SOUTHERN HEALTH & SOCIAL CARE TRUST

PROCEDURE FOR THE MANAGEMENT OF SICKNESS

ABSENCE

CONTENTS SECTION PAGE NO

1.0 Background 2.0 Introduction

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3.0 General Principles 4.0 Reporting Procedure in the Event of Sickness

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5.0 Certification 6.0 Keeping in Touch During Sickness Absence 7.0 Recording and Monitoring Absenteeism

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8.0 Return to work Meeting 9.0 Disability Discrimination Act 1995 & Disability Discrimination Amendment (NI) Regulations 2004

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10.0 Probationary /Confirmation of Appointment 11.0 Management of Short-Term / Casual Absence 12.0 Management of Long-Term Abence 13.0 Right of Appeal 14.0 Injury Benefit

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APPENDICES PAGE NO Appendix 1 O/H Management Referral Form and Procedure Appendix 2A Letter confirming Occupational Health Appointment Appendix 2B Letter confirming Occupational Health Review appt

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Appendix 3 Return to Work Meeting Proforma Appendix 4A 4th Episode Cause for Concern letter Appendix 4B 3rd Epsiode Cause for Concern letter (probationary)

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Appendix 5 Informal Warning Letter Appendix 6 Letter sent prior to meetings Appendix 7 Follow-up letter re meetings/action taken

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Appendix 8 Proforma for approval to withhold pay Appendix 9 Withhold pay letter (unacceptable reason) Appendix 10 Withholding of pay letter (No contact) Appendix 11 Internal Ill-Health Retirement Procedure Appendix 12 Letter of termination Appendix 13A Individual Absence Record Proforma (5 days) Appendix 13B Individual Absence Record Proforma (7 days)

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38-40

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44 Appendix 14 Southern Trust Absence Return Procedure

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1.0 BACKGROUND 1.1 The following procedures are set out in support of the Southern Health &

Social Care Trust (hereafter referred to as the Trust) Interim Sickness Absenteeism Policy.

2.0 INTRODUCTION 2.1 Managers will be expected to monitor and control staff’s work attendance.

This is a recognised and accepted part of any manager’s responsibilities. 2.2 When work attendance is affected by sickness absence related issues

however, the situation demands sensitive consistent handling if a manager is to fulfil this particular function effectively.

2.3 When poorly handled, or worse still simply ignored, sickness absence can

breed feelings of resentment, disinterest and discontent amongst staff. Very quickly, staff will reach the conclusion that it is of little consequence to anyone – themselves included – whether they come into work or not. Any approach that fosters this sort of attitude has serious implications for managers, staff, and the service which we provide to patients/clients as a whole.

2.4 By adopting a more proactive approach to reviewing sickness absence,

managers can encourage staff to feel that they are valued and their contribution is an important part of the organisation’s output.

2.5 The procedures as laid down must be followed by all managers and staff.

Failure to do so may lead to disciplinary action. 3.0 GENERAL PRINCIPLES 3.1 Basically sickness absence from work falls into one of two categories: - Short-term / Casual Absenteeism - Long-term absence 3.2 For the purposes of this procedure, the following definitions are made

3.2.1 Short Term - any period of absence of less than 4 calendar weeks duration will be regarded as “Short Term”.

3.2.2 Long Term – any period of absence lasting 4 calendar weeks or more will be regarded as “Long Term Absence”

3.3 In cases where absence (short or long-term) is related to a disability or is

pregnancy-related, relevant legislation will guide the management of these absences.

3.4 This procedure is designed to help managers deal with both types of absence effectively and confidently. It also clearly outlines to staff what their responsibilities are in relation to sickness absence from work.

4.0 REPORTING PROCEDURE IN THE EVENT OF SICKNESS 4.1 Any staff member who is unable to report for work due to sickness must

notify their line manager or in their absence another manager / person in charge as early as possible on the first day of absence. In the instance of staff involved in direct patient care, as much advance notice as possible should be given before the start of a shift. In all other cases this should be no later than 1 hour after their normal starting time on that day.

4.2 The staff member should make the notification personally. Other persons

should only make the call in exceptional circumstances e.g. hospitalisation. This will allow the manager to check duties which may need to be reallocated or completed within a timeframe.

4.3 If the absence is attributable to an accident where damages are sought from

a third party, the member of staff must inform their manager who should in turn inform the Litigation Department, 1st Floor, Nursing Home, Daisy Hill Hospital.

4.4 Staff should indicate the reason and expected duration of the absence.

Failure of staff to notify the line manager of their illness (whether as a result of an accident or otherwise) may result in the withholding of sick pay.

5.0 CERTIFICATION 5.1 Staff are required to submit the following certification as appropriate: 1-3 days of sickness No certification required 4th day of sickness Self certification

(to be dated from 1st date of sickness)

8th day of sickness Medical certificate 5.2 The above certificates relate to the 4th and 8th day of sickness and not the

4th or 8th working day, i.e. weekends/days off are included. 5.3 Each time a certificate is received by a manager, this should be forwarded

immediately to the Southern Trust Payroll Department at St Luke’s Hospital, Loughgall Road, Armagh, BT61 7NQ.

5.4 The member of staff must keep in regular contact with their manager,

informing them prior to the expiry of their sick certificate of the current state of their health and whether they are fit to return to work. If a new certificate is required, this must be forwarded to the manager within 3 working days of the expiry of the original sick certificate.

5.5 In the event that a member of staff fails to submit a medical certificate the manager should adopt the following procedure:

5.5.1 Try to contact the staff member by telephone to ascertain the reason

for the missing certificate.

5.5.2 When contact is made, the manager must decide if the reason given by the staff member is acceptable. If it is considered that it is not an acceptable reason the manager should consult with their Senior Manager/Head of Service with a view to deciding whether or not the staff member’s pay should be stopped. Proforma at Appendix 8 should be completed and signed by both the manager and the Senior Manager/Head of Service. If a decision is taken to stop pay, the manager must advise the staff member immediately and follow this up in writing (See Appendix 9). The Employee Engagement and Relations Department and the Southern Trust Payroll Department must also be advised in writing by the manager.

5.5.3 If there is no contact from the individual following initial steps, the

manager should send a recorded delivery letter (See Appendix 10) advising that failure to contact or produce a medical certificate by a set date will lead to withholding of pay. In this instance the Employee Engagement and Relations Department and Southern Trust Payroll Department should be notified and kept advised accordingly.

5.5.4 It should be noted that continued failure to be absent from work

without appropriate certification will be deemed as unauthorized absence and in this respect will be managed in accordance with the Trust’s Disciplinary Procedure.

5.6 It should be noted in all circumstances, particularly where a staff member

has obtained a medical certificate from their GP, they may only return to work once they are fit to do so. Where a manager has any concerns about fitness for duty, they will have the right to delay the return pending advice from Occupational Health. In such circumstances special leave with pay will be given pending this advice.

6.0 KEEPING IN TOUCH DURING SICKNESS ABSENCE

6.1 The onus is on the staff member to keep in touch with his/her line manager

during the absence to ensure their manager is updated on their progress and knows when they are likely to return to work.

6.2 Throughout any period of absence, a manager is permitted to contact the

staff member to seek feedback on progress and offer support or discuss relevant work matters.

6.3 The member of staff must not be involved in any activity which could bring

into question the genuineness of the illness. 6.4 Staff should be aware that taking a holiday whilst on sick leave may call into

question the genuineness of their illness. If however, as part of the staff

member’s recuperation from their illness they intend to take a holiday, they must notify their line manager in advance giving details of location and dates. Advice may be sought from Occupational Health Department. A staff member not complying with this rule shall have his/her sick pay withheld and will be subject disciplinary action.

In some circumstances holidays abroad (outside of the EU) may mean that Statutory Sick Pay cannot be paid (employees should seek advice from Southern Trust Payroll Department on this matter).

6.5 When a long term absence covers a period of pre-arranged annual leave

then this leave is reinstated. 6.6 Reinstatement of pre-arranged annual leave in the circumstances where the

absence is of a more short-term nature will also normally be reinstated. The member of staff must formally notify their manager on their first day of sickness. Appropriate certification will be required for any period of sickness in these instances.

6.7 Staff will not be entitled to an additional day off if sick on a statutory holiday. 7.0 RECORDING AND MONITORING ABSENTEEISM 7.1 It is the responsibility of the manager to monitor and manage sick leave and

causes of absence in their department/area. 7.2 It is important that a systematic and simple method of recording

absenteeism operates through all Directorates / Departments. These records not only serve as a recording of individual absence but provide the basis for identifying patterns of absence. A sample form to assist in this is detailed at Appendix 13A and 13B.

7.3 It is important that managers record and monitor partial day absences (i.e.

those where a member of staff reports for duty but goes home early). Such absences may be indicative of an underlying problem or an abuse of provisions.

7.4 Managers are responsible for submitting sickness absence returns in

respect of their staff on the Trust’s standard absence returns form at the end of each week / fortnight / month. In the event of no sickness within a Department a “nil” return must be submitted. A copy of the form is attached in Appendix 14 and is available for on-line completion on the Trust’s Intranet.

8.0 RETURN TO WORK MEETING 8.1 Following each absence from work due to sickness, the line manager

should meet with the staff member to conduct a Return to Work meeting. The meeting should therefore have both a welfare and managerial perspective.

8.2 Meetings should normally be undertaken on the day of return, or as soon as practically possible, in a confidential setting. Normally this would only involve the manager and the staff member.

8.3 Whilst these meetings are informal, it is recommended that a record is kept.

A sample form to assist in this is detailed at Appendix 3. 8.4 In all instances the manager should;

� welcome the staff member back to work; � provide an update on work related issues; � re-assure the staff member that their contribution has been missed.

8.5 Depending on the reason for absence the manager should discuss with the

staff member any ongoing difficulties, work situations or medical conditions which may result in further absence,

8.6 Any reasonable adjustments that have been identified by the Occupational

Health Department in conjunction with Employee Engagement and Relations and the line manager, should also be discussed.

8.7 If an individual’s sickness record is a cause for concern the manager should

make the staff member aware of this, discuss the improvement required and advise that continued poor attendance may lead to action being taken, as described in the following sections:

• Management of Short Term / Casual absence (Section 11)

• Management of Long Term absence (Section 12)

8.8 If, during the return to work meeting, the manager has any concerns about the staff member’s fitness they should seek immediate advice from Occupational Health. Following this advice the line manager may have to delay the staff member’s return to work. In such circumstances special leave with pay will be given pending this advice.

9.0 DISABILITY DISCRIMINATION ACT 1995 (DDA) AND DISABILITY

DISCRIMINATION (AMENDMENT NORTHERN IRELAND) REGULATIONS 2004

9.1 When managing sickness absence, managers need to be mindful of

employment legislation that may be relevant, namely the DDA. 9.2 Under the Disability Discrimination Act 1995 (DDA) and Disability

Discrimination (Amendment Northern Ireland) Regulations 2004, if the nature of the ill health means that a person is classed as a disabled person, consideration should be given to reasonable adjustments in consultation with the employee.

9.3 Expert assessment and advice should normally be sought from

Occupational Health in conjunction with the Employee Engagement and Relations Department. Reasonable adjustments may be varied. Examples of such are;

� allocating elements of the disabled persons duties to another person

in exchange for other duties which they are able to undertake; � altering working hours;

� acquiring or modifying equipment;

� re-deployment (with training if necessary).

(this list is not exhaustive) 10. PROBATIONARY/CONFIRMATION OF APPOINTMENT Where absence during the probationary period gives cause for concern managers should clearly communicate this to the employee at the earliest opportunity. The manager should ascertain whether there are any underlying issues contributing to this absence, and if necessary refer staff member to Occupational Health Department. The manager should use their discretion and own judgement in relation to this, and be mindful in relation to disability and pregnancy-related absences. However the general rule would be as follows:-

• Two periods of sickness during the initial probationary period will necessitate the manager verbally notifying staff member that their absence is giving cause for concern, and that should there be a further episode then it is likely that they will not be confirmed in post;

• Should there be a 3rd episode, then the manager should extend the probationary period (can be between 1 month and 3 months). Member of staff should be advised that if there is a further episode during initial or extended period, then it is likely that they will not be confirmed in post and termination could result (template letter can be found in Appendix 4B).

For details on how to manage this, please refer to the “Management of Probationary Guidelines”. 11. MANAGEMENT OF SHORT TERM / CASUAL ABSENCE 11.1 In all instances, Managers should be alert to ongoing patterns of sickness

absence and take appropriate action where this raises concern. Discretion should be used in every case depending on the individual circumstances whilst at all times striving to ensure a consistent and fair approach to all staff.

11.2 At all times, the member of staff should be kept advised of the

consequences of poor attendance, which may ultimately result in dismissal. Documentation is essential to demonstrate that the situation has been discussed objectively therefore the manager should keep records of any discussion, and any action taken, to manage the member of staff’s attendance at work. Details of any action taken should be followed up in writing by the line manager to the member of staff.

11.3 In the event of repeated absence a manager may have cause for concern.

For example there may be a pattern of frequent absences of short periods of time;

� one, two or three days absence at regular intervals or; � linked to particular rota arrangements or; � linked to particular patterns i.e. weekend or Bank Holidays

11.4 While managers are required to exercise discretion, normally three periods

of absence within any rolling 12-month period should be the prompt for managers to consider appropriate action which could be one or a combination of the following;

a) Advise the member of staff that the fact that he/she has had 3

periods of absence in the preceding 12 months is giving cause for concern. Point out any difficulties these absences have caused for the team. Emphasise the importance the Trust places on good attendance;

b) Establish if any possible underlying reason exists whether medical,

domestic or work-related, and if any steps can be taken to alleviate such problems.

c) Discuss how the attendance can improve which may involve

considering support measures such as reduction in hours or time off (Unpaid or annual leave) to accommodate any underlying medical conditions or other circumstances such as domestic arrangements;

d) Use Discretion; Line Managers are required to use their discretion

when managing period’s absenteeism – for example, an ‘unfortunate’ period of increased sickness episodes in an otherwise excellent past record, sickness episodes as a result of surgery, sickness as a result of outbreaks within Trust hospital/facility setting such as gastroenteritis. Managers should also be mindful of disability and pregnancy-related absences.

11.5 Short Term/Casual Absence Where No Medical Condition Exists

The following procedure is appropriate if the absence is not related to pregnancy or disability and there is no underlying medical condition recorded by Occupational Health. If, however at any stage, there is a medical condition established, the manager must try to assist the employee through Occupational Health to regain their health status (refer to Section 11.6). Where there is conflict between Occupational Health and the individual’s doctor, the Occupational Health Physician, with the consent of the individual, will liaise with the individual’s doctor with a view to resolving the situation.

At every stage in the following process, the manager should put in writing to the member of staff details of any decisions made. Please refer to Appendix 7 for template letter.

11.5.1 If a member of staff has a fourth episode of sickness in a

rolling year the manager may deem it appropriate to issue a “4th Episode Cause for Concern letter” (Appendix 4A). i.e. advising the member of staff that if he/she has a further episode of sickness in a rolling 12 month period that further action will be taken, which could include the issue of an informal warning. It may be appropriate at this stage to make a referral to Occupational Health. (Please refer to Appendix 1 for Management Referral Form and Procedure)

In this regard, Managers should familiarise themselves with the Trust’s Disciplinary Procedure. Please note that during the following stages, the staff member will have the right to attend meetings accompanied by either a trade union representative or trusted work colleague.

11.5.2 Informal Action

If there is no improvement in attendance after issue of cause for concern letter and there is no underlying medical condition, move to discipline i.e. issue of an informal warning. (Appendix 5).

11.5.3 Stage 1 (Formal)

If there is no improvement in attendance recorded after issue of informal warning, and again it is clear there is no underlying medical condition move to disciplinary action up to and including a formal warning as appropriate.

11.5.4 Stage 2 (Formal)

If there is no improvement in attendance recorded after Stage 1, move to disciplinary action up to an including a final warning.

11.5.5 Stage 3 (Formal)

If there is no further improvement in attendance and if there is no underlying medical condition established move to discipline up to and including dismissal.

Where abuse of the Sickness Absenteeism Policy is established this will be dealt with directly through the Disciplinary Procedure.

11.6 Short Term/Casual Absences Caused By Incapacity/Medical Condition

If indications are that the pattern of casual absenteeism is due to a medical condition (as assessed by Occupational Health) the following steps should be followed by the manager (Please refer to 11.4 section b);

11.6.1 Assess the facts of the situation, that is;

(a) The proportion of time;

• actually absent

• when or how work performance is affected.

(b) the result of the Occupational Health assessment (which will relate to the staff member’s capability to carry out the duties of his/her post. This information will be given on a standard report)

11.6.2 Based on the above information the manager will have to

decide whether reasonable adjustments (as advised by Occupational Health) can be facilitated to allow the person to remain in their substantive post.

If reasonable adjustments cannot be facilitated the manager should ascertain from Occupational Health if redeployment is an option.

If reasonable adjustments can be facilitated this should be carefully monitored and reviewed. Should there be no improvement in attendance, the manager should ascertain from Occupational Health if redeployment is a suitable option.

11.6.3 There may be some cases, however, where termination of

contract on ill-health grounds / ill-health retirement may have to be considered. (e.g. where reasonable adjustments and redeployment is not an option)

11.6.4 Employees must be made aware in writing of all the possible

options. If termination of employment is a possibility this issue should be raised at as early a stage as possible in the proceedings. All options should be discussed via a meeting with the member of staff, their line manager and Employee Engagement and Relations. All meetings should be followed up in writing by the line manager (Appendix 7).

11.6.5 Termination will either be through;

a) an application by the staff member for an

incapacity/Superannuation pension

b) or if deemed unfit by Occupational Health Department (if not Superannuable) to undertake any work within the Trust or after the Trust has exhausted all avenues as stated above

If termination is to take place the following process must be undertaken:

1. The line manager must first inform the staff member in writing (Appendix 6) of their intention to terminate and arrange to meet to discuss.

2. The staff member will be invited to meet with their line

manager and a representative from the Employee Engagement and Relations Department. Where a decision is made to terminate the employment contract of the staff member, he/she will be advised of their period of notice, last day of service and of their right of appeal. This should be followed up in writing by the line manager (Appendix 12).

3. The staff member has the right of appeal to any

termination decision and will be advised of the appeal’s procedure in writing by their line manager. (Appendix 12).

The staff member will have the right to attend meetings accompanied by either a trade union representative or trusted work colleague only. Advice and guidance can be sought from Employee Engagement and Relations at all times. 12.0 MANAGEMENT OF LONG-TERM ABSENCE 12.1 There are times when ill health will cause longer periods of sick leave (see

paragraph 3.2.2 for a definition of long term sick leave). 12.2 Due to its nature, long-term sickness needs careful handling particularly in

light of the Disability Discrimination legislation and pregnancy related. However, the issue does need to be managed and the Trust will require managers to actively manage long-term sickness in conjunction with the Employee Engagement and Relations Department.

12.3 In all instances of long term absence, the manager will be responsible for

keeping staff appropriately informed of any major changes in the workplace during their absence.

12.4 The manager should also ensure that staff are provided with access to

whatever support services the Trust is able to provide to assist their return to work at the earliest opportunity.

12.5 In managing long-term absenteeism the following points should be noted: -

12.5.1 As soon as a long-term sickness absence is identified, it is important for the manager to refer the member of staff to the Occupational Health Department via the referral form (Appendix 1) and subsequently notify the member of staff of the appointment by telephone or in person followed up in writing using template letter as seen in Appendix 2A. This should normally be instigated after 4 calendar weeks of the absence commencing unless there are extenuating circumstances. However in the instance of one of

the following illnesses, immediate referral to Occupational Health is appropriate;

• Musculoskeletal

• Sick leave following maternity leave

• Work related injury/accident at work

• Stress/Perceived Work related Stress/anxiety

12.5.2 Where a referral appointment is to be made, the manager should clearly set out their request to the Occupational Health Department in writing using the Occupational Health referral form and procedure as seen at Appendix 1.

The manager should discuss the contents of this form with the member of staff prior to sending to Occupational Health. This should normally be done initially by telephone or, if deemed necessary, through a meeting.

12.6 Following the member of staff’s appointment with the Occupational Health

Department a confidential report will be provided to the Manager and copied to the Employee Engagement and Relations Department. The manager should contact the member of staff to discuss the outcome of their appointment and offer any support or assistance if appropriate.

12.7 Rehabilitation

Depending on the reason for long term absence, Occupational Health may recommend that the member of staff is fit to return to their substantive post but under rehabilitation arrangements. 12.7.1 Under 'rehabilitation', an employee could be

offered various measures to help 'ease' them back to work. For example:

• Reduced hours

• Restricted or alternative duties within their own department or another department

• Access to specific treatment interventions such as

Physiotherapy

The Occupational Health Department will recommend the length

of time for the rehabilitation period. Managers are encouraged

to be supportive of the rehabilitation period and will be expected

to determine actual arrangements with staff members in

accordance with the recommendations from Occupational

Health.

12.7.2 In circumstances where Occupational Health advise that an

employee returning from long-term sickness absence should

return on a rehabilitation programme involving reduced hours,

the employee should receive their normal full pay for up to a

maximum of 4 weeks following the return to work, based on

contracted hours.

Annual leave may be used to reduce the working week for a

further period, however this will be at the discretion of the line

manager. There may be instances where a return from sick

leave is close to the end of the annual leave year and a member

of staff has the majority of their annual leave owing, the line

manager should consider if it is appropriate for this to be used

before a return to work, or to further facilitate a shortened

working week.

12.8 Permanent adjustments / modifications

Where the Occupational Health report advises that an employee is fit to

return to their current post, and if the manager is able to accommodate

modifications to the post, the manager should initially consider if these are

practical / possible. Where necessary, a Risk Assessment can be

undertaken. At all times, managers need to consider the requirements of

Disability Discrimination legislation.

The manager should meet with the member of staff to discuss the

Occupational Health Report along with an Employee Engagement &

Relations Officer, and explore what modifications would be practical. If

modifications are possible, then these should be in place before the

member of staff returns to work.

If the outcome is that it is not reasonable to accommodate the

recommended modifications, the manager should explore with the member

of staff whether they wish to be considered for redeployment. Occupational

Health opinion will require to be sought on the employee's suitability for

redeployment. 12.9 Redeployment

There may be occasions where Occupational Health recommends redeployment as a means of ensuring an individual remains in work. If this is the case, Employee Engagement and Relations will be involved in this process and will discuss what it entails, at a meeting with the member of staff and their manager. The details of any discussion should be followed up in writing.

In certain circumstances Occupational Health may recommend a temporary period of redeployment to facilitate an employee’s return to the workplace.

12.10 Termination of Employment

Termination will either be through:

a) an application by the staff member for ill-health retirement

b) or if deemed unfit by Occupational Health Department to undertake any work within the Trust (not Superannuable) or after the Trust has exhausted all avenues as described in 11.6.2 and 11.6.3. The process, as outlined in 11.6.5 should be followed.

a) Application for Ill-Health Retirement This is applicable where an employee is a member of the HPSS/Health & Social Care Superannuation Scheme (HSC) and has paid their contributions for a minimum of 2 years. There may be occasions when Occupational Health may deem an employee unfit for the foreseeable future and advise that the staff member is a suitable candidate for applying for ill health retirement. However, there may be cases where Occupational Health do not support an application for ill-health retirement but it is the employee’s right to apply if they so wish. The line manager and an Employee Engagement and Relations Officer will arrange to meet the staff member (where possible) before applying to provide support and guidance in relation to the steps to be taken in applying for ill health pension and to inform the employee about the implications of applying for ill-health retirement. Where a member of staff decides to apply, they should notify Employee Engagement and Relations of this in writing. (The Employee Engagement and Relations Department/Southern Trust Payroll Department will co-ordinate this process and liaise with the manager and the employee). If someone applies for ill–health retirement and is unsuccessful the Trust will terminate the contract of employment on ill-health grounds (appropriate payment of notice will be given) and the individual will be notified of their right of appeal and details of how to do this under the Health and Social Care Superannuation Scheme. Please refer to Appendix 11 for information on the process of applying for ill-health retirement. b) Termination on ill-health grounds. Where it is identified by Occupational Health that a member of staff on long term sick leave is unlikely to return to work in the foreseeable future (and the member of staff does not/cannot apply for ill-health retirement), action will be taken to consider the termination of the contract of employment in advance of the exhaustion of sick pay. Staff should be met with and made aware in writing at as early a stage as possible that termination is being considered. The process as outlined in 11.6.5 will apply. 13.0 RIGHT OF APPEAL 13.1 Staff will have the right to appeal the decision to terminate their employment

on the grounds of ill-health.

13.2 Staff wishing to appeal the decision should write to the Head of Employee

Engagement and Relations stating grounds of their appeal, within seven working days of receipt of the letter.

13.3 The Director of Human Resources & Organisational Development or nominated

deputy (unless previously involved) and another Director or nominated deputy who has not previously been involved will review all the circumstances of the case and make a joint decision. This will require a further meeting. In all circumstances an appeal hearing shall:

• be organised within 12 weeks of the termination; and

• be organised in a timescale which allows proper representation to occur, consistent with principles of natural justice.

13.4 The Appeal Panel will have the authority to confirm, or set aside, the decision

to terminate. Where the decision of the Appeal Panel involves a variation of the original decision, it should state the reasons. The decision of the Appeal Panel is final and will be conveyed in writing to the individual within seven days of the decision being taken.

13.5 In the event of reinstatement following an appeal the appropriate back

payment will be made. Provided the employee was in receipt of either Occupational Sick Pay (OSP) or Statutory Sick Pay (SSP) at the time of the original meeting.

Please note; that during any stages, the staff member will have the right to attend meetings accompanied by either a trade union representative or trusted work colleague.

14.0 TEMPORARY INJURY BENEFIT

Temporary Injury Benefit is payable if you have sustained an injury or contracted a disease which is wholly or mainly attributable to your HSC employment, resulting in a temporary reduction in earnings ability of 15% or more.

Signed on behalf of TU Side: Signed on behalf of Trust: _________________________ ___________________________ Noel Muldoon Kieran Donaghy TU Side Chair Director of HR & OD Date: ____________________ Date: ______________________

Management Referral To The Occupational Health Department

For OH use only OHS appointment date:

Time of appointment:

OHS Physician / Nurse:

Location:

Employee’s Personal Details Name (full name):

D.O.B.: Address:

Home Tel. No.:

Job Title: Dept / Facility:

Work Tel. No.: Staff Number:

GP:

Referring Manager Name: Job Title:

Location: Tel/Ext. No.:

Directorate: Email address:

I can confirm that the employee has been informed of the content and reason for referral. Signed: Date:

APPENDIX 1

Date of Absence: From: To:

Reason for Absence:

Reason for referral Long-term sickness absence – Employee not at work at present

Poor attendance – Employee at work, attendance difficulties attributed to health problems

Specific health concern – Affecting work performance or work affecting health

Resumption after sickness absence – Specific concerns regarding capability or

safety issues

Is the above employee currently on sick leave? Yes No

Specific Queries / Additional Information (e.g. interpersonal difficulties, grievance, capability, disciplinary, etc.)

(See Guidance Sheet)

APPENDIX 1 (cont)

APPENDIX 1 (cont)

Guidance Sheet Suggested questions to be asked on referral form Does this employee have an ongoing medical condition and has their absence/s been as a result of the medical condition? Has the employee reported any work related problems: Has the employee any impairment or health problem that is likely to have a long term or adverse effect on day to day activities? Is the employee fully fit for work, if not when is he/she likely to return?

What is the likelihood of a recurrence of the problem? Is there more advice / information needed for this employee (e.g. Refresher training on Manual Handling?) Is there anything which can be done to facilitate a return to work? Is there any short or long term limitation on ability to work? Is any sort of adaptation or change needed in the workplace or working methods? Could this person come back to another job, and if so, what type? Could there be risks in return or redeployment? What is the likely risk?

Will this employee be able to provide regular and reliable service in the future?

APPENDIX 1 (cont)

MANAGEMENT PROCEDURE FOR MAKING REFERRALS TO THE

TRUST’S OCCUPATIONAL HEALTH DEPARTMENT

First Referral

1. A manager can refer a member of staff to Occupational Health (OH) at any time during their employment in order to provide support, guidance and advice, to both the member of staff and the manager.

2. The general rule is that referrals should be made when:

- an employee has been on sick leave for 4 weeks; - a manager has concerns about casual absenteeism; - a manager has concerns about an employee’s fitness; - reason for absence is given as musculoskeletal, sick leave following

maternity leave, work-related injury/accident at work, stress/perceived work-related stress/anxiety.

3. The manager should complete the OH Referral Form, ensuring that they give as much information to OH as possible to ensure that OH Doctor/Nurse can make an informed decision based on all the facts.

Please refer to guidance sheet at the back of OH Referral Form for examples of questions to ask. In addition, it would be beneficial to include the following:-

- Any discussions with the employee regarding their reasons for absence;

- Any support, adjustments, training/development etc that have already been facilitated to ensure satisfactory attendance at work;

- Details of considerations (if any) that you have/could facilitate to try to improve attendance;

- Impact on department/service/other staff.

4. The details of the Referral Form should be shared with the member of staff before their appointment. This can be done via the telephone or at a meeting. All information should be in writing/emailed to Occupational Health Department. Only in exceptional circumstances will information be taken by telephone.

Once Occupational Health give a date for the appointment, you should inform member of staff in writing using template letter in Appendix 2A. You will receive a report following employee’s appointment at OH. Should you require further clarification on the contents, the line manager can contact the OH Practitioner directly. It is advised that you should update OH of any additional information prior to review appointments i.e. agreement on phased return, adjusted duties etc. This should assist in ensuring an early return to work, if possible. If a review is required, OH will notify you as manager and you will be required to confirm with the member of staff in writing (template letter – Appendix 2B).

PROFORMA CAN BE DOWNLOADED OFF INTERNET

APPENDIX 2 A

CONFIRM OCCUPATIONAL HEALTH REFERRAL

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME RE: OCCUPATIONAL HEALTH APPOINTMENT I refer to our telephone conversation/meeting on DATE, when I advised you that an appointment will be made for you to attend the Occupational Health Department. I also discussed with you the information that I will provide to Occupational Health for this appointment. I can now confirm that your appointment will take place on DATE, TIME at LOCATION. Please note that it is compulsory that you attend this appointment. If for any reason you are unable to attend please contact me as soon as possible. On receipt of the Occupational Health Report, I will undertake to contact you to discuss and, if necessary, will arrange to meet with you. Should you have any queries in the meantime, please do not hesitate to contact me. Yours sincerely

LINE MANAGER

APPENDIX 2 B

CONFIRM OCCUPATIONAL HEALTH REVIEW

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME RE: OCCUPATIONAL HEALTH APPOINTMENT Thank you for attending your Occupational Health Department appointment. DR/NURSE has indicated in their report the need to schedule a further appointment with you and accordingly an appointment has been arranged for DATE, TIME and LOCATION. If you have any difficulty attending this appointment, please contact me on TELEPHONE NUMBER.

LINE MANAGER

APPENDIX 3

RETURN TO WORK MEETING

AS PER TRUST POLICY A RETURN TO WORK MEETING MUST BE UNDERTAKEN FOLLOWING EVERY OCCASION OF SICKNESS ABSENCE

Name: _______________________Ward/Dept/Facility/Team: _______________ Band: __________________________ JobTitle: ________________________ Staff Number: ___________________ Hours of Work: __________________ 1. Has the staff member been assessed by Occupational Health as falling

under the definition Disability Legislation (DDA) YES/NO 2. Does the staff member having read the definition under DDA (1995)

consider themselves to have a disability? YES/NO

Did the employee comply with local reporting arrangements? Yes No

If ‘no’ please note any reasons/explanations and any follow-up action taken: Date of First Day of Absence:

Dd/mm/yyyy

Note: Partial day absences should be recorded on the Staff Absence Return.

Please indicate if Uncertified or Certified Sickness Uncertified □ Self Certificate □ Medical Certificate □ Last Day of Absence:

Dd/mm/yyyy

Calendar days Working days Duration of Absence

Give Brief Details of the Reason for Absence:

Is the member of staff fully recovered?

Yes No

If’ no’ please explain health condition and any factors associated with return to work arrangements: Was rehabilitation programme agreed by Occupational Health? Yes No

If so give details of hours / days /agreed, alternative / restricted duties and duration of rehabilitation period: Are there any modifications / reasonable adjustments to the workplace/duties to be made?

Yes No

If so give details: ADDITIONAL COMMENTS OR DETAILS OF FURTHER ACTION e.g. Appointment with Occupational Health, follow-up meeting to discuss progress, need to arrange formal interview to discuss sickness absence levels as per Trusts procedure, review of work arrangements:

Manager Signature: __________________________ Date: ____________

Employee Signature: ________________________ Date: ____________

APPENDIX 4A

4TH EPISODE CAUSE FOR CONCERN LETTER

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME Following our meeting on DATE I wish to confirm the issues discussed. A review of your sickness absence record demonstrates that you have had NUMBER episodes of sick leave in a rolling year period as follows:

Day Date From Date To Number of Days Reason Monday 7.10.08 8.10.08 2 Cold

Etc

I discussed with you that your level <and pattern> of sickness absence is causing concern and that as a result this will now be closely monitored. Should there be no improvement in your sickness absence, I may have no alternative other than to issue you with an informal warning. Further absence could lead to formal disciplinary action I am hopeful that this course of action will not be necessary and would encourage you to make every effort to improve your attendance at work. Yours sincerely LINE MANAGER

APPENDIX 4B

3TH EPISODE CAUSE FOR CONCERN LETTER FOR THOSE ON

PROBATIONARY

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME Following our meeting on DATE I wish to confirm the issues discussed. A review of your sickness absence record during your probationary period demonstrates that you have had NUMBER episodes of sick leave as follows:

Day Date From Date To Number of Days Reason Monday 7.10.08 8.10.08 2 Cold

Etc

I discussed with you that your level of sickness absence is causing concern and that as a result your probationary period will be extended for [1-3] months, and your attendance at work will now be closely monitored. Should you have a further sickness absence during your extended probationary period it may not be possible to confirm you in post which in turn may result in the termination of your Contract of Employment. I am hopeful that this course of action will not be necessary and would encourage you to make every effort to improve your attendance at work. Yours sincerely LINE MANAGER

APPENDIX 5

INFORMAL WARNING LETTER STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME

I am writing to confirm the outcome of our meeting on DATE which was held to discuss your sickness absence record.

As I have already indicated on previous occasions, your absence record is giving cause for concern, not only because of the extent of the absences but also because of the frequency <and pattern> of their occurrence.

I can confirm that a recent review of your sickness absence record has shown that you have been absent during the 12-month period ending [date] as follows:

Day Date From Date To Number of Days Reason Monday 7.10.08 8.10.08 2 Cold Monday 12.01.09 12.01.09 1 Tummy Bug

Etc

Whilst it is appreciated that absence due to illness may be unavoidable, you should however be in no doubt as to the emphasis that is placed on regular attendance and the fact that frequent absences, irrespective of cause, adversely affects the service which you can give. I am therefore issuing you with an informal warning as your attendance is unsatisfactory. You should understand that if an immediate and sustained improvement is not forthcoming it is likely that formal disciplinary action will be taken under the Trust’s Sickness Absenteeism Procedure (a copy of which I have enclosed for your information).

I am hopeful that this course of action will not be necessary, and would encourage you to make every effort to improve your attendance at work.

You have the right to appeal this decision. Should you wish to appeal you must write to NAME OF MANAGER’S MANAGER within seven working days of receipt of this letter, stating the grounds of your appeal.

Yours sincerely LINE MANAGER Copy to: Employee Engagement and Relations, file

APPENDIX 6

LETTER SENT PRIOR TO MEETING

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME I write further to your long-term sickness absence, and to your attendance at Occupational Health with DOCTOR, Occupational Health Physician on DATE. As you are aware, DOCTOR has advised that you < >, therefore, HR CONTACT, HR Advisor and I would wish to meet with you on DATE in LOCATION, to discuss further. The format of our meeting will be to discuss DOCTOR report, and the possible option of <returning to work -rehabilitation/redeployment/applying for ill health superannuation pension. Failing this/these option/s the Trust may have no alternative other than to end your contract on the grounds of ill health.> Please note that you have the right to be accompanied, should you so wish, by either a trade union representative or a trusted work colleague. Should you have any queries in respect of date or time, please do not hesitate to contact me on TELEPHONE NUMBER. Yours sincerely LINE MANAGER cc Employee Engagement and Relations file

APPENDIX 7

SAMPLE OF FOLLOW-UP LETTER TO MEETINGS

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME

I write further to your long term absence and to our meeting on DATE with HR CONTACT, UNION REP and myself and wish to outline what we discussed with you. At the outset (detail which of these where discussed and agreed in more detail)

• Recommendations from Occupational Health

• Return to work date

• Rehabilitation

• Phased Return

• Redeployment

• Applying for Ill Health Superannuation Pension or finalizing outcome

• Termination of employment contract on the grounds of Ill Health Set out timescales if reviewing again I hope this accurately reflects the content of our meeting, if you need to contact me for any clarification on the above you can do so on TELEPHONE NUMBER. Yours sincerely LINE MANAGER Cc Employee Engagement and Relations file

APPENDIX 8

Proforma for approval to withhold pay following failure to submit Medical

Certificate.

Line manager to complete Name of Staff Member: Details of sickness absence, including dates, reason for sickness and any certification outstanding.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Details of contact made with staff member, via telephone in relation to non submission of certificates, including dates, time etc:

________________________________________________________________________________________________________________________________________________________________________ If contact has been successful, reason given by member of staff for failure to submit certificate:

________________________________________________________________________________________________________________________________________________________________________ Detail why this reason is considered unacceptable.

________________________________________________________________________________________________________________________________________________________________________ Signature of line manager _______________________ Date ________________

Head of Service / Assistant Director to complete

Withholding of pay approved? Yes / No Reason for decision ____________________________________________________________________________________________________________________________________________________________________________________ Signature of Head of Service / Assistant Director:_____________________________ Date: _________________

APPENDIX 9

WITHHOLDING PAY (UNACCEPTABLE REASON)

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME I write in relation to our telephone conversation of DATE regarding your failure to submit a certificate to cover your current period of sickness absence. You advised me that your reason for not submitting a certificate was ……. . After considering this, in conjunction with my Senior Manager/Head of Service NAME, it has been decided that the reason given by you for not submitting a certificate was unacceptable. In light of this, we will be withholding your pay in accordance with the Trust’s Management of Sickness Absenteeism Procedure. Therefore, I have to advise that pay will be withheld effective from DATE to DATE. You should note that continued failure to be absent from work without appropriate certification will be deemed as unauthorized absence and in this respect, will be managed accordingly. I have enclosed information as to your responsibilities as a member of this Trust when reporting off on sick leave and I would hope that you would adhere to the Trust Procedures in future. Yours sincerely LINE MANAGER Cc Employee Engagement and Relations

Payroll Department

APPENDIX 10

WITHHOLDING OF PAY LETTER (NO CONTACT)

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME I write in relation to your current period of sickness absence and note that you have not provided a medical certificate to cover this absence, as is required in accordance with the Trust’s Management of Sickness Absenteeism Procedure. Furthermore, you have not contacted me to discuss this, and my attempts to contact you have been unsuccessful. I am therefore writing to you to advise that failure to contact me by DATE, and failure to submit a medical certificate by that date will result in your pay being withheld effective from DATE. You should note that continued failure to be absent from work without appropriate certification will be deemed as unauthorized absence and in this respect, will be managed accordingly. I am hopeful that this course of action will not be necessary and look forward to hearing from you. Yours sincerely LINE MANAGER Cc Employee Engagement and Relations Payroll Department

APPENDIX 11

Procedure for Staff Applying for Ill Health Superannuation Pension

The following steps are to be taken if a Staff member wishes to apply for Ill Health Superannuation Pension.

1. Human Resources Officer must ensure that all options have been exhausted i.e. redeployment, reasonable adjustment etc.

2. The Staff member has paid into the Superannuation Scheme for a

minimum of 2 years. 3. A meeting should be arranged and the staff member must be informed

that if s/he wishes to apply for Ill Health Superannuation Pension s/he must put it in writing to the Human Resources officer that is present at the meeting.

The HR Officer must make it clear to the member of staff that by putting

their request in writing they are in fact saying that they are not fit to take up the duties of their post, and if the outcome of their application is unsuccessful that the Trust would have no alternative at that stage but to terminate their contract.

Also advising on Tiers;

Tier 1 is granted if one is unable to do their current job due to permanent ill health, therefore, one would only get accrued service no enhancements;

Tier 2 is granted if one is unable to carry out any regular employment due to permanent ill health, therefore, one would receive accrued service plus an enhancement of up to 2/3 of your prospective service

4. When the HR Officer receives the letter from the staff member they will;

• Send a copy of the letter and the staff members Job Description to Occupational Health Department advising them that the Staff member wishes to apply for Ill Health Superannuation Pension.

• Send a copy of the letter to Salaries and Wages advising them of the staff members request to apply for Ill Health Superannuation Pension.

• HR Officer will then send a copy of the AW33-09 form to the Line Manager and arrange to meet to help the Line Manager complete part A. HR Officer will write to the applicant explaining at what stage the application form is at and what the next steps are;

• HR Officer will then send/bring the AW33-09 form to Payroll for authorisation, and in turn Payroll will forward the form to the Applicant.

5. Occupational Health will inform the Line manager that an appointment has

been made for the staff member to meet with the Occupational Health Doctor/Consultant to complete Part C of the application form. (*Part C is a medical report from OH Doctor/Consultant to the Superannuation Branch to support the staff members application). The Line Manager will inform the Staff member of this appointment

Occupational Health will give the staff member a copy of their Job Description and self addressed envelope to the Superannuation Branch at this appointment.

6. The Staff member will finalise completion of the AW33-09 application form

and forward the form along with Job Description to the Superannuation Branch in the envelope supplied.

7. It usually takes 6-8 weeks for any decision from the Superannuation

Branch, during holiday periods it may take longer.

8. The Staff member and Salaries and Wages will be notified of the Superannuation Branch’s decision at the same time. * Note if Superannuation Branch requires further information the Trust will wait the outcome of that decision before continuing to No 10 of the procedure

9. Salaries and Wages will then notify Human Resources Officer who will

arrange a final meeting with the Staff member and their Line Manager.

a) At the meeting if the Staff members application has been successful Human Resources Officer will inform the Staff member of the date of their last day of service and the date their pension begins, advise them that Salaries and Wages will be sending AW6 (see point 11-13);

b) However, if the application is unsuccessful the Human Resources

Officer will inform the Staff member;

• Of their entitlement to notice and last day of service inclusive of annual leave, and their right of appeal.

• Of the appeal process against the decision of the Superannuation Branch

c) The Line Manager would take the opportunity to acknowledge the

Staff members service, and for the return of uniforms, personal identification/passes, locker keys etc. (The Line manager can take this opportunity to arrange farewell gathering.)

10. Human Resources Officer will send a letter to the Staff member outlining the outcome of the meeting i.e. final date of service and the start date of the pension if applicable. A copy of this letter will be sent to Salaries and Wages.

Human Resources Officer will remind the Line Manager to submit a

termination form to Salaries and Wages and Human Resources. 11. Salaries and Wages will then send the Staff member an AW6 Claiming

payments form which asks for original personal documents e.g. birth certificate, marriage certificate etc.

12. The Staff member will return this AW6 form and relevant documentation to

Salaries and Wages.

13. Salaries and Wages will complete their part of the AW6 form and forward all to the Superannuation Branch for them to release payment of the pension to Staff member.

CONTACT NUMBER FOR HUMAN RESOURCES: 028 3741 2601

APPENDIX 12 TERMINATION LETTER DUE TO SICKNESS ABSENCE

STAFF NUMBER DATE NAME ADDRESS Dear TITLE SURNAME I write further to your long term absence and to our meeting on DATE with NAME/S and wish to outline the matters we discussed. At the outset of the meeting we discussed your Occupational Health report from <DOCTOR> which he states that you are permanently unfit for your substantive post. <add here what was discussed reasonable adjustments/redeployment >. You agreed <?>. Therefore, I had to inform you<as you do not pay into the Superannuation Scheme/as you did not meet the requirements for superannuation pension> it is with regret that the Trust has no alternative at this stage but to end your contract for reasons of ill health. In accordance with the terms and conditions of your service, you are entitled to < NUMBER> weeks notice inclusive of annual leave, and therefore your last day of service will be {Note:Calculate last day by DATE OF MEETING PLUS NOTICE} <date> which will be forwarded to you in due course. Termination of your contract will not prejudice any future application by you for employment. Application would of course have to be in response to public advertisement and any offer of employment would be subject to you being medically fit to carry out the duties of the post. You have the right to appeal this decision and if you wish to do so you should write stating the grounds of appeal to Mrs Vivienne Toal, Head of Employee Engagement and Relations, Human Resources Department, Hill Building, St Luke’s Site, Loughgall Road, Armagh, BT61 7NQ, within seven days of receipt of this letter. Should you have any queries in respect of any of the above please do not hesitate to contact me on TELEPHONE NUMBER. I should like to take this opportunity to express the Trust’s appreciation of your service within Southern Health and Social Care Trust and extend every best wish for the future. Yours sincerely LINE MANAGER Copy to: Employee Engagement & Relations, Payroll, File

ABSENCE RECORD - 2009/2010 (5days) Appendix 13A Name:_____________________ Band: ________ WTE: ________Hrs/week: _________

A/L Entitlement (inc of c/f leave) ________St/L Entitlement:_______ MON TUES WED THUR FRI A/Leave Hrs

Entitlement Stat/Leave Hrs

Entitlement Hours

Worked Per Day

W/B MON TUES WED THUR FRI

Used /week Left

Used /week Left

Approved by/ Remarks:

30 MAR

6 APR

13 APR

20 APR

27 APR

4 MAY

11 MAY

18 MAY

25 MAY

1 JUNE

8 JUNE

15 JUNE

22 JUNE

29 JUNE

6 JULY

13 JULY

20 JULY

27 JULY

3 AUG

10 AUG

17 AUG

24 AUG

31 AUG

7 SEPT

14 SEPT

21 SEPT

28 SEPT

5 OCT

12 OCT

19 OCT

26 OCT

2 NOV

9 NOV

16 NOV

23 NOV

30 NOV

7 DEC

14 DEC

21 DEC

28 DEC

4 JAN

11 JAN

18 JAN

25 JAN

1 FEB

8 FEB

15 FEB

22 FEB

1 MAR

8 MAR

15 MAR

22 MAR

29 MAR

Total Annual/Stat leave hours to be c/f into 2010/2011

ABSENCE RECORD - 2009/2010 (7days) Appendix 13B

Name: ________________________Band ________ WTE: _______ Hrs/week: _______

A/L Entitlement (inc of c/f leave): ____________St/L Entitlement: _______

MON TUE WED THU FRI SAT SUN A/Leave Hrs Entitlement

Stat/Leave Hrs Entitlement

Hours Worked Per Day

W/B MON TUE WED THU FRI SAT SUN

Used /week Left

Used /week Left

Approved by/ Remarks:

30 MAR

6 APR

13 APR

20 APR

27 APR

4 MAY

11 MAY

18 MAY

25 MAY

1 JUNE

8 JUNE

15 JUNE

22 JUNE

29 JUNE

6 JULY

13 JULY

20 JULY

27 JULY

3 AUG

10 AUG

17 AUG

24 AUG

31 AUG

7 SEPT

14 SEPT

21 SEPT

28 SEPT

5 OCT

12 OCT

19 OCT

26 OCT

2 NOV

09 NOV

16 NOV

23 NOV

30 NOV

7 DEC

14 DEC

21 DEC

28 DEC 1

04 JAN

11 JAN

18 JAN

25 JAN

1 FEB

8 FEB

15 FEB

22 FEB

1 MAR

8 MAR

15 MAR

22 MAR

29 MAR

Total leave hours to be c/f into 2010/2011

Appendix 14

GUIDELINES FOR COMPLETION OF STAFF SICKNESS ABSENCE RETURN FORM

(See below for completed sample Staff Sickness Absence Return Form)

Staff Sickness Absence Return form is for the purpose of capturing details of all sickness absence to enable the Trust to monitor this effectively.

You must ensure that the appropriate details are filled in properly;- MONTH ENDING; WARD/DEPARTMENT; COST CENTRE; DIRECTORATE; Line manager’s name and contact telephone number Administrator’s name and contact telephone number (if applicable)

* Staff Number: Full Staff Number must always be used e.g. 024/01/01234 SICK LEAVE DETAILS

First Day of Absence:

This should be the first day of the period of absence even if the absence began in the prevweek/month. (see employee A, overleaf)

Last Day of Absence:

If the period of sickness absence finishes within the month, the last day of sickness must be filled in. Please note the last day of actual sickness/absence should be recorded and not the date of return to work. If the employee is still absent on the last day of the week/month, please indicate by an arrow

e.g. → (see Employee’s C & E overleaf)

Total Work Days Lost/Total Hours Lost:

These are the actual full working days/actual working hours lost. Examples: If employee works 5 days per week and is sick from 1 May 09 to 31 May 09 = 21 working days lost If employee works 2 days per week and is sick from 4 May 09 to 11 May 09 = 2 working days lost If employee works 5 days per week and is sick from 4 May 0 9 to 11 May 09 = 5 working days lost The totals are cumulative i.e. total days / hours lost from the first full day of the sickness period. (see Employee A overleaf) In the event that an employee leaves work early/arrives late due to sickness it is only necessary to record the number of hours lost and this should be recorded as a separate entry. (see Employee B* overleaf)

If an episode of sickness incorporates a Statutory Leave day, this day should be counted as a Working Day Lost.

Reason for Sickness:

It is a Manager’s responsibility to ensure that all sickness absence is classified. The reason for absence should be as accurate as possible and, where applicable, as stated on the medical certificate. (See Sickness Codes on pull down menu on form/attached) If sickness is continuing from the previous week/month you should still complete the reason for absence. Should the reason for sickness change please include new reason and code.

Other leave details:

Do not record: annual leave, statutory leave, leave for courses / Conferences & Training Trade Union Leave, Jury Service, Marriage Leave. *Maternity leave, *adoption leave, *Crisis Leave, *Unpaid Leave, *Career Break, *Work Break. on this form * Please refer to Worklife Balance Policy for guidance and application forms.

If no sickness within team/department

Indicate NIL across form.

(SAMPLE) STAFF SICKNESS ABSENCE RETURN COST CENTRE: WEEK / MONTH ENDING: May 2009 WARD / DEPARTMENT: HR Information

SICK LEAVE DETAILS

Dates Of Sickness

Name Staff Number First Last

Cumulative Work Days

Lost

Total Hours Lost

Reason and Code for Sickness Absence

Employee A 700/01/12345 7 Jan 09 20 May 09 100 750

{NOTE A PULL DOWN MENU OF REASONS AND CODES WILL APPEAR ON THE ORIGINAL ON THE INTRANET} Chest infection J03

Employee B* 700/01/12346 11 May 09 11 May 09 0 3.5 Light Head R02

Employee B 700/01/12346 12 May 09 22 May 09 9 36 Light Head/Vertigo R02

Employee C 700/01/12347 25 May 09 � 5 37.5 Fractured leg M10

Employee D 700/01/12348 4 May 09 13 May 09 6 45 Hyperemesis (Pregnancy sickness) 005

Employee E 700/01/12349 21 May 09 � 7 28 Road Traffic Accident R08

LINE MANAGER'S NAME : John Brown DATE: 1 June 2009 ADMIN CONTACT NAME: Joanne White CONTACT TELEPHONE NO.: 028 3830000 Ext: 1

PLEASE NOTE: THIS FORM CAN BE FOUND ON THE INTRANET AND MUST BE EMAILED BY THE 3RD WORKING

DAY OF EACH MONTH TO:- staffabsence.return@southerntrust.hscni.net

ANY OTHER LEAVE MUST BE APPLIED THROUGH THE WORK LIFE BALANCE POLICY

Page 43 of 43 August 2009