Trust Policy Human Resources - Paul Farrand...with the presentation of a suitable fit note. 3.5 It...

Managing Absence

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Key Points:

Absences that hit Short term triggers, which are either two occasions of absence in three

months or three occasions of absence in a twelve month rolling year, will be managed in line

with short term absence flow chart A1. (see section 5 of policy)

Absences that hit the long term absence trigger, which is a period of absence lasting four

continuous weeks or more, will be managed in line with the long term absence flow chart

A2.(see section 6 of policy).

When a manager identifies there is an unusual high level of absence, or have identified

unusual patterns of absence, a review will be undertaken in line with the continual persistent

absence flow chart A3.(see section 7 of policy)

If an individual is covered by the Equality Act consideration will be given to adjusting the

triggers and targets outlined in this policy. This must be done with advice from Human

Resources and on the recommendation by Occupational Health

Occupational Health can be involved at any time, via management referral, to support staff so

that they can return to work and continue in employment.(see guidance note G)

Case Conferences will be used in order to provide an opportunity to identify appropriate ways

of supporting the employee to return to work at the earliest opportunity and also provides

management to discuss with staff member current situation. (see guidance note H)

Trust Policy Human Resources

Title: Managing Absence

Author(s): Mandy Black, Senior HR Advisor

Policy Lead: Isobel Clements, Acting Director of Human Resources

Accepted by: Operational Partnership Forum

Active date: 16th December 2013

Ratification: Policy Review Group November 2013

Review date: 16th December 2016

Applies to: All staff Exclusions: Bank staff with no substantive contract

Purpose: The purpose of this policy is to set out a fair, supportive and effective process for managing absence.

VERSION CONTROL - This document can only be considered current when viewed via the Policies and Guidance database via the Trust intranet. If this document is printed or saved to another location, you are advised to check that the version you use remains current and valid, with reference to the active date.

Managing Absence


Managers and employees have a responsibility to follow the process as set out in this policy,

fairly and appropriately. (See guidance note B & C).

The requirements under this policy for ensuring that all staff sickness is managed fairly and

consistently will be monitoring under the policy performance monitoring framework.

Managing Absence


Stage One – Return to Work Interview held

Stage Two Meeting – Set monitoring targets – 1 occasion in 3 months. Review meeting held at month 2. Return to work interviews after every absence Send outcome letter

Return to work interview and written invitation to Stage 2

2nd

Occasion of absence during three month monitoring period .

1 or no occasions of absence during three month monitoring period. Meet to advise and send completion letter.

Meeting to discuss a breach in monitoring targets and agree to move to next stage of policy. Manager to complete checking sheet and written invitation sent for Stage 3

Further absence hits a trigger within 0-3 months. Proceed to stage 3 – send invite letter and manager to complete checking sheet

Stage Three Meeting- At stage two however HR Advisor present at meeting. Offer OH referral. Set monitoring targets – 2 occasions in 6 months. Send outcome letter At least bi-monthly review meetings and return to work interviews after every absence

3rd

occasion of absence during six month monitoring period

2 or less occasions of absence during 6 month monitoring period

Meeting to conclude the monitoring period and send completion letter. Confirm that absence must stay within Trust limits.

Meeting to discuss a breach in monitoring targets and agree to move to next stage of policy.

Stage Four – Final Review Final Review meeting to consider further monitoring period, redeployment or termination of employment

Written invitation to stage 4 sent

On next occasion of absence- 3

rd occasion in 3 months or 4

th Occasion in 12

months

Further absence hits a trigger within 3-6 months. Back in at stage 2 – send invite letter

Further absence hits a trigger within 3-6 months. Back in at stage 3 – send invite letter

Further absence hits a trigger within 0-3 months. Proceed to stage 4 – send invite letter

SHORT TERM ABSENCE On 2

nd occasion of absence in 3 months

Or 3

rd occasion of absence in 12 month rolling year

http://intranet.tsft.nhs.uk/humanresources/UsefulDocuments/ManagingAbsenceLetters/tabid/10787/language/en-GB/Default.aspx





















Managing Absence


LONG TERM ABSENCE

4 Weeks plus

Offer OH referral Agree regular contact plan – minimum contact every 2 weeks

Declined – Manager to document

Accept – complete O/H referral form & forward to HR

Keep written record of contact and sickness notes

Following appointment Occupational Health report will be sent to the Manager & copied to HR

Return to work stated

Yes – Return to work interview

No Arrange a case conference with HR support, discussing report

Discuss;

Long Term prognosis

Timescales

Report from O/H

RTW/Redeployment

Consider reasonable adjustments Send outcome letter

Return to work date set


No Possible further case conference. Discuss way forward.

Returning to work – complete RTW interview

No return to work date within 4 months absence obtain new occupational health report and arrange Final Formal meeting

Final Formal – 4 month final meeting

Return to work date within 2 months of Final Formal


No return to work date within 6 months Further Final Formal Meeting – Hold at 6 month. Decision taken re-employment













Managing Absence


OVERALL HIGH LEVELS OF PERSISTENT ABSENCE / PATTERNS OF

ABSENCE Identified by Manager

Produces evidence and background information of employee’s absence.

Manager writes to individual with 7 days notice advising of the need to hold a meeting

to discuss absence history. Invite letter persistent absence review

meeting.

Outcome letter sent following meeting. Advising that senior manager will be in

contact to arrange a Final Formal meeting.

Outcome letter persistent absence review meeting

Obtain Occupational Health report and hearing manager invite to Formal Review

meeting. Invite to Formal Review Meeting letter.

Final Formal Meeting held to review absence history and decision taken to continue with

employment or termination of contract due to high absence rate.

Contact HR advisor to discuss case history and high % of absence rate.

Offer O/H referral

No – Manager to document

Yes – contact HR for referral form





Managing Absence


1. Introduction

1.1 The policy is to ensure all staff are supported during periods of health related

absence, to provide staff with the appropriate support to return to work, as soon as

possible and to ensure that they are able to fulfil their contractual obligations.

1.2 This policy applies to all staff with a substantive contract with Taunton and Somerset

NHS Foundation Trust.

1.3 This policy does not differentiate between genuine and non genuine absence, as it is

assumed that every episode of sickness reported by an employee is genuine. All

sickness absence, including surgery, will contribute to monitoring under this policy,

unless the policy specifically excludes it, or following discussions with HR allows the

absence to be counted as a reasonable adjustment as the condition falls under the

Equality Act.

1.4 This policy has been produced and agreed in partnership between management and

Trade Union representatives of the Trust to ensure all employees are treated

equitably when their attendance fails to meet the expected standards set within the

Trust.

2. Definitions

2.1 Short term triggers are either two occasions of absence in three months or three

occasions of absence in a twelve month rolling year.

2.2 The long term absence trigger is a period of absence lasting four continuous weeks

or more.

2.3 Continual persistent absence is when a manager identifies that there is an unusual

high level of absence, or they have identified unusual patterns of absence which does

not fall under either two of the above and a review is therefore required.

3. Policy principles

3.1 When a period of absence falls under any of the definitions above the manager must

ensure the appropriate stages /process of the policy is being followed.

3.2 The short term process incorporates four levels of review. The long term absence

requires a Final meeting at four months and a persistent absence meeting can be

undertaken at any time that a manager feels there is a significant high level of

absence that falls outside the Trust sickness targets. The final meetings can result in

Managing Absence


dismissal on the grounds of failure to meet the required levels of attendance in line

with the Trust’s Managing Absence Policy without reverting to the Disciplinary Policy.

3.3 The policy must be followed stage by stage. It is not possible to progress to a further

stage until the initial processes have been adhered to.

3.4 All periods of absence must be reported at the earliest possible opportunity to their

appropriate manager who will keep a full record of all absences. This includes

individuals who are not due to be in work as they are not rostered, are on annual

leave, or working from home/alternative work base. There is no expectation that

individuals will undertake any work related activity whilst absent from work due to ill

health, unless advised by Occupational Health, or on advice from the individual’s GP

with the presentation of a suitable fit note.

3.5 It is the employee’s responsibility to ensure they provide a Fit note from a doctor after

7 days of absence or longer. The employee must ensure that this is provided to the

manager as soon as possible, and no longer than after the 10th day of absence. For

continuing absence the employee must obtain and submit their Fit note certificate no

later than two days after the last day covered by the previous certificate. Failure to do

so may lead to the non-payment of salary

3.6 Every period of absence, full and part shifts must be discussed at a return to work

interview. The manager must complete the appropriate return to work form,

discussing with the individual the reason for the absence, and whether any further

support is required.

3.7 Special consideration will be given to those employees who potentially receive

protection under the Equality Act 2010. In circumstances where an individual has a

long term condition, potentially covered by the Equality Act, which impacts on their

attendance at work or the ability to undertake their role, consideration will be given to

adjusting the triggers and targets outlined in this policy. This must be done with

advice from Human Resources and on the recommendation by Occupational Health.

Each case will be treated individually.

3.8 The Trust must ensure that all reasonable adjustments are considered. This could

include change to the working environment, hours, triggers and targets. It may also

be of benefit to involve outside agencies such as a disability advisor or access to

work for advice if needed.

Managing Absence


3.9 When an employee falls pregnant, or as a result of IVF, any sickness which is related

to the pregnancy or IVF will not be included for monitoring purposes. However a

return to work form must be completed.

3.10 It is essential that all managers ensure a safe working environment, which includes

the awareness that stress can lead to short and long term absence.

3.11 When an employee is absent due to stress, the manager or agreed third party should

contact the individual to offer an immediate referral to Occupational Health. The

contents of this referral must be agreed by the individual prior to this being sent to HR

for action.

3.12 At the formal stages within the policy the employee will have the right to be

accompanied by a Trade Union Representative or work colleague, – this does not

extend to the right of legal representation, partners, and family members

3.13 If an employee is absent and as a consequence has been unable to take the statutory

annual leave entitlement under the Working Time Directive within the current leave

year, permission to carry forward the remainder into the new leave year will be based

on prevailing legislation. Please contact HR for further clarification.

3.14 If an employee falls ill whilst on annual leave, they will be required to report their

sickness following the normal locally determined procedure. It may be possible to

credit the annual leave for the period in question only if the sickness would affect their

capacity to do their job – annual leave does not get credited if the sickness meant

they just couldn’t enjoy their holiday. A doctor’s fit note will be required.

3.15 Employees will not be entitled to an additional day off if sick on a statutory holiday.

3.16 All forms of employment, both paid and unpaid should be declared to the Trust. Staff

should not undertake any paid or unpaid employment elsewhere whilst absent from

the Trust, unless this has been discussed with HR. Any concerns should be reported

immediately to the Trust’s Local Counter Fraud Department.

3.17 Dismissal may only be authorised by an appropriate level of manager. Those

authorised to dismiss may delegate the power of dismissal, in writing prior to the

meeting, to another manager at a senior level.

3.18 When arranging the final meeting of any of the absence processes laid out,

individuals will be given at least seven days prior notice. In the event of the need to

reschedule every effort should be taken to ensure a reasonable time frame is met.

Managing Absence


Should individuals fail to attend this re-arranged meeting, the Trust may decide to

hold the meeting in the employee’s absence.

4. Duties/Responsibilities

Human Resources

The HR team is available to provide advice and guidance regarding managing

absence. HR involvement is required from Stage 3 in line with the short term process.

HR advisors will support managers during long term cases, as well as providing

support when a persistent absence case is highlighted.

Managers

Managers are expected to follow the process as set out in this policy, fairly and

appropriately.

It is essential that the manager is able to demonstrate that a fair process has been

followed.

Guidance note B sets out the responsibilities of the manager when managing

absence.

Employees

Guidance C sets out the responsibilities of the employee when absent.

5. Process

Short Term Absence Process

5.1 When an employee hits one of the short term triggers being either two occasions of

absence in three months, or three occasions of absence in a twelve month rolling

year. This process will be instigated. See short term absence flow chart.

If an individual is covered by the Equality Act 2010 consideration will be given to

adjusting the triggers and targets outlined in this policy. This must be done with

advice from Human Resources and on the recommendation by Occupational Health.

Each case will be treated individually

Episodes of absence where an employee has left work early (at any time during their

shift) due to being unwell will be counted as a part shift. If the individual has not

commenced work this will be counted as a full days absent.




Managing Absence


If three part days occur in a twelve month rolling year, this will count as one occasion

of absence towards monitoring. A return to work interview will be required to be

completed after each part shift.

5.2 Stage One –

The Stage One acts as an indicator to employees that their absence is causing

concern and that monitoring could commence on the next occasion of absence. The

aim is to try and prevent any further absence by identifying and addressing issues

and consider any support required as part of the return to work interview.

The standard return to work interview form is completed by the line manager however

it is recorded that this is a Stage One return to work interview by ticking the

appropriate box at the top of the form and recording that the stage one interview has

taken place.

Guidance note E

5.3 Stage Two

This stage takes place when an employee has another period of absence following

the Stage 1 return to work interview, and hits the triggers which will mean the

absence is the third occasion within three months or the fourth occasion within a

twelve month rolling year. On their return from the absence the manager will carry out

a return to work interview with the employee and during this inform them that a further

meeting will be arranged to discuss their absence. This will be the Stage Two

meeting.

If the employee is happy to proceed with the Stage Two meeting during the return to

work interview this can be undertaken by the manager at the same time. This must be

clearly documented in the outcome letter following the meeting stating that the

employee was happy to proceed.

Should the employee wish to have the Stage Two meeting at a later date, the

manager will write to the employee inviting them to the meeting, giving seven days

notice, and explaining that they have the right to representation and provide a copy of

the managing absence policy. This meeting, where possible, will be held within 14

days of the employee’s date of return.

The aim of the meeting is to:

Discuss the episodes and reasons for the absence and ensure that the employee

is aware of the absence triggers that they have hit;


Managing Absence


Assess the possibility of an underlying medical condition by referring to

Occupational Health;

Inform the employee that continued absence periods are unacceptable and state

that the employees continued employment could be at risk (dismissal due to

failure to meet the required levels of attendance in line with the Trust’s Managing

Absence Policy);

Consideration is to be given to any personal problems or worries with discussion

on the ways in which they may be resolved and any support that can be provided.

Advise that the employee’s attendance will be monitored for a period of three

months, setting a target of no more than one occasion of absence during the

monitoring period, which will commence from the date of the meeting.

Consideration should be given to adjusting the monitoring targets where an

employee is covered by the Equality Act as their condition may expect unusual

levels of absence. If the post cannot support adjusted targets consideration

should be given to redeployment;

Inform the employee that there will be a mid way review meeting during the

monitoring period.

Details following the meeting must be confirmed in writing to the employee.

A review meeting will be held at the end of the agreed monitoring period, if

satisfactory improvement has been achieved and sustained during the monitoring

period no further action will be taken. The employee must be written to and informed

that they have been taken off monitoring and that they need to keep their absence

rate below the Trust target levels. If an absence trigger is hit the policy can be

invoked again at the next stage if it is within three months of completing monitoring or

the stage which had previously been reached if it is between three and six months of

completing monitoring.

If during the monitoring period the employee exceeds the targets set, then they will be

informed at their return to work interview that there has been no satisfactory

improvement and it is therefore necessary to proceed to the next stage of the policy.

If an employee is absent for four continuous weeks or more during a monitoring

period, the monitoring period will be extended. The extension will depend on what

length of time was remaining on the monitoring period.

Any employee who is being monitored under Stage Two of the Policy and wishes to

undertake additional shift/hours including on the Trust’s Bank must have a

conversation with their manager to obtain agreement. This must be documented in

the employees file. Taking into account the medical reasons the manager has the

Managing Absence


right to decline this request should they feel that extra work would have a detrimental

effect on the staff member’s attendance or health.

5.4 Stage Three

This can occur when;

When the targets set in Stage Two are not met

An individual successfully completes Stage Two but then has a further occasion

of absence within the 0-3 months and hits the triggers

An individual successfully completes Stage Three, but has a further occasion of

absence within the 3-6 months and hits the triggers

When this happens a Stage Three meeting will be arranged with the employee’s

manager and an HR Advisor. Prior to the meeting the manager will complete the

checking sheet and forward to HR together with the personal file to ensure triggers

are being hit and the process has been followed. This must be confirmed in writing

giving seven days notice and providing the right to representation, where possible,

this will be held within 14 days of the employee’s date of return.

The meeting format should follow the same process as for Stage Two, however the

employee should be advised that the monitoring period will be for six months with a

target of no more than two occasions of absence. There will be regular review

meetings which will take place bi monthly. The stage 3 monitoring period will

commence from the date of the meeting.

The consequences of not reaching the given targets must be clearly indicated, this

will involve consideration of termination of employment. The meeting will be

summarised in writing to the employee including what will happen if these targets are

not met.

A final review meeting will be held at the end of the agreed monitoring period, if

satisfactory improvement was achieved and sustained during the monitoring period

no further action will be taken. The employee is taken off monitoring and advised that

they need to keep their absence rate below the Trust trigger levels. If an absence

trigger is hit the policy can be invoked again at the next stage if it is within three

months of completing monitoring or the stage which had previously been reached if

between three and six months of completing monitoring.

If during the monitoring period the employee exceeds the targets set, then they will be

informed at their return to work interview that there has been no satisfactory

improvement and it is therefore necessary to proceed to the next stage of the policy.

Managing Absence


If an employee is off absent for four continuous weeks or more during a monitoring

period, the monitoring period will be extended. The extension will depend on what

length of time was remaining on the monitoring period.

Any employee who is being monitored under Stage Three will not be permitted to

work any additional shifts/hours, including on the Trust’s Bank – it is the responsibility

of the Manager to notify the Bank of this. In addition, a review of any secondary

employment arrangements should be undertaken and a decision made as to whether

those arrangements can continue under the circumstances. Individuals will continue

their contractual commitment to on-call.

5.5 Stage Four

When the targets set on Stage Three, are not met or an individual is absent following

completion of Stage Three which hits a trigger within 0-3 months a review meeting

will be arranged. The Manager will write to the individual inviting them to this meeting

advising that they have the right to be accompanied at this meeting. The purpose of

this meeting will be to advise the employee of the reasons why they are proceeding to

a stage four.

Following this meeting the Stage Four meeting will be arranged.

The meeting will be arranged and conducted by a senior manager with the authority

to dismiss and a senior member of the HR team. Also present will be the employee’s

manager who maybe supported by an HR Advisor.

The employee must be informed of the Stage Four final review meeting date in writing

by the chair of the panel, and that termination of their contract due to failure to meet

the required levels of attendance in line with the Trust’s Managing Sickness Policy

may occur. Employees must be reminded of their right to representation.

The employee must be provided with a copy of all the paperwork relevant to the

meeting at least seven days in advance of the meeting. This could include the

following documentation:

A complete sickness record including a summary of reasons for absence;

Copies of all letters sent throughout the process;

Copies of all return to work interview records;

Copy of the formal return to work interview record;

A copy of all Occupational Health and/or specialist medical reports;

A time plan which sets out the key dates for the whole process;

Any other information as deemed relevant.

Managing Absence


If the individual is covered by the Equality Act any reasonable adjustments that

may have been made to the role, targets or triggers that are set out in the

process will need to be clearly visible.

Any new information given at the meeting regarding ill health or a change in the

nature of the sickness is to be assessed with a referral to Serco Occupational Health,

which may result in the review meeting being adjourned. The termination of the

employee’s contract should not be considered unless a recent assessment by

Occupational Health has occurred. However, if an employee does not wish to be

referred or fails to attend the OH appointment without an explanation that is

satisfactory to the Trust, the meeting will proceed and a decision will be taken on the

information that is available.

Having considered the employee’s mitigation the possibility of terminating the

employee’s contract could be considered.

If dismissed the employee has the right to appeal against the dismissal.

6. Long Term Absence Procedure

When an employee hits the long term absence trigger of four continuous weeks the

long term absence procedure must be followed. Long term process

6.1 Managers must offer an employee a referral to Occupational Health when they hit the

long term absence trigger. This referral should be made as soon as the manager is

aware that the absence will be for four weeks or more. Guidance note G sets out the

Occupational Health referral process and expectations.

6.2 Managers are required to maintain contact with employees on an agreed basis, but

not less than fortnightly. If the employee is not happy for the manager to be their point

of contact then they can request for an agreed third party to maintain contact.

However the manager must be kept up to date at all times and a written record of all

contact must be kept in the employee’s personal file.

6.3 Once a referral has been made to Occupational Health, all long term absence cases

can be discussed and monitored via the Case Conference system as appropriate.

This will provide an opportunity to identify appropriate ways of supporting the

employee to return to work at the earliest opportunity. Guidance note H provides

detailed information regarding the case conference approach and the expectations for

all parties.




Managing Absence


Special consideration will be given to those employees who potentially receive

protection under the Equality Act 2010. In circumstances where an individual has a

long term condition, potentially covered by the Equality Act, which impacts on their

attendance at work or the ability to undertake their role, consideration will be given to

those circumstances will be given to any reasonable adjustments. All cases will be

treated on individual merit.

6.4 When an employee returns to work after a prolonged period of absence the manager

should arrange an initial return to work interview and then ensure that follow up

discussions occur as necessary. An induction programme should also be considered

where appropriate.

6.5 In some cases, usually following advice from Occupational Health, the employee may

require a sheltered return to work. A sheltered return is suitable for employees where

there is a realistic expectation that they will be able to return to their current post,

hours and full duties. The sheltered return will be for either a period of part time work

or a post with alternative duties or less demanding duties and is a temporary change.

6.6 A Fit note is given to the employee by their GP stating what adjustments are required

in order for the individual to return during the sheltered return to work period. A

Manager can agree a sheltered return with the employee for a period of no more than

two weeks. If a longer sheltered return is required this needs to be through

Occupational Health, The maximum amount of time that an employee can have on

sheltered return where they are paid their contractual hours, is four weeks within a 12

month rolling year.

6.7 If after this period the employee is still not able to fulfil their substantive post, their pay

will reflect what they are currently doing in the new adjusted role/hours, even if this is

a temporary arrangement. Alternatively holiday can be used in addition rather than an

employees pay being reduced. In addition a review will need to take place on whether

the employee will be able to return to their substantive post. Managers will need to

meet and review the employee on a weekly basis; if there is no improvement then

they will need to refer the employee back to Occupational Health.

6.8 The Equality Act place an onus on the employers to ensure that they make

reasonable adjustments in the workplace or the duties of a post to ensure that an

individual with a disability is not at a disadvantage in comparison with employees who

are not disabled. It may be beneficial to involve outside agencies such as the job

centre disability advisor or access to work for advice if needed. For further information

please refer to the HR team.

Managing Absence


6.9 Whilst it is always the hope that the individual will be able to resume their normal

duties, if this is not the case in the foreseeable future, the manager, in line with the

advice from Occupational Health and a HR Advisor will need to consider the options

available as part of a Final Review.

6.10 The Final Review Process

When it is identified that the employee will be unable to return to work, or at the very

latest when they have had four months of absence from work, the manager must

arrange a final review meeting where a decision can be made on the appropriate way

forward.

The employee must be informed of the final review meeting date in writing giving at

least seven days notice, reminding them of their right to representation and that

termination of their contract due to ill health may occur.

The review meeting will be chaired by a senior manager with the authority to dismiss.

During this final review the senior manager, with HR support must consider what, if

any, reasonable adjustments could be implemented to support the employee

returning. The manager will make all reasonable attempts to have an up to date

Occupational Health report to determine whether a return to work is likely within the

next two months. If a return to work is not possible at this time or within the next two

months the following options must be considered if appropriate:

Redeployment:

On the advice of Occupational Health, redeployment can be considered on the

grounds of ill health. For more information on the process of this see the

Redeployment Policy.

Flexible Working

This should be an option that is considered to support the employee returning to

work. For more information on this see the Flexible working Policy

Career Break

This is an option that can be discussed at the meeting, but will need authorisation

from the Directorate Manager. Information on Career Breaks can be found in the

Special leave Policy

Termination of Contract:

Where an employee is not able to return to work within reasonable timescales despite

all of the above being considered, then termination of their contract on the grounds of

http://knowhow.tsft.nhs.uk/documents/ppg/Flexible%20Working%20Policy.pdf

http://knowhow.tsft.nhs.uk/documents/ppg/Special%20Leave%20Policy%20Draft%20Final%20Version.pdf

Managing Absence


capability due to ill health will be considered. In order for this decision to be made,

the report from Occupational Health must state the following information:

Up to date medical evidence;

Treatment Plans

The prospects of a likely return to the substantive post, with or without

adjustments within 2 months;

A sheltered return with or without adjustments;

Redeployment;

The possibility of a successful ill health retirement application.

The employee must be given the opportunity to bring to the meeting any new medical

evidence, which may alter the decision. When looking to terminate the employee’s

contract the manager must have written a letter informing them that at the meeting

termination of contract will potentially be discussed.

There will be occasions when individuals that remain in employment following the 4

month Final meeting and are still absent from work at six months. At this stage a

Further Final Meeting will be held. The employee must be informed of the meeting

date in writing, reminding them of their right to representation and that termination of

their contract due to ill health may occur. The second review meeting will be chaired

by the same senior manager and member of the HR team. The meeting format

should follow the same process with the same considerations.

A decision will be made at this meeting regarding continued employment.

If an employee refuses to attend case conferences or a final review meeting without

an explanation that is satisfactory to the Trust, the process will proceed in their

absence and a decision will be taken on the information that is available. The

employee will be informed of any outcome in writing

7. Continual Persistent Absence

Each case that is managed in line with this process will be treated on an individual

basis and the principles below will apply. To ensure a fair approach is being

considered in the management of these cases robust monitoring arrangements have

been made which are in Section 9 of the Policy.

If a manager identifies that an individual has a significant high level of reoccurring

absence, which is not hitting any short term trigger but is giving cause for concern,

the manager should contact a HR Advisor to discuss the case. This can be managed

through the continual persistent absence route to ensure appropriate action is taken.

Persistent absence flowchart.


Managing Absence


When reviewing the case with an HR advisor, the manager is required to state the

facts as to why a case review is required, produce the absence history of the

employee and the pattern of the absence. Special consideration will be given to those

employees who potentially receive protection under the Equality Act 2010.

Once the case has been reviewed with the HR advisor, the manager will arrange for a

meeting with the individual. This meeting must be confirmed in writing giving seven

days notice and providing the right to representation.

At this meeting the HR Advisor will be present and the manager will discuss with the

employee the purpose of the meeting. The manager will explain that due to the

individuals high percentage or pattern of absence compared to the Trust levels, they

are required to attend a Formal Review meeting.

The employee must be informed of the final review meeting date in writing giving at

least seven days notice, reminding them of their right to representation and that

termination of their contract due to absence rates may occur following a review of the

case history.

The employee must be provided with a copy of all the relevant paperwork that will be

discussed at the meeting at least seven days in advance of the meeting. This could

include the following documentation:

A complete sickness record including a summary of reasons for absence;

Copies of all letters sent throughout;

Copies of all return to work interview records;

A copy of all Occupational Health and/or specialist medical reports;

Any other information as deemed relevant.

The employee must be given the opportunity to bring to the meeting any new medical

evidence, which may alter the decision. When looking to terminate the employee’s

contract the manager must have written a letter informing them that at the meeting

termination of contract will potentially be discussed.

The review will be chaired by a senior manager with the authority to dismiss. The

senior manager must have an up to date Occupational Health report in order to make

a final decision. However, if an employee does not wish to be referred or fails to

attend an appointment without an explanation that is satisfactory to the Trust, the

meeting will proceed and a decision will be taken on the information that is available.

Managing Absence


8. Appeal Rights

An employee may appeal against dismissal at Stage Four of the short term absence

procedure, against dismissal under the long term absence procedure or against

dismissal under continual persistent absence, as set out in this policy. The right of

appeal must be exercised within 14 calendar days of the date of the letter confirming

the outcome of the meeting. The appeal letter must clearly state the specific reasons

for appeal and should be addressed to the named manager stated in the outcome

letter.

9. Policy Review

This Policy will be reviewed three years after its implementation, or earlier at the

initiative of either side of the Partnership Forum or following legislative changes.

10. Performance Monitoring

The requirements under this policy for ensuring that all staff sickness is managed

fairly and consistently shall be monitoring according to the arrangements set out in

the Policy Performance Monitoring Framework see below.

11. Equality Impact Assessment

This policy has been subject to Equality Impact screening. This assessment identified

no impact on any specific group equality group, with the exception of disability, for

which a positive impact was identified. This recognises the provision made for

adjustments to the processes for staff with disabilities.

A full assessment has not been undertaken as no negative impact is evident from the

screening.

Managing Absence


Policy Performance Monitoring Framework – Managing Absence Policy

Element of policy for monitoring

Monitoring method - Information source (eg audit)/ Measure / performance standard

Item Lead Monitoring frequency / reporting frequency and route

Arrangements for responding to shortcomings and tracking delivery of planned actions

Arrangement for ensuring learning

Staged process as set out in the Absence flow charts chart- Short term Long term Overall High Levels of persistent absence.

Cases that reach Stage Four under the short term process and those cases that

reach a Final Formal Meeting under both long term and overall high levels of

persistent absence will be recorded on the Monitoring Database by the HR Advisor

leading on the case.

All details of where a case should have proceeded to a stage four hearing, or a

final hearing, and advise has been given from a HR Advisor not to proceed will be

recorded on the database

On an annual basis the HR Advisor team will carry out an audit of all the cases that

have not proceeded to the final stages, to identify any common themes or trends

which need resolving through either direct one to one support, training, or policy

changes.

A sample of 10 departments across the Trust which will include clinical and non-

clinical departments and across directorates will be six monthly audited. If during

these audits scores fall below the agreed HR Governance Committee scoring

criteria the department will be re-audited. Timescales for re-audits are dependent

on level of scoring.

The HR Advisor Team will review the cases that fall under the ‘Continual Persistent

Absence’ section of the policy. These finding will then be fed into the HR

Governance Committee to ensure fair application of the policy .

The nominated Lead within the HR Team

Monitoring reported to the HR Governance Committee, six monthly. Bi monthly to the HR Governance Committee via a report, unless it is nil return which will be reported verbally.

If the HR Committee identifies a concern they will oversee the development of an action plan or escalate as appropriate to the Director of HR.

The Operational Management structure will be the primary route for communicating any learning / changes required.

Managing Absence


Managing Sickness Guidance Notes

The following standard documents have been written to assist managers and HR staff in the

delivery of a consistent approach in accordance with the Trust’s Managing Sickness Policy.

DOCUMENTS

A1

A2

A3

B

C

D

Short Term Absence Flowchart Page 2

Long Term Absence Flowchart Page 3

Continual Persistent Absence Flowchart Page 4

Managers responsibilities Page 22

Employees responsibilities Page 24

Return to Work Interviews Page 25

E Return to Work Interview Record Page 26

F Short Term Absence Definition Page 28

G

H

Staff Occupational Health Page 29

Case Conferences Page 32

I Hospital Acquired Infections Page 33

Managing Absence


Guidance Note B – Managers responsibilities

Managers are required to appropriately document all action taken under this policy. This

includes telephone conversations that they may have when an individual is on a period of

long term sickness leave.

It is the manager’s responsibility to record every absence and the practice of carrying out

documented return to work interviews is a measure to ensure that all absences are discussed

to ascertain whether there are regular patterns emerging, including part shift absences.

A consistent approach to return to work interviews ensures that sickness absences are

acknowledged. Guidance note D sets out the process for carrying out a return to work

interview.

It is recognised that it is not always possible for some areas, e.g. wards to carryout out the

return to work interview on the first day back and therefore it should take place ideally no later

than 48 hours after they return in line with policy.

In these cases the delay and reasons must be documented on the return to work interview

record form.

Where there are regular patterns of absence emerging the manager should contact HR to

discuss the case in line with the continual persistent absence process.

It is the manager’s responsibility to ensure that any accident at work should be recorded on

an incident form as set out in the Trust Incident policy. Sickness absence following an incident

must be discussed with Human Resources in order to determine whether the absence will be

excluded for monitoring purposes. For information on Temporary Injury Allowance the

manager must contact the HR Advisor Team.

Managers are responsible for ensuring they attend the Trust training on this policy, and keep

updated with any changes. Managers are also required to ensure that their staff are aware of

any changes within the Policy.

Managers must ensure that their staff are aware of and understand the Trust’s Managing

Absence Policy. Managers should also ensure that their staff are aware of their

responsibilities under Health & Safety legislation and that these are followed.

Managers must give their support in finding suitable alternative employment for any staff that

require redeployment on health grounds in co-operation with Occupational Health and Human

Resources.

Managing Absence


Managers are responsible for proactively managing their staff, and where possible

considering what support is required to reduce an employee’s absence. Managers should

consider offering Occupational Health referrals or getting advice before an employee is

absent from work.

Managers should seek advice from Occupational Health and HR as appropriate.

Managing Absence


Appendix C- Employees responsibilities

It is the employee’s responsibility that they follow the departments local reporting procedure at

the earliest opportunity if they are unable to attend work, providing the reason for the absence

and their likely return date. This procedure must also be followed when an employee is unwell

at weekends, on a non-working day, or during a period of annual leave. Failure to correctly

follow this process could result in the absence being treated as unauthorised and unpaid.

Employees are required to notify their manager once they are fit to return to work, even if this

falls on a weekend, a non-working day or annual leave. Failure to do so will extend the

recorded length of the absence.

Employees have a responsibility to be familiar with the Trust’s Managing Absence Policy and

to co-operate with managers in its implementation.

All employees are expected to attend work and carry out their duties only when fit to do so.

It is the employee’s responsibility to ensure they provide a Fit note from a doctor after 7 days

of absence or longer. The employee must ensure that this is provided to the manager as soon

as possible, and no longer than after the 10th day of absence. For continuing absence the

employee must obtain and submit their Fit note certificate no later than two days after the last

day covered by the previous certificate. Failure to do so may lead to the non-payment of

salary

Upon the employee’s return they will attend a return to work interview where possible on the

day they return from their absence.

Employees must notify their managers as soon as possible, when they expect to return to

work. If a member of staff is fit to return to work, but is on a day off or annual leave they also

need to inform their manager that they are well enough to return, otherwise the sickness will

continue to be counted.

Employees must be honest and open about their reason for absence so that support can be

given as necessary.

Employees have a responsibility to co-operate in managing their absence and return to work

to ensure that managers have all the necessary information to support them.

Failure to follow this policy or local absence processes may result in disciplinary action being

taken.

Managing Absence


Appendix D – Return to work Interviews.

A return to work interview provides the manager with the opportunity to see the employee on

their return from absence and to express their concerns about their health problems, let them

know they were missed and make arrangements to update them on any information they may

have missed while away. It is during these discussions that underlying problems maybe

identified. Special attention should be drawn to those who have frequent absence following

days off, annual leave or weekends.

The manager must ensure that they check the employee’s periods of absence are not related

to anything else apart from sickness. If any medical condition is identified at this stage, which

is likely to affect the employee carrying out their job, a referral to Occupational Health must be

completed with the employee’s consent. This is a mechanism to support the employee in

carrying out their job. Guidance note G sets out the process of how to make a referral.

The return to work interview form must be completed in full; this includes ticking the relevant

box at the top of the form and being signed by both the manager and the employee. The

return to work record form must be filed in the employees personnel file.

Managing Absence


Guidance note E- Return to Work Form

RETURN TO WORK INTERVIEW RECORD

eturn to Work

Stage 1 (2nd occasion in 3 months, or 3rd

occasion in 12 months)

Name & Address

State reason why you were unfit for work

I now declare I am fit for work

Yes

No

Department

Job Title

Have you consulted a doctor or visited hospital?

First day of absence from work:

Please tick if left part way through shift:

First day sickness reported [if earlier]:

Last day absence reported:

Date of return to work:

Was the illness related to Ward closure? Yes/No

Is the absence counted for monitoring? Yes/No

IF No, reasons why?

Is there any support or adaptations that need to

be put in place? (e.g. O/H referral)

Was absence due to an accident at work?

YES/NO

If yes, has accident/incident been reported on

Trust Incident Reporting form/system?

YES/NO (If No, give reasons below)

State Incident Number:

Absence notified on:

Date: …………………………..

Reported to:.…….…………………

Was your absence related to your long term

condition?

Return to Work Interview

Managing Absence


Notes of any additional discussion during return to work interview

Employee

I declare that the information as discussed at my return to work interview is true and that I did not undertake paid

or unpaid employment during this period of absence.

Signature: ………………………………………………….. Date: ……………………..

Giving false information may result in criminal and disciplinary action and or the loss of sick pay benefits .

Manager

Signature: ………………………………………………….. Date: ……………………..

This section is to be completed by line manager/supervisor as a result of any comments or action taken, following the

return to work interview.

Comments/Action taken following Return to Work Interview:

Signature: …………………………………………Name: ……………………………………….

Department: ………………………………………………Date: ……………………………

Managing Absence


Guidance Note F – Short Term Absence Definition

Short Term Absence can be defined as periods of absence of less than four weeks, usually

odd single days or a few days at a time, through-out the year. This sickness may be covered

by a Fit Note, although these periods tend to have no particular trend related to medical

conditions. If a trend does occur where there are several occasions with the same reason it

may be that the manager needs to look at meeting with the individual & discuss whether a

referral to Occupational Health is appropriate. This can be discussed with an HR Advisor.

Managers must remember that although all absence may be genuine, when collated together

it may constitute a bad attendance record. Should this result in a high overall unacceptable

level of attendance, this can be managed through the high level of persistent absence route.

In exceptional circumstances when absence is found not to be genuine i.e. deceit is

suspected/proved, the Disciplinary Procedure should be used.

Managing Absence


Guidance Note – G Occupational Health Service

Occupational health is a distinct branch of medicine concerned with how a worker’s health

can affect his or her ability to do the job and how work and the work environment can affect

an employee’s health.

Occupational health is about the effect work has on health and about making sure

employees are fit for the work that they do. As a result of a referral occupational health can

provide advice to managers and aim to assist employees with health problems.

When an Occupational Health referral is required, the manager must contact the HR team to

discuss the referral and obtain a referral form. The HR team will email the form to the

manager. The manager will complete the details and then email back to HR, after the

individual has agreed with the content of the referral. The email address is [email protected].

A copy of the referral form is then kept in the individuals file. It is important that the

occupational health adviser is made aware of all relevant facts about a case to ensure that

objective advice is given, based on a full understanding of the issues of concern to the

referring manager.

The Occupational Health Referral Form is designed to help managers provide sufficient

information and specify the type of advice they are seeking when making a referral.

Occupational Health will then;

Review the information provided by the manager.

Elicit further information from the employee

Carry out any appropriate examination’s relevant to the employee’s health problems.

Subject to the employee’s written consent, obtain, if necessary, further medical

information from the employee’s own General Practitioner or Hospital Specialist.

Determine the advice that will be offered to the manager and advise the employee of

this.

Arrange a follow-up appointment if required.

Advice given to the manager will not contain confidential medical detail, but is concerned with

matters of employment and fitness and will contain the following:

Whether or not the employee is suffering from a health problem which will have an

impact upon their fitness to carry out their duties. Where there is no medical evidence

or any medical problem to account for an employee’s absence record, then this will

be clearly stated;

The potential effects of the problem on current and future performance or attendance;

mailto:[email protected]

Managing Absence


Adjustments to the work place or tasks that would assist in maintaining health and

reducing the effects of the health problem on attendance and performance;

The likely duration of any period of absence or, if it is not possible to be precise about

this, the minimum likely period of absence;

Where the employee becomes fit to work, whether it will be on return to full duties or

whether limitations should apply;

If limitations will apply, whether these limitations are likely to be temporary or

permanent;

If an individual will not be fit again for normal duties, the nature of other types of

duties for which they will be fit;

The likelihood of ongoing episodes of sickness absences, whether such episodes

may be of long or short duration and the period of time during which such absences

are likely to occur;

Whether the employee’s health problem may in any way be related to their duties;

Arrangements that have been made for further review of the employee;

Opinion on the implications of the Equality Act;

The potential for an individual to maintain a good attendance record, and if

appropriate, suitability for Ill Health Retirement

If the manager has concerns or questions relating to the advice provided then they should

contact Occupational Health for further clarity.

For General enquiries 08448260306

Needle stick and Contamination Line 08448260308

Email [email protected]

In the event of conflicting medical opinion occupational health will obtain a report from the

medical practitioner and / or seek to obtain their medical file.

mailto:[email protected]

Managing Absence


Medical Suspension

Medical suspension is applied in a situation where a GP would certify a member of staff fit to

work, however the Trust or Occupational Health have deemed them not able to work for a

defined period. This situation would apply primarily because of an infectious condition which

could place patients or other members of staff at risk. This medical suspension should be

recorded on the weekly sickness return as medical suspension, and not as sickness. This

should also be noted on the return to work form as medical suspension.

In every case the manager should discuss with occupational health if temporary redeployment

or different duties could support the employee returning to work sooner, and where possible

should support this.

Managing Absence


Guidance Note H – Case Conferences

Case conferences are an opportunity for all parties to sit down together and discuss the

employee’s absence and look at the process and support needed to either stop the employee

going off sick, or to support the employee in returning to work.

The case conference will comprise of the employee and their representative, the manager,

and an HR Advisor.

During the case conference the latest up to date OH report will be discussed provided the

employee is happy for this to be shared with all parties present. If this is not available the

discussion will centre on the individuals wellbeing, long term prognosis, support and possible

return to work plan.

The case conference will provide a regular setting to assess and monitor employees who are

off sick, and provide an opportunity to determine what action is required.

The case conference is not the forum for formal discussions to take place e.g. placing on the

redeployment register, serving notice etc, however discussion taking place at the case

conference will form the basis of decisions which are made about moving forward.

Managing Absence


Guidance Note I – Hospital Acquired Infection

When suffering from D & V all employees must ensure they wait 48 hours after cessation of

symptoms before returning to work. The 48 hour period after cessation of symptoms will be

classed as medical suspension and will not be monitored as part of the short term absence

process; however it will be recorded on the weekly sickness return as medical suspension.

During the medical suspension period individuals should remain available to work and discuss

with their line manager whether any work can be undertaken from home.

Medical suspension cannot be applied if the individual has not phoned in sick.

During an outbreak on a ward, which results in Ward closure, any period of absence when the

employee has D&V and is unfit to work will not form part of the short term absence process

and relevant monitoring periods, however the absence will be recorded as sickness. This

relates only to those staff who are required to work on a ward during the wards outbreak.

In all other circumstance the period of absence prior to the 48 hour rule will count for targets

and monitoring purposes as set out under this policy. This includes weekends and non

working days.

The definition and criteria from the Management of Hospital Outbreak of Viral Gastroenteritis

policy should be used to decide on what is an outbreak.

Every employee who is off with D&V will be required to complete a return to work interview on

their return.

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