Lothian NHS Board
=
Waverley Gate
2-4 Waterloo Place
Edinburgh
EH1 3EG
=
Telephone: 0131 536 9000
www.nhslothian.scot.nhs.uk
Date:
Our Ref:
24/03/2015
5080
Enquiries to :
Bryony Pillath
Extension:
35676
Direct Line:
0131 465 5676
[email protected]
Dear
FREEDOM OF INFORMATION – STAFF SICKNESS ABSENCE
I write in response to your request for information in relation to staff sickness absence in NHS
Lothian.
I have been provided with information to answer your request by Ms Ruth Kelly, Associate
Director of Human Resources, NHS Lothian.
Questions:
1. Do you have a Sickness Absence Policy?
2. Could you please supply a copy of your policy?
Answer:
NHS Lothian’s sickness absence policy, the Promoting Attendance Policy and
Procedure, is enclosed with this response.
Question:
3. What are your levels of sickness absence for the past 3 years?
Answer:
Sickness absence levels for all NHS Lothian staff are detailed in the table below:
NHS Lothian sickness absence levels for all staff
Year
Absence rate
2012
4.63%
2013
4.65%
2014
4.73%
5080 Staff Sickness Absence March 2015
Question:
4. Does your policy deal with stress and mental health issues?
Answer:
The Promoting Attendance Policy does not specifically deal with stress and mental
health issues, but these are covered in a separate Dealing Positively with Stress Policy
at Work, which I have enclosed.
Questions:
5. Do you hold separate statistics on stress and mental health issues?
6. Can you please advise what those levels are for the past 3 years?
Answer:
NHS Lothian holds some statistics on stress and mental health issues. This information
is collected using national codes and categories for recording absence, which includes
a category combining anxiety, depression and psychiatric illness. We do not collect
data which would determine what proportion of the absences recorded under this
category relate to stress and mental health issues only.
The percentage of hours lost through sickness which are in the category of anxiety,
depression and psychiatric illness is detailed in the table below.
Hours lost through absence due to anxiety, depression and psychiatric illness as
a percentage of total hours lost through staff sickness, NHS Lothian
Year
Percentage hours lost
2012
19%
2013
19%
2014
19%
Questions:
7. Does your policy deal with Work/Life Balance issues?
8. How is this done?
Answer:
NHS Lothian has a separate suite of policies dealing with work life balance, including
policies on flexible working arrangements, carers leave, special leave, maternity leave,
paternity leave and parental leave.
Page 2 of 4
5080 Staff Sickness Absence March 2015
Questions:
9. Do you have occupational health provision for your employees?
10. Please say how this is carried out.
Answer:
All NHS Lothian employees have access to Occupational Health Services either
through a management referral or through self referral. The service includes a staff
counselling service and a staff physiotherapy service.
Questions:
11. Does your policy have triggers to instigate intervention in the sickness absence
levels of your employees?
12. Do these triggers apply equally to disabled and non-disabled people?
13. Do you adjust the triggers to meet reasonable adjustments for disabled people?
14. What adjustments do you offer to meet the needs of disabled people?
Answer:
Yes, the Promoting Attendance Policy uses triggers for absence levels. Review is
required if a member of staff has been off for four or more spells or a single absence of
ten days or more in a twelve month period.
These triggers apply equally to disabled and non-disabled staff, but individual
circumstances will be taken into account when deciding on appropriate action to be
taken and any reasonable adjustments are made at this stage on a case by case basis.
Please see Appendix D of the Promoting Attendance Policy. Advice is also available to
staff from the Occupational Health Service.
I hope the information provided helps with your request.
If you are unhappy with our response to your request, you do have the right to request us to
review it. Your request should be made within 40 working days of receipt of this letter, and we
will reply within 20 working days of receipt. If our decision is unchanged following a review and
you remain dissatisfied with this, you then have the right to make a formal complaint to the
Scottish Information Commissioner.
Page 3 of 4
5080 Staff Sickness Absence March 2015
If you require a review of our decision to be carried out, please write to the FOI Reviewer at
the address at the head of this letter. The review will be undertaken by a Reviewer who was
not involved in the original decision-making process.
FOI responses (subject to redaction of personal information) may appear on NHS Lothian’s
Freedom of Information website at:
http://www.nhslothian.scot.nhs.uk/YourRights/FOI/Pages/default.aspx
Yours sincerely
ALAN BOYTER
Director of Human Resources
and Organisational Development
Cc: Chief Executive
Enc.
Page 4 of 4
EMPLOYMENT
POLICIES AND PROCEDURES
DEALING POSITIVELY
WITH STRESS AT WORK
SEPTEMBER 2007
1. INTRODUCTION
1.1 Definition
1.2 Commitment
2
2
2
2. SCOPE
2
3. POLICY AIMS
3
4. RESPONSIBILITIES
4.1 Senior Managers
4.2 Line Managers
4.3 All Staff
4.4 Human Resources
4.5 Trade Unions/Professional Organisations
4.6 Occupational Health Service
4.6.1 Staff Support and Counselling Service
3
3
4
4
5
5
5
6
5. RISK ASSESSMENT IN THE WORKPLACE
5.1 NHS Lothian Process
5.2 Control Measures
5.3 Risk Assessment Review
5.4 Risk Assessment Process
6
6
7
8
8
6. STRESS AUDIT
8
7. DIAGNOSIS OF WORK RELATED MENTAL ILL HEALTH
8
8. ANNUAL STAFF SUPPORT AND COUNSELLING SERVICE
REPORT
9
9. CRITICAL INCIDENTS
9
10. EDUCATION & TRAINING
9
11. OTHER RELEVANT POLICIES
9
12. MONITORING & REVIEW
10
APPENDIX A:
APPENDIX B:
APPENDIX C:
APPENDIX D:
APPENDIX E:
APPENDIX F:
TEAM RISK ASSESSMENT
(TEMPLATE AND EXAMPLE)
INDIVIDUAL RISK ASSESSMENT
(TEMPLATE AND EXAMPLE)
RISK ASSESSMENT FLOW CHART
RECORDING OF OCCUPATIONAL MENTAL ILL HEALTH
ADDITIONAL INFORMATION AND GUIDANCE
PSYCHOLOGICAL FIRST AID: INFORMATION SHEET
1
1
Introduction
NHS Lothian is committed to promoting a healthy workforce by placing value on both
physical and mental health. It is acknowledged that stress problems have many
causes, including the workplace and the outside world. NHS Lothian recognises that
excessive and sustained pressures at work can have negative effects on staff, and
will encourage and actively promote a supportive environment and working culture
for all employees to help reduce, control and manage stress at work. It is also
recognised that domestic factors (for example housing, family problems and
bereavement) may add to levels of stress experienced by staff.
1.1
Definition
The term “stress” is often misused and misunderstood, and is a complex subject.
For the purposes of this policy, NHS Lothian follows the Health and Safety
Executive’s definition and regards stress as an adverse reaction that people have to
excessive pressures or demands placed upon them, and arises when individuals
believe they are unable to cope. Stress therefore is not an illness or a type of ill
health; it is a cause of illness or ill health.
1.2
Commitment
NHS Lothian is committed to taking steps, as far as is reasonably practicable, to
ensure that an employee’s health is not placed at risk through excessive and
sustained levels of pressure arising from the way work is organised, the way people
deal with each other or the day-to-day demands placed on the workforce. All staff
have a responsibility to contribute to this positive way of working.
NHS Lothian is committed to a proactive plan of action that includes:



2
Being proactive in the prevention of stress by carrying out workplace risk
assessment and putting in place controls and corrective measures as required.
Taking positive action to tackle stress and help all staff to manage and identify
causes and effects of stress by developing appropriate awareness training and
stress management tools.
Ensuring that appropriate measures are taken to manage the return to work of
those who have suffered mental or physical health problems associated with
stress, to make sure their skills are not lost. This will include managing health
problems associated with stress by recognising stress early, managing stress
appropriately, providing access to counselling and providing advice and sources
of help.
Monitoring and reviewing employees’ perception of stress through stress audit
across the organisation.
Scope
This policy applies to all staff employed by NHS Lothian.
3
Policy Aims
This policy aims to maintain and encourage staff well being within NHS Lothian.
Positive action will be taken to discourage the stigma attached to stress and raise
2
awareness of ill health associated with stress, its causes and associated factors:






This involves changing aspects of the workplace/job which have been identified
(through risk assessment) as increasing the stress risk, and enhancing the
factors that reduce the risk of stress.
The proactive identification of the causes of work related stress through the risk
assessment process (see guidance below) must be continuous. It is a legal
requirement to undertake such an assessment under the Management of Health
and Safety at Work Regulations, regulation 3.
It is NHS Lothian’s intention to educate staff in techniques for coping with
pressure and stress, and through information and education encourage everyone
to recognise problems.
Appropriate measures will be put in place to prevent stress arising in the
workplace. NHS Lothian will also provide staff with help if they have mental or
physical health problems associated with stress, including well-publicised
systems of support.
The organisation will encourage staff to get help at an early stage, and offer easy
access to counselling and other professional help and, as far as is reasonably
practicable, assure job security, sick leave and the retention of status and
generally make sure there is no blame attached to those using the support
mechanisms.
As part of dealing with stress positively NHS Lothian has procedures for return to,
and rehabilitation in, work and will make sure that these procedures are flexible
enough to meet varying needs.
Note:


4
NHS Lothian has other policies which may be relevant in particular
circumstances, including Promoting Attendance at Work, Managing Employee
Capability and Dignity at Work; these should be consulted where appropriate in
conjunction with this policy.
Appendix E attached to this policy gives additional information to assist in dealing
positively with stress at work.
Responsibilities
4.1
Senior Managers
It is the responsibility of senior managers to implement processes to proactively
measure and control potential hazards in the workplace associated with stress, and
to make sure that an organisational culture is developed where stress is not seen as
a sign of weakness or incompetence and where seeking help in managing negative
stress is seen as a sign of strength and good practice.
It will be policy to ensure:



advice and information is provided for managers on their duty of care to staff,
suitable training and guidance is provided to equip them to undertake the
necessary risk assessments in relation to stress in the workplace, and effective
control measures are implemented where appropriate;
stress, which is likely to lead to ill health, is eliminated from the work environment
as far as is reasonably practicable;
information is provided for staff on the effects of stress at work and how to
3




recognise the symptoms of negative stress in themselves and others;
positive coping mechanisms and general health improving activities are
promoted within the workplace;
a working environment is promoted where employees who feel they are at risk of
suffering from the negative effects of stress can raise the issue in confidence,
and necessary support mechanisms are put in place;
good practice guidelines based on current evidence and knowledge are
produced and reviewed regularly;
risk assessments are acted on and resources are made available to address the
issues highlighted.
4.2
Line Managers
Line managers also are responsible for assessing proactively and managing
potential hazards in the workplace associated with stress, to make sure that an
organisational culture is developed where stress is not seen as a sign of weakness
or incompetence and where seeking help in managing negative stress is seen as a
sign of strength and good practice.
As part of their responsibility they must also ensure, as far as is reasonably
practicable:







that the work environments for staff are safe and do not expose them to risks that
may give rise to stress at work, by carrying out risk assessments in accordance
with this policy;
a robust recruitment, selection and employment process is in place which
includes the provision of clear and concise job information, job descriptions
(outlining lines of responsibility, accountability and reporting), individual
supervision, ongoing appraisal and development with clear objectives that are
regularly reviewed and monitored;
that all new staff receive appropriate induction to and training for their job,
including reference to support services, for example, OHS, HR and the Staff
Counselling Service;
they consider the implications and impact for staff of any changes to working
practices, ways of working, work location, new policies or procedures and the
need for appropriate support and training. This will also include regularly
reviewing excess hours worked by staff, time back, absence monitoring and staff
turnover, and carrying out exit interviews;
they encourage the involvement of individual staff and staff teams in seeking
solutions, as part of the risk assessment process;
promote openness and discussion and involve others outside the team as
necessary; also make sure that staff teams take time out to review and celebrate
positive achievements and likewise less positive outcomes so that a sense of
balance can be achieved;
practical management of absence in accordance with the policy on Promoting
Attendance at Work, and linking to other policies as necessary such as Dignity at
Work, Managing Employee Capability etc.
4.3
All Staff
All staff have a duty to take care of themselves and others who may be affected by
their acts or omissions at work, including those issues associated with stress.
Where control measures have been provided to reduce work related stress
employees have a duty to use them, and must report any incidents associated with
4
stress. They also have a responsibility for treating colleagues in an appropriate and
respectful manner and to co-operate with their employer in ensuring Dignity at Work.
Staff can resolve issues by talking to their manager if there is a problem, or
accessing areas of support i.e. OHS, HR or their trade union/professional
organisation; also by:
 being actively involved in the risk assessment process, discussing with their
manager how it may be possible to resolve the issues identified, including
altering the job if necessary to make it less stressful, while recognising all team
members’ needs.
 supporting their colleagues if they are experiencing work related stress and
encouraging them to talk to their manager, OHS, HR or trade union/professional
organisation.
4.4
Human Resources
The role of HR is in making sure that organisational policies and codes of working
are compliant with changes in the law and promoting adherence by all staff.
They will also become involved in:
 facilitating discussions within areas of conflict;
 liaising with management to carry out risk assessments, including reviewing
absence figures and linking these with other policies that may be relevant;
 advocating clarity of roles and responsibilities, advising on job descriptions and
organisational structure;
 monitoring trends in conduct (disciplinary and grievance issues), attendance,
turnover etc;
 promoting positive cultural change within the workforce.
4.5
Trade Unions/Professional Organisations
Trade unions/professional organisations are responsible for encouraging members
to speak up as soon as they feel they that their working environment is beginning to
affect their health, and to seek information and advice on coping with work
pressures. This could involve them investigating potential hazards and complaints
from their members, and receiving information they need from the employer to
protect members’ health and safety.
This could also involve encouraging members to keep a written record of any
problems and to put things in writing to management, so that there is evidence of
any problems and that management is aware of them.
4.6
Occupational Health Services
Occupational Health Services play an active part in the prevention, investigation and
diagnosis of work related illness, including that resulting from work related stress.
They have experience and knowledge in the field, providing advice and services to
both management and staff.
Key roles include:
 provision of advice on occupational stresses, the risk assessment process, and
mechanisms of control;
 at the request of management, investigation and evaluation of particular groups
of staff where occupational stresses may be an issue, including use of interviews,
focus groups and small stress audits;
 management referral, providing advice on the formal diagnosis of illnesses
5



related to work related stress, management of affected staff, further control
measures in the workplace and requirements for a return to work;
health input into the education and training programme;
monitoring work related illness in terms of sickness absence and
self/management referral numbers;
by management or self-referral providing support for staff experiencing the
negative effects of stress.
4.6.1 The Staff Support & Counselling Service
The Staff Support and Counselling Service is an independent part of the
Occupational Health Service. Experienced counsellors provide counselling to staff
who self refer with a wide range of problems, including stress, in a safe confidential
environment. Counsellors have a responsibility to support and assist employees in
managing their experiences of stress and to work with individuals towards
implementing effective strategies to maintain emotional/mental health by:




offering an opportunity to talk in confidence about any problem, whether work
related or not;
offering support to help people gain insight into their difficulties and enabling
them to be more effective in dealing with their situation;
helping individuals to identify, think through and resolve current difficulties;
assisting individuals to develop strategies that will help them to deal with future
difficulties.
The service is for all NHS Lothian staff who wish to self refer. Management referral is
not an option, but managers may feel it is appropriate to inform/remind staff that the
service is available. If staff do self refer, no information will be sent to line
management.
5.0 Risk Assessment In the Workplace
Stress is recognised as a significant workplace hazard, resulting in mental and
physical ill health. As such there is a statutory requirement to undertake workplace
risk assessment, and where appropriate instigate effective control measures.
Managers and staff must comply with the risk assessment processes documented in
this section.
In common with a number of workplace hazards such as noise or ionising radiations,
there is significant variation in an individual’s ability to cope with work pressure and
hence their susceptibility to work related stresses. In addition, an individual’s
susceptibility may vary with time, particularly in relation to the amount of non-work
related pressures they are encountering. This situation determines that risk
assessment for work related stress and mental ill health should have components
which are both individual and continuous. In addition, staff operate within teams,
with common goals and common pressures. Risk assessment therefore requires
consideration of the team as a whole as well as the effect on the individual.
Risk assessment for work related stress must therefore form an important part of a
manager’s regular discussion with the team as well as an integral part of regular
performance review of individual team members.
5.1
The NHS Lothian Process
The Health and Safety Executive (HSE) commissioned research which identifies 6
major areas in the workplace associated with pressure and stress. These are
6
Demands, Control, Support, Relationships, Role and Change. The risk assessment
process used in NHS Lothian is based on this data, and divides workplace pressures
and stresses into three general categories:
 stressful exposures (such as noise, violence and aggression, fear of violence and
aggression, poor lighting etc);
 capability constraints (i.e. time, staffing, qualifications, work pattern);
 relationships at work (individuals, groups, management, patients, customers).
In addition, it is recognised that other aspects not fundamentally related to the work
itself can place pressures on staff i.e. changes, perceived job insecurity, disciplinary
considerations etc.
Within the context of normal team management, and team meetings, a team
summary of the important stresses must be documented at least annually. The
format for this documentation, including a worked example, is at Appendix A. Based
on this team consideration, the need for team based control measures must be
identified, documented and implemented.
Additionally, personal development planning for the individual staff member must
include a review of this team based work related hazard identification. At this
review, the need for individual based control measures should be considered and
documented. The format for this documentation, including an example, is at
Appendix B.
When deemed appropriate by the team or requested by the individual, a review of
the current risk assessment must take place.
5.2
Control Measures
Control measures can be considered in relation to the grouping of stresses identified
earlier:
Stress from exposure

Risk assessment and control of the exposure itself

Individual training on the nature of the hazard and control of the causes of the
stressful exposure

Provision of appropriate personal protective equipment
Balance of capability and expectation

Individual training to enhance capability

Measures to enhance team capability

Adequate staffing

Effective performance review and personal development review
Relationships at work

Effective communications

Teamwork and team solutions

Open systems and airing problems
Others

Communication regarding changes

Implementation and monitoring of appropriate policies and procedures

Regular contact between manager and staff, at both individual and team
7
level, is in itself an effective control measure for work related stress.
The risk assessment process will in some cases identify the need for control
measures with financial implications in terms of training, staffing, protection etc.
In addition to the control measures aimed at eliminating the hazard or reducing risk,
measures can be introduced to reduce the effect. These include stress awareness
training, stress management and time management training, and individual services
such as counselling and Occupational Health involvement. Details of these are
recorded in the other sections of this policy.
Where risk assessment indicates the potential for significant team based problems
the manager may seek assistance from Human Resources and Occupational
Health; specific stress audit and stress support may be indicated.
5.3
Risk Assessment Review
The team-based documentation (Appendix A) should be reviewed at least annually.
The individual assessment (Appendix B) should be reviewed:
 at each performance review/appraisal;
 at the request of the individual (management style and systems should
encourage the airing of problems);
 when management consider it necessary, for example change of work or
responsibility, considerations of performance.
In considering situations of uncertainty, change, discipline and grievance issues, the
management responsibility is not to ensure that these situations do not occur, but
that the systems in place function well enough to ensure that the processes
themselves do not add to the pressures felt by those involved; additionally, that the
system provides the individuals with the information they need.
5.4
Risk Assessment Process
A flowchart summarising the risk assessment process can be found in Appendix C.
6
Stress Audit
Stress audit provides a valuable tool to identify staff perceptions of organisational
structure, culture and work pressures. As such it is separate from the risk
assessment process outlined above. There are a number of tools available for this
purpose, including one issued by the HSE.
NHS Lothian obtains stress audit data on the organisation as a whole from the
regular NHS Scotland Staff Survey. Audit of small groups and teams may be
instigated following discussions in partnership, including the OHS, where specific
issues have been suggested or in relation to the introduction of new processes.
7 Diagnosis of Work Related Mental Ill Health
Where staff members attend Occupational Health by either management or self
referral with a perceived stress condition, a key function of the assessment is the
identification of whether the staff member suffers from an illness which is related to
their work. This situation applies in relation to stress through considering work
related mental ill health. For information, the principles of the system operated by
NHS Lothian in this regard are at Appendix D, which outlines the prognosis and
8
recording of occupational mental ill health.
8 Annual Staff Support and Counselling Service Report
In addition to risk assessment, audit and numbers of cases of occupational ill health,
the annual Staff Support and Counselling Service Report provides data on the
perceptions of clients on the relevance of both home and work-related pressures in
relation to their problems.
9 Critical Incidents
Some events in the workplace have the potential to raise psychological issues for
staff. Some of these may trigger contact with the Staff Support and Counselling
Service. In order to be of maximum help to their staff, managers should make use of
the guidance in Appendix F.
10 Education and Training
To deal positively with stress in the workplace, NHS Lothian recognises the
importance of:



the link between home and the workplace;
identifying particularly vulnerable groups, and;
the effects of prescribed medication on work performance.
These key points will be highlighted in general health education and induction
programmes.
It is also important that specific management training (i.e. stress recognition and risk
assessment), and awareness training for employees are developed in line with this
policy.
Currently available to all NHS Lothian employees is a two-day Stress Resolution
Programme, which is run on a regular basis:




The programme will help identify what contributes to people’s stress on an
organisational and personal level.
It will explore the sources of stress and an individual's emotional and physical
responses to stressors.
The programme will be delivered in small groups, providing a safe and
confidential space with time to explore the issues of stress and how this impacts
on daily life.
The programme aims to help individuals identify ways and strategies to manage
stress.
For further information, contact the Workforce and Organisational Development
Department.
11 Other Relevant Policies
NHS Lothian has in place a number of other policies which complement and support
this policy, including the various Work-Life Balance Policies. Also of particular
relevance is the Policy on Managing Employee Capability, which should be read in
conjunction with this policy wherever there are issues in relation to individual
performance.
9
12 Monitoring and Review
Risk assessments should be reviewed in light of any changes to work activities.
Regular evaluation of staff turnover, sickness absence and stress related incidents
identified from the application of other NHS Lothian policies and accidents will
contribute to the monitoring and reviewing of the policy.
The effectiveness of the overall policy will be reviewed after a period of two years by
the Lothian Partnership Forum.
10
APPENDIX A
TEAM RISK ASSESSMENT
Sources of Stress at Work – Work related stress hazard identification form
(Used as part of ongoing team meetings and discussions to identify/recognise areas
of potential stress in the workplace.)
LOCATION
DEPT
MANAGER
TEAM
ROLE/OPERATION/ACTIVITY
EXPOSURES (Workplace exposures recognised as a potential stressor)
Controls required
1
2
3
4
5
6
CAPABILITY CONSTRAINTS (List constraints of time, staffing, qualification, work pattern)
11
2 (continued)
KEY RELATIONSHIPS (List/identify key groups within or outwith the team which team
members must relate to at work)
Example:
Controls required
1 HR Team
2 General Managers
3 Groups of Staff/Employees
4 Staff Representatives
(Team to identify issues or stressors they think
may be present in relation to contacts they
have outwith their own teams.
Individuals’ issues and control mechanisms
will be discussed on a one to one basis using
Appendix B.)
5 External Contacts
Others
1
2
3
4
5
6
Assessment based on team input
Signed
………………………………………………………………………..
(Manager)
Designation ………………………………………………………………..
Date …………………..
N.B Team risk assessment when used as part of ongoing regular team discussions may
produce general team concerns.
Individual concerns identified as part of this process will be detailed and progressed
using Appendix B.
12
APPENDIX A
EXAMPLE
TEAM RISK ASSESSMENT
Sources of Stress at Work – Work related stress hazard identification form
(Used as part of ongoing team meetings and discussions to identify/recognise areas
of potential stress in the workplace.)
NHS Lothian
LOCATION
Jane Smith
DEPT
MANAGER
TEAM
ROLE/OPERATION/ACTIVITY
Lift from role of department in job description.
EXPOSURES (Workplace exposures recognised as a potential stressor)
Controls required
1. Lack of admin support due to staff Review admin tasks and prioritise essential
vacancies / sickness
tasks.
Utilise Promoting Attendance policy.
2. Managing difficult people /aggression
Complete Violence and Aggression risk
assessment / provide relevant training to staff
4. Policies / decisions outwith our control
Provide as much information as possible to
e.g deadlines on Agenda for Change/ staff e.g Agenda for Change updates, Lothian
uncertainty re pay / review process
Report. Discuss concerns with staff.
7. Inter-agency working
Need to review models of good practice.
Continue to develop relationships with
Edinburgh Council.
CAPABILITY CONSTRAINTS (List constraints of time, staffing, qualification, work pattern)
Lack of clarity over postgraduate qualifications required for the posts.
Action: Complete KSF post outlines
Staff doing A & C tasks due to staffing constraints.
Action: Repeat unique review
13
2 (continued)
KEY RELATIONSHIPS (List/identify key groups within or outwith the team which team
members must relate to at work)
Controls required
1. Staff within the immediate department
Communicate with mutual respect and
understanding. Possibly develop a team
contract.
2. Staff within the extended department
Foster relationships. Develop lines of
communication / procedures for referral.
3. Managers
Use the phone rather than email on individual
issues.
4. All staff
Utilise influencing and coaching skills. Provide
training in this if required.
Others
1
2
3
4
5
6
Assessment based on team input
The team managed to identify stressors and potential controls well through discussion and
negotiation.
Signed
………………………………………………………………………..
(Manager)
Designation ………………………………………………………………..
Date …………………..
N.B Team risk assessment when used as part of ongoing regular team discussions may
produce general team concerns.
Individual concerns identified as part of this process will be detailed and progressed
using Appendix B.
14
APPENDIX B
INDIVIDUAL RISK ASSESSMENT
Sources of Stress at Work – Work related stress hazard identification form
(Used as part of employee’s ongoing KSF/Performance Review based on Team
Risk Assessment dated: ……………...)
LOCATION
DEPT
MANAGER
NAME
ROLE/OPERATION/ACTIVITY
EXPOSURES (Workplace exposures recognised as a potential stressor)
Individual control measures
CAPABILITY CONSTRAINTS (List constraints of time, staffing, qualification, work pattern)
Individual control measures
15
2 (continued)
KEY RELATIONSHIPS (List key groups within or outwith the team which team members
must relate to at work; starting point is team risk assessment – see Appendix A.)
Individual stressor control measures
1
Others
2
3
4
5
6
Signed: ……………………………………………
Team Member
Date: …………………..
16
APPENDIX B
EXAMPLE
INDIVIDUAL RISK ASSESSMENT
Sources of Stress at Work – Work related stress hazard identification form
(Used as part of employee’s ongoing KSF/Performance Review based on Team
Risk Assessment dated: ……………...)
LOCATION
NHS
Lothian
DEPT
MANAGER
NAME
ROLE/OPERATION/ACTIVITY
EXPOSURES (Workplace exposures recognised as a potential stressor)
Individual control measures
1. Lack of admin support due to staff Review admin tasks and prioritise and
vacancies.
undertake essential tasks only until situation
resolved.
2. Managing difficult people/aggression Attend Violence and Aggression training.
Regularly discuss how to manage difficult
people with line manager.
CAPABILITY CONSTRAINTS (List constraints of time, staffing, qualification, work pattern)
Individual control measures
Required to undertake A & C tasks Prioritise admin tasks and professional tasks.
therefore less time to do professional tasks Discuss this prioritisation with line manager
regularly.
17
2 (continued)
KEY RELATIONSHIPS (List key groups within or outwith the team which team members
must relate to at work; starting point is team risk assessment – see Appendix A.)
Individual stressor control measures
Managers
1
If there is lack of clarity or concern in relation
to tone of an email, phone the staff member
concerned
Others
2
3
4
5
6
Signed: ……………………………………………
Team Member
Date: …………………..
18
APPENDIX C
RISK ASSESSMENT PROCESS
Annual Team Risk Assessment
Annual Individual Risk Assessment/PDP
Stress Hazards Identified
Reduce the Effect
Training and/or
Counselling
Control Measures Identified –
seek advice as necessary
Implement Control Measures.
Monitor and Review
No Stress
Identified
No Stress
Identified
No Action
Stress Identified
Further Support
Guidance
and
This process should be repeated as appropriate, for example on specific request or
when there is organisational change.
19
–
APPENDIX D
Recording of Occupational Mental Ill Health
NHS Lothian requires to gather Health and Safety data on the number of staff
suffering work related mental ill health and the resultant sickness absence. This
requirement defines the need for a standard recording and diagnostic system.
Diagnostic system
The diagnostic system used for all occupational ill health recording in NHS Lothian is
as follows:
1 The responsibility for diagnosis rests with the Occupational Health professional
to whom the individual has been referred. The process may involve seeking
reports, clinical examination and investigations. When a decision is reached as
to whether the condition is considered related to work or not, in all cases the
individual is informed of this conclusion.
2 It is not considered possible to diagnose occupational illness in a clinic without
consideration of the workplace itself. Diagnosis therefore requires direct contact
with line management, seeking of reports, and where appropriate investigation.
Contact with management involving direct considerations of a clinical case may
only proceed where the staff member’s consent has been obtained. In
circumstances where the diagnosis of occupational causation cannot be
confirmed without managerial contact and the patient withholds consent, the
case is categorised as not confirmed.
Basic principles for occupational mental ill health reporting
1 Only cases where in the view of the Occupational Health professional work or
workplace considerations are the predominant factor in inducing mental ill health
will be recorded. A crucial test will be whether it is considered that in the
absence of the occupational incident or exposure there would have been a
significant difference in the individual’s underlying mental health.
2 Occupational stress is regarded as a physiological process or response, rather
than a diagnosis of ill health itself. Individuals will only be recorded on the
system where occupational factors have resulted in significant ill health
recognised by national or international systems of disease classification.
3 It is important to include some estimate of the causative factors of work
responsible for the mental ill health. Without such data appropriate corrective
action and learning from experience cannot occur.
4 There are work related factors such as job uncertainty, termination of
employment and the operation of disciplinary procedures which, even when
handled appropriately by management, may nevertheless result in stress and in
turn mental ill health. It is not considered that these events are preventable
under the legal obligation placed on management by the Heath and Safety at
Work Act and as such they will not be recognised within this system as
occupational mental ill health. The system will however record incidences of this
type separately under a category of non-occupational workplace mental ill health.
20
Categories of occupational mental ill health reporting
Category M1
Significant occupational mental ill health related to specific workplace
exposures ie toxic chemical, risk of violence and aggression, noise etc.
Category M2
Significant occupational mental ill health related to the imbalance of capability
and work load/work contact ie work overload, work underload etc.
Category M3
Significant occupational mental ill health related to interpersonal or interorganisational relationships at work ie bullying, managerial style, workforce
attitude, lack of autonomy, relations with colleagues.
In addition to the three categories of occupational mental ill health data will
also be recorded on the incidence of the following category:
Category M0
Significant mental ill health related to workplace factors, but not in relation to
the duties of the employer under the Health and Safety at Work Act, ie job
uncertainty, termination of employment, operation of disciplinary procedures.
(Note – the existence of disciplinary case or job uncertainty etc does not in
itself determine the categorisation of any mental ill health as M0. Against a
backdrop of M0 issues, significant mental ill health can occur related to M1,
M2 or M3 and would be categorised accordingly.)
21
ADDITIONAL INFORMATION AND GUIDANCE
APPENDIX E
1
STRESS RECOGNITION
Managers and supervisors will be trained to understand the causes of stress and to
recognise the signs and symptoms of stress in the people working for them.
Managers should, more importantly, be aware of stress within themselves and the
impact this can have on others. Individuals will also be trained to recognise the
signs of stress within themselves.
Daily contact with employees by managers and supervisors will enable recognition
of stress-related symptoms.
As part of part NHS Lothian's Policy on Promoting Attendance at Work, where it is
suspected that stress may be the cause, it should be fully investigated and the
causes, where reasonably practicable should be eliminated. Managers should also
plan an individual’s return to work after a stress-related illness to ensure ongoing
support is provided.
2
WORK RELATED STRESS FACTORS
There are many factors in the workplace that can cause an increase in pressure,
which can result in stress and mental ill health. It is convenient to divide these into
three groups.
(i) Stressful exposures
There are a number of workplace hazards, for which you will already have risk
assessments, which can result in pressure and stress on staff. These include:
i)
ii)
iii)
iv)
threat of violence and/or aggression
noise
fear of chemical exposure
lack of work space
(ii) Imbalance between capability and expectation
Imbalance between an individual’s capability and workload is a common cause of
pressure and stress in a number of situations:
i)
ii)
iii)
iv)
work overload
work underload
work beyond an individual’s knowledge or skills
work much below an individual’s knowledge or skills
(iii)Relationships at work
Interpersonal relationships in the workplace can also result in pressure and stress on
individual or groups of staff, for example:
i)
ii)
iii)
iv)
tension and conflict between colleagues
poor relationships with clients/patients
management style
bullying and harassment
22
The important elements of the team member’s activity should be documented using
the work related stress hazard identification form. The form should be completed
based on discussions of the team and the individual’s role and work.
3 SIGNS & CAUSES OF STRESS
(i) Signs that may indicate a stress problem may include:
Work Performance: a reduction in output or quality; increased wastage or mistakes;
accidents; poor decision making.
Employee Attitude and Behaviour: loss of motivation; working longer hours for
diminishing return; not taking annual holidays; reluctance to let go; erratic
timekeeping.
Sickness Absence: increase in overall absence; frequent short absences.
Relationships at Work: tension and conflict between colleagues; poor relationship
with customers and/or clients; increased disciplinary problems; lack of
communication; mood swings.
(ii) Stress can be due to one or more of the following causes:
Work Environment: excessive heat; noise; humidity; vibration; hazardous
substances; overcrowding; unsuitable work equipment or furniture; inadequate
welfare facilities (toilets, rest areas, etc); new technology.
The Job: excessive or insufficient workload; unrealistic deadlines and targets; lack of
direction, goals or objectives; inadequate or too much supervision; job isolation;
pace and flow of work; boring or repetitive work; excessive or lack of skills and/or
aptitude; and under-utilisation of skills.
Contractual Problems: unsociable hours, shift work; insecurity (reorganisation,
redundancy, temporary contracts); and low pay.
Relationships: lack of communication; lack of leadership; lack of support; exclusion;
bullying; sexual and racial harassment.
The above causes of stress are only examples and the list is not exhaustive. It
should also be noted that each case should be considered individually, as what
would cause one person stress may be acceptable to another.
4
PHYSICAL SYMPTOMS
Personal signs and symptoms: If excessive pressure has led or is leading to stress
and this becomes prolonged, it is likely that there could be an increase in the
following: back pain, increase in alcohol intake, increased smoking, drug taking,
irritability, lack of concentration, stammering, headaches, visual problems, muscular
pains, tiredness, disturbed sleep patterns, insomnia, shortened temper, change in
appetite or loss of self esteem.
23
5
LIFESTYLE
Some of the following lifestyle factors may indicate that there is a potential problem:
 eating on the run and constantly rushing, hurrying.
 being available to everyone,
 doing several jobs at once
 taking work home with you
 having no time for exercise or relaxation.
6
STEPS TO REDUCE STRESS
Steps that management can take may include:
Reduce/Increase Workload: a temporary reallocation of work or consideration of
work methods to enhance productivity may make a workload more manageable or
reasonable.
Alternative Work: where the nature of the work is the source of stress, the employee
or the manager may consider voluntary transfer to another job or section.
Reduced Hours: fewer or changed hours may reduce the pressure at home or at
work. If hours worked are excessive, or breaks or holidays are regularly not taken,
this must be tackled by reviewing the workload.
Job Redesign: if the balance of tasks within a job is problematic, consider changing
it through planning, rotation, automation or different work distribution within a
section.
Increased Supervision: if particular aspects of the work are the source of the
problem, increased involvement and support from the supervisor may alleviate some
of the concerns.
Management Style: if the style or mode of supervision is the source of pressure then
consider changing or adopting a different management or supervisory style, where
appropriate.
Management should ensure that work aims, objectives, targets and priorities are
known and clearly understood by all employees when implementing any of the
above measures.
7
AREAS OF SUPPORT AVAILABLE
The following support should be considered:
Management Support: a supportive environment in which employees can approach
their line manager should be provided. The acceptance and recognition of stress as
a genuine problem that requires management support and action is encouraged.
Managers should tackle signs of stress both proactively and reactively. Managers
should however be aware of their own limitations in counselling staff with problems.
Employee Approach: employees are encouraged to be open and speak to their
manager if they are experiencing problems or are aware of a situation that may lead
24
to a stress problem, on either an individual or a group basis. Employees may also
approach their trade union representative or seek confidential support from the Staff
Support & Counselling Service.
Employees who feel the problem is not being adequately addressed by their
manager, or who feel that they are unable to discuss the situation openly with their
manager, may contact any other of the sources of support mentioned for advice.
The Staff Support & Counselling Service: access to a qualified counsellor at no
charge, with time off work with pay, if necessary, is currently available.
Development & Training: ensure the identification and meeting of training needs,
particularly where an employee moves to a new or changed role.
Training to enable managers and individuals to recognise and manage stress will be
available through management development programmes.
Confidential Contacts: Under NHS Lothian’s Policies on Dignity at Work, Equal
Opportunities and Race Equality, the organisation has identified and trained a
number of individuals who can be contacted by employees who feel they may have
been subject to bullying, harassment or discrimination in order to discuss their
situation and to seek support in making a decision about how they wish the matter to
be dealt with.
The Confidential Contact has no formal role within the Dealing Positively with Stress
at Work procedures and is not expected or trained to fulfil a professional counselling
role.
It is important to understand that the Confidential Contact is only there to support the
individual in making the decision about the way forward – not to make the decision
for them.
Occupational Health: advice is available from the Occupational Health Service for
staff with health problems that either affect their work or are affected by their work.
In the event that an employee is absent with work-related stress, then they should be
referred to the Occupational Health Service, following a meeting with management,
at the earliest opportunity. Any such referral should clearly be seen as supportive.
Further discussions should occur on receipt of the Occupational Health Service's
report and any recommendations/actions discussed openly between management
and the individual.
25
APPENDIX F
Psychological First Aid
Information for Managers
Introduction
Working in the NHS can involve staff facing a range of challenges and unpredictable
situations. Such events can be difficult for the individuals directly involved, their
colleagues and managers. This information sheet aims to give guidance for the
support and management of the staff affected.
Definition of a Critical Incident
Formal Definition: Person exposed to event in which:- they experienced, witnessed or were confronted with an event, or events, that
involved actual or threatened death, or serious injury, or a threat to the physical
integrity of self or others,
AND
- the person’s response involved intense fear, helplessness or horror.
In more general terms a critical incident within our work context could involve a
serious assault, suicide, life threatening accident, perceived threat or other traumatic
event.
Management Response
It is important that all staff who have had ANY involvement in, or exposure to, a
traumatic event have the opportunity to be supported.
Individual reactions to such event can vary enormously, as will individual support
networks and attitudes towards asking for help. Therefore, it is a manager’s
responsibility to check with all concerned as to how they are coping.
Research informs us that the acknowledgement of a traumatic event by managers
and early informal support has a major impact on long term recovery. It is also
important that staff are aware of the range of normal responses to an abnormal
event. See the separate information leaflet, Critical Incident Protocol: Information for
Staff, available from the OHS and HR Departments.
Suggested below is a process for supporting staff in the immediate aftermath of a
critical incident
* Incident *
1. Identify who is on shift – make a list of all personnel, any of whom may be
affected by the incident.
2. Prioritise from the list key individuals involved in the situation; this should
include immediate witnesses to the event, but may include others e.g.
telephonist.
3. Make time to check with individuals to find out how they are feeling. This
26
needs to happen as soon as possible after the event in order to reassure staff
with regards to their safety and any practical help that can be offered. In
some situations this may involve staff going home or some time out. Being
offered the support is often more helpful than anything else.
4. Listen to staff concerns and allow them to express their feelings.
5. Ensure that all staff are aware of typical reactions to trauma so that feelings
are normalised and people reassured; offer the information leaflet to take
home and share with others in a support network.
6. Arrange to check in with staff 2-3 weeks after the event to give recognition to
what has happened and facilitate the ‘moving on’.
7. Encourage informal support within the group affected, even where there may
be confidentiality boundaries. It is very important for staff to know they can,
and may need, to talk about their feelings.
8. Ask Occupational Health for advice or support at any stage in the process if
required, and ensure information on the Counselling and Support Service is
available to all.
9. When giving information about Occupational Health and the Counselling
Service please ensure the incident is reported to these services in order that
appropriate response and support can be offered.
10. Continue to provide any appropriate information regarding the event so that
staff have answers to likely concerns regarding the outcome or consequences
of the event.
11. If formal proceedings or investigations are implemented, managers should
keep relevant staff informed as much as possible – particularly if staff are
suspended or under investigation.
Occupational Health Enquiries: 0131 537 (4)9364
Staff Counselling Service: 0131 537 (4)9373
27
EMPLOYMENT
POLICIES AND PROCEDURES
PROMOTING ATTENDANCE
POLICY AND PROCEDURE
Technical Update
FEBRUARY 2012
Unique ID:PA
Category/Level/Type: Final
Status: Revised
Date of Authorisation: February 2011
Date added to intranet: March 2012
Key Words: Promoting Attendance. Absence
Author: HR Policy Group
Version: 4.0
Authorised by: Lothian Partnership Forum
Review Date: January 2014
Comments:
1
CONTENTS
1
INTRODUCTION
1.1 Principles & Values
1.2 Scope
1.3 Aims
3
3
3
3
2
TYPES OF ABSENCE
2.1 Short Term Sickness Absence
2.2 Long Term Sickness Absence
2.3 Unauthorised Absence
2.4 Medical and Maternity Suspension
2.5 Other Absences
3
3
3
4
4
4
3
NOTIFICATION AND EVIDENCE OF ABSENCE
3.1 Notification Requirements
3.2 Evidence Requirements
3.3 Statement of Fitness to Work – ‘Fit Notes’
4
4
5
5
4
ABSENCE MANAGEMENT PROCEDURE
4.1 Health Assessment during the Recruitment and Selection Procedure
4.2 Procedure for the Management of Absence
4.3 Maintaining Contact
4.4 Annual Leave During Sick Leave
5
5
6
7
8
5
OCCUPATIONAL HEALTH SERVICE
5.1 Referral to the Occupational Health Service
5.2 Self-Referral to the Occupational Health Service
5.3 Outcomes from an Occupational Health Service Referral
8
8
9
9
6
REHABILITATION AND SUPPORT TO REMAIN AT OUR RETURN TO WORK
6.1 Phased Return to Work
6.2 Rehabilitation Return
6.3 Temporary Modification/Placement
6.4 Unsuccessful Rehabilitation
6.5 Permanent Incapacity in Current Post
6.6 Ill Health Termination
6.7 Terminal Illness
10
10
11
11
12
12
12
13
7
ILLNESS OR INJURY AT WORK
13
8
RECORDING AND MEASURING ABSENCE
13
9
MONITORING AND REVIEW
14
APPENDIX A Guidance on Return to Work Discussions
15
APPENDIX B Record of Return to Work Discussion
16
APPENDIX C NHS Lothian OHS Management Referral form and Employee
Consent form
18
APPENDIX D Guidance on the Disability Discrimination Act 1995
21
APPENDIX E Guidance on Rehabilitation Programmes
22
APPENDIX F Incapacity Dismissal Procedure
24
APPENDIX G NHS Injury Benefits Scheme
26
APPENDIX H Bank Shifts/Additional hours scheduled during or immediately after
an episode of sickness
27
APPENDIX I Good Practice Guidance Management Tool – Traffic Light System
For Managing Attendance at Work
29
2
1.0
INTRODUCTION
1.1
Policy Principles and Values
NHS Lothian aims to adopt a positive approach to the management of sickness absence. A
key principle of this approach is the commitment to fair and consistent treatment of all staff
who are absent from work on the grounds of ill health, combined with a recognition that
each case must be dealt with individually, taking account of the person concerned and the
nature of the illness.
This policy supports an employee’s right to self-refer to the Occupational Health Service.
1.2
Scope
This policy and its procedure applies to all NHS Lothian employees.
1.3
Aims
The primary aim of this policy is to ensure that managers throughout NHS Lothian adopt a
fair, consistent and supportive approach to staff with health problems. To maintain a
consistent and fair approach all managers and supervisors with responsibility for absence
management will receive training on the effective application of this policy.
This policy also aims to:

provide a healthy and safe workplace;

ensure effective monitoring and a reduction in the sickness absence rate across NHS
Lothian;

facilitate workplace rehabilitation actions to allow timeous return to work;

resolve long term absence through the most appropriate means available;

promote joint training for trade union / professional organisation representatives and
managers to ensure consistency of approach;

effectively communicate the aims, procedures and potential outcomes of this policy
through involvement and communication with employees.
2
TYPES OF ABSENCE
Sickness absence occurs where an employee is unwell and unable to attend work through
illness, disability or injury. This absence may be self-certificated or medically certificated
(see Section 3 of this policy) and may be categorised as short term or long-term sickness
absence.
2.1
Short Term Sickness Absence
Short term sickness absence is defined as any period of absence of less than 4 weeks in
length.
2.2
Long Term Sickness Absence
Long term sickness absence is defined as absence of more than 4 weeks in length which is
subject to medical certification and which may or may not have a specified end date.
3
2.3
Unauthorised Absence
When an employee fails to follow notification procedures absence is regarded as
unauthorised and will normally lead to a loss of pay and referral to the NHS Lothian
Management of Employee Conduct: Disciplinary Policy and Procedure.
2.4
Medical & Maternity Suspension
NHS Lothian has a duty to take all reasonable steps to ensure the health and safety of its
staff. Staff can therefore be suspended from work if it is believed that an employee may be
at particular risk or may be a risk to others. For example, you may be suspended if you
become seriously allergic to a chemical at work, or if you are a newly expectant mother
working in a lab that uses radiation. Any decision to suspend should be based on a risk
assessment.
A decision may be made to medically suspend an individual if there is a concern that the
employee’s fitness to practise is impaired due to either physical or mental health issues. As
before, any decision should be based on a risk assessment.
Where it is identified that suspension from duty is appropriate this will be enforced pending
a formal medical opinion obtained from the Occupational Health Department. Where
possible an ER Manager should be consulted before enforcing such a suspension on full
pay.
2.5
Other Absences
It is recognised that some absences that are classified as sickness are in fact some other
form of absence, for example medical suspension or a period when an employee is
prevented from coming to work due to infection control. Absences of this kind should not be
classified, treated or recorded as sickness absence. Further guidance on classification of
absences can be found in Appendix A of NHS Lothian’s Absence Recording Policy.
3
NOTIFICATION AND EVIDENCE OF ABSENCE
As a first stage in the management of absence it is essential that every employee, from the
date of appointment, is aware of their local departmental procedure for notifying and
providing evidence of their absence. Evidence of absence should be provided where
required (see below), without gaps, and the manager must ensure that all dates and
personal information are accurate. Employees should also be made aware of the
consequences of failure to comply with the procedure.
In some circumstances such as planned and elective treatments, the employee will be
aware well in advance that the absence will occur. In these circumstances, the employee
should give management as much notice as possible of likely future absence.
3.1
Notification Requirements
On the first day of absence the employee will notify his/her absence in accordance with
departmental policy. This notification must be made by telephone to the identified
manager/supervisor in line with departmental policy.
The manager/supervisor will clarify with the employee, or, in exceptional circumstances, the
person phoning on behalf of the employee, the nature of the absence and an indication of
the likely duration. If there is any subsequent change in the likely duration of the absence,
the appropriate manager/supervisor must be notified as soon as possible.
In all cases of absence, the manager should be notified, wherever practicable, of the date of
return no later than the day prior to commencement of the employee’s first shift after
returning from absence.
4
3.2
Evidence Requirements
3.2.1
Absence of 1 to 3 calendar days (inclusive of non-working days)
The employee will be required to notify the absence in accordance with the rules for
notification, but need not submit a written self-certificate.
3.2.2
Absence of 4 to 7 calendar days
The employee will be required to submit a self-certificate of absence (Form SC2) within 8
calendar days of the first day of absence. SC2 forms may be obtained from the line
manager, the Employee Relations (ER) Department, GP practices or the local office of HM
Customs and Revenue. The form may also be downloaded from the Customs and Revenue
website, www.hmrc.gov.uk.
3.2.3
Absence of 8 calendar days or longer
The employee will be required to submit a fit note to the manager/supervisor for all periods
of absence exceeding 7 days. If the absence continues beyond the period covered by the
first fit note, further fit notes must be submitted timeously to cover the full period of absence.
If there are delays in obtaining a GP appointment, the member of staff should phone in to
advise of the situation, and ensure the fit note is sent in as soon as possible thereafter to
ensure continuity of pay.
NB: Altered, defaced or photocopied fit notes will not be accepted. Alteration of a fit note in
any way will also lead to investigation under the Management of Employee Conduct Policy
and may lead to dismissal.
3.3
Statement of Fitness to Work – ‘Fit Notes’
The fit note will advise the employer if the employee is unfit for work or alternatively if they
may be fit for work subject to support. Where it is confirmed that an employee may be fit for
work, however they have not yet been referred through the NHS Lothian Occupational
Health Service, managers may use their discretion to implement GP recommendations eg
phased return to work. Occupational Health advice may be sought for more complex cases.
Further information on the Statement of Fitness for Work ‘Fit Note’ is available on line at:
http://www.dwp.gov.uk/fitnote/
4
ABSENCE MANAGEMENT PROCEDURE
4.1
Health Assessment During the Recruitment and Selection Procedure
The management and control of absence should begin during the recruitment and selection
process. However, in line with the Equality Act 2010, it is important that no questions
regarding a candidate’s health or absence record are asked prior to an offer of employment
being made.
Confidential pre-employment health assessments must be undertaken by the Occupational
Health Service to ensure that all potential new employees are fit to undertake the duties of
the post. Confirmation that the Occupational Health Service has undertaken a health
assessment and a satisfactory outcome has been notified must be obtained before any
conditional offer of employment is confirmed. Where an offer of employment is the result of
redeployment on health grounds, the role of the Occupational Health Service will be to
confirm the alternative post as suitable.
Where a potential new employee is deemed to have a disability in terms of Disability
Discrimination legislation within the Equality Act 2010 – and in any other cases where the
Occupational Health Service so advises - consideration will be given to the feasibility of
reasonable adjustments to the post or the workplace; see also Appendix D.
5
During the departmental induction process all new employees should be advised of local
rules covering notification and evidence of absence. The following points should be
stressed:



4.2
the importance of adhering to timescales for notification;
that rules for notification of absence apply equally to absence spanning periods of
rostered days off and occurring during periods of annual leave or public holidays;
the procedure for notifying return to work from a period of absence.
Procedure for the Management of Absence
It is inevitable that employees will, on occasion, be off work through illness. This procedure
is intended to ensure that staff are treated in a consistent and fair manner throughout NHS
Lothian. Managers should adopt a sympathetic and understanding approach at all times
when dealing with staff on sickness absence. Staff may already be concerned about their
future in employment and, particularly for those on long term sick leave, undue pressure
from their manager could seriously affect their efforts to get back to work.
In all circumstances, if the employee so wishes, his/her staff representative will be kept fully
advised of all developments and be present at any meeting with the employee.
Every spell of absence will be recorded and monitored. The standard measurement for
calculating time lost is:
Sickness Hours in Month
Available Hours
4.2.1
x 100 = Percentage Figure
Return to Work Interview
On return from every spell of absence, the manager/supervisor will discuss the absence
with the employee and if appropriate ensure a self-certificate of absence form has been
completed. A short summary of the discussion should be compiled and the content agreed
with the employee. This should be done in accordance with the guidance contained in
Appendices A and B.
4.2.2
Managing Absence
In general, absence may be defined as being high if there are 4 or more spells of, or 10
days, absence, within a 12 month period, whether or not the causes of absence are related.
Where a manager establishes that there are frequent periods of short-term absence which
are causing concern and disruption to the workplace, the manager should advise the
employee regarding absence levels and explain that high levels of absence cannot be
sustained. Reference can be made to Appendix I, an example of a Traffic Light System, as
one good practice tool to support managers in the management of staff absences.
If appropriate, agreement should be reached on a reasonable 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 and maintained. Warning may need to be given that, ultimately, if
there is no lasting improvement then employment is at risk and the contract may be
terminated. Individual circumstances will determine at what stage, and how often, an
employee should be warned of this possible outcome.
Where practicable and available, relevant assistance should be offered to the employee. In
addition, it may be appropriate to suggest referral to the Occupational Health Service.
If, after formal discussion, an employee’s level of attendance fails to improve, or when it is
known that a longer absence will last more than 4 weeks, the manager/supervisor should
6
consult with the ER Department regarding a referral to the Occupational Health Service or
ongoing management of the case.
4.2.3
Absence Reviews
The need to review absences at an early stage, whatever the circumstances, is paramount.
Failure to do so can mean that the employee is unaware that full or half occupational sick
pay is about to expire. Failure to take action when a pension is involved could mean the
employee having no source of income for a number of weeks while the pension is
processed.
A series of regular reviews should be carried out to assess and monitor staff when they are
off sick. All necessary review and decision dates should be set out in light of an individual’s
sick pay entitlements. This will ensure that staff are promptly reviewed and necessary
decisions taken before their sick pay ends. For those members of staff on long term
absence this would culminate in a final review where a decision on the appropriate way
forward is made i.e. return to work, redeployment or termination of contract.
To ensure that managers meet their responsibilities in relation to reviewing absences from
work, sick pay for those who have exhausted sick pay entitlements will be reinstated at half
pay, after 12 months of continuous sickness absence, in the following circumstances:

staff with more than 5 years reckonable service - sick pay will be reinstated if sick pay
entitlement is exhausted before a final review meeting for long term absence has taken
place.

staff with less than 5 years reckonable service - sick pay will be reinstated if sick pay
entitlement is exhausted and a final review does not take place within 12 months of the
start of their sickness absence.
Reinstatement of sick pay will continue until a final review meeting has taken place.
Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12
months of continuous absence.
These arrangements will only apply where the failure to undertake the final review meeting
is due to delay by the employer. This provision will not apply where a review is delayed due
to reasons other than those caused by the employer.
4.2.4
Extending Sick Pay Entitlements
Managers will have the discretion to extend a member of staff’s period of sick pay on full or
half pay beyond the occupational entitlement in the following circumstances:

Where there is the expectation of return to work in the short term and an extension
would materially support a return and or assist recovery. Particular consideration
should be given to those staff who have not yet accrued service to qualify for full sick
pay entitlements.

In any other circumstance that is deemed reasonable.
Prior to any extension of sick pay advice should be obtained from the local ER Manager to
ensure appropriate application of this provision.
4.3
Maintaining Contact
Managers are advised, where agreed and without exerting any kind of pressure, to make
regular contact with the employee to offer help and support and to make him/her aware of
their pay situation.
Home visits should only be made in exceptional circumstances and must not be made to
employees during periods of sickness absence without prior consultation and agreement
with the ER Department, the employee and, if relevant, the staff representative to ensure
that this is an appropriate course of action in the circumstances.
7
Telephone calls may, depending on individual circumstances, be more appropriate. An
appropriate call might begin with confirmation that a new medical certificate has been
received.
The opportunity to periodically write to members of staff who are absent to offer additional
support should be taken as appropriate by line managers in consultation with the ER
Department.
4.4
Annual Leave during Sick Leave
It is recognised that staff on sick leave will accrue annual leave during the period of their
sick leave. Staff will receive any outstanding statutory leave due to them either on their
return to work or at the point of termination.
5
OCCUPATIONAL HEALTH SERVICE
5.1
Referral to the Occupational Health Service
The purpose of management referral to the OHS is:

to obtain an understanding of the relevance of the illness in relation to the work
circumstances of the employee, including consideration of whether the illness should be
considered as being work related;

to establish if any additional support can be offered to assist the employee with their
health problem and their rehabilitation to work;

to be able to make an informed assessment of a likely return to work, to enable the head
of the department to plan the work of the department accordingly.
It is imperative that the management referral provides any relevant background information
to provide context to the absence, and that a current job description is provided.
The outcome of a management referral is a report to the referring manager to provide
advice, and in particular to answer the questions posed by the referral. Typical questions
include:
- Is the employee fit for work?
- When will the employee be fit for work?
- Is the condition a result of work activity?
- Will work aggravate the condition?
- Are modifications (temporary or permanent) needed to allow a return to work?
- Is there a clear medical cause for frequent short-term absence, and is it likely to continue?
- Is the Disability Discrimination Act relevant in this case?
The OHS may also suggest a review frequency and provide further updating reports. Where
appropriate the OHS will seek (with employee consent) reports from the employee’s GP or
specialists before providing advice. OHS reports do not normally include any clinical detail,
unless it is considered necessary for management to know the information. In these
circumstances the OHS will seek further employee consent.
After an employee has been absent for 4 weeks or longer advice should be sought from the
ER Department, and if appropriate from the Occupational Health Service, and a decision
will be taken on whether referral to the OHS is appropriate.
If it is considered appropriate to refer the employee to the Occupational Health Service, the
head of department will enter into a sympathetic correspondence to obtain the employee’s
written consent. All correspondence will contain an offer of help and support and an update
8
regarding entitlements to pay and benefits. There must be no suggestion of harassment of
an employee to return to work no matter how difficult the departmental circumstances may
be as a result of the absence.
It should be recognised that each employee’s circumstances will be different and it will not
always be necessary to refer the employee as early as 4 weeks.
Where it is feasible and appropriate, a meeting will be arranged between the manager and
the employee to allow the manager to obtain information for a management referral to the
Occupational Health Service. The employee, if he/she wishes, may be represented or
accompanied by his/her staff representative or a work colleague at this meeting.
Any management referral sent to the Occupational Health Service should be copied to the
designated Employee Relations contact. The relevant Management Referral Form, with
associated Employee Consent Form, may be found at Appendix C.
Where an employee:

refuses to provide any other appropriate medical information or fails to attend
Occupational Health Service appointments;

refuses to consent to information being provided by their GP to the Occupational
Health Service;

refuses to undergo an independent medical examination;
the line manager will notify the ER Department accordingly.
In these circumstances it must be explained to the employee that decisions will still be
made concerning their employment and will therefore be based on the limited information
available at the time, i.e. with no independent assessment of their medical status.
5.2
Self-Referral to the Occupational Health Service
Employees can self-refer to the OHS at any time, including in relation to causes of sickness
absence. In addition to providing support, the OHS may suggest that a report to
management would be of benefit. In these circumstances if the employee consents a report
will be sent to the line manager.
5.3
Outcomes from an Occupational Health Service Referral
The report from the Occupational Health Service is likely to indicate one of the options
detailed below:
In all options involving a return to work reference should be made to advice given by the
employee’s General Practitioner through reference to the fit note.
5.3.1
Fit to Work
It is anticipated that the employee will be medically fit to work within a reasonable specified
timescale. In this case the line manager should continue to monitor the employee’s
absence and, taking into account the needs of the department, should keep the employee’s
position open. Once fit to work the employee may return to their normal role and working
pattern or may be supported by the options detailed in Section 6.0 below as appropriate.
Should the timescale for the return be extended at a later date, the manager will need to
reconsider the position and may need to discuss options of redeployment or termination of
the employee’s contract on the grounds of incapacity.
9
5.3.2
No Underlying Health Cause
The Occupational Health advice may indicate that there is no underlying health cause to the
absence. This is more common in cases of frequent, short-term absence. In such cases,
the member of staff should be advised that if they are unable to achieve a regular and
effective service, it may be necessary to consider termination of their contract.
6.0
REHABILITATION AND SUPPORT TO REMAIN AT OR RETURN TO WORK
NHS Lothian recognises the clear benefits to both staff and the organisation that
rehabilitation programmes and continued attendance at work provide and will endeavour
wherever possible to support such programmes.
Rehabilitation programmes may take a number of forms as detailed below. In normal
circumstances the phased return to work, as detailed in section 6.1, will be the initial option
considered. Alternatives such as rehabilitation return, temporary modification/placement
can only be used on the recommendation of the Occupational Health Service.
6.1
Phased Return To Work
After a prolonged period of absence or severe ill health, it may be identified that although
the employee is in the process of full recovery, a return to the full demands of the post may
not be immediately possible. In such circumstances a phased return to work may be
appropriate. In most cases a phased return to work occurs after prolonged absence. Many
staff will have already been subject to an Occupational Health referral and the Occupational
Health Department will advise on the make up of a phasing programme. However in the
absence of Occupational Health advice, managers can implement simple phasing
programmes based on their own experience or advice from the General Practitioner
specified on the fit note (see section 3.3).
A phased return to work will normally be no longer than 6 weeks in duration and may take
one of the following formats:
A return to the existing role with modified duties;
A return to the existing role with modified hours;
A combination of the above.
The member of staff will be entitled to normal pay during a phased return. Prior to the end
of the six week period, advice will be obtained from Occupational Health regarding the
member of staff’s progress and timescales for an anticipated return to the full duties of the
substantive post. Where a phased return has been implemented without Occupational
Health advice and it appears that the employee is unlikely to reach full fitness within the 6
week period, referral to Occupational Health must be made and advice sought. On receipt
of advice discussion will take place with the employee, their representative, line manager
and the designated ER Practitioner to consider the scope for continuing the phased return
on the above basis with due consideration for the exigencies of the service. Where the
phased return is extended beyond the six week period discussion should take place around
the format of the extension including the use of outstanding annual leave to extend normal
pay or the potential for redesignation of the staff member’s return to a different category of
rehabilitation.
In the event that the phased return to the full duties/hours of the post is unsuccessful
reference should be made to options available in section 6.4.
10
6.2
Rehabilitation Return
It is recognised that on occasion rehabilitation to work may take significantly longer than the
6 weeks of a conventional phased return to work and in these circumstances a rehabilitation
return programme may be agreed.
It is also recognised that there are some circumstances where, despite some recovery from
ill health, it is unclear to medical advisers and Occupational Health whether the employee’s
recovery will allow them to return to work in their substantive post, and in these
circumstances a rehabilitation programme may be used as a means of testing the capability
of the employee to return and the suitability of types of work.
Such a programme can only be instigated following Occupational Health advice on the
member of staff’s progress, estimated timescales and anticipated return to full duties, and
will take account of the needs of the service.
During the rehabilitation return to work the member of staff will be entitled to normal pay for
the first six weeks, and thereafter payment will be linked to outstanding sick pay
entitlements whereby the employee will continue to be paid in line with remaining full pay
and half pay entitlement. When full sick pay entitlement is exhausted and the period of half
pay is reached the employee will be paid the greater of either half pay entitlement or hours
worked at the band of the post they have returned to.
On expiry of the sick pay period payment will be at the rate of the job for the number of
hours worked (See Appendix E for examples). When determining the arrangements for a
rehabilitation return there is always a need for discussion with the employee, their
representative, line management and designated ER Practitioner, with regular reviews of
decisions and updates of Occupational Health advice. As with phased returns, rehabilitation
returns may require amendment to role, hours, or both, or alternatively there may be a need
for the staff member to be temporarily placed in a different role from their substantive post,
eg temporarily unfit for clinical duties.
In the event that the rehabilitation return to the full duties/hours of the post is unsuccessful,
reference should be made to options available in section 6.4.
6.3
Temporary Modification / Placement
It is recognised that situations may arise where a member of staff, for a relatively fixed
period, is temporarily unfit to undertake their full role, but remains fit for some work. These
situations may arise for example in relation to staff members awaiting investigation or
surgical procedures, or in relation to relatively short term exacerbations of known health
conditions. In these circumstances it is recognised that there may be significant benefit,
both for the member of staff and for NHS Lothian, in allowing the staff member to remain at
work in a temporarily modified role or a temporary placement in a different role. Where
possible temporary modification of duties or placement should be used pro-actively prior to
the commencement of absence as a means of preventing the member of staff going off sick.
All cases of fixed term temporary modification or placement require advice from
Occupational Health on the required modifications, and probable duration of the term. In
most cases, action of this type will centre around modification rather than placement, and
placements when occurring should normally be arranged within the individual’s local
directorate/management. Extension of the search for suitable placement outwith the local
management area should only occur when local management have confirmed the lack of
local availability.
As with rehabilitation returns, advice to consider a temporary placement/modification should
trigger discussions with the employee, their representative, line manager and designated
ER Practitioner.
11
On completion of the period of temporary modification/placement, a decision will be
reached on the return of the individual to their contracted role, which may entail a phased
return, rehabilitation return, the need for permanent modification or redeployment.
An additional important use of the temporary modification/placement system is for staff
considered unfit for their contracted role and moving through the redeployment process.
For such staff, temporary placement is often of significant benefit, both to the staff member
and to NHS Lothian as an alternative to sickness absence while redeployment action
proceeds.
6.4
Unsuccessful Rehabilitation Programme
If, on completion of a rehabilitation programme, which may take the form of a phased return
to work or rehabilitation return, the member of staff remains unable to perform their original
post in its entirety the following options are available:
a) where the member of staff is able to undertake the full range of duties of the post but
is unable to meet their contracted hours, a reduction in hours in their substantive
post may be considered subject to service needs. Salary will be reduced to that of
the new hours of work.
b) Where the member of staff is unable to undertake the full range of duties of the post
advice will be sought from Occupational Health regarding permanent modification of
duties. The member of staff will be paid the appropriate band for the post with
modified duties. However, where service needs cannot be met through permanent
alteration of duties, redeployment to a suitable alternative role will be sought. In
these circumstances the member of staff will be paid the appropriate band for the
suitable alternative post. The process for redeployment to an alternative post will be
as set out in section 6.5 below.
c) Where all avenues have been exhausted and it is deemed, through Occupational
Health advice, that the member of staff is unfit for work, termination of the
employee’s contract on the grounds of incapacity will be considered.
6.5
Permanent Incapacity in Current Post – Reasonable Adjustments / Redeployment
Occupational Health advice may indicate that the employee is not fit for the current post
without the need to test this through a rehabilitation programme. Again the provisions of the
Equality Act 2010 (see Appendix D) must be considered carefully at this stage, in
conjunction with the ER Department, and the following options considered:
6.6

Whether there are any reasonable adjustments which may be made to the current
duties on a permanent basis to allow the employee to return to this post;

Identification of alternative employment within NHS Lothian in accordance with the
NHS Lothian Redeployment Policy and Procedure. Alternative employment, where
possible, should be reasonably comparable in terms of remuneration, conditions and
types of duties when set against the original contract. Guidance will be sought from
the Occupational Health Service on the suitability of the alternative work and the
identification of such alternatives will be time limited to 3 months from the period of
initial discussion with the employee;

If neither of the above options is possible it may be necessary to consider
termination of the employee’s contract on the grounds of incapacity.
Ill Health Termination
Where the Occupational Health Service indicates that an employee is unable to return to
work as a result of illness, disability, or injury the employee will have his/her contract
terminated following appropriate consultation and notice. Guidance on this procedure can
be found in Appendix F.
12
Where an employee is a member of the NHS Superannuation Scheme they may be eligible
for ill-health retirement. A two-tier arrangement providing different levels of benefits for
members dependent on the severity of their condition and the likelihood of them being able
to work again is in place, as follows:

Lower Tier – this will apply where a member is assessed as being permanently
incapable of efficiently discharging the duties of their present job. They would
receive early payment of actual benefits without an actuarial reduction but with no
enhancement.

Higher Tier – this will apply where a member is not only assessed as being
permanently unable to do their job but also could not undertake any other job across
a general field of employment to the same extent as the member was undertaking
their original job. They would receive an enhancement of 2/3 of their prospective
membership to normal pension age.
It is important to note that NHS Lothian cannot guarantee that the employee will receive an
incapacity pension as the final decision on such matters rests with the Scottish Public
Pensions Agency. A member of the ER Department will be available to assist the employee
with the application process.
6.7
Terminal Illness
In the case of terminal illness, line managers should consult with the Occupational Health
Department and ER Department as soon as possible prior to taking any action to ensure
that any necessary specific provision in the NHS Pensions Scheme is, where appropriate,
facilitated.
7.0
ILLNESS OR INJURY AT WORK
Where there is a suggestion that an illness or injury is work-related, advice regarding
confirmation will be sought from the Occupational Health Service.
Where absence occurs as a result of an illness or injury at work and there is a subsequent
reduction in earnings, the appropriate ER Manager will be informed.
The ER Department will assist in the completion of an Application for Award of Injury
Benefits (INJ1), if required, and any application for DSS Injury Benefits. Details of the NHS
Injury Benefits Scheme can be found in Appendix G.
8. 0
RECORDING AND MEASURING ABSENCE
Recording of absence is essential for identifying absence patterns, highlighting short
term/long term absences, health and safety issues, meeting the requirements of Statutory
Sick Pay Regulations and defending appeal cases within NHS Lothian or at Employment
Tribunal.
An individual’s absence/leave record card must be used to record all absence. The
appropriate manager/supervisor will examine each individual record at least once per month
in order to identify potential problems at an early stage. All absence data must be recorded
electronically using the e-Manager module on the Empower system/SSTS to enable record
keeping and reporting on absence.
The appropriate departmental procedure will be used to record details of the employee’s
absence in accordance with the rules of notification. It is at the notification stage that the
cause of absence and, if possible, the likely duration of absence should be clarified.
Original self certificates and medical statements will be retained by the manager/supervisor
for each member of staff for a period of 3 years. These must be held separately and
confidentially in the employee’s departmental personal file. If the originals are required by
the Department of Social Security then copies must be retained.
13
Sickness absence reports will be compiled for departments, divisions, Community Health
Partnerships and NHS Lothian as a whole, and will be monitored as part of the quarterly
workforce reporting system.
For further information on recording absence and absence classification please refer to
NHS Lothian’s Absence Recording Policy.
9
MONITORING AND REVIEW
This policy will be reviewed after a period of two years by the Lothian Partnership Forum, or
sooner in light of any changes in legislation and/or NHS Scotland policies.
The policy will be monitored through divisional, directorate and departmental absence rates.
Managers and the Occupational Health Service will highlight high absence levels and target
individual areas where further investigation may be necessary
14
APPENDIX A
GUIDANCE ON RETURN TO WORK DISCUSSIONS
The following guidance on conduct should be observed by all managers in discussions with
staff on their return to work:

The discussion must be held in private, without interruptions, and confidentiality
must be observed.

An appropriate supervisor or line manager should conduct the meeting. Individual
departments must decide whether or not it is appropriate to delegate this task in the
absence of the departmental supervisor or line manager.

If the employee so wishes, his/her staff representative will be present at the meeting.

Return to work meetings should be conducted as soon as possible after the
employee’s return.

The employee should be told the purpose of the meeting, which is to provide any
necessary support on the employee’s return to work and to ensure that the
appropriate documentation is completed:
* Record of Return to Work Discussion
* Self Certificate (SC2) for absences of 4-7 calendar days
* Medical Certificate for absences of 8 calendar days or more

The supervisor/manager should establish the reasons for absence and for absences
of 8 calendar days or more ensure the employee has been passed fit to return.

The supervisor/manager should raise any concerns with the employee regarding
their absence record, e.g. explaining emerging patterns, emphasising the value and
importance of the employee’s attendance to the workplace team, ensuring that the
employee is aware of the NHS Lothian Promoting Attendance Policy and Procedure
and considering appropriate follow up arrangements.

The manager should offer any support necessary in the workplace to prevent future
absence.

If necessary, return to work discussions can be conducted over the telephone. The
discussion should be recorded using the format given in Appendix B. The record
should be shared with the employee, giving the opportunity to comment and to sign
if wished, and then placed in the personal file.

The manager should bring the employee up to date with any relevant work matters
which occurred during the period of absence

A record should be kept of the main points discussed, using the format given in
Appendix B. The record should be shared with the employee, giving the opportunity
to comment and to sign if wished, and then placed in the personal file.
Note: Bank Shifts Following an Episode of Sickness
As part of the Return to Work process, the line manager should establish whether or not
there is a concurrent bank contract. This may be determined by asking the employee as
part of the Return to Work Discussion, and liaising with the Staff Bank Manager to confirm
any bank work patterns.
If there is a concurrent bank contract, reference should be made to Appendix H relating to
restrictions on bank shifts following sickness absence.
15
APPENDIX B
RECORD OF RETURN TO WORK DISCUSSION
Note to Employee:
This Return to Work meeting, which may last only a few minutes, is aimed at finding out
how you are keeping and updating you on what has been happening while you were
absent. There will be opportunity within this meeting to discuss any aspects of your sick
leave that might be affected by your work, and to consider what support you might require in
the future.
Once this form has been completed it will be shown to you for information, prior to placing in
your personal file. If you wish to add any written comments, you will be given the
opportunity to sign the form.
Name: ______________________________
Job Title ________________________
Directorate: _________________________ Department/Ward: ______________________
Hospital/Site: ________________________
Payroll Number: _____________________
Date and Time of Commencement of Absence: __________________________________
Date and Time of Return to Work:
___________________________________
Brief details of the reason for absence:
_________________________________________________________________________________
Was the absence a result of:
1/ An accident at work?
Yes _____
No _____
(If Yes, was an incident form completed?)
Yes _____
No _____
2/ Other work related cause?
Yes _____
No _____
3/ Non-work related cause?
Yes _____
No _____
Medical certification provided?
Yes _____
No _____
16
Actions taken or proposed as a result of the Return to Work Discussion:
(For example, OHS referral, any resultant health care issues that may need to be
addressed, plans for improvement in attendance)
Employee’s comments on Return to Work Discussion:
(An opportunity to advise the supervisor/manager of any aspect of health which might affect
work performance, raise any concerns, and/or add any comments in relation to the recent
period of absence)
Employee Signature (optional) ____________________________
Date
___________
Line Manager Signature
Date
___________
____________________________
17
APPENDIX C
NHS LOTHIAN OCCUPATIONAL HEALTH SERVICES
MANAGEMENT REFERRAL
Hospital Division
RHSC
RIE
St John's
WGH
Liberton
CHP
Edinburgh CHP
Midlothian CHP
East Lothian CHP
West Lothian CHCP
REAS
REH
Other
Dentistry
General Practice
LH
Napier University
Other (please state)
_____________________
Personal Details
Surname: __________________________
Forenames: _____________________ Title: ___
Date of Birth: _______________________
NI if available: ____________________________
Address: _________________________________________________________________________
___________________________________
Tel No: __________________________________
GP Name: __________________________
GP Address: ______________________________
______________________________
Employment Details
Job Title: __________________________________________
Department: _______________________
Specific Location Site/Ward: __________________________
Hours per week: ___________________
Date appointed NHS Lothian: _____________________
Current post: ___________________
Referring Manager
ER Pratitioner
Name: _______________________________________
Name: _______________________________________
Designation: __________________________________
Designation: __________________________________
Signature: ____________________________________
Signature: ____________________________________
Telephone: ___________________________________
Telephone: ___________________________________
Location and Dept: _____________________________
Location and Dept: _____________________________
The employee has been informed of this referral and has completed an attached consent form
Yes
No
Date: ________________________________________
18
Work Pattern:
Mostly:
Manual Handling:
Days
Nights
Shifts
Seated
Standing
Mobile
Little
Some
Heavy
Management
Responsibility:
High
Medium
Low
None
Job Description Attached
Additional NHS Post Held
Yes
Yes
No
Driving:
No
HGV
Other
Commercial
Car
Forklift
None
SPPA Membership
Yes
Absence details if relevant:
Absence details attached
Yes
No
Is employee currently on sick leave
Yes
No
Date sickness absence commenced
_____________________________________________
Reason for current absence
_____________________________________________
Medical Certificate expiry date
_____________________________________________
Date to commence half pay
_____________________________________________
Date to end pay
_____________________________________________
No
Additional information, please include any further information you may feel relevant.
Reason for Referral:
Please use separate sheet if necessary
Previous Referral
Yes
No
If yes, date _______________________
Information required by Manager
What is the employee's current state of fitness for work?
Is it possible to assess when the employee will be fit?
What effect will the illness/injury have on the employee's ability to carry out their occupation?
If yes, is this effect likely to be temporary or permanent?
Are there particular duties which they will be unable to carry out on return?
Are there work modifications which would alleviate the condition or facilitate rehabilitation?
Does a condition exist that could be worsened by work?
Does a condition exist that could be referred as a disability under the Equality Act 2010?
Is the sickness absence the result of an accident or illness sustained at work?
Is there a medical cause for frequent short-term sickness absence and is this likely to continue?
Is ill health retiral supported?
Is there further support we can provide?
19
MANAGEMENT REFERRAL
EMPLOYEE CONSENT TO ATTEND OCCUPATIONAL HEALTH
I, the undersigned, consent to attend NHS Occupational Health Services.
I confirm that the reasons for this referral have been discussed with me and I understand
that a report on my fitness for work, or otherwise, will be sent to my manager.
I further understand that the Occupational Health Nurse/Physician may wish to write to my
GP/Consultant for a report on my medical condition, and that the need for this will be
discussed at the time of the consultation.
Name:
DOB:
Address:
Post title:
Place of Work:
Telephone Number:
Signed:
Date:
20
APPENDIX D
GUIDANCE ON THE DISABILITY REGULATIONS IN THE EQUALITY ACT 2010
It has been unlawful to discriminate against individuals on the grounds of their
disability, since the Disability Discrimination Act of 1995. This Act was incorporated
into the Equality Act in 2010.
Definition of Disability
The Act says that a person has a disability if they have a physical or mental
impairment which has a long-term and substantial adverse effect on their ability to
carry out normal day-to-day activities. Physical or mental impairment includes
sensory impairments such as those affecting sight or hearing..
Requirements of the Act
If an employee becomes disabled in the course of their employment with NHS
Lothian, the organisation is required to make reasonable adjustments to the existing
workplace or arrangements, where these would currently place the disabled person
at a substantial disadvantage. Adjustments may include:







adjustments to premises;
altering working hours;
assigning to a different place of work;
reviewing duties and allocating some to another person;
redeploying the employee;
allowing time off for rehabilitation and training;
acquiring or modifying equipment.
In considering what is reasonable, an employment tribunal would consider cost
(including any available assistance from external agencies), the impact of any
changes on other employees and the benefits to the organisation in the individual
circumstances.
There is no legal obligation on employers to create a job, radically alter a job, or
retain salary level, but NHS Lothian will make every effort to accommodate the
needs of the individual. The employee is in turn expected to co-operate with the
process.
Further information
More information can be found on the Equality & Human Rights Commission
website, including guidance and codes of practice for employers. See:
http://www.equalityhumanrights.com/advice-and-guidance/guidance-for-employers/
21
APPENDIX E
GUIDANCE ON RETURN TO WORK / REHABILITATION PROGRAMMES
The line manager must plan the phased return to work / rehabilitation programme taking
account of OHS advice, the needs of the employee, the needs of the service and the impact
on other employees in the department. The plan should be prepared in consultation with
the employee, their representative where applicable and the ER Department. In addition to
planning the return to the workplace the manager must ensure that he/she arranges to
update the employee on any changes within the department/division, policies and work
practices which may have changed during the employee’s absence.
Where appropriate working from home may be considered as part of the phased return to
work / rehabilitation programme and guidance should be sought from NHS Lothian’s Home
Working Policy and Procedure and the local Employee Relations Practitioner.
Support for other members of the team who may be affected should be taken into
consideration when developing any the phased return to work / rehabilitation programme.
Practical Considerations:
The manager should agree the phased return to work / rehabilitation programme with the
employee and, where applicable, their representative which clearly details the following:
 the initial timescale of the programme and the scope for extension;
 support to be provided to the employee;
 monitoring arrangements;
 arrangements for employees to raise concerns;
 details of duties;
 details of hours worked with incremental increase/target dates as appropriate;
 rate of pay;
 links e.g. dedicated resources such as Physiotherapy and Staff Counselling Service
and/or further assessments by the OHS.
Monitoring and Review
It is essential that during the phased return to work / rehabilitation programme the manager
meets regularly with the employee to assess progress and identify and resolve any
problems.
If, during the course of the phased return to work / rehabilitation programme, problems are
encountered there should be discussion on how best to resolve these involving the line
manager, employee, their representative and an appropriate representative from the ER
Department. It may be that further advice will be necessary from the OHS.
Examples of Application:
Scenario 1:
A full time Band 5 staff nurse with 20 years service with entitlement to full sick pay of 6
months full pay and 6 months half pay, returns to work under a rehabilitation return
programme after 3 months absence, working 15 hours per week . It is anticipated that it may
take a minimum of 9 months for a full return to work.
Payment arrangements would include – full pay for 3 months (which would include the
minimum of 6 weeks at normal pay) then moving onto half pay rates. If and when the
employee increased her hours beyond 18.75 hours per week (0.5wte) payment would be for
the number of hours worked.
22
Scenario 2:
A full time Band 4 administrative worker with 4 years service returns to work after 6 months
absence however is unable to undertake current role but is able to undertake the role of a
Band 2 post. It is anticipated that the rehabilitation to work may take between four and six
months. Sick pay entitlement for a member of staff with 4 years service is 5 months full pay
and 5 months half pay.
As the employee has been absent for 6 months the full pay entitlement has been used plus
the first month of the half pay period leaving 4 months half pay outstanding.
As the employee has no full pay remaining they will return to work topped up to normal pay
for 6 weeks and thereafter revert to the remaining half pay entitlement. This will equate to
four months less the 6 weeks they have already worked which was topped up to normal
pay.
On moving onto the half pay situation the individual will be entitled to receive the greater of
half pay at Band 4 for four months or number of hours worked at Band 2. On expiry of the
sick pay period payment will be the rate for the job for the number of hours worked.
Superannuation contributions during a Rehabilitation Programme will be as per sick pay
entitlement i.e. full employer superannuation contributions would continue to be paid until
the individual returns to their normal working hours.
23
APPENDIX F
INCAPACITY DISMISSAL PROCEDURE
Informal Discussion/Consultation
Where possible, managers should discuss their possible course of action with employees
who are absent or who have recurring absences prior to initiating this procedure, i.e. prior to
confirmation of final health status from the OHS.
As soon as is reasonably practicable following confirmation from the OHS that an employee
is:

permanently incapable

incapable in their current post

unable to return within a reasonable period of time sustainable by the department

likely to have an unsustainable level of recurrent absence in the future

unable to be redeployed
a meeting should be arranged with the employee to discuss the outcome of the OHS
referral, the manager’s likely course of action, the procedure for incapacity dismissal and
the options for superannuated employees where appropriate.
At this meeting the manager dealing with the case should make arrangements for a formal
incapacity hearing.
Where there is consensus to proceed to a formal incapacity hearing, the manager dealing
with the case may chair the hearing and authorise the termination (if that is the decision).
Where there is no consensus to move to a hearing a different manager should chair the
hearing. This manager should have formal power to dismiss under the terms of NHS
Lothian’s Management of Employee Conduct: Disciplinary Policy and Procedure.
Formal Hearing Process

The incapacity hearing will take place as soon as practically possible.

The employee will be given advance notice in writing of the date, time, location and
reason for the hearing.

The employee will have the right to be accompanied by his/her staff representative
or a colleague.

A member of the appropriate ER Department must always be present at incapacity
hearings.
Hearing (Original Manager)

The outcome of the OHS referral will be confirmed, and the member of staff and/or
their representative will be given the opportunity to comment.

Taking account of these comments, the manager will convey the decision, including
all of the options explored.
Hearing (Other Manager)

The process for this meeting will be in line with that for a disciplinary hearing.
i.e. The manager who has been dealing with the employee will present the reasons
why incapacity dismissal should be considered.
24

The employee and/or their representative will give their reasons against this
consideration.

Each party will have the opportunity to ask questions of the other and both will have
a chance to sum up.

The manager supported by a member of the ER Department not previously involved
in the employee’s case will make a decision on whether to dismiss the employee or
suggest an alternative course of action.

It should be made clear to the employee that if their employment is being terminated
on the grounds of incapacity from a specified date they are eligible for payment for
their notice period and any outstanding annual leave. Employees should be advised
of their right to appeal.

A letter confirming the outcome of the hearing will be issued to the employee within
7 calendar days.
If an employee is unable or fails to attend a hearing, it will be adjourned and a new date
agreed with them and their representative. If the employee is unable or fails to attend the
rearranged hearing the incapacity dismissal may be actioned by letter without a formal
hearing, or the hearing may proceed in the absence of the employee with the employee’s
case being presented by their representative.
Appeal
Following termination of employment on the grounds of incapacity, an employee has the
right to appeal. Any appeal against termination must be submitted to the ER Department in
writing within 21 calendar days of receipt of the letter confirming the outcome of the hearing.





The letter must state the grounds for appeal.
The ER Department will acknowledge the letter within 7 calendar days and an
appeal hearing will normally be arranged within four calendar weeks.
The employee will have the right to send or be accompanied by a staff
representative or colleague of their choice.
Appeals will normally be heard by a Director of Operations/CHP General Manager or
equivalent, partnership representative and a senior ER representative.
The employee will be notified in writing of the outcome of the appeal hearing within 7
calendar days.
Superannuated Employees
In cases of incapacity and where the employee is superannuated and has the necessary
associated service, the process for application for an incapacity pension should be clearly
explained to the individual. Section 6.6 outlines the changes in Ill Health Benefits from 1
April 2008. Employees should be made aware that although they may apply to the Scottish
Public Pensions Agency (SPPA) for an incapacity pension NHS Lothian cannot guarantee
the success of their application. Every effort will be made to assist the employee in the
application process.
It must be made clear to employees in this situation that if their application for an incapacity
pension is unsuccessful there would be no right to return to their former employment within
NHS Lothian as their contract of employment would have formally terminated on the
grounds of incapacity.
Following any formal incapacity hearing, the termination form and the completed SPPA
form should be sent to the ER Department to ensure they are forwarded to Payroll for
further completion and submission to SPPA as soon as is reasonably practicable.
25
APPENDIX G
NHS INJURY BENEFITS SCHEMES
The NHS Injury Benefits Scheme is administered by the Scottish Public Pensions Agency
(SPPA), but covers all NHS employees in Scotland whether or not they are members of the
pension scheme.
Benefits are payable where an employee has suffered a loss of income or earning ability as
a result of an injury sustained or a disease contracted as a consequence of his/her NHS
duties, and where the injury or disease was not mainly due to or seriously aggravated by
his/her own negligence or misconduct.
There are 2 types of benefit payable:
Temporary Injury Allowance
This is paid where an employee is temporarily absent from work on a reduced income and
raises the income of the employee to 85% of their salary.
Permanent Injury Allowance
This is payable where NHS employment ends or earnings are reduced as a consequence of
the injury or disease and it is established that there is a permanent loss of earning ability in
excess of 10%.
The degree of loss of earning ability and the length of service in the NHS determine the
level of benefits payable. Benefits are also payable to surviving dependants in the event of
death as a result of injury or disease.
Applying for Injury Benefits
Managers should make employees aware of the injury benefits system as appropriate.
Employees apply for benefits by completing an INJ-1 Application for Award of Injury
Benefits Form, which is available from the ER Department. The form is completed by the
employee in the first instance, then the manager, and should be forwarded to the ER
Department along with a copy of the applicable incident report form. Payroll will then be
asked to complete the relevant sections on pay and will forward the form to SPPA. The
SPPA will then send the employee an INJ-2 form which authorises the SPPA to obtain
relevant information on other state benefits.
Where an employee is applying for a Permanent Injury Allowance, the Occupational Health
Service will be required to provide a report on the employee. This should be co-ordinated
through the ER Department.
Managers will be expected to refer all employees who sustain an injury or disease through
their employment to the Occupational Health Service after their absence exceeds 4
consecutive weeks, in accordance with the NHS Lothian Promoting Attendance Policy.
26
APPENDIX H
BANK SHIFTS/ADDITIONAL HOURS SCHEDULED DURING OR IMMEDIATELY AFTER
AN EPISODE OF SICKNESS
An employee will not be permitted to work additional hours (e.g. overtime, excess hours) or
bank shifts during the 7 day period immediately following an episode of sickness. It is the
responsibility of the line manager to inform the member of staff of this position during the
return to work interview. It is the responsibility of the member of staff to advise the bank
office in the event that they are unable to cover an agreed shift during the restricted period.
BANK SHIFTS/ADDITIONAL HOURS FOLLOWING A PERIOD OF SICKNESS
In addition to the provisions above, where a member of staff has been absent for a period of
time it is important that consideration is given to the impact that working additional hours
might have on the employee’s well being.
There is an onus on NHS Lothian as an employer to ensure that staff do not work excessive
hours, which may impact on their health and have a detrimental effect on the quality of
patient care. It may be appropriate to restrict additional hours and bank work for an
appropriate period after the employee’s return to work. This restriction should not be seen
as a punitive measure but as an aid to full recovery. It is the responsibility of the line
manager to inform the member of staff of this position during the return to work interview.
A number of factors should be taken into consideration before deciding whether it would be
advisable for the member of staff to refrain from working additional hours or on the Staff
Bank for a period of time to ensure their return to full fitness.

Phased Return


The reason for absence


The duration of the period of sickness may influence the period of restriction
that is required to ensure a return to full fitness for work, whether or not a
phased return is in place.
The number of episodes


The physical and mental well being of staff must be considered. An illness
which has depleted the physical and/or mental stamina of the member of
staff would imply that the member of staff should not work additional hours
for a specified period. Advice should be sought from OHS in relation to
specific conditions where the manager has concerns regarding the impact of
additional hours or bank work on the condition.
The length of sickness absence period


By its very nature an employee returning to work on a phased return should
not undertake any additional hours or bank work during this period unless
OHS advise otherwise. Towards the end of the phased return any additional
restrictions on bank work need to be discussed with the employee.
The number of episodes of sickness may indicate that the member of staff
has underlying issues / problems. Any referral to OHS should include
reference to additional work. OHS may advise restricting additional hours via
the bank.
The pattern of bank work/additional hours
27

The pattern of bank work/additional hours around episodes of sickness may
illustrate work patterns that are affecting the employee’s health. To assist
decision making detail of work patterns can be provided by reference to the
NHS Lothian Staff Bank or staff duty rosters.
The decision to defer additional hours or bank shifts for a period will lie with the local
manager in consultation with the employee. A full explanation of the rationale should be
afforded to the employee, and recorded in the return to Work documentation.
The Staff Bank must be advised in writing / by email of the period of restriction. The Staff
Bank Manager will adjust the Staff Bank database to “disallow” the member of bank staff for
the specified period. The member of bank staff should not accept offers of bank work from
local sources during the specified period. If an employee works while “disallowed” this will
be investigated as potentially posing a risk to their own or other’s health and safety. Should
any period of restriction need to be extended the local manager should provide written /
email confirmation to the Staff Bank Manager of agreements reached with the staff member.
If the employee feels that they are being treated unfairly, they should indicate this to their
local manager and/or ER Practitioner. The employee can, of course, seek support and
advice from their staff representative. There are appropriate policies and procedures in
place to manage any grievance arising.
Beyond any agreed period of inactivity the member of staff may refuse to work additional or
bank hours, or may request a further period of inactivity on the Staff Bank, should they feel
their health may be compromised.
28
APPENDIX I
GOOD PRACTICE GUIDANCE MANAGEMENT TOOL
TRAFFIC LIGHT SYSTEM FOR MANAGING ATTENDANCE AT WORK
Question
What is it?
How does it work?
What’s its purpose?
What is it not to be used
for?
What’s a red?
What’s an amber?
What’s a green?
If someone’s a red what
do I do?
Answer

It’s a simple but systematic way of assessing and managing the
attendance at work of your staff.
It uses the red/amber/green traffic light system which we are all familiar
with on the roads. It highlights the level of input a line manager needs to
give to a member of staff’s attendance at work e.g. red means hands on
input is needed.

The purpose for line managers is to ensure that they give attention
to staff on an individual basis as it is recognised that, frequently,
absence falls when staff are given attention.
For the organisation the purpose is to reduce the absence costs.

It is not to be used to threaten staff, nor is it to be used to drive staff
to work when they are ill and particularly not when they have an
infection which they would pass to others.

NHS Lothian’s approach is to support staff who have health
problems to return to fitness as soon as possible and we have the
privilege of being paid while we are recovering. The responsibility each
of us has in return is not to abuse this privilege or the goodwill of our
colleagues by taking “sickies” i.e. being off when we’re not ill.

NHS Lothian identifies high absence as 4 episodes in a 12 month
rolling period or 10 days absence in a 12 month rolling period. Any
member of staff who has that level of absence or more would be
flagged up as red using this system

A member of staff who has not reached the 4 episodes/10 days
absence in a 12 month period but who has 3 episodes or has between
5 and 9 days absence may have a health issue which they need
support with. Staff with this absence level would be flagged as amber.

Many staff are in good health and take care to continue that, so they
have very little absence. 1 or 2 episodes / 4 or less days in a 12 month
period would be green in this system.
 The objective with staff who have a high level of absence is
to support them to improve their attendance at work in the
short term.
Step 1 - assess the reasons why they have a high level of absence.
Step 2 – decide what kind of support is available for them e.g. do
they need and can you adjust their work arrangements or do you and
they need Occupational Health advice. Discuss this with ER if you
need to.

Step 3 – invite them to meet with you and continue to do that
regularly until they’re back at work.

Step 4 - prepare for each meeting and in particular identify what it is
you want to get out of the meetings

Step 5 – meet with them and help them to tell you what their issues
are, ensure they understand what the service and their colleagues need
from them, discuss what they and you can do to improve their health
and to return to work a.s.a.p make a follow up plan with them and
arrange either another meeting date or a return to work date. ER will
attend with you if it is a difficult meeting for you to take.

Step 6 – act on the follow up or plan their return to work with them

Step 7 – document the meetings and actions


What if that doesn’t work
and the absence stays
If you have been meeting with and supporting the member of staff
for 3 months since they reached a high level of absence, there is no

29
high?
improvement in their attendance and you can’t think of anything more
you can do to help them, you should set time aside and request an
attendance planning meeting with your ER Practitioner.

There are a variety of options for moving forward but these are
usually only applicable on an individual basis so you need to discuss
and plan what the next steps are.

At the end of the day if we have done as much as we can, it
sometimes means that ending their employment is the only answer for
them and their service.
If someone’s an amber
 The objective is to provide the support and help these staff
what do I do?
need before they reach a high absence level and to ensure
their absence reduces in the long term.
Step 1 - understand why they have been off and assess whether
they have health issues they need support with.

Step 2 – assess if there are adjustments you can make for a short
period to help them e.g changing shift pattern and / or if there is support
available for them

Step 3 – meet with them and talk over with them why they’ve been off
and what you can do jointly to ensure they’re not off again, make a
follow up plan with them and arrange further meeting dates until you
and they are confident their attendance is dropping again.

Step 4 – document the meetings and actions
What if despite that their  You need to change the member of staff to a red and manage them
absence becomes high? on a more active basis with the advice of ER, as above
If someone’s a green The objective is to encourage these staff that they are doing well and to
what do I do?
continue to take care of their health to maintain their attendance.

If it’s unusual for a member of staff to be off but they’re off a couple
of times or for up to 4 days you need to do a return to work meeting with
them. These should be supportive and encouraging and are about
checking whether or not there is anything you can do for them.
What do I do if someone  You need to change the member of staff to an amber and manage
then
has
more them as above.
absence?
Is this for short or long  It’s for use with both short term and long term absence. The traffic
term absence or both?
light system is a more detailed way of looking at the absence and lends
itself to managing individuals but short / long term absence is still a
useful and quick way to get a feel for what the absence is like overall in
an area such as a ward or service

NHS Lothian considers short term absence to be anything up to 4
weeks. Long term is considered to be 4 weeks or more.
Do I have to do the  It’s necessary that you use the same principles to make your
same thing every time decisions for everyone so that all staff are treated equally.
For
with every member of example, it would be unfair if you have two members of staff with 4
staff?
episodes of absence in a 12 month period and you meet with one of
them every fortnight and don’t discuss absence with the other one at all.

However there is always an element of judgement in how you work
on their attendance with each member of staff. You must always be
fair but the individual circumstances will determine how firm you need to
be.
Can you give me a

For example in relation to long term absence:
practical example of
~ if a staff member is waiting for surgery or has cancer and is
what you mean?
undergoing treatment such that they can’t attend in the meantime, they
are likely to have a high absence but there may be little they can do
about it. You should keep in touch with these staff on a minimum of a
fortnightly basis simply to support them. It is very difficult to come back
to work after a long absence so phoning them for a chat and to check if
you can do anything that will help them.
~ if you have a member of staff who is off for a long period but DNAs
at OHS, doesn’t respond to letters, and fails to attend meetings with
you, you need to be more active about two things – checking whether
there are reasons for this that they need help with and making it clear
30

that they cannot continue to do it.
For example in relation to short term absence:
~ If someone has not been off for a two or three years but is then off
twice in 6 months, they may have hit a bad patch. The approach
should be to share the problem with them, check that they’re doing all
they can and getting as much help as possible, and encourage them.
~ If someone has been off for a day here and there, every year for the
last several years, for minor and unrelated reasons e.g. a cold, a
headache, toothache, you will need to check the issues they have but
also let them know that the pattern and amount of absence is
unsustainable for the service and for their colleagues.

The Promoting Attendance Policy is about the principles and policy
we have to work within. The system is about how we go about “doing”
attendance management. You have to read the Policy and know what
the parameters are before you start working with the traffic light
system.

Yes - but there is a pack of standard letters to go with the Promoting
Attendance Policy. These are templates that let you fill in the specifics
of the case you are managing. If you don’t have them please ask your
line manager or your ER Practitioner for them.

NHS Lothian has an Absence Recording Policy which sets out
minimum requirements for recording absences.

Most areas of NHS Lothian have an IT based absence recording
system. The system is commonly known as Empower. If you don’t
know if you have access to this you should ask your line manager or ER
Practitioner.

It is the easiest way of getting the information and you can get it
whenever you want. If you have access but don’t know how to use it we
can help you learn and, again, ask your line manager or ER Practitioner
for help.

If you have a manual system, but not access to the IT system, it is
about keeping your system up to date and ensuring that it lets you
check the absence data easily. If you need help to check what you are
recording the right things please ask your ER Practitioner.

How does this link with
the Promoting
Attendance Policy?
Do I have to write all the
letters etc myself?
How do I get the
information about the
number and length of
staff’s absences?
That tells me how to get
the information but how
do I keep track of all the
work I do on it?
You will need to do file notes for the individual staff members’ files
when you meet them. We’re very conscious that this needs to be as
little extra work as possible so - they can be handwritten as long as
they’re legible, dated, and signed or if you are writing to the member of
staff you can summarise the position in the letter and that can stand as
the record of your meeting.

In terms of keeping a handle on all the work - we have a table format
which allows you to annotate in short form what the history is and
where you’ve got to with each of the staff you’re working with. This lets
you run through it quickly when you need to check. Please ask your
ER Practitioner if you need advice on this.
What does it not do?

It doesn’t do the work for us! We still have to do it but it helps to
organise the work.

It doesn’t provide an assessment of whether there are underlying
causes of the absence for a group of staff e.g. workload increases
leading to stress. Work on these wider issues has to run in tandem with
the traffic light system
Is there anything else I  Please do remember that if you have a member of staff whose
should know?
absence you are struggling to cope with the Trade Union and
Professional body representatives are a good source of help, as they
too have lots of experience with it. They will talk things over with you
and help you come up with ideas of what you can do and also help you
sort out if you’ve reached the point where you’ve done everything.

31
Absence Action Plan (4 or more absences within the last 12 months)
Service Area:
……………………………………………………………
Line Manager:………………………………………….
KEY:
Red
Amber
Green
-
Individual currently managed under Promoting Attendance Policy
Management of absence required
No immediate action required
ABSENCE – MONTH 2008
Name
Joe Bloggs
1
Dates Absent
01.04.08 – 02.04.08
05.10.08 – 12.11.08
Reason
Flu
Depression
Status
(e.g. Short/
Long/Linked
Absences)
Short
Long
Referred
to OHS?
No
Yes
Action Plan
To date: 1 episode = 2 days
2 episodes = 9 days
COMMENTS
Return to work interview done after both episodes. Non work related depression. Charge Nurse keeping in touch and supporting.


To date: X episodes = X
days
