence from work due to ill health which lasts no longer than
three weeks.
(In the context of this policy 1 week is equivalent to the amount of hours per week the
employee is contracted to work.)
Persistent Absence
Persistent absence is characterised by a pattern of absences due to illnesses which
are usually not connected. Such patterns could vary from single days of absence, to
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fewer occasions of absence involving a loss of up to a week or more or a
combination of both. High levels of this type of absence may indicate problems
which may not be health related and which need to be explored and resolved.
Unauthorised Absence
This is an absence which is not supported by medical evidence, or has not previously
been reported or authorised by the appropriate level of management or where the
employee has failed to follow the appropriate procedure for the notification of
absence. Each case of unauthorised absence will be assessed based on the
individual circumstances of the case. All unauthorised absences should be dealt with
as a conduct issue under the NHS Forth Valley Management of Employee Conduct
Policy.
If unauthorised absence continues for more than one week without reasonable cause
or contact by the employee, this may be considered as a resignation. Confirmation
of this will be sent in writing to the employee. In all such cases, advice must be taken
from Human Resources.
6.
ATTENDANCE MANAGEMENT PROCEDURES
6.1 Notifying Absence
The line manager must ensure that everyone knows who they should contact if they
are sick and the time by which contact is expected.
If an employee is sick, they must telephone the agreed person, usually their line
manager, to inform them that they are going to be absent, by the agreed time for their
team on the first day of absence.
If the employee is unable to telephone in person, they must arrange for someone to
telephone the line manager on their behalf within the timescales detailed above.
However, in this situation, it is expected that the employee will make contact with
their line manager as soon as they are able to do so.
When notifying absence the employee must advise their manager of the following:



the nature of the illness;
the day the illness began;
the expected return date.
The First Call Absence Checklist Booklet (Appendix 1) should be completed by
the line manager at the time the absence is first notified.
If the duration of the absence is uncertain the employee will be required to make
daily contact with their line manager.
If by the 3rd day of continuous absence the employee has not returned to work, they
must telephone their line manager again notifying them of how long they are likely to
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remain absent. Contact should again be made on the 7th day, if the absence is
continuing, and at least one day prior to their return to work.
If the employee does not make contact by the end of the 7th day, then the line
manager should make contact on the 8th day.
During these contacts, the line manager should advise of the range of supports
available to the employee via the Occupational Health Service e.g. staff
physiotherapy.
6.2 Medical Evidence
The employee should complete an NHS Forth Valley Self-Certificate Form
(Appendix 2) from day 1 of the absence. This self-certificate form should be
completed at the Return to Work discussion. If the absence continues beyond 7
days, the employee must provide a doctor’s certificate from the 8th calendar day and
these should continue to be provided by the employee until the absence ends.
These must:



give the nature of the illness;
be completed by a qualified and registered health professional;
be dated, signed and stamped with the practitioners name and address,
and this will now take the form of a Fit Note. It is intended to support the
individual to stay at work, which is on the whole better for health, or get back
to work sooner with help from their employers. This could include a phased
return to work, altered hours, amended duties or workplace adaption.
Unlike the old medical certificate the fit note has the option for the examining doctor to
state that the employee is:


unfit for work
may be fit for work.
A doctor will give a ‘may be fit for work’ Statement if they think that their patient’s
health condition may allow them to work if they get suitable support from their
employer. If the employer cannot meet the requirements of the fit note, then the
employee will revert to being off sick with out the need for any further medical advice.
The four options the Doctor can suggest on the Fit note are:




a phased return to work;
amended duties;
altered hours;
workplace adaptations.
These options are ones which have been supported by NHS FV for many years
through the Rehabilitation to Work procedure.
A self-certificate or Fit Note must cover all periods of sickness absence continuously.,
where appropriate, must be submitted prior to or on the day of the return to work, a
self-certificate should also be completed on the day of return to cover the initial 1-7
day period.
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Employees and line managers are still expected to follow the procedures for Keeping
in Touch during the period covered by the certificate.
6.3 Keeping in Touch
Keeping in touch is an integral part of the attendance management process and
contact with employees should normally be made at least once per month on a face
to face basis, but more regular contact can be agreed on a case by case basis.
Equally, where the line manager is well-informed on the employee’s circumstances
and is satisfied that all appropriate support is in place, it may not be essential to meet
on a monthly basis, and in such circumstances, contact by telephone or letter may be
sufficient. This approach should be kept under review.
The Keeping in Touch Form, provided at Appendix 1, should be used to document
dates and discussions. It is important that employees are kept up to date with what is
happening within their team and of changes taking place in their absence, particularly
where the absence is on a continuing long term basis. This aspect is crucial in
helping people back to work and to continue to feel a valued member of the
organisation.
Where, as line manager, you are aware that the employee is dealing with a longerterm/serious health condition, please ensure that your interactions with them are
undertaken with sensitivity and tact. For advice and support please contact HR/OHS
colleagues.
If it is known that the employee’s condition will require a longer period of absence,
consideration should be given to the most appropriate method of keeping in touch
e.g. telephone contact
7.
RETURN TO WORK DISCUSSION
When an employee returns from sickness absence, a Return to Work discussion will
be conducted by the line manager or the line manager’s deputy on the day the
individual returns to work; or as soon as possible thereafter (but not exceeding 3
working days, unless in exceptional circumstances). The overall purpose of the
discussion is to welcome employees back into the workplace as a valued member of
the team. This may be quick informal discussion, or may require more in-depth
discussion about an individual’s health or workplace issues. The following key points
that should be covered:





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welcome the employee back to work;
confirm that they are fit to return to work;
let them know what has been happening in the team and with their
workload since they have been off;
help them to re-prioritise their workload and to offer assistance in this area
if necessary;
discuss any underlying reason for absence and to inform them of the
support available to them;
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

remind the employee of the contents of the Attendance Management
Policy particularly where the level of absence is approaching an
unsatisfactory level to make the employee aware of this;
where appropriate, identify problems which are contributing to the absence
and to discuss possible solutions and interventions which may benefit the
individual.
Line managers should produce a written record of this discussion by completing the
Return to Work Form provided at Appendix 1, each party should sign this and each
retain a copy for their own records.
If the Return to Work meeting is dealing with 9 or more days short term and long term
absence over 3 episodes or a 4th absence in a 12 month rolling period, the manager
should follow Step 1 of the Attendance Management Procedure. Alternatively if a
pattern becomes apparent over consecutive 12 monthly periods the procedure
should be invoked to address this. Any 12 month period begins on the 1 st day of
absence. This should be a 1:1 meeting without HR and Staff-Side as this will give the
manager and employee the opportunity to discuss the reasons for their absence and
decide if further action is needed e.g. monitoring period, referral to Occupational
Health. It is anticipated that in doing so the manager is able to use their knowledge
and relationship of any background issues which may be affecting attendance whilst
the employee should feel with more at ease if dealing with their line manager and
therefore able to discuss any pertinent issues from home or work,
8.
ATTENDANCE RECORDS
Recording of absence is essential in order to meet the requirements of Statutory Sick
Pay Regulations and enable managers and HR to monitor, manage and control
absence patterns. SSTS is used throughout the organisation and the manager
needs to ensure that all appropriate information has been collated.
Managers should ensure that there is a suitable recording procedure for absence
within their area and all sickness absence should be reported to payroll and HR, as
appropriate. It is important that absence details are recorded, even where absence is
for part of a day or is uncertified. In particular, it is crucial that the reason for the
absence is recorded clearly.
Absence other than sickness
Employees and managers should be aware that paid time off due to sickness
absence is only available to staff when they are unfit to attend work due to illness.
Where employees need time off or flexible working arrangements due to other
reasons such as relative/spouse or child’s illness or bereavement, reference should
be made to other relevant policies of the organisation. Please see NHS Forth
Valley’s Special Leave Policy or Flexible Working Policy.
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There are circumstances in which it will be necessary to discount sickness absence
for trigger purposes. These include, but are not limited to:

Industrial injury

Medical exclusion

Illness arising from pregnancy
Separately, there may be circumstances in which an episode of sickness absence
occurs within a very short space of time after a previous episode, suggesting that
the individual may not have been sufficiently recovered prior to returning to work.
Whilst such subsequent absence will be included fortrigger purposes, Boards
should give consideration as to whether, depending on the individual case, both
absences should be considered to be one single occasion for trigger purposes.
Medical exclusion following infectious/notifiable disease

Where the absence is the result of diarrhoea and vomiting or other relevant
notifiable infectious disease and whilst the employee is suffering from the
effects of the disease, the absence will be recorded in the usual way.

The manager must obtain information regarding the nature of the illness and
obtain advice, if necessary, from the Infection Control or Occupational Health
Department as to whether a period of medical exclusion is required after the
symptoms have subsided.

Where the advice requires the employee, for purposes of infection control to
remain off work for a period after expiry of symptoms, this period will be
regarded as a medical exclusion with pay, and not as sick leave.
Diarrhoea and Vomiting
Any episode of Diarrhoea and Vomiting where the employee is symptomatic should
be recorded as sick leave and will be counted as a sickness episode. Normal sick
leave monitoring should apply and should be counted as a trigger point if applicable.
The only exception would be in the case of an outbreak under the “Staff Screening
During Healthcare and Associate Incidents and Outbreaks Policy”
However, following a Diarrhoea and Vomiting episode the employee must remain off
duty until they have been symptom free for 48 hours. This should be recorded as
Special Leave.
9.
OCCUPATIONAL HEALTH SERVICE ADVICE
The NHS Forth Valley Occupational Health Service (OHS) can provide advice
regarding employees who have health problems affecting their level of attendance. A
referral can be made by a line manager or by the employee themselves.
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If the employee has health problems which have been diagnosed, their line manager
must consider referral to OHS, though referral should not be made routinely just
because the individual has reached the trigger point for short term absences.
In seeking medical advice a line manager should only ask specific job or employment
related questions, making it clear that they wish to consider applying reasonable
adjustments to support and assist the employee in performing their duties.
10. UNSATISFACTORY ATTENDANCE PROCEDURE
This section deals with attendance levels which have become problematic for service
provision.
10.1 Trigger Point for Short-Term Absence/Persistent Absence
It is important to have in place clear trigger points for the review of sickness absence
and that these are applied consistently throughout NHS Forth Valley. The earliest a
line manager may consider formal unsatisfactory attendance action is when an
absence has reached or exceeded these trigger points.
10.2
Short-Term/Persistent Absence Procedure
The trigger point at which unsatisfactory attendance action should be taken is 9 or
more days short term absence over 3 episodes or 4 periods of absence in a 12
month rolling period. Alternatively if a pattern becomes apparent over consecutive 12
monthly periods the procedure should be invoked to address this. Any 12 month
period begins on the 1st day of absence.
The procedure given below should be followed where individuals have reached or
exceeded the trigger point.
Step 1
Employees should be invited to attend an initial Return to Work meeting. This should
be a 1:1 meeting with Line Manager and employee.
This meeting should aim to:





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welcome the employee back to work, ensure employee is fit to return to work
and discuss the reason for recent absence;
update the employee on the frequency and number of days of absence they
have had within the preceding 12 month period;
discuss whether the employee has any underlying health concern. If this is
the case make immediate referral to Occupational Health Service;
consider any personal problems the employee may have that are impacting
upon their attendance and explore what options may be available to support
them;
consider if the individual’s shift or work patterns are contributing to the
absences and if so what options are there to alter this in the best interests of
the organisation and the employee;
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


ensure the employee is fully aware of the contents of the policy and explain
what action could be taken should attendance levels not improve; include
reference to the Employee Capability Policy or the Employee Conduct
Policy;
If required the manager will determine an appropriate period of time (e.g. 3
or 6 months) during which attendance will be monitored and a defined level
of improvement is expected to be achieved;
If the employee is dissatisfied with the outcome, it may require a formal
meeting with HR/Staff Side.
Step 2
If the employee’s attendance is satisfactory at the end of the monitoring period the
employee and HR should be informed of this in writing and no further action taken.
Step 3
If there is a further absence during the monitoring period a meeting should take place
between the line manager, the employee and HR. The employee should be given a
minimum of 5 working days notice, in writing, of the time, date and reason for this
meeting. The employee has the right to be accompanied by a Staff Side
Representative or colleague.
Where no underlying medical explanation or any other mitigating circumstances can
be identified, continuing short term absence can be dealt with under the Managing
Employee Conduct Policy. It would not be anticipated this should occur every time
and in some circumstances monitoring periods may be extended or no further action
taken.
After this meeting if necessary, the manager can refer the case for investigation
under the Managing Employee Conduct Policy. After the investigatory process the
appropriate manager will make a decision on whether the matter should be
considered at a disciplinary hearing.
Step 4
There may be some circumstances where an underlying health problem causes
repeated short-term absences. Where frequent absence or inability to perform duties
because of ill health are causing problems with work or the provision of a service this
may be dealt with under the Managing Employee Capability Policy.
If during the investigatory process an underlying health problem is highlighted a
referral should be made to the Occupational Health Service (See Section 10.4) and
appropriate medical advice should be taken into account before further action
considered.
The line manager should seek advice from HR and should liaise with Occupational
Health to ascertain the effects of the employee’s health status on their ability to work.
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10.3 Long Term Absence Procedure
When an employee has been absent for 3 consecutive weeks and is not due to
return to work imminently, and where the line manager is not aware of a forward plan
in relation to the long term prognosis, the line manager should arrange a 1:1 meeting
with them to find out more about the absence and how the employee can be helped
to return to work. It is intended for this meeting to be carried out informally, however
the employee is entitled to be accompanied by a Staff Side Representative or
colleague if they wish. If the employee does wish to be accompanied to the meeting
they must inform their manager as soon as possible prior to the meeting taking place,
as the manager should then be accompanied by an HR representative. A referral
should be made to the Occupational Health Service as soon as the absence is
identified as long term (Section 10.4)
Where a meeting is not appropriate at this point, e.g. where the line manager is wellinformed on the employee’s condition and future return to work plans, or not fit to
attend, the line manager should note this and the reasons for this decision eg
elective surgery. A further date should be arranged to review the situation.
Where possible this meeting should be on a face to face basis but may be
appropriate in some circumstances by phone. Although it is anticipated that all
meetings will take place on Forth Valley premises, in some circumstances it may be
appropriate to consider an off-site venue. Home visits should only be considered at
the request of the employee and in those circumstances; the line manager should be
accompanied by an HR representative. The invitation to attend this meeting should
be given in writing (see sample letter Appendix 3).
The aim of this meeting is to:





keep the employee in touch with work issues;
explore the current reason for their absence and establish if they need any
support or adjustments to the work environment in order to help them
return e.g. through use of the rehabilitation/phased return procedures;
find out how long they are likely to be absent;
inform the employee of the next steps, and
agree regular face to face contact arrangements.
Regular face to face meetings are crucial to maintaining a relationship with the
employee whilst they are off ill. It is expected that these will take place at a minimum
of 4 weekly intervals, although this may of course be varied dependent upon the
employee’s illness.
It is important to note that it is more difficult for an employee to return to work after a
lengthy absence if regular contact is not maintained. It is the responsibility of both the
employee and the line manager to ensure that this is not an issue.
A record of each meeting should be recorded on the form on the Keeping in Touch
Form held at Appendix 1 and confirmed in writing to the employee (See sample letter
Appendix 4).
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10.4 Occupational Health Referral
In all cases of long term absence or where an underlying health problem is
suspected, a referral should be made to the Occupational Health Service. This
referral should be made as soon as the absence is identified as being long term, but
should be no later than three weeks into the absence (as Manager should have had
a meeting at three weeks).
If a reason for absence is stress/anxiety/depression an immediate referral should be
made to the Occupational Health Service.
The referral should be discussed with the employee, and they should be advised that
the organisation requires to have as much information as possible with which to
assess any ill-health situation and so it is in their interests to attend. The employee
can however choose not to attend, however if they refuse to attend their
appointment, any necessary decisions will have to be taken in the absence of
medical advice and the employee must understand this.
The Manager should continue to encourage staff to attend Occupational Health to
enable early access to the support services available.
Occupational Health are moving to an online referral service. For those managers
who have completed the training, this method can be used to refer staff. For those
still to attend for the training, an Occupational Health Referral Form (Appendix 7)
should be completed by the line manager and submitted to OHS.
Irrespective of the way in which the referral is sent, OHS will establish contact with
the employee. This may be by telephone consultation or it may be through an
appointment to attend.
OHS will then send an appointment date to the employee, a copy of which will be
sent to the line manager.
The purpose of the referral to OHS is:





to establish if any additional support and services can be offered to assist
the employee with their health problems;
to obtain as full a picture as possible of the nature and extent of the illness
and its relation or relevance to the employment circumstances of the
employee;
to ascertain how an earlier return to work can be achieved through the
Support to Work procedure;
to be able to make an informal prognosis of the likely outcome of the
illness to enable the manager to plan the workload of the department
accordingly;
answer any specific questions the line manager may have e.g. with regard
to reasonable adjustments or whether absences are linked.
Following the consultation with OHS a report will be submitted to the manager and
copied to the relevant HR Representative and employee if requested. The manager
and the HR Representative should then discuss what action to take based upon the
information provided.
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Action Following the Referral
Following the receipt of the Occupational Health Report the employee should be
invited to attend a meeting with their manager to discuss the report. The individual
should be provided with a copy of the report prior to the meeting.
Individuals will be entitled to be accompanied by a staff representative or colleague
and should be informed that a member of the HR team may also be in attendance at
the interview.
During discussions with the employee the manager should consider the following
implications for employment:





future referral to the Occupational Health Service for a further review on
whether the employee is likely to return to work;
measures for rehabilitation to work or return to existing duties, both of
which should be discussed with Occupational Health and HR (see Support
to Work Procedure – Appendix 9);
redeployment on health grounds (see NHS Forth Valley Redeployment
Policy – intranet - Area Wide Policies)
appropriateness of suitable alternative employment which may include a
change of location or function at work at an alternative grade. This needs
to be considered on an NHS wide basis not simply within the employee’s
own department;
rolling notice depending on the circumstances.
Medical Suspension
Where the manager believes the individual is medically unfit for work in that they may
adversely affect the delivery of patient care or endanger the wellbeing of colleagues
or themselves the manager must contact Occupational Health Department for an
assessment to be carried out. Under these circumstances it may be necessary to
medically suspend a member of staff.
11. REVIEW PROCESS, CASE MANAGEMENT, FINAL REVIEW MEETING
Regular departmental reviews should be carried out to assess and monitor staff
when they are off sick, and determine what action is needed at each stage.
Where a member of staff is unlikely to return to work this would culminate in a final
review where a decision on the appropriate way forward is made i.e. return to
substantive employment/redeployment/termination of contract. It is assumed that as
part of this process that reasonable adjustments have been considered. Medical
evidence should be made available to support the review process and occupational
health advice should be sought on the likelihood of:



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
a potential ill health retirement application, the final decision on this lies
with the Scottish Public Pensions Agency (SPPA)*.
In addition Managers, and HR staff should work with OHS colleagues in a case
management approach.
* Further information regarding pensions is available from www.sppa.gov.uk
12. TERMINATION OF EMPLOYMENT ON THE GROUNDS OF ILL HEALTH
Decision to Terminate Employment
If after consultation with the employee, together with the appropriate medical
evidence, there is no indication of a likely date of return and all other options have
been pursued, a decision may be taken to terminate their employment on the
grounds of ill health.
This termination may occur prior to the expiry of Occupational Sick Pay in
circumstances where it is clear that the employee will not be fit for work in the
foreseeable future. However, it is important to note that the exhaustion of
Occupational Sick Pay is not in itself a fair reason for dismissal.
Before termination is recommended the line manager must be satisfied that the
following can be demonstrated:





they have consulted the employee and discussed the position with them;
they have made a thorough investigation of the medical and any other
relevant facts;
they have balanced the employee’s likely future health with the needs of
the organisation;
they have considered offering the employee alternative employment;
where alternative employment options were unavailable or impractical they
took the decision to dismiss.
Procedure
The procedure given below should be followed where a termination of employment is
being considered and at all times HR advice should be taken

employees should be invited to attend an interview with their designated
manager. They should be given a minimum of 5 days notice, in writing, of
the time, date and reason for this interview. Employees will be entitled to
be accompanied by a staff representative or colleague and should be
informed that a member of the HR team will also be in attendance at the
interview. At this interview the employee will have the opportunity to
provide counter evidence as to why the decision to terminate should not
be taken.

once all possible considerations have been fully explored and a decision
to terminate is recommended all relevant information should be passed to
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the appropriate Director or General Manager who will authorise the
termination;

the employee will receive a formal letter of dismissal giving them the
appropriate period of notice of termination of employment. The letter
should also contain the employee’s right to appeal against the decision
and to whom the appeal must be written to;

normally the employee’s employment will be terminated to coincide with
the expiry of Occupational Sick Pay. The employee’s period of notice,
when they will be reinstated to full pay, will therefore, normally, run
concurrently with the end of their period of Occupational Sick Pay;

where employment is not terminated to coincide with the expiry of the
period of Occupational Sick Pay, appropriate pay in lieu of notice should
be given. However nothing in this Policy prevents NHS Forth Valley from
terminating employment on the grounds of ill health before the end of the
period during which Occupational Sick Pay is payable;

on termination of employment the employee will be entitled to receive
payment in lieu for accumulated untaken annual leave. Only statutory
leave entitlement is carried over between leave years.
It is important to realise that termination of employment on the grounds of ill health is
a decision that will be made by NHS Forth Valley ideally with, but not solely based on
the agreement of the employee.
13. PREMATURE RETIREMENT ON THE GROUNDS OF ILL-HEALTH
If the employee is a member of the Superannuation Scheme, consideration should
be given to making an application for premature retirement due to permanent
incapacity providing they have a minimum of 5 years superannuable service. The
employee may therefore be eligible to receive a pension and lump sum if the
condition they are suffering from permanently affects their ability to undertake the
role on which they are employed. This is a requirement for payment of Tier 1 and
Tier 2 pensions. Please refer to the Scottish Public Pensions Agency for further
guidance (www.sppa.gov.uk ).
Where such application is made an AW8 superannuation form should be completed
by the employee and an AW8 MED form, completed, in strict confidence, by the
Occupational Health Physician, attached in a sealed envelope. These forms must be
sent to the Scottish Public Pensions Agency (SPPA) via the Forth Valley NHS Payroll
Department as the Payroll Department are required to provide SPPA with salary
details as supporting information on the AW8 form. Human Resources will provide
information regarding job description and sickness records and appropriate support
to the member of staff seeking retirement.
The decision as to whether or not an individual is eligible to be paid a pension and
lump sum early on the grounds of permanent incapacity due to ill health is taken by
the Scottish Public Pensions Agency and is not at the discretion of NHS Forth Valley.
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14. REVIEW OF POLICY AND PROCEDURE
This policy and procedure has been updated in partnership with Divisional/Board
Managers and staff representatives through a partnership working group. This policy
will be formally reviewed in 3 years by the Area Policy Group or as requested by the
Area Partnership Forum/Staff Governance Committee.
This policy will be reviewed no later than 2015.
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APPENDIX 1
FIRST CALL ABSENCE CHECKLIST/RETURN TO WORK FORM
In Confidence
On the first Day of Sickness Absence this Sheet should be completed by the Line
Manager and retained by them in a secure file
Name of Employee:
........................................................................................................................................................
Who reported the Absence:
Employee/Representative (Delete as Applicable)
Date of first day of illness:
........................................................................................................................................
Nature of the illness:
........................................................................................................................................
Have they sought medical advice:
Yes/No/Not Sure
Date they expect to return to Work:
(Delete as Applicable)
...................................................................................................................
Date next contact is expected: ......................................................................................
Any Work Issues that are urgent?
......................................................................................................................
...........................................................................................................................................
Up to Date Contact Number:
Line Manager Name:
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KEEPING IN TOUCH FORM
Date of
Contact
Form of
Contact*
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What was Discussed?
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Next
Agreed
Contact
Date
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RETURN TO WORK FORM
In Confidence
The purpose of this form is to provide a basis for the discussion that should take
place between an employee returning form sickness absence and the line manager
within 3 days of return. The meeting should be conducted by the line manager and
each question ticked to indicate it has been discussed. The form should then be
signed by both the line manager and the individual and retained in a secure file.
Points to be covered in the Discussion:
Has the employee been welcomed back to work?
Have you confirmed the employee is fit to return to work?
Have you updated the employee of what is happening in the workplace and with
their job, in particular?
Have you asked the employee if they need any help with their workload?
Have you discussed whether there is any underlying reason for the absence that
you as a Line Manager need to be made aware of?
Have you informed the employee of their current absence levels in the last 12 months?
Has the employee reached an unsatisfactory level of attendance eg 9 or more days
short term absence over 3 episodes or 4 or more absences in 12 months?
mths
Has a monitoring period been put in place? If so state duration
Has the employee been informed of the potential outcome should their attendance
not improve and/or they breach the monitoring period put in place?
-
may be managed under NHS Forth Valley Managing Employee Conduct Policy
-
may be managed under NHS Forth Valley Management of Capability Policy
Have you asked what support you can offer the employee to help improve their
attendance levels? Has Occupational Health Referral or Employee Counselling
Services been considered?
Yes/No
Has the Self Certificate been completed?
Yes/No
Have all Fit Notes been received
Summary of discussion:-
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We both confirm that all of the above points have been discussed and the relevant paperwork completed.
Line Manager Name:
________________________________________________________________________ Date:
_________________
Line Manager Signature: ______________________________________________ Date:
_________________
Employee’s Name:
_________________
Employee’s Signature:
__________________________________________________________________________
Date:
________________________________________________________________________ Date:
Reason for Absence:
_________________
Date of Return:
Nature of Discussion:
Previous sickness record in last year:
* Please ensure that a copy of this document is given to the employee for their information.
** If a monitoring period has been implemented a copy should also be sent to the appropriate HR
Adviser.
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APPENDIX 2
NHS FORTH VALLEY SELF-CERTIFICATE
In Confidence
THIS FORM SHOULD BE COMPLETED AT THE RETURN TO WORK DISCUSSION
AND RETAINED BY THE LINE MANAGER IN A SECURE FILE
A Self Certificate Form must be completed to cover the first 7 days of absence due
to sickness.
Name (Capitals):
Unit/Department:
Base:
Job Title:
Date of Birth:
National Insurance Number:
Payroll Number:
Please give brief details of your sickness:
When was the last day you worked:
On what date did your sickness begin:
What date did you return to work:
On what date did your sickness end:
Employee Name (print):
Employee Signature:
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APPENDIX 3
NB: THIS SAMPLE LETTER SHOULD BE CUT AND PASTED ONTO APPROPRIATE
LETTERHEADED PAPER, THE APPROPRIATE INFORMATION ADDED AND
APPENDIX NUMBERS AND GUIDANCE DELETED BEFORE ISSUE.
MODEL LETTER FOR MEETING LONG TERM SICKNESS ABSENCE
Dear [Name]
[Subject Heading] Attendance Management Policy - Absence Meeting
I am sorry to note that you remain unwell and have done so since (Date). In order to see
how we can assist you best, it would be useful if we met to discuss how I can support your
return to health and work.
I have arranged a meeting for (Date) at (Time) and this will be held in (Venue), in
accordance with the NHS Forth Valley’s Attendance Management Policy [copy enclosed].
The purpose of this meeting is to discuss your current health in relation to work and any
support that we can assist you with. (Name), HR Adviser will also be in attendance and
you are of course entitled to be accompanied by a Staff Side Representative or colleague
if you wish.
I would be grateful if you could confirm your attendance on receipt of this letter to myself
by calling (Telephone Number) and confirm whether or not you will be accompanied
I look forward to seeing you.
Yours sincerely
[Name of Manager]
[Job Title]
cc: [HR Representative – insert name]
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APPENDIX 4
MODEL LETTER POST SICKNESS ABSENCE MEETINGS
Dear [NAME]
[Subject Heading] Outcome of Attendance Management Meeting
Thank you for attending our meeting on (Date) in accordance with our Attendance
Management Policy (when you chose to be accompanied by Name) or (when you chose
not to be accompanied). (Name), HR Adviser was also present.
The purpose of the meeting was to discuss your absence and what support could be put in
place to assist your return to work. Our discussions were as follows:
(Insert: Summary of what was actually discussed at the meeting and any agreed action,
eg Occupational Health referral, GP input/report, actions to be followed up and dates for
review)
We agreed to meet again on (date and time) to review the situation. but if you need further
support in the interim, please do not hesitate to contact me or alternatively you may also
wish to make contact with Occupational Health on 01324 566663 or the Employee
Counselling Helpline on 0800 389 7851 if appropriate.
Yours sincerely
[Name of Manager]
[Job Title]
cc: [HR Adviser – insert name]
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APPENDIX 5
MODEL LETTER FOR BREACH OF MONITORING PERIOD
Dear [Name]
Attendance Management Policy – Absence Meeting
I refer to our return to work meeting on [Date of the Meeting]. At that time we discussed
your absences which have reached a level that needs to be addressed more formally and
we agreed to monitor your attendance for a period of 3/6 months during which time I
expected an improvement in your attendance levels.
I note you have had a further episode of absence during this monitoring period on:[DATES
No. of DAYS
REASON]
I have therefore arranged a meeting for (Date) at (Time) and this will be held in (Venue),
in accordance with the NHS Forth Valley’s Attendance Management Policy. (Name), HR
Adviser will be supporting me during this meeting. The purpose of the meeting will be to
discuss this period of absence and your overall absence record and how we take this
forward. You are entitled to be accompanied by a Staff Side Representative or Colleague if
you wish.
Please note that Occupational Health provides a confidential healthcare service to all staff.
You can self refer by phoning Occupational Health Services on 01324 566663 (Delete if
referral already made). You can also contact the Employee Counselling Services
Helpline on 0800 389 7851 for further support.
workforce. Employees are expected to attend work in accordance with their contractual
arrangements unless ill health prevents them from doing so. The aim of the organisation
is to establish and reinforce a culture of attendance at work whilst providing support for
improvement.
I would be grateful if you could confirm your attendance to this meeting to myself on
receipt of this letter by calling (Telephone Number).
Yours sincerely
[Name of Manager]
[Job Title]
Encl: NHS Forth Valley Attendance Management Policy
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APPENDIX 6
APPENDIX NUMBERS AND GUIDANCE DELETED BEFORE USE.
MODEL LETTER FOR OUTCOME OF BREACH OF MONITORING MEETING
Dear [Name]
[Subject Heading] Outcome of Breach of Monitor Meeting
Thank you for attending our meeting on (Date) in accordance with our Attendance
Management Policy. You were accompanied at this meeting by (Name)/ You chose not be
accompanied at this meeting and (Name), HR Adviser was also present. The purpose of
the meeting was to discuss your recent absence(s) during the monitoring period
implemented at your return to work meeting on (date) and to explore how we should
proceed in the management of your attendance at work.
It was my decision that you were placed on a monitor on XX and breached this on XXX
which accumulates to XXX of absences over the past 12 months. You explained that your
recent absence was due to (expand on details of discussion)
Taking into account the above it was my decision that your monitor would be extended by
XX months, effective from the day after your current monitoring period. I informed you that
we would expect no further absence during this period, however we would consider your
individual circumstances if there is a further absence.
Or
Taking into account the above we informed you that your attendance has remained
unsatisfactory and it is now my decision that this will be managed under the NHS Forth
Valley Managing Employee Conduct Policy/Managing Employee Capability Policy. We
discussed with you the next steps in the process and in line with the aforementioned
policies an Investigating Officer will be appointed to take this forward. The Investigating
Officer will contact you shortly in writing to invite you to attend an investigatory meeting. A
copy of both the above policies is available on the intranet for your information.
workforce. Employees are expected to attend work in accordance with their contractual
arrangements unless ill health prevents them from doing so. The aim of the organisation
is to establish and reinforce a culture of attendance at work whilst providing support for
improvement.
If you require any further support in the interim, please do not hesitate to contact me. You
may also wish to contact Occupational Health on 01324 566663 or the Employee
Counselling Services Helpline on 0800 389 7851 for additional support and advice.
Yours sincerely
[Name of Manager]
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[Job Title]
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APPENDIX 7
NHS FORTH VALLEY
OCCUPATIONAL HEALTH SERVICE
MANAGEMENT IN CONFIDENCE
REFERRAL FORM
Please provide the following details of individual being referred
NAME (in full):
DATE OF BIRTH:
(please circle)
……./……./…….
Mr, Mrs, Miss, Ms, Other
HOME ADDRESS:
Tel (Home):
.............................................................
Tel (Mobile): ..............................................................
Tel (Work):
.............................................................
JOB TITLE:
START DATE:
WARD / DEPARTMENT:
HOURS OF WORK:
The Occupational Health Service aims to provide the manager and the employee with
unbiased professional advice. When a referral is being made, managers should be aware
of the following:1. Managers and employees should understand that all correspondence, including the
manager’s referral correspondence, may be seen by the employee under the Data
Protection Act 1998.
2. The employee should be informed of, and understand, the reason for the referral and
their agreement to attend should be obtained.
3. This referral form should be sent by the referring manager to the Occupational Health
Service outlining the circumstances and reasons for referral and highlighting the
questions which require to be answered.
4. The report from the Occupational Health Service to the referring manager will be
discussed with the employee by the Occupational Health Physician or nurse
undertaking the assessment.
5. The confidentiality of clinical details is respected, unless informed consent is given for
disclosure.
6. Communications with General Practitioner or Consultant will only take place with the
freely given, informed, written consent of the employee, taking into account the Access
to Medical Reports Act 1988.
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As we are now an integrated service, we are based at
Forth Valley Royal Hospital
Stirling Road
Larbert, FK5 4WR
Tel. 01324 566663
All referrals to be sent to the Occupational Health Department at Forth Valley Royal
Hospital or via e-mail to – [email protected], which is a confidential e-mail
service direct to Occupational Health
Reasons for referral (please )

Long term sickness absence.
Please give details

Frequent intermittent short-term sickness absence
Please give details










The likely timescale for this current absence.
The impact of the employees health problem on their current post.
Where the work process may be affecting health.
Concern regarding possible substance use.
Any adjustment/changes required in current post as a result of their health problem.
How the employee can be assisted in their return to work and good health.
For advice regarding early retirement on health grounds.
For information about general fitness for transfer to new duties or a new post.
Employee Counselling Service.
Staff Physiotherapy Service
I met with the employee to discuss their current health situation and have informed them of
this referral
Yes
No
Is it acceptable to contact the employee on their home telephone number, if required:
Yes
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Summary of previous 3 years sickness – (including present absence)
Dates of
Absence
No of Working Days
Reason
Brief details of current post
Any additional information you feel may be relevant to this referral.
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Must be completed in all cases
Name of Referring Manager:
Print:
--------------------------------------------------------------------------------
Signature: --------------------------------------------------------
Job Title & Location: -----------------------------------------------------------------------------------------------------------------------------------------Contact Tel No:
e-mail address:
----------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------
Name of HR: -------------------------------------------------------------------------------------------------------------------------------------------------------Job Title & Location:
---------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------
e-mail address:
------------------------------------------------------------------------------------------------------------------------------------------------
Date of Referral:
-------------------------------------------------
Should you require any help to complete this form, please feel free to contact us.
Thank you
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APPENDIX 8
SICK PAY ENTITLEMENT CHART
DURING THE 1ST YEAR OF
SERVICE
ONE MONTHS’ FULL PAY AND TWO MONTHS’
HALF PAY
DURING THE 2ND YEAR OF SERVICE TWO MONTHS’ FULL PAY AND TWO MONTHS’
HALF PAY
DURING THE 3RD YEAR OF SERVICE FOUR MONTHS’ FULL PAY AND FOUR
MONTHS’ HALF PAY
DURING THE 4TH AND 5TH YEARS OF FIVE MONTHS’ FULL PAY AND FIVE MONTHS’
SERVICE
HALF PAY
SIX MONTHS’ FULL PAY AND SIX MONTHS’
HALF PAY
AFTER COMPLETING 5 YEARS OF
SERVICE
All individuals employed by NHS Forth Valley are entitled to Occupational Sick Pay. The
amount received varies dependent upon length of service. Details of current rates are
contained in Appendix 8. The Payroll Department will advise the relevant HR
representative when full pay is exhausted and half pay is due to begin. The HR
representative will contact the appropriate manager and will then inform the employee, in
writing, of the salary position.
In the event of employment coming to an end, entitlement to sick pay ceases from the last
day of employment.
The definition of full pay will include regularly paid supplements, including any recruitment
and retention premia, payments for work outside normal hours and high cost area
supplements. Sick pay is calculated on the basis of what the individual would have
received had he/she been at work.
Full pay needs to be inclusive of any statutory benefits (so that sick pay is not greater than
normal working pay). The combined addition of statutory sick pay to half pay must not
exceed normal pay.
Employees will not be entitled to an additional day off if sick on a statutory holiday.
Extension of Contractual Occupational Sick Pay
Guidance on the NHS Forth Valley procedure for the Extension of Contractual
Occupational Sick Pay has been developed by the Terms and Conditions sub-group. The
HR representative will complete an authorisation form as appropriate for further approvals.
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APPENDIX 9
SUPPORT TO WORK GUIDELINES
1.
INTRODUCTION
In support of the Health Efficiency Access and Treatment (HEAT) target which requires
all health boards to have a sickness absence rate of less than 4%, NHS Forth Valley
aims to promote the health of their staff, promote programmes which help to reduce
absence levels and ensure that all employees who are or could be absent from work
due to ill health are treated in a consistent and equitable manner.
Most employees may lose some time from work due to sickness during their working
life. The majority of sickness absence is short term, however the longer an employee is
absent from work, the harder it may be for them to return. NHS Forth Valley is
committed to assist employees who have been, or could be absent from work due to
their health to either return to work at the earliest appropriate date, or to help prevent
the need for any absence in the first place
2.
PURPOSE
The purpose of the Support to Work Guidelines is to establish a temporary facility to
restore the ability of an individual to return to or to remain at work, when their health or
wellbeing has been affected. It also aims to provide a framework to managers as to
how NHS Forth Valley will aim to support the advice provided by a GP on a Fit Note,
particularly where that Fit note advises a reduction in hours, alternative duties etc. This
will thereby support the employee maintain their skills and confidence at work and
reduce or prevent sickness absence.
3.
DEFINITION
Support to Work can be considered under the two main categories of:


Rehabilitation to Work - when an absences has occurred
Prevention of Absence - primary prevention of absence occurring in the first
place
Rehabilitation to Work can be defined as managed, temporary, short term
alternatives/modifications to work until fully able to return to normal duties. This would
normally be no longer than 8 weeks but in certain circumstances this can be extended
to a maximum of 12 weeks at the Manager’s discretion and in exceptional
circumstances over 12 weeks with the HR Director’s approval.
This should not be confused with redeployment in the context of ill health which can be
defined as a transfer to a new position or permanent adjustment of duties when
capabilities no longer match job requirements. Nor should it be confused with
redeployment in the context of organisational change.
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Prevention of Absences Occurring is where the organisation takes due cognisance of
advice provided in a Fit Note issued by a General Practitioner or other health
professional.
The main aim of a Fit Note is to try, where possible, to prevent absences occurring in
the first place, or shortening the duration of the absences to a minimum. It is therefore
clearly in NHS Forth Valley and the employee’s best interests to try to accommodate
the requirements of a Fit note where possible, with the caveat that if it is not possible
then the employee will revert to sickness absences.
4.
BENEFITS
These Supports to Work Guidelines provide a mechanism which enables employees to
stay at work or to return to work at an early date, with the ultimate aim of attaining full
fitness to work. The benefits to the individual, their team and the organisation are as
follows:
Individual

Retaining competence, motivation, skill, peer and workplace interaction

Enhancing self esteem and self development

Preventing social stigma, isolation, and loss of confidence
 Improvements to well-being
Work Team

Provide support to colleagues

Standard of fairness to all

Contribution to workload

Return to the workplace of a skilled and valued individual
Organisation

Demonstrate that the organisation values employees

Mutually agreed return to duty at an early date

Development of an enabling culture

Effective use of resources

Prevention or reduction of sickness absence
5.
KEY STAKEHOLDERS
A collaborative approach between key players is essential for this procedure to be
effective. Although not appropriate in every case, liaison between the following people
can be expected:







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Manager/Adviser
Occupational Health
GP
Human Resources
Individual’s advocate e.g. Trade Union Representatives
Other appropriate specialists
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While arrangements made between the Key Stakeholders to facilitate rehabilitation to
work are of a confidential nature, the operational requirements of the programme may
require the sharing of specific information with other specific individuals.
Whilst the overall aim of the Fit Note is to reduce the need for sickness absence, but
still support the health of the individual, it has also been created to enable better
communication between the employer, employee, GP and occupational health so that
the need for absence from work is kept to a minimum.
6.
ROLES AND RESPONSIBILITIES
Rehabilitation to Work
In line with the NHS FV Absence Management Policy the individual who is absent from
work due to ill health will be seen by their Manager/Adviser after three weeks
continuous absence. Referral to the Occupational Health Department will be made if
appropriate. This referral should include previous sickness absences records.
If the individual is deemed an appropriate candidate for rehabilitation, and is in
agreement to participate in the procedure, liaison with relevant Key Players must take
place. Specifically this will include:









Occupational Health Services assessment of the individual’s capabilities and
limitations.
The Manager/HR Adviser identifying appropriate work opportunities e.g. job
modification or alternative duties which may extend beyond the individual’s
normal work base.
Collaboration between the appropriate Key Stakeholders to match the
individual’s ability to the available options.
Communication between appropriate Key Stakeholders of clear, agreed and
achievable goals with a return to full duties expected within a maximum of
normally 8 weeks.
Implementation of the agreed plan time spans and frequency of monitoring
as is deemed to be appropriate for that individual. It is recommended that
the Manager/HR Adviser reviews the individual’s progress no less than
weekly, in the first instance, with Occupational Health reviewing on a
monthly basis, unless requested otherwise by the manager/adviser.
As part of the review ongoing evaluation of the effectiveness of the
procedure will take place, with modifications made as appropriate.
The Manager/HR Adviser has a duty of care to ensure that the employee,
their colleagues or those that they care for are not placed under any undue
risk to their health and safety during the rehabilitation programme.
The Manager must keep records of the agreed rehabilitation programme
including any revised Risk Assessments.
The employee has a responsibility to bring to the Manager’s/HR Adviser’s
attention any issues or concerns regarding the programme which may
affect its success.
If the Manager feels that they cannot support employee back to work within the
advice and recommendations given by occupation health, then they must discuss this
with occupational health service and the employee to ensure that they are not putting
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the employee and organisation at risk by altering or overlooking specific advice on
restrictions that apply.
Prevention of Absence from Work
As discussed above, following consultation with their patient, a GP now provides a Fit
Note which can advise on modification to duties or hours/shifts worked either as an
alternative to being off sick or as a way to help get the person back to work quicker.
These recommendations are made on a temporary basis only and if the employer
cannot meet the requirements of the fit note then the employee would automatically
revert to sickness absence, without requiring to see the GP again. As such it is clearly
in NHS Forth Valley’s and the employee’s best interests to try to accommodate these
recommendations.
Fit Notes can therefore be issued without any sickness absences occurring and the
same consideration should be made to accommodating the advice of the GP as would
be for those returning to work.
The manager is at liberty to deal with the situation themselves, or to involve
Occupational Health if they feel the situation may not be straightforward and further
advice or support is required.
If the manager is unable to adhere to the advice given in the Fit Note, then the
employee would revert to sickness absence without the need of another Fit Note from
the GP.
7.
METHODS
This Support to Work Guideline forms part of NHS Forth Valley’s Attendance
Management Policy and demonstrates the way in which NHS Forth Valley is working to
keep sickness absences to a minimum. All our employees are individuals who will have
particular health needs and these will require to be considered on an individual basis.
In implementing this guideline, Managers/HR Advisers should embrace the ethos of
Family Friendly Policies and in considering an individualised plan for that member of
staff, may wish to consider the following on a temporary basis:









Phased return to Normal Duties
Reduced Hours
Alteration to Shift Pattern/Days
Modified Duties
Buddy System/Mentor/Supernumerary Status
Temporary Relocation/Role
Positive Interventions and interventions to facilitate a return to work
Staff Physiotherapy
Team approach to rehabilitation
If the employee has been attending the Occupational Health Service, advice will be
given on what is considered appropriate return to work or stay at work plan. If the
Manager is unable to support the recommendations from the Occupational Health
Service, then the Occupational Health Service should be advised of the reasons why,
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as these arrangements have been recommended to ensure the well being of the
individual and the reduction of sickness absence
8.
RISK ASSESSMENT
In considering the rehabilitative duties the Manger/HR Adviser must consider the health
and safety of not only employee who is returning to work or staying at work with
reduced capacity, but also that of other employees and patients.
Assistance with Risk Assessment is available from the Risk Management Team i.e.
Health and Safety Adviser, the Manual Handling Adviser or the Occupational Health
Department.
9.
REMUNERATION DURING REHABILITATION OR PREVENTION OF ABSENCE
PERIOD
The NHS has favourable terms and conditions of employment which includes a
sickness absence pay scheme dependant upon length of service. When the
rehabilitation of an employee back to work is being undertaken or the organisation is
trying to prevent absence from occurring, clearly this should not be to the financial
detriment of the employee. For example a scenario could present whereby NHS FV
would pay an individual their full salary when off sick, but during the rehabilitation or
support at work phase the employee could only work part time. Clearly it would not be
an incentive to return to work or stay at work if only a part time salary was then paid.
The Manager/HR Adviser will consider the following points when coming to a decision
and each decision will require to reflect the individual’s circumstances and will be made
in conjunction with the HR Adviser to ensure consistency of application







Length of service
Attendance Record
Disability Discrimination Act
Role within organisation
Equity with other employees
Impact on patient care of continued absence
The use of accrued, but not prospective, annual leave. However this must
not be the sole consideration
As guidance for Managers/HR Advisers, it is suggested that during the first four weeks
of rehabilitative duties, the employee should receive their full pay irrespective of the
hours worked. Should the rehabilitative period last longer and into the next four week
period, the employee should then be paid double the amount of actual hours worked to
a maximum of full pay. It would be expected that the rehabilitation period would only
have to be extended in exceptional circumstances.
10. MONITORING AND REVIEW
The procedure will be monitored in conjunction with NHS FV Attendance Management
Policy.
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Attendance Management Policy
A Guide to Staff and Managers
Employee becomes unwell
Short Term Absence
1 to 3 days
Employee should
make contact with
the designated
manager as soon
as possible in line
with departmental
procedure.
Resume from sick
leave
Phone call to line manager on first day
of absence.
Continue
on sick
leave
Absence from 4
to 7 days
NHS Forth Valley
Self-certification
form required
Obtained from
line manager or
H/R Dept
Continued
absence lasting 8
days or more
Fit Note required from
GP and advise
manager of likely
duration of absence or
possible adjustments
to duties to enable
employee to stay at or
return to work
Return to work
interview carried
out
Resume from sick
leave
Return to work
interview carried
out
No further
action taken
Resume from sick
leave
Return to work
interview carried out
No further
action taken
No further
action taken
Will all members of staff and managers please
remember that this is a guide. Always refer to
the Attendance Management Policy.
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Long term absence.
absent for more than 3
consecutive weeks
supported by Fit Note
Frequent short term absence. 9 or
more days of short term absence
over 3 episodes or 4 or more
periods of short term absence in
any 12 month rolling period.
On week 3 of absence long term
absence procedure initiated.
The manager should meet with
the employee to discuss the
reason for frequent absence. As
part of the return to work
interview.
Line manager to arrange meeting
with employee (Which can be
informal, refer to section 10.3 of the
Attendance Management Policy).
Meetings should be scheduled for
every 3 weeks where possible. A
record of the interview is to be
made and kept by line manager.
If no issues or
concerns
identified no
further action.
If there appears to be an
underlying health problem the
manager may make a referral to
Occupational Health.
This should be discussed and
agreed with the employee.
The manager will keep a record
of the meeting and notify H/R.
Line manager should refer to O/H
where appropriate.
All avenues should be explored to
facilitate a return to work, including
any advice on the Fit Note, and
agreed by the employee seeking
advice from O/H and H/R if
necessary.
This may include a return to a
different job, role or location on a
temporary basis.
If unfit to
return to work.
H/R and O/H
will advise on
possible
options in
keeping with
policy.
At the meeting agree, if appropriate, a reasonable
period of time over which attendance will be monitored
e.g. 3 to 6 months. Agree the level of improvement
expected, if appropriate.
Advise the employee of the consequences of failing to
achieve and maintain the desired level of improvement.
At the end of
monitoring period
significant
improvement noted.
Resume from
long term
absence.
Return to work
interview carried
out
No further
action taken
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Meeting with manager
and H/R
No further
monitoring
required
At the end of
monitoring period no
significant
improvement noted.
Meeting with
manager and H/R
will be arranged,
and if appropriate
the relevant stages
of the Management
of Employee
Conduct Policy
should be followed.
Unauthorised absence.
Absence not supported
by medical/selfcertification or reported
to line manager
No pay will be received
for periods of
unauthorised absence.
Where appropriate, the
relevant stages of
Management of
Employee Conduct Policy
should be followed.
If unauthorised absence
continues for 5 working
days without reasonable
cause or contact by the
employee. This may be
considered as a
resignation. Confirmation
of this will be sent in
writing to the employee.
The ongoing employment
of an employee may be
reconsidered in
exceptional
circumstances.
Publications in Alternative Formats
NHS Forth Valley is happy to consider requests for publications in other language or
formats such as large print.
To request another language for a patient, please contact 01786 434784.
For other formats contact 01324 590886,
text 07990 690605,
fax 01324 590867 or
e-mail - [email protected]
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Attendance Management Policy and

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