Sickness Absence Policy

Page 1 l

Sickness Absence Policy

Workforce Readership (Target Audience): All employees NHSLA / HSE / IGT etc.): N/A Page 2 Document (delete as appropriate): http://kingsdoc/docs/policies or x:\Trust Wide Policies \ Archive - All out of date or superseded Trust Wide Policies

Group: Policy Review Group January 2025 Partnership Committee April 2025

Versi on Date Type of Change Summary of Changes Author 1.1 08/2007 Minor General update due to new guidance

Keith Loveridge 1.2 10/2009 Minor General update due to new guidance Elaine Boyle 2.0 07/2010 Major to KE Updated to reflect change from SSP1 sick note form to new fit note. Monitoring requirements specified throughout have been collated into one section .Format change to reflect updated policy on policies Marion Lorman

Barbara Conroy

Barbara Conroy 2.1 02/08/2010 Minor Equality Impact Assessment added. Correct spelling of drive Barbara Conroy 2.1 24/05/2012 Minor Amended hours for phased return for medical staff to read 40 or p/r Marion Lorman Page 3 2.1 10/07/2012 Minor Added paragraph on Secondary Employment Mark Preston 3.0 29/01/2014 Minor General update due to new guidance and additional clarification on; informal monitoring, annual leave entitlements, ill health retirement. X drive references replaced with KingsDocs. STARS reference replaced with MAPS e- Rostering. Victoria Tyler 4.0 30/06/2017 Major to KE New long term sickness trigger of 28 days Revised review points for staff on probation Clarification on short and long term stages Change to welfare meeting for informal stage, Clarification of reporting on HealthRoster. New appendix with flowchart of process

Jen Wallbank 5.0 12/01/2021 Periodic review and major changes. The policy has been shortened, removal of the review points for new employees, long term sickness process has been reviewed, removal of stage 2 combined sickness management, decisions are made on overall sickness John Wall 5.1 13/06/2022 Minor Section 21 (Notifiable and other Infections Diseases) -latest advice on staff who specifically have symptoms of COVID-19

Page 4 5.2 18/07/2022 Minor Minor changes to wording and updates

6.0 02/04/2025 Major Revised the Sickness Absence Process and Procedure Natasha Elvidge 6.1 25/05/2025 Minor Updated Return-to-Work form to include menopause and disability related questions. Minor changes to wording. Alex Kuzminas 6.2 08/12/2025 Minor Minor changes to Informal Stage of Sickness Absence wording Lauren McEvoy

Keywords: Sickness, absence, ill health, review points, long term, short term.

Distribution Person Responsible Confirmation Receipt Required? Replacement for Previous All staff KingsDocs No

Daily Bulletin Intranet news item Page 5 Table of Contents Section Page 1 Introduction 7 2 Purpose and Scope 7 3 Definitions 8 4 Wellbeing and Practical Support 9 5 Duties & Responsibilities 10 6 Sickness Absence Reporting 11 7 Recording of Sickness Absence 12 8 Medical Certification 13 9 Sickness Absence whilst overseas 14 10 Occupational Health 14 11. Employee Assistance Programme 16 12. Stress at Work 16 13. Mental Health & Psychological Support 16 14. Occupational Sick Pay (OSP) 16 15. Statutory Sick Pay (SSP) 17 16. Non-Payment of Sick Pay 17 17. Sickness Absence and Annual Leave 18 18. Ill Health During a period of A/L 18 19. Ill Health During a Bank Holiday 18 20. Untaken Annual Leave due to Ill Health 18 21. Use of Annual Leave during a Period of Absence due to Ill Health 22. Returning to Work 19 23. Phased Return to Work Plan 20 24. Re-Deployment 20 25. Review Points 21 26. Terminal Illness 21 27. Contact Arrangements 22 28. Informal Management 22 29. Formal Management 22 30. Ill Health Retirement 23 31. Long Term Health Condition Impacting on Ability to Carry out Role 32. Sickness Hearing Panel and Attendees 24 33. Appeals 25 Page 6 34 Disability and Absence 25 35. Pregnancy and Sickness Absence 25 36. Reasonable Adjustments 25 37. Absence resulting from an accident at work 26 38. Outside of work 26 39. Medical & Dental Appointments 27 40. Notifiable and other infections 27 41. Diarrhoea and Vomiting (D&V) 28 42. Surgery and Medical Procedures 28 43. Ill Health Absence during investigations and Formal Processes 44. Medical Suspension 29 45. Absence relating to Unauthorised Absence 29 46. Bank Work 29 47. Career Break whilst on sick leave 29 48. Monitoring and Compliance 30 49. Associated Documents 30

Appendices: Appendix 1 Return to Work Interview 31 Appendix 2 Managing Short - Term Sickness Absence Procedure Flowchart Appendix 3 Managing Long - Term Sickness Absence Procedure Flowchart

Appendix 4 Equality Risk Assessment Form (ERAF) 35

Page 7 1. Introduction

King's College Hospital NHS Foundation Trust is committed to supporting the physical and mental wellbeing and health and safety of all employees, whilst ensuring that we deliver and maintain an efficient and consistently high standard of care to our patients and service users.

King's College Hospital NHS Foundation Trust is dedicated to embracing the broad diversity of our employees, patients and communities and stand firmly against all forms of prejudice and discrimination. Our commitment extends to all protected characteristics under the Equality Act 2010 as well as other vulnerable groups. We expect every employee to respect and uphold this in relation to all our trust policies, practices, and procedures. It is against the law to discriminate against anyone because of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race (including colour, nationality, ethnic or national origin), religion and belief, sex, and sexual orientation. Discrimination towards our employees or patients, in any form, is strictly prohibited. This includes, but is not limited to, racism, ableism, homophobia, biphobia, transphobia, sexism, ageism, religious discrimination, and any other prejudiced behaviour that undermines the rights, wellbeing and identity of our employees, and patients. Discrimination can be displayed in various forms including, but not limited to, language, behaviours, unequal treatment, harassment, exclusion, stereotyping, or denying access to opportunities. We embrace our duty to address discrimination in all its forms, and we pledge to: - listen to the voices and lived experience of colleagues and patients, and other groups who suffer discrimination or lack of fair representation - commit to working towards removing inequalities within our Trust, including differences in access, experience and outcomes for our diverse patient groups - turn that commitment into positive action and real change - use our voice and influence within the wider system to address the wider social determining factors of health - accept our responsibility to listen to, and learn from, the experience of all underrepresented groups - listen with respect and genuine curiosity, acknowledging that continued action and resource is required to bring about the change we need to see - ask all colleagues to work with us to remove unfairness and discrimination within our organisation and within our wider communities

2. Purpose and Scope

This policy applies to all King's employees and provides a framework to manage short and long term sickness absences. It will support employees through periods of ill health to return to work or remain in work through facilitating early efficient pathways of support, care and management.

Page 8 The Trust encourages open and honest conversations between managers and employees so both can work together to ensure the right support is in place to meet the aims of this policy and where possible remedy any workplace causes of absence or sickness/ill health.

The aim of this policy is in line with our values and behaviours: - Kind - We show compassion and understanding and bring a positive attitude to our work - Respectful - We promote equality, are inclusive and honest, speaking up when needed - Team - We support each other, communicate openly, and are reassuringly professional

This policy is designed to: - Promote a positive culture of wellbeing and attendance at work (e.g. undertaking health and wellbeing conversations with employees regularly and offering tailored support during sickness) - Support managers and employees in the management of sickness absence in a way which is fair and consistent and promotes the Trust's commitment to balance the needs of employees and service delivery - Establish the roles and responsibilities of all parties involved - Ensure compliance with legislation, including the Equality Act 2010, Health & Safety at Work Act 1974, Agenda for Change Terms and Conditions and Terms and Conditions of service for Doctors and Dentists

3. Definitions

'Must' and 'Should'

Throughout this policy the word ' should' is used to indicate what the Trust considers to be good practice, rather than mandatory requirement. The word 'must' is used to indicate where something is mandatory or legal requirement.

Right to Representation

This is the right of an employee to be accompanied to formal meetings by an accredited Trade Union (TU) representative or workplace colleague employed by the Trust.

Reasonable Adjustments

Reasonable adjustments are changes the Trust makes to remove or reduce a disadvantage related to employee's disability in order to carry out their role . Under the Equality Act 2010, there is a legal duty on employers to make these reasonable adjustments for disabled employees.

Page 9 Short-Term Sickness Absence

Short-term sickness absence is defined as short but pe rsistent periods of absence due to sickness shorter than 28 calendar days. The review points for short term sickness are as follows:

- 3 episodes of sickness or 6 calendar days of sickness absence within a 6 month s rolling period. - A combination of odd single days or where a discernible pattern of sickness absence has been identified which causes concern. Examples of a discernible pattern of sickness absences are:

Absence on consistent days / periods

- Absence on days where annual leave has been requested but not authorised by management or before/after a period of booked leave or scheduled day off - Sickness days taken before and/or after weekends/bank holidays and / or during school holidays - Sickness on, before or after festivities - e.g. birthdays, weddings, sporting events, Christmas period, etc... - Sickness that falls consistently just outside of the review points (triggers).

Long-Term Sickness Absence

Long Term sickness absence is defined as a period of continuous sickness absence of 28 calendar days or more. It would normally cover long term illnesses, disability, serious health conditions, rehabilitation, therapy, operations and recovery from accidents.

Phased Return

A phased return to work is when an employee who has been absent due to sickness gradually builds up to returning to work, for example, starting on reduced hours, doing work that is different to their usual job, having a lighter workload.

4. Wellbeing and Practical Support

There is a wealth of information, advice, and resources and practical support available to employees to enhance their mental and physical wellbeing and help them make healthy choices. These options include: - Occupational Health - See section 10 - Employee Assistance Programme - Staff Psychology Service - Health and Wellbeing Service - Respectful resolution services, including mediation - Employee networks, including dedicated networks for Inter Faith & Belief Network, King's Able (Disability) Network, King's & Queers (LGBTQ)+ Network, REACH Network and Women's Network - Spiritual and pastoral services Page 10 - Support with cycling to work - A wide range of discounts on goods and services, including transport, fitness and food

5. Duties and Responsibilities

All parties ( employees, Managers, People Directorate , Trade Unions and Occupational Health) agree to work in partnership with the shared goal of maximising an employee 's attendance, return to work and support in wellbeing at work and to manage sickness absence in a sensitive and confidential way. For the Trust to support the wellbeing of employees and reduce sickness absence the following responsibilities apply: Managers must: - Promote good health, wellbeing, and safety. - Ensure that employees are aware of the local sickness reporting procedures and the importance of adhering to them. - Ensure employees with disabilities are supported to work to their full potential. - Adhere to Trust policies when managing sickness absences, taking advice from their site -based People teams, Occupational Health , or T rade Union representatives where needed. - Maintain accurate attendance records on the Trust's Health Roster system. - Ensure all employees understand how to report their absences. - Immediately investigate accidents at work, ensuring any policy and statutory reporting requirements are met, in accordance with the Adverse Incidents Policy. - Only end an episode of sickness absence once the employee returns to work to avoid having multiple episodes recorded on the system. - Notify an employee when their sick pay entitlement will enter half pay and nil pay at the end of the 2nd month prior to pay being reduced. Site-based People teams can support with this. - Be proactive in talking to the local site People Business Partner as soon as it is identified employees may be off longer -term, so the right support can be provided. - Conduct return to work meetings after all absences to investigate the facts and establish the reason(s) (whether obvious or underlying) for long -term, or repeated short-term absence before taking any action as well as complete the self- certification form with the employee. - Ensure sickness data and paperwork is recorded and stored securely. - Seek medical information, advice and evidence to assist in any decision making process concerning a n employee's member's health. Early involvement of the Occupational Health Service should take place as appropriate. - Put in place reasonable adjustments to support employees who may need them. - Act on reports of workplace stress, and undertake a stress risk assessment as soon as there is an indication of an employee reporting that they may be experiencing stress, regardless of whether it is work or non -work related; the Page 11 holistic approach to staff wellbeing enables improved performance. - Undertake Stress risk assessments whilst an employee is absent from work, so that any work-based factors can be actioned, before a return to work, noting that it may be beneficial in some complex cases to ask your People Business Partner to allocate a different manager to undertake the stress risk assessment, although the line manager will still be responsible for implementing any actions identified. - Refer to Occupational Health where indicated and complete a workplace stress risk assessment in accordance with the Management of Workplace Stress Policy.docx. - Assess and manage risks in the workplace that may impact on employee's mental or physical health. - Ensure that they speak to employees when they call to notify their sickness absence. If they are unable to take the call, they must call the employee back as soon as possible. - Agree frequency and method of contact with the absent employee that is appropriate to the nature of the absence. Telephone, Teams call, face to face on site and in rare cases, a home visit may be indicated in potential ill -health retirement or cases where an employee has substantially restricted movement or sensory deficit - Apply the guidance contained within this document in a consistent, equitable and sympathetic manner and to ensure all information regarding the reason for absence remains confidential. All employees must: - Familiarise themselves with the contents of this policy and adhere to the policy and procedures. - Report sickness absence on the first day of absence - Advise/ handover to the line manager any outstanding tasks/ meetings which need to be re-arranged. - Ensure GP or other medical appointments are arranged in good time if the absence/ Fit Note may need to be extended, and keep the manager informed. - Keep in touch during longer term absences - at least a weekly call to the line manager unless other contact frequency has been agreed. - Attend Occupational Health appointments, return to work and sickness absence meetings as requested by management. - Ensure Fit Notes (Medical Certificates) are submitted within 24 hours of receipt. - Report accidents at work immediately (the same day as the accident happens) in line with the Trust's Health & Safety Policy Trust Health and Safety Policy.docx. - Engage with this policy and attend all meetings; failure to do so may result in formal action being initiated under the Trust's Disciplinary Policy Disciplinary Policy and Conduct Standards.docx and/or may result in Occupational Sick Pay being withheld. - Not undertake paid or unpaid work, study or training whilst absent from the Trust due to sickness. Any such employment will be investigated in accordance with the Trust's Disciplinary Policy and Conduct Standards and will be referred to the Local Counter Fraud Team.

6. Sickness Absence Reporting The employee must notify their line manager (or other nominated person), by phone (or by Page 12 other local agreed communication) as soon as possible if employee is unable to attend work because they are ill, ideally prior to the start of their shift or working day, unless they are incapacitated, e.g., in hospital. In the absence of any local procedure the default requirement shall be to report any absences to the immediate line manager or appropriate nominated person two hours prior to the expected time on duty.

It is t he employee's responsibility to report sickness absence s themselves. Only in very exceptional circumstances it is acceptable for someone to ring in on their behalf (e.g., emergency hospitalisation). The same information is required when someone else is ringing in on the employee's behalf such as: - reason for the absence - estimated length of absence - immediate work issues needing to be addressed - agree ongoing contact arrangements Notification of ill health via email, text message or leaving messages with colleagues is in most cases not appropriate. However, if this is locally agreed then it must be followed up with a call as early as possible (with the appropriate person in charge), providing sufficient notice so that appropriate plans can be arranged without impacting on the service and patient care. Employees who do not attend work and fail to make contact in line with the sickness absence reporting procedures, will be contacted on their home or personal phone number by their manager to confirm their wellbeing. In cases where there is a real concern for an employee's welfare, their manager may attempt to contact the employee's next of kin to check their wellbeing. Discretion must be exercised in judging the suitability of this, and site-based People colleagues and senior management advice must be sought. An employee is encouraged to speak up if they feel they are experiencing symptoms of workplace stress, to enable management to address this. Failure to notify absence properly may lead to the absence being classified as unauthorised absence, which will be unpaid, and may lead to disciplinary action in line with the Trust's Disciplinary Policy and Conduct Standards.docx.

7. Recording of Sickness Absence Records must be maintained for every employee by their line manager in line with Trust recording procedures. Sickness absence is recorded as 'Calendar Days Lost' which should include Saturdays, Sundays and public holidays as well as scheduled rest days (if applicable), all of which count towards a continuous period of absence. Employees should confirm to their line managers when they are fit to return to work, prior to when they are rostered or scheduled to work next. Sickness absence must be recorded as full calendar days to ensure correct sick pay. Sick pay cannot be paid for part days. If an employee leaves early due to illness and has completed less than a full shift, it should be recorded as a full day of sickness absence. If an Page 13 employee leaves after completing more than half a shift, managers will record it as "Part Day Sickness" in the HealthRoster, but it will not count as a full day of sickness absence. 8. Medical Certification For the first 7 calendar days of sickness absence employees can self-certify. The Trust has the right to request a Fit Note during the self-certification period if there is any doubt as to the validity of the sickness absence (some GP's charge for this, but the fee may be refunded via expenses in exceptional circumstances if there is evidence a cost was incurred). Self-certification is required for any period of absence from Day 1 by signing the sickness certification declaration contained within the Return to Work Meeting Form ( Appendix 1) which should be completed by the line manager on the first day back at work. If the line manager is not available on that day it should be completed by the person acting in that capacity on the day. A medical certificate must be provided covering the 8 th day of sickness absence onwards. Should the illness continue beyond 7 calendar days or more, further medical certificates should be provided on or before the expiry date of the previous medical certificate, within 3 working days of the previous certificate's expiry , unless there are exceptional circumstances that prevent this happening. Ideally the original copies of medical certificates should be sent to the line manager however, scanned copies will be accepted where it is not possible to send the original. The original copy should however be retained as evidence where required. Failure to provide appropriate medical certification in a timely manner may result in withholding of pay for unauthorised absence. Managers must update the certification field on the sickness absence record in the Trusts Healthroster system to Medically Certified. In exceptional circumstances the Trust reserves the right not to guarantee back payment on backdated medical certificates from GPs, and therefore employees are required to provide detailed reasons for the delay in writing to their line manager if this becomes necessary. If pay is to be stopped the manager must confirm the details in writing to the employee. A medical certificate from the employee 's clinician can be requested for any period of absence, if required by the manager - this will only happen in exceptional circumstances, where there are significant concerns about the employee's level of absence. The Trust will reimburse any costs incurred for this if a receipt is provided. Managers should seek advice from the People Team before proceeding with this action. If an employee decides to return to work before their medical certificate expires, they should consult with their line manager prior to returning to work. In exceptional circumstances, the manager may request this is delayed until appropriate Occupational Health advice is sought. In these circumstances Medical Suspension, see section 44, may apply. Where there is a question regarding the validity of any medical certificate this may be investigated by the Local Counter Fraud specialist prior to being accepted. It is important to also report the last day of sickness even if not required on duty in order that an employee's cover arrangements are made.

Page 14 Nurses, occupational therapists, pharmacists , physiotherapists, hospital doctors and general practitioners can legally certify Fit Notes. Scanned or digital copies of these will be accepted.

9. Sickness Absence while Overseas For sickness occurring whilst on annual leave outside of the United Kingdom (UK), employees are required to report their sickness and provide medical certificates in the normal way within the re levant timeframes ( see Section 8). The Trust reserves the right to verify medical certificates from outside the UK. If the period of sickness absence abroad exceeds 4 weeks, the employee is required to be available to attend an on-line Occupational Health appointment. The Trust reserves the right to request travel documentation regarding the employee's trip.

10. Occupational Health (OH) The early involvement of the Occupational Health team can be helpful to advise on which workplace adjustments might enable an employee to return to work, or provide advice on the employee's sickness absence but their involvement will not be required in every case. Managers have the authority to use their discretion in when Occupational Health will be accessed, but they must follow a safe, equitable and regulatory compliant process, that does not discriminate. The Occupational Health team are there to provide expert advice and information to help promote, maintain, and enhance the physical and psychological wellbeing of employees, and to prevent illness and injury at work. The team do this by both proactive and reactive approaches to health in the workplace. Examples of work undertaken include: - Fitness for work assessments for new recruits and existing employees - Advice and recommendations to managers and employees when work is impacting on health, or health is impacting on work - Return to work plans for injured or unwell employees - Advice around potential adjustments for employees with disabilities - Screening and immunisation to protect employees - Management of sharps and needle-stick injuries - Counselling via Employee Assistance Programme Managers can refer employees to Occupational Health using the electronic referral form via the myCority referral system if an expert view is needed about the ability of an injured or unwell colleague to be at work and/ or do the full range of their role. Examples of when the manager would normally refer an employee to Occupational Health include:

- When an employee is likely to be off for four weeks or more and where support from Occupational Health may be required to facilitate a safe return to work or where advice is needed on appropriate absence - Depending on the case, Occupational Health advice won't always be needed, for example, if someone is off due to planned surgery and already has a rehabilitation plan agreed by their specialist that wouldn't impact on a return to work, a referral would not be needed - Where the absence may be linked to work, such as stress or a workplace injury - Where sickness absence is related to a disability or a pregnancy or any underlying long term health condition(s) - If an employee is often taking short periods of time off sick for similar Page 15 illnesses or due to an underlying medical condition

In order to see a member of staff, Occupational Health require: - a completed electronic management referral on which it is indicated the employee is aware of the referral. - a current job description. - details of previous sickness record. - details of any other relevant information (as appropriate to the case). - cases where an employee reports work or non-work related stress, information on what steps have been taken to undertake and action a stress risk assessment and details of the mutually agreed actions to be taken by all parties, before being referred to Occupational Health. To provide the best advice, the Occupational Health department will sometimes, with the agreement of the employee, request information from the GP or Specialist to inform the decision making. The advice to management from Occupational Health will consider which work place adjustments may support a return to work, the likely timescale for a return to work, or whether a return to work is not advised or not possible. Occupational Health provide evidence-based advice, along with Employee Relations, but it is the manager's responsibility to agree and action any Occupational Health recommendations.

Employees will be entitled to see any Occupational Health reports and make amendments with consent from the Occupational Health department prior to them being sent to the referring manager. If consent is not received within 7 calendar days then Occupational Health will advise the department that consent has not been provided and a report cannot be issued. Noting that all communications regarding employees with Occupational Health are disclosable to the employee.

As the opinion of the Occupational Health clinician will not be changed, unless the facts of the case have not be en accurately presented by a manager or employee, or the assessing clinician has made a genuine interpretation error regarding the facts, employees can, in rare cases, give permission for the Occupational Health report to stand, but the employee may add their own addendum that will be attached to the report, and it is for the manager to decide, upon which content they wish to follow. Once a health report is received, the manager should arrange a meeting with the employee to discuss the contents of the Occupational Health report. This could take place both within the informal or formal sickness management process or via a separate meeting as appropriate.

It is usually in the employee's best interests for their manager to know the details surrounding their employee's health situation that is impacting on their attendance so that the appropriate support can be offered . Where employee consent is not given for an OH referral or for the report to be released within the timescale outlined above the manager can only make decisions about their absences based on the information available. All information about the employee's health and medical history will be handled sensitively and confidentially.

Finally, where a safeguarding, drugs, alcohol or substance misuse or criminal issue may be disclosed during an Occupational Health assessment, an assessment may be paused whilst Page 16 the priority of risk is managed and the manager will be advised, within the scope of informed consent that the above issues are in play. 11. Employee Assistance Programme (EAP) Staff can contact EAP for advice and can access the counselling service through Employee Assistance Programme, further information is available via the staff intranet Employee Assistance Programme (EAP) - access details - Kingsweb (interactgo.com).

12. Stress At Work In cases where stress (workplace or otherwise) is listed as a reason for absence a risk assessment should be undertaken by the line manager (please cross reference to Management of Workplace Stress Policy.docx for further guidance on supporting employees with stress at work).

The Trust offers specific support to staff who are experiencing stress. Please see Management of Workplace Stress Policy.docx for detailed information which is useful for both staff suffering from stress and managers looking to support their staff. Employees are encouraged to speak to their managers directly regarding stress, they can also speak to the Employee Assistance Programme offered by EAP and refer to the support available. All staff are able to use the EAP which is provided on a 24/7 basis, free of charge. It can be accessed at www.vivup.co.uk 13. Mental Health and Psychological Support Staff can access the Staff Psychology Service via Occupational Health where they are experiencing psychological distress that is impacting on their ability to work, or their psychological wellbeing has been impacted by their work. Examples of this include anxiety, low mood and post-traumatic stress disorder. The Staff Psychology Service is a primary care service and offer assessment and short -medium term interventions. They are not a crisis service and where staff present with significant levels of risk or severe psychological distress, they will be redirected/supported to access secondary and tertiary levels of care. Staff referred to the psychology service will be screened for appropriateness, followed by an assessment, and where the team are able to support, offered evidence-based psychological therapy. Further information can be found on Kingsweb on the "Staff Psyc hology Service" page. Support is also available for Doctors and Dentists from www.practitionerhealth.nhs.uk.

13.2 Health & Wellbeing Service The Wellbeing Team is available to all Staff on all Sites. The Team are trained Mental Health First Aiders, they are skilled listeners and can offer emotional support, confidential and non-judgemental 1-1 conversations, as well as give informal advice on a range of wellbeing practices to help maintain good physical and mental health.  For more information please visit Health and wellbeing - Kingsweb.

14. Occupational Sick Pay (OSP) Occupational Sick Pay entitlements are set out in the nationally agreed Agenda for Change Page 17 NHS Terms and Conditions of Employment and Medical and Dental Terms and Conditions. Occupational sick pay (OSP) is worked out by the length of the employee's continuous service (no previous break(s) of more than 12 months) with the NHS and is calculated on a rolling twelve-month basis. Most sickness absence will be on full pay, but for longer absences - or where the full pay entitlement has expired, - sickness absence will be paid for on a 50% basis (half pay). Once the total sick pay entitlement has expired, sickness absence will be unpaid. Please note that if you are no longer entitled to full pay, you may still receive statutory sick pay (SSP) while off sick (see Section 15).

- Statutory and OSP is calculated and paid using calendar days. - The entitlements under Agenda for Change NHS Terms and Conditions are:

Length of Service Entitlement During the first year of service One month's full pay and two months half pay During the second year of service Two months full pay and two months half pay During the third year of service Four months full pay and four months half pay During the fourth and fifth years of service Five month's full pay and five months half pay After completing five years of service Six months full pay and six months' half pay

The Trust pays OSP allowance to mitigate the financial impact for employees if they are injured or unwell. It is important to remember that the time periods in the table above don't indicate how much absence each colleague is entitled to take - the allowance is there for those who need it.

15.Statutory Sick Pay (SSP) All employees are entitled to SSP for up to 28 weeks if they earn at least £ 116.75 per week on average and have been off for at least four days in a row - this may include days when you were not actually scheduled to be in work. The current rules and rates of SSP entitlement are available at https://www.gov.uk/employers- sick-pay/entitlement. There are also other eligibility criteria for the payment of SSP.

OSP and SSP is paid through payroll and cannot be more than full pay, so SSP will be paid as follows: - If absent on full pay OSP, this includes SSP. - If absent on half pay OSP, SSP is paid on top, unless this total exceeds full pay (in which case, full pay is provided). Page 18 - If OSP has run out, SSP will be paid instead (up to 28 weeks from the start of absence).

16. Non-Payment of Sick Leave There are rare circumstances, other than where entitlements have run out where the Trust would not provide sick pay when on sick leave. These include:

- If an employee breaches this policy, such as failing to report sickness absence in line with policy or failing to provide medical certificates. - Submission of forged or false medical certificates. - Time off for cosmetic surgery, unless a GP tells Occupational Health that the surgery is needed for medical reasons. - Illness or injury caused by an accident where damages are being paid by a third party. - Illness or injury caused by professional participation in sport. - Illness or injury caused or exacerbated by the staff member's negligence or actions. - Fraud or dishonesty - such as where an employee works elsewhere (including bank and agency work) while off sick from the Trust. This should be referred to the Trust's Local Counter Fraud Specialist and may be treated as a criminal investigation (Fraud by False Representation) and/or may also be treated as a disciplinary matter. Deliberate conduct prejudicial to recovery from sickness/injury.

17. Sickness Absence and Annual Leave

It is important to take annual leave throughout the year, to ensure sufficient rest and recuperation having time away from work. It may not be possible to take the full leave entitlement when an employee is off sick long -term and/ or at the end of the annual leave year. Annual leave is still accrued during sick leave.

If it is impossible to take leave due to sickness absence, there are various options available to the employee, such as taking it on a 'block basis' when they are fit to return to work, using it as part of a graduated return as part of the phased return to work plan following long term sickness absence. The employee and line manager will need to discuss and agree a suitable option, keeping in mind the wider team and service needs.

18. Ill Health during a period of Annual Leave

If an employee is unwell during a period of annual leave, they can retrospectively request that this is recognised as sick leave instead if they have followed the reporting procedures at the time of sickness (i.e., by calling in on the first day of absence and notifying the relevant manager) and can subsequently provide a medical certificate verifying the date from when they were ill. If an employee becomes sick whilst overseas, they will need to provide a certified translation if the medical certificate is not in English. They will forfeit this right should they fail to notify the Trust at the appropriate time as detailed within the agreed reporting arrangements. Annual leave will not be reimbursed where the correct notification procedure is not followed. Should a pattern emerge of sickness around annual leave then the manager may initiate the procedure for managing persistent short-term sickness absence.

Page 19 19. Ill Health during a Bank Holiday

Please note, should a n employee who is absent during a Bank holiday, the Bank holiday entitlement will be automatically deducted by the line manager, from the Bank Holiday entitlement in the Trust's Healthroster system, this applies to all employees and includes non- working days.

20. Untaken Annual Leave due to Ill Health

Where an employee is absent due to sickness, they will continue to accrue all their contractual annual leave entitlement for any periods of absence regardless of whether they are receiving full, half pay or no pay.

Employees on long term sickness absence which continues into the next financial year may carry forward up to a maximum of 12 months' worth of accrued contractual annual leave. Any untaken annual leave entitlement preceding this time will be lost. Leave carried forward to the next financial year should be taken as soon as possible and in any case not later than 6 months following the return to work. If the carry over leave entitlement is not taken within this time period, it will be lost. Managers should encourage staff to consider taking their accrued annual leave to support their phased return to work if required and if the need for such was recognised. Bank Holidays are not accrued during periods of sickness absence. 21. Use of Annual Leave during a Period of Absence due to Ill Health It is recognised that employees on long-term sick leave may wish to take their accrued annual leave, particularly when their Occupational Sick Pay reduces to half or nil pay, or when there is already a pre -existing planned holiday. In such circumstances, the line manager must advise payroll by e-mail of the dates of annual leave so that the correct payment is made. It is important to note however that the employee will still be regarded as unfit for work. The following form must be completed for employees unable to take annual leave due to sickness absence and requiring payment in lieu of annual leave. http://kingsdocs/docs/kchdocs/Payment In Lieu Of Annual Leave.pdf Managers must not end the sickness absence period in the Health Roster, as this will impact sickness entitlement. They must also ensure that the annual leave being paid is deducted from the Annual Leave Entitlement in the Health Roster. Employees who become sick immediately prior to or following a period of annual leave, must notify their line manager in the normal way. The usual certification requirements will apply from the first day of sickness and remain in place until they return to work. Should a pattern emerge of sickness around periods of annual leave, then the manager may initiate the short term sickness absence process.

22. Returning to Work

Employees should take every reasonable step and be proactive in obtaining the medical care they need to enable their return to work as soon as reasonably possible. Page 20

After any period of sickness absence, there needs to be an informal discussion between the employee and their line manager. This should be on the first day back at work wherever possible, and the line manager will make a note of it on the Return to Work Meeting Form (Appendix 1) and also record that this has been undertaken on Healthroster. The confidential meeting should cover how the employee is feeling now, whether they need any support (such as an Occupational Health referral), and updates on any work. This will be an opportunity for the manager to fully understand the reasons for the sickness absence and where appropriate, identify and implement any support and/or reasonable adjustments and support a return to work and assist in sustaining the employee's attendance moving forward.

In the case of prolonged sickness absence, the manager, if needed, will need to ensure they make a timely referral to Occupational Health in advance of an employee returning to work in order that the feasibility of implementing any changes can be assessed and the necessary arrangements can be made. A more detailed return to work plan may be needed to s upport the employee's return to work.

If the employee has reached one of the review points outlined in section 25, then section 28 Informal Management should be followed as part of this conversation.

The return -to-work plan may include a temporary change to the ty pe of work that the employee will be doing, a phased return or other adjustments. A review date will always be built in for any changes unless these are agreed as permanent adjustments by the manager.

The 'Return to Work Interview' box should be checked, and the date of the meeting added to the sickness episode on the Health Roster.

23. Phased Return to Work Plan

A phased return to work plan is not an entitlement but may be considered where the employee has had a significant illness and/or there are barriers to returning to work. Where Occupational Health recommend a gradual return to work to aid rehabilitation, the manager will have discretion to agree a phased return to work plan.

The employee can receive full pay for a maximum period of four weeks (pro-rata for part time employees) whilst undertaking a phased return. However the manager will have discretion to extend a paid phased return to work plan in exceptional circumstances up to six weeks. Should this period need to be extended beyond the six weeks, the employee would need to use annual leave or unpaid leave via the Annual Leave and Unpaid Leave Policies. Employees should not perform any other form of work (whether paid or unpaid) whilst absent from work due to ill health or during a phased return to work including Bank shifts.

As part of the return to work the manager will also review the employee attendance record over the past rolling 12 months and sick pay entitlements.

The Trust will grant full pay for a phased return for up to four weeks, or up to six weeks where an extension is agreed at manager discretion, and this entitlement can only be used once Page 21 within a 12-month period. Any phased return beyond this must be taken as annual leave or unpaid leave in line with the relevant policies.

24. Medical Redeployment

It may be that the employee is no longer able to perform the job they were employed to do due to their ill health . In this situation, the Trust will explore along with Occupational Health advice, options for temporary or permanent redeployment constituting alternative suitable duties and retraining opportunities.

Employees who are redeployed for ill health reasons to a post on a lower pay band/reduced hours or in a different location which involves additional travelling costs either without a trial period or after the trial period has ended, will not be entitled to pay protection or excess mileage.

If the employee opts to consider redeployment, they will be required to apply for available posts that have been identified as suitable.

Please refer to the Trust's Re -deployment Policy for further information on Medical Re - deployment.

25. Review Points

Every employee is an individual with their own individual circumstances, and whilst this will always be considered, it is important for fairness and consistency to have specific review points that will prompt a more detailed discussion about absence.

Short-Term - within a rolling 6 month period, whichever of these is reached first: - 3 episodes of sickness - 6 calendar days. - Or a clear pattern of absence (e.g., sick days adjoining weekends or annual leave, or sick days falling on the same day(s) of the week).

Short-term absence is defined as an episode or occasion of sickness of 1 to 27 calendar days.

Long-Term - any absence of 4 weeks (28 calendar days) or more.

Any noticeable trends or patterns, such as time off sick around holidays, weekends, or other periods of leave/ non-working time. As a guide, two or more long-term absence episodes within a period of 24 months or less will identify the need for this support to be explored. The management of this absence should continue from the previous stage that the process ended with. For example, if a n employee was on stage one of the formal process and returns to work, then has a further long -term period of absence, this would invoke a move to stage two of the policy. Page 22 Patterns of absence either short-term or long-term, i.e., significant absences over many years may also be reviewed under this policy and considered collectively to conclude appropriate outcomes.

Employees who have a long-term health condition, which impacts on their ability to perform their duties within their substantive role, will be managed in line with the Trust's Sickness Absence Policy.

26. Terminal illness Terminal illnesses will always be handled supportively, with kindness and compassion. Help is available to make things a little easier in this eventuality, including the option of commuting NHS pension benefits to a one-off lump sum.

In very rare circumstances, the Trust may suspend a n employee from duty on medical grounds, if the Trust believes that their health poses a serious risk to themselves, patients or colleagues. Any such suspension is on full pay, pending an Occupational Health assessment to determine fitness to work. Only managers with the appropriate seniority can suspend an employee on medical grounds.

27. Contact Arrangements

Employees who are not able to attend work due to ill health should remain contactable via telephone and be available to attend meetings with management.

The line manager (or other nominated person), and employee should discuss and jointly agree a plan to maintain regular contact during periods of long -term sickness absence. Whilst it is recognised that the frequency of contact will depend on the circumstances surrounding the absence, it is recommended that such contact takes place every 1-2 weeks. Contact between the employee and their manager should continue throughout the period of sickness absence. A supportive approach will always be taken about long-term absence. However, the reality is that in some circumstances there may be no prognosis for a return to work within a reasonable timescale. This can be the case despite positive interventions by the Trust, including the exploration of all reasonable alternatives that may allow an employee to sustain a satisfactory level of attendance.

28. Informal Management

If an employee's sickness absence record has reached one of the review points, the manager must arrange an informal confidential meeting.

For short-term absences including where the staff member has triggered , this meeting should normally be held as part of the Return to Work discussion and confirmed in writing using either the Return to Work Form and/or the Informal Sickness Absence Meeting letter offering appropriate support, setting a monitoring period and agreeing next steps. If the staff member triggers again following this meeting, the manager should then proceed with the formal stage of the policy.

Page 23 For long-term sickness absence, the informal meeting should take place while the employee is still off sick, to maintain communication and offer appropriate support. The manager should confirm the discussion and any agreed actions in writing, either by following up in a meeting upon the employee's return or by issuing an Outcome Letter summarising the discussion and next steps. If the staff member's long term absence continues, the manager should then proceed with the formal stage of the policy.

The purpose of the informal meetings for short term and long term absences is to discuss how best to support the employee's health, wellbeing, and recuperation, and to identify any reasonable adjustments or assistance that may help their return to or continuation at work. The reasons for absence will always be considered, particularly where they relate to a known disability or long-term health condition.

These meetings are intended to be supportive and informal in nature. Employees may, if they wish, seek advice or support from their Trade Union representative before or after the meeting.

29. Formal Management

Where a review point has been reached, and the informal meeting has already happened (or the manager has made reasonable efforts to have the meeting with the employee), a formal process may be the next step if there are concerns about the employee's long-term or short- term sickness absence levels and/ or patterns to their sickness absence. If there is a formal meeting, the employee will have at least seven calendar days' notice of this. The employee has a statutory right to be accompanied by a trade union representative or a workplace colleague to the formal meeting, and someone from the People team may also be present. Employees that have a disability may also choose to have a second companion who has knowledge of their disability and its effects, such as a support worker. There is a three-stage formal process for addressing concerning levels of sickness absence. The aim of the formal process is to try to improve the situation, and in many cases the latter stages will not be needed. Where issues persist, such as where it is unclear if or when someone will be well enough to return to their current role, other routes may be considered, such as redeployment (temporary or permanent) or ill health retirement, subject to eligibility.

The three stages are summarised below: ➢ Formal Stage 1 meeting - a solutions-focused discussion of the issue, acknowledging current impacts on the service/ team. The outcome agreed adjustments and expected improvements (where appropriate) must be confirmed in writing within 7 calendar days of the meeting. There will be a monitoring or review period of 6 months, following this meeting to make sure that the necessary adjustments and/ or improvements (where appropriate) are made. If enough improvement is made, no further review meetings will be needed.

➢ Formal Stage 2 meeting - run in a similar way to the stage 1 meeting. The stage 2 meeting happens if attendance is still a concern. After considering all the facts - including any mitigating circumstances , it may be that further adjustments may need Page 24 to be explored in the case of long -term absence. There will be a further monitoring period of up to 6 months, and notification that if attendance continues to be a concern over the following 12 months, then it is possible that things will move to stage 3 or in the case of long -term absence, further stage 2 meetings may be held. A potential outcome of stage 3 is dismissal, so other options and possible reasonable adjustments must always be explored first. As with the stage 1 meeting, the outcome must be confirmed in writing within 7 calendar days.

➢ Final Stage 3 meeting - if attendance is still a concern after the informal, stage 1 and stage 2 meetings a stage 3 formal meeting may be held. Possible outcomes of the meeting are an extension of the monitoring period, redeployment or dismissal (with notice) on the grounds of ill health capability. If an employee was considering ill health retirement, the Pensions Manager would advise on applying separately to this procedure. The line manager will prepare a case summary for the person chairing the hearing, and the employee will have the chance to respond to it. The case summary should include: o Up-to-date attendance records o Impact of the absences on the service and team o Records of the previous meetings to discuss o Occupational Health or other medical advice o Any adjustments considered or already implemented o Details of the alternatives to dismissal that have been explored (and the reasons why these have not been feasible to date) Any employee who is dismissed from the Trust has the right of appeal as outlined in Section 33. If sickness absence deteriorates again within 12 months of the end of the monitoring period, this procedure may be reinstated at the same stage or progressed to the next stage, as appropriate, at the manager's discretion.

30. Ill Health Retirement If an employee is permanently incapable of carrying out the duties of their post on the grounds of ill health they may be eligible and may wish to apply for ill health retirement. The decision to approve ill health retirement rests with NHS Pensions and not with the Trust. An Ill h ealth Retirement application does not prevent the management of an employee's sickness absence and therefore the formal management of sickness absence will continue and may run concurrently. 31. Long Term Health Condition Impacting on Ability to Carry out Role If an employee has an underlying medical condition that is likely to be protected under the Equality Act 2010 (as confirmed by Occupational Health) and their sickness absence or health is of a concern, they will be monitored for a reasonable period of time and additional support will be provided by their line manager. Further advice must be sought from the Employee Relations Team. Specific Occupational Health advice must be obtained. If all other alternatives have been considered/exhausted and the employee is still unable to carry out their substantive job role a possible outcome at a Final Formal Sickness Absence Page 25 Hearing may be dismissal on the grounds of capability due to ill-health.

32. Sickness Hearing Panel and Attendees

Where an employee fails to meet the required standards and their sickness remains a cause for concern, a final Stage 3 hearing will be arranged as outlined above. This hearing must be chaired by a senior manager minimum Band 8C and supported by an independent senior manager, neither of whom have had any prior involvement in the process. A note taker may also be present.

We will strive to ensure the panel is representative of the lived experience of the employee. This includes but is not limited to diversity in terms of gender, race, ethnicity, age, disability, sexual orientation. In all formal hearings, a representative of the People Directorate will be present to advise on the process but will not be in a decision -making role. The employee will have the right to representation accredited Trade Union (TU) representative or workplace colleague employed by the Trust. The manager who has been responsible for sickness absence management will complete a sickness absence report and present this to the panel at the Hearing, this should include:

- The employee's sickness record and reasons for absence. - The actions the manager has taken to support the employee, which should include workplace adjustments. - The medical advice sought from Occupational Health. - Occupational Health reports. - Discussions around redeployment. - The impact of the employee's absence on the service including the team.

The employee must take all reasonable steps to attend the hearing, but if this is not possible, they may submit a written statement or ask a representative to attend on their behalf. If the employee has an exceptionally strong reason that prevents them from attending the sickness hearing, then they should ask (in email or writing) the Chair of the disciplinary hearing if they would be prepared to reschedule the hearing.

However, the decision on when the hearing should be held rests with solely the Chair. If an employee fails to attend a scheduled hearing without prior notification, a decision may be taken for the hearing to proceed in the employee's absence.

33. Appeals

The outcome of the Hearing will be confirmed in writing within 7 calendar days and employees have the right to appeal against the decision within 14 calendar days of the date of the letter in accordance with the Trust Appeals Policy and Procedure. 34. Disability and Absence

Page 26 Under the Equality Act 2010 a person is disabled if they have a physical or mental impairment which has a substantially adverse and long-term effect on their ability to carry out normal day- to-day activities. Cancer, HIV and Multiple Sclerosis are regarded as disabilities from the point of diagnosis. Please follow this link for further information on the Definition of Disability and other useful information:

- Where an employee has a chronic illness or disability, the manager should consider; what is a 'reasonable' and 'sustainable' level of absence. - As part of a reasonable adjustment, consideration may be given to amending the attendance trigger points applicable. This modification should be done in accordance with advice from Occupational Health and site-based People teams. - The manager should also work with the employee to review working practices and consider environmental risks and any reasonable adjustments that may be required to the role to help the employee achieve an acceptable level of attendance. - Disability related absences should still be recorded on a n employee 's sickness absence record

35. Pregnancy and Sickness Absence

An employee who is absent due to pregnancy-related sickness will not be subject to the formal stages of this policy, however wellbeing support and Return to Work meetings should still take place as normal. Reasonable adjustments to the review points may also be appropriate where absence is related to a disability.

The requirement to make up time/take leave does not apply to employee taking time off for ante-natal care. Pregnant employees are allowed paid time off to go to antenatal appointments, although it is requested that appointments are arranged in a way that minimises disruption to the working day where possible. Maternity/Parental leave will commence automatically if an employee is on sick leave due to pregnancy and the employee has chosen to work past the 4th week prior to their EWC (Expected Week of C hildbirth). Maternity/Parental leave will commence at the beginning of the 4th week before the EWC or the beginning of the next week after the employee last worked, whichever is the later. Please refer to the Parents Policy for further information.

36. Reasonable Adjustments A reasonable adjustment is an al teration that an employer could make that would enable a disabled person to continue to carry out their duties without being at a disadvantage compared to others. Under the Equality Act 2010, there is a legal duty on employers to make these reasonable adjustments for disabled employee. An 'adjustment' is a change. This can be a physical change or a change in the way something is done. This might include exploring flexible working options (e.g., reduction in hours) or specific equipment to enable employees to do their job without causing harm to themselves.

'Reasonable' will depend on several circumstances but the tests include : Page 27 - How much will a reasonable adjustment reduce the disadvantage? - The practicality of the change. - The financial & other costs & the extent of any disruption caused. - The extent of the Trust's financial & other resources

Although the Trust must consider reasonable adjustments for employees who have a disability or are pregnant, it is best practice for them to be considered for all employees to facilitate attendance and implemented where service delivery allows.

Please refer to the Workplace Adjustments Policy for further guidance and information in the Workplace Adjustments Policy.

37. Absence resulting from an accident at work If a n employee sustains an injury or accident at work, the employee should notify their manager within 24 hours . Reporting accidents and ill health at work is a statutory legal requirement. For further information managers should refer to the InPhase. The incident should be reported on InPhase and the RIDDOR regulations should be followed in the event of a death or major injury or accident at work resulting in over 7 days absence, reportable work-related disease, or a dangerous occurrence. It is the manager's responsibility to ensure a RIDDOR form has been completed either by themselves or the Health and Safety Advisor. The Health and Safety Advisor should always be notified that an incident has been reported. The employee may be entitled to an Injury Allowance in these circumstances if the sick pay reduces below 85 per cent. If the employee has sickness absence due to an injury caused by an accident at work the absence needs to be recorded as sickness absence on the Trusts Healthroster System and the Industrial Injury field checked and if it involves a third party. If the employee is off sick because of an accident at work, the manager must let Payroll know, so that the right level of OSP is paid. Managers should also inform employees of the additional sources of support that are available within the Trust during this time and must provide them with information about the Injury Allowance provision where applicable. 38. Outside of work Where an employee is absent because of an accident out of work they are not entitled to sick pay if damages are received from a third party. The Trust will advance to an employee a sum not exceeding the amount of sick pay payable providing the employee repays the amount of sickness allowance to the Trust when damages are received. Once received, the absence will not be considered in relation to the amount of sick leave accrued. The employee must notify their line manager of any such accident and legal proceedings so arrangements can be made for sick pay to be recovered. Determining Eligibility To determine eligibility as part of the decision -making process for the claim, employees are required to provide all relevant information in accordance with the normal sickness absence Page 28 management processes. This includes appropriate medical advice, for example, accident reports from RIDDOR, notes and records from Occupational Health , details of the injury sustained, or the disease contracted (that is, the condition), copies of any other relevant supporting letters and correspondence relating to any other medical advice received. Please note this is not an exhaustive list and other relevant additional supporting evidence may be required. For further information, please refer to Sections 19 - 24 in the NHS Employers guide on Injury Allowance which is in accordance with Agenda for Change, Medical and Other Health Appointments

39. Medical and Dental Appointments

The Trust is committed to supporting employee's wellbeing. Wherever possible medical appointments (especially those that are routine and predictable) should be made outside the employee's working hours. However, the Trust is aware that this is not always possible and will support employees to attend appointments with the required time off. Employees are required to request in advance and get approval from their line manager if they wish to attend a medical or dental appointment during the working day, other than emergency appointments, which should be reported as soon as possible. The employee will need to provide verification of their appointment if asked for it by their manager, such as an appointment card / letter or confirmation text. The employee can discuss with their line manager whether attending an appointment during working hours is unavoidable to agree a solution, such as working the time back later or taking the time off unpaid or annual leave. Some disabled colleagues may require more time off for appointments related to their medical condition, as advised by Occupational Health as a reasonable adjustment (Section 36).

If an employee opts to undergo elective cosmetic surgery rather than for medical reasons, annual leave or unpaid leave will need to be taken. Medical and surgical procedures as part of gender-affirming care may require time off work, sometimes at short notice. Managers should show the same flexibility during this time as they would for other medical treatment. More information can be found in the Supporting Trans and Non-binary Staff Policy Supporting Trans and Non-Binary Staff Policy

40. Notifiable and other infections

Following contact with an infectious disease (see the Trust's Infection Prevention and Control policy), employees and their manager should promptly seek advice from the Occupational Health Service using the Occupational Health Management advice line.

Where an employee is unable to attend work due to restrictions placed on them following contact with an infectious disease (as detailed in the Infection Prevention and Control policy), their absence will be recorded, however, managers will take advice from a member of the Employee Relations Team before any formal management action is taken.

Page 29 41. Diarrhoea and Vomiting (D&V) Diarrhoea and vomiting (D&V) including Norovirus is not in itself a notifiable disease, however, some notifiable diseases will have symptoms of D&V, such as salmonella and dysentery. A confirmed diagnosis will be required and Occupational Health should be contacted to provide further advice. Employees who have been absent from work due to D&V should remain off work for 48 hours after the symptoms have subsided. Where possible, this should be certified by their Healthcare Professional. These periods of enforced absence and the days on which th e employee is unwell will be recorded as sick leave. However, managers will use their discretion whether or not to include this absence when reviewing sickness levels.

42. Surgery and Medical Procedures

If declared unfit for work by a GP or specialist, absence for surgery/ a medical procedure, including elective, cosmetic and laser eye surgery, will be deemed as sickness absence and managed in accordance with this policy. In the absence of such declaration from a medical professional, annual leave will need to be taken to cover the period of required absence. Where the entitlement to annual leave has been exhausted, the manager may agree a period of unpaid leave, subject to service needs.

Employees should discuss this in advance with their manager, ensuring they provide at least 6 weeks' notice where possible.

Employees who undergo medical treatment relating to gender affirming care will be entitled to sick pay and leave provisions if they are not fit to work because of the treatment.

43. Ill Health Absence during Investigations and Formal Processes

In cases where there is a need to interview an employee who is absent due to ill health as part of a workplace investigation or other formal process and the employee states they are unfit to participate, an immediate referral should be made to Occupational Health for an opinion on their fitness/ability to participate.

If it is the opinion of Occupational Health that the employee is fit to participate in a workplace investigation or a formal process, then it is reasonable to expect the employee to comply with this. Failure to do so, without good cause could be considered under the Trust's Disciplinary Policy and Conduct Standards.docx

If in the opinion of Occupational Health, an employee is unfit to participate in a workplace investigation or a formal process, the Trust reserves the right to continue the relevant process in the employee's absence, up to and including deciding on terminating employment.

44. Medical Suspension Medical suspension may be applicable in the following circumstances:

Page 30 - When there are concerns regarding an employee's safety/fitness to continue working - the employee may be required to remain off duty until OH advice is obtained.

- Risk of infection to others (in accordance with the Infection Prevention and Control Policy Control of Outbreak of Infections FINAL 15.3.21.docx.

In cases where an employee is asked to remain away from work for one of the above reasons, they will receive full pay for the recommended period imposed. This includes any allowances for enhancements based on the employee's rota pattern.

Medical suspension should only be considered when all other options have been exhausted (such as temporary or permanent redeployment, working from home, reasonable adjustments, etc.). 45. Absence relating to Unauthorised Absence In situations of misconduct, it may be necessary to take some form of disciplinary action in line with Trust's Disciplinary Policy and Conduct Standards. This would be where a n employee fails to: - Follow the sickness reporting procedure (please see Section 6); Provide relevant information regarding their sickness (e.g., provide GP certificates or travel documentation). - Provide a satisfactory reason for being absent from work. 46. Bank Work

Staff Bank members may not work a bank shift at King's during paid sick leave from another employer. Anyone found to be doing this will be reported to the relevant Counter Fraud Team (which may be external to the Trust if the substantive absence is with another employer) and will be investigate accordingly. Anyone found to be doing this within the Trust will be managed via the appropriate disciplinary policy. Substantive employees are not permitted to work bank shifts for two weeks following a sickness episode. 47. Career Break whilst on Sick Leave

If an individual is considering taking a Career Break whilst on Sick Leave, please refer to Section 2.4 of the Career Break Policy Career Break Policy .

48. Monitoring and Compliance

Measurable Policy Objectives Monitoring / Audit Method Frequency Responsibility of Monitoring Responsible Committee Page 31 Sickness Absence rates against KPI targets Workforce Trigger Report and Long Term Sickness Absence Report

Monthly

People Business Partners/ Employee Relations Service / Line Managers Trust wide Performance Meetings

49. Associated Documents - Appeals Policy - Capability Policy - Career Break Policy - Disciplinary Policy and Conduct Standards - Flexible Working Policy - Parents Policy - Unpaid Policy - Workplace Adjustments Policy - Supporting Trans and Non-Binary Staff Policy - Sickness Absence Toolkit | NHS Employers

Page 32 Appendix 1 Return to Work/Health and Wellbeing Conversation Form (Self-certificate)

This form must be completed jointly by the employee and line manager for every episode of sickness absence. The original form should be kept in the employee's local personnel file, and a copy given to the employee. All sickness episodes must be entered and updated on HealthRoster to ensure correct pay.

Part 1: Personal Details Name: Post and Band: Department:

Part 2: Sickness Absence Date of return-to-work meeting: Dates of absence on this occasion: From To

Reasons for absence on this occasion (was this work related)?

Total number of calendar days off sick on this occasion: Total number of episodes of sickness absence in the last 6 months:

State dates and reasons:

Did the employee see a healthcare professional?

Has a medical certificate been provided if required?

 Yes  No

 Medical Certificate (8 days+) Additional information:

Is the recent sickness absence related to a disability/ long-term health condition/ menopause? If Yes, please provide more details

Has work contributed to this absence? If Yes, please provide more details

Is any additional support or workplace adjustments required? If Yes, please provide more details

Does the employee have a workplace adjustment plan (passport)?

If Yes, please discuss and update if necessary.  Disability/ long-term health condition  Menopause  Not related

 Yes  No

 Yes  No

 Yes  No

If No, please signpost to workplace adjustment plan (passport) and guidance as appropriate. Page 33 How is the employee's general wellbeing now following their recent absence?

Is the employee receiving any ongoing treatment? Is employee able to carry out all their normal duties, or are any workplace adjustments required?

Were there any communication problems during the period of absence?

If Yes, what were they and what are the expectations?  Yes  No

Are there any issues inside or outside work that have an impact on the employee's health and wellbeing that they would like to talk about?

What support might be required to improve their health and wellbeing?

Has employee carried out any employment (paid or unpaid) or attended any training/study during this sickness absence episode?

Part 3: Management Action Is a referral to Occupational Health appropriate? If Yes, has it been actioned?  Yes  No  Yes  No Is their sickness absence already being monitored?

If No, please explain implications of further sickness:  Yes  No

Is action required under the Sickness Absence Policy?

If Yes, please indicate action:  Yes  No

Confirm with employee that they have not undertaken any other work whilst off sick? If Yes, seek advice from the People Directorate.  Yes  No

Employee told to refrain from working bank shifts?  Yes  No King's Staff Bank notified?  Yes  No Does a stress or pregnancy risk assessment need to be completed? If Yes, when will this be completed by:  Yes  No

Has the absence been fully entered and updated on HealthRoster?  Yes  No Has the employee been updated about any work priorities or developments during their absence?  Yes  No Additional comments:

Part 4: Declaration Name of Manager: Signed: Date: Name of Employee: Signed: Date: Copy Given to employee:  Yes  No Copy for local personnel file:  Yes  No Page 34 Appendix 2 Procedure for Managing Short-Term Sickness Absence Flowchart

- Formal Stage 3 Review Meeting (Hearing) - End process - Confidential Informal meeting - No Improvement? - Progress to Stage 1 - Formal Stage 1 Review Meeting - Continue monitoring - Set review period for 6 months - Seek OH advice

- Improves? End Process - No Improvement? Progress to Stage 2 - Formal Stage 2 Review Meeting - Consider any reasonable adjustments - Continue monitoring - Set review period 6 months

- Improves? End Process - No Improvement? Progress to Stage 3 Still a concern? Still a concern? Still a concern? Page 35 Appendix 3 Procedure for Managing Long-Term Sickness Absence Flowchart

- Employee absent 28 calendar days - Return to work? End Process - Sickness continues? - Progress to the next stage - Confidential Informal Meeting

- 4- 6 weeks later

- Stage 1 Formal Sickness Review Meeting

- Return to work? End Process - Sickness continues? - Progress to the next stage

- Within 6 weeks

- Return to work? End Process - Sickness continues? - Progress to the next stage

- Stage 2 Formal Sickness Review Meeting

- Within 6 weeks

- Stage 3 (Final) Formal Sickness Review Meeting (sickness hearing) - End Process Absence continues? Absence continues? Absence continues? Page 36 Appendix 4 Equality Risk Assessment Form

EQUALITY RISK ASSESSMENT FORM Name of Policy / Project / Function Sickness Absence Policy Date of Assessment 09/02/2024 What are the aims of this project, policy, function, and or service? To provide the Trust with an equitable and consistent framework for the management sickness absence to support in improving employee's wellbeing and attendance at work. Who could be affected by this proposal? (e.g., applicants, employees, customers, service users, members of the public) All KCH employees are impacted Which policies are related to or referred to as part of this assessment? Parents Policy Capability Policy Flexible Working Policy Menopause Policy Reasonable Adjustments Policy Supporting Trans & Non-Binary Staff Policy How will the impact on people be assessed? (e.g., consultations forums, meetings, data collection) Direct feedback from employees and their managers, data collection and reporting from Workforce Information team. Please include available Equality Data relating to the use or implementation of this policy, project, function, or service. (e.g., Care Group breakdown, WRES, WDES, Sexual Orientation monitoring standard, Patient Feedback, Workforce data etc.) To support the assessment sickness figures used from locally collected data over April 2022 to March 2023. Sickness absence in the UK labour marker 2022 from Office for National Statistics were used to identify any trends ( Sickness absence in the UK labour market - Office for National Statistics (ons.gov.uk)) Which stakeholder consultations have been included in the development or implementation of this policy, project, function, or service? Employee Relations (sickness absence policy) EDI (ERAF advice and support) Workforce Information (sickness data collected and report produced) Page 37 What are the potential impact/s of implementing this policy, project, function, or service on people who share protected characteristics as listed below?

Protecte d

Charact eristic: Neutral Positive: Negative: Describe the impact and if applicable how you will ensure equitable outcome. Age (People of all ages) x The policy is designed to support all employees of the Trust irrespective of their age. No data was collected as part of this category

Disabilit y (Mental, Physical, and Carers of Disabled people)

x

Disabled Sickness headcount Percentage Total headcount Percenta ge No 2494 84.26% 12440 85.94% Not Declared 286 9.66% 1297 8.96% Prefer Not To Answer - - 4 0.03% Unspecified 51 1.72% 243 1.68% Yes 129 4.36% 492 3.40% Grand Total 2960 100.00% 14476 100.00% 4.36% of employees on sickness absence had a disability recorded Disabled staff disproportionately more likely to experience sickness, and are therefore over-represented in Trust sickness data by almost 1% Training the managers how to support employees with disability, making reasonable adjustments to workplace, using Access to Work initiatives and getting professional advice from Occupational Health would get positive outcome. Flexible Working policy and Reasonable Adjustment policies can further support Trust's employees. Gender Reassig nment x The policy is for all employees within the Trust, irrespective of their gender. No data was collected affecting this category.

Page 38 What are the potential impact/s of implementing this policy, project, function, or service on people who share protected characteristics as listed below?

Protecte d

Charact eristic: Neutral Positive: Negative: Describe the impact and if applicable how you will ensure equitable outcome. Marital Status (Married and Civil Partnershi ps) x The policy is for all employees within the Trust, irrespective of their marital status. No data was collected affecting this category. Pregna ncy and Maternit y

x The policy is designed to support pregnant employees who may be out of work due to sickness prior to going on maternity leave. Pregnancy related sickness are not included into sickness management triggers. Carrying out (if needed regular) Risk Assessment for New and Expectant Mothers, making adjustments to workplace and getting professional medical advice would reduce the sickness absence levels. Flexible Working policy supports employees to request working from home to minimise the risk to the pregnancy and to support employees to attend antenatal appointments.

Race (All Racial Groups) x Ethnicity Group Sickness headcount Percentage Total staff headcount Percenta ge Ethnic minority 1773 59.90% 8108 56.01% Not Stated/Unknown 173 5.84% 822 5.68% White 1014 34.26% 5546 38.31% Grand Total 2960 100.00% 14476 100.00%

Ethnic minority staff are disproportionately more likely to experience sickness and are therefore over-represented in Trust sickness data by 4%.

Page 39 What are the potential impact/s of implementing this policy, project, function, or service on people who share protected characteristics as listed below?

Protecte d

Charact eristic: Neutral Positive: Negative: Describe the impact and if applicable how you will ensure equitable outcome. Religio n or Belief x

Religious Belief Headcount Percentage Headcount Percentag e Atheism 324 10.95% 1686 11.65% Christianity 1497 50.57% 7339 50.70% Islamic 246 8.31% 1092 7.54% Not disclosed or specified 431 14.56% 2213 15.29% Other Religious belief 462 15.61% 2146 14.82% Grand Total 2960 100.00% 14476 100.00%

The following groups of staff are over-represented in sickness data: -

Muslim staff by 1%

Sex (Men and Women Includes non- binary) x

Gender Headcount Percentage Headcount Percentage Female 2362 79.80% 10825 74.78% Male 598 20.20% 3651 25.22% Grand Total 2960 100.00% 14476 100.00% The sickness rate is higher for women than men which correlates with the overall representation of female employees.

Page 40 This ERA was completed by: Name: Natasha Elvidge Department: Employee Relations

ERA Action Planning Form Action Plan Owner: Commencement date: Sign off date: What are the potential impact/s of implementing this policy, project, function, or service on people who share protected characteristics as listed below?

Protecte d

Charact eristic: Neutral Positive: Negative: Describe the impact and if applicable how you will ensure equitable outcome. Female staff are disproportionately more likely to experience sickness and are therefore are over -represented in Trust sickness data by 5%

Sexual Orientat ion (Lesbian, Gay, Asexual, Bisexual, and Straight) x The policy is for all employees within the Trust, irrespective of their sexual orientation. No data was collected affecting this category.

How will the policy, project, function, or service impact people who are impacted by non-legislative factors? Including but not limited to social economic factors (i.e., poverty and or isolation), caring responsibility, unemployment, homelessness, urbanisation, rurality, health inequalities, and new arrivals. All employees within the Trust are required to comply with this policy, irrespective of their role, banding, social and economic status. Non- legislativ e factor Neutral Impact: Positive: Negative: Describe the impact and if applicable how you will ensure equitable outcome. Non- protecte d characte ristics x The policy is for all employees within the Trust, irrespective of role and banding. Page 41

What actions can be taken to remove or reduce the unhelpful impact(s) on people (employees, applicants' customers, members of the public etc.) who share protected characteristic or non- legislative factor? Impact Protected Characteristic or local non-legislative factor Recommended Actions Responsible Lead Completion Date Review Date All Undertake a deep dive on all sickness data breaking down by all characteristics and reasons by Care Group to identify common themes Natasha Elvidge, Associate Director Workforce December 2024

All Create a Trust Health & Wellbeing strategy/action plan Flavia Moller, Head of Wellbeing

Disability Increase the recording of employees with a disability on ESR Workforce/EDI Disability Section on Stress at Work and Mental Health & Psychological supported added into the policy Natasha Elvidge, Associate Director Workforce September 2024

Disability Increase awareness/training of Workplace Adjustments Passport to both managers and employees Workforce/OH/EDI Sex Further promotion of Menopause policy and support available also consideration of recording of menopauae as a reason on ESR Denise Grant, H&W Lead

Sexual Orientation Clarity added in policy in relation to time off for gender re- assignment and also signposting to the Supporting Trans & Non-Binary Staff Policy Natasha Elvidge, Associate Director Workforce September 2024

FOR EQUALITY DIVERSITY AND INCLUSION TEAM Date of Assessment: (dd/mm/yyyy)

Arfan Bhatti Page 42 Names and roles of the people who contributed to ERA:

Head of Equality, Diversity & Inclusion EDI authorisation Arfan Bhatti Date of review 3/09/2024