HR Policy
To Be Categorised
CoSO 18
NHS Fife
01 June 2017
01 January 0001
01 January 0001

General Note

NHS Fife acknowledges and agrees with the importance of regular and timely review of policy/procedure statements and aims to review policies within the timescales set out.

New policies/procedures will be subject to a review date of no more than 1 year from the date of first issue.

Reviewed policies/procedures will have a review date set that is relevant to the content (advised by the author) but will be no longer than 3 years.

If a policy/procedure is past its review date then the content will remain extant until such time as the policy/procedure review is complete and the new version published, or there are national policy or legislative changes.


Document Title:

Attendance Management


Circulation to Executive Directors Group, for cascading to Management Teams, HR, Payroll and Nurse Bank Manager.

Document Reference Number:

CoS018 – Updated June 2017

Content Based Upon:

PCS(AFC)2008/2 – Managing Sickness Absence

Policies: HR 20 – NHS Fife Management of Ill Health Policy and HR7 – NHS Fife Management of Capability Policy.


Annex Z of PCS(AFC)2008/2 is attached for your information.


The purpose of this document is to inform managers of the agreed changes to Section 14 of the NHS Terms and Conditions Handbook and the application of Annex Z, Managing Sickness Absence. Managers at all levels must ensure that they are fully conversant with these documents and act in accordance with the contractual arrangements for all staff covered by the AfC Terms and Conditions.


NHS Fife has agreed the arrangements which are to be applied to all staff in implementing the above AfC terms and conditions of service changes.

The existing NHS Fife policies and procedures are very similar to the recommendations detailed in Annex Z, (a copy of which is attached for your information and reference).

1.1 There are, however, some key additions in respect of the potential to extend occupational sick pay, which are detailed below:

  • Sick pay for those who have exhausted sick pay entitlements should be reinstated at half pay, after 12 months of continuous sickness absence, in the following circumstances:
    • - Staff with more than 5 years reckonable service - sick pay will be reinstated if sick pay entitlement is exhausted before a final review meeting for long term absence has taken place.
    • Staff with less than 5 years reckonable service - sick pay will be reinstated if sick pay entitlement is exhausted and a final review does not take place within 12 months of the start of their sickness absence.
  • Reinstatement of sick pay should continue until the final review meeting has taken place. Reinstatement of sick pay is not retrospective for any period of zero pay in the preceding 12 months of continuous absence.
  • These arrangements will be in accordance with local sickness absence procedures established in accordance with Annex Z and will only apply where the failure to undertake the final review meeting is due to delay by NHS Fife. This provision will not apply where a review is delayed due to reasons other than those caused by the employer.

This will require localmanagers to closely monitor all long-term absences within their areas of responsibility.

1.2 As a result of the need to meet the HEAT standard of 4% absence, such monitoring should already be taking place in conjunction with the necessary HR and Staff Wellbeing & Safety support. However, it is important to ensure that managers are applying the Management of Ill Health effectively, thus complying with the normal sick pay provisions where extensions to sick pay will not arise.

1.3 A focus upon the relationship between the Management of Ill Health policies and the Capability policy is a priority established in NHS Fife within the content of the attendance management training programme. Operational HR staff are working with managers to ensure a smooth and timely transition between Ill Health Reviews and Capability meetings and this will remain a priority to support the required improvement in attendance management.

If a situation arises where a question of an extension to sick pay becomes an issue, the circumstances must be discussed with the appropriate HR Officer and no extension should be actioned prior to agreement with Deputy Director of HR input, along with the and the relevantDismissing Officer.

Section 14 detailing Para 14.11 confirms the existing approach taken during phased returns and this will continue to include the use of annual leave as an element of the phased return process.

Annex Z reinforces NHS Fife existing practice. In circumstances, where it appears possible that a member of staff may no longer be fit to carry out their duties, a referral to occupational health in advance of any final review meeting will require to have established the likelihood of a return to work within an acceptable timescale, or the possibility of adjustments / adaptations to enable a return to work, or redeployment or re-training, before a decision is made regarding termination on health grounds. Advice on the ill health retirement for staff who are members of the SPPA scheme will be requested separately from Staff Wellbeing & Safety.


Section 14 of the Terms and Conditions of Service Handbook should be applied, along with Annex Z in the Management of Ill Health and Capability policies.


It is the responsibility of all NHS Fife managers to ensure that the arrangements for managing attendance within their areas of responsibility are in line with this guidance and both Policy HR 20 – NHS Fife Management of Ill Health Policy and HR7 – NHS Fife Management of Capability Policy.



  1. The management of ill health within the NHS is challenging, but provides opportunities to improve the overall health and well-being in the workplace, which will ultimately boost organisational productivity and support service improvements for patients.
  2. The arrangements set out in this annex are intended to support employers and staff in the management of sickness absence and in managing the risk of premature and unnecessary ill health retirements. It is intended that employers will amend, in partnership with local staff sides, their local policies and procedures consistent with the provisions of this agreement.
  3. This agreement details the responsibilities of both staff and employers in the management of ill health in the NHS.
  4. This annex should be read in conjunction with:
    1. Section 14 - Sickness Absence
    2. Section 30 - General Statement on Equality and Diversity
    3. Section 32 - Dignity at Work
    4. Section 34 - Flexible Working Arrangements


Effective partnership working is crucial in achieving the effective management of sickness absences. Employers therefore, in partnership with local staff side representatives, should ensure that their local sickness absence procedure and working arrangements incorporate the minimum standards set out below to minimise the risk of premature and unnecessary ill health retirements. This will ensure that, where possible, staff are able to continue working despite experiencing periods of ill health or disability. The minimum standards are:

Legal responsibilities;including mutual responsibilities of employers and staff to comply with health and safety requirements, reporting of injuries and dangerous occurrences (RIDDOR), disability discrimination and other relevant legislation.

Key employer responsibilities;employers are expected to:

  • Communicate appropriately with absent staff.
  • Manage absences under the locally agreed sickness absence procedure.
  • Provide support and advice through the use of occupational health services where appropriate.
  • Develop reporting arrangements, recognising that high levels of sickness absence are a financial risk to the organisation.
  • Have appropriate management systems in place to collect good quality data on sickness absence.
  • In partnership with Trade Union representatives, regularly monitor and review arrangements to identify where and how policies can be improved.

Key employee responsibilities;employees are expected to:

  • Ensure regular attendance at work.
  • Communicate appropriately with employer when absent from work.
  • Co-operate fully in the use of the locally agreed sickness absence procedures.

Partnership arrangements should also ensure the regular monitoring and review of local policies and procedures is undertaken, to identify where and how policies can be improved.

Key elements of local procedure:

Absence Reporting

  • Local policies should define how and when staff notify their employer of their sickness absence.
  • Early notification that the absence is work related will enable an employer to make a timely determination of future injury allowance entitlement, as defined in Section 22.

A structured review process

Regular reviews should be carried out to assess and monitor staff when they are off sick, and determine what action is needed at each stage. Where a member of staff is unlikely to return to work this would culminate in a final review where a decision on the appropriate way forward is made i.e. return to substantive employment / redeployment / termination of contract. It is assumed that as part of this process that reasonable adjustments have been considered. Medical evidence should be made available to support the review process and occupational health advice should be sought on the likelihood of:

  • The prospects of a likely return to the previous employment with or without adjustments.
  • A phased return with or without a need for adjustments.
  • Redeployment.
  • A successful ill health retirement application.

Early Interventions

In order to avoid premature and unnecessary ill health retirements employers should also consider the following interventions as early as is practically possible and at the latest within one month of an employee going sick:

Rehabilitationidentifying appropriate ways of supporting staff to remain in work or return to work at the earliest opportunity through intervention with appropriate treatment. This will mean providing staff with direct access through appropriate dedicated resources, such as physiotherapy and cognitive behavioural therapy.

Phased return- enabling staff to work towards fulfilling all their duties and responsibilities within a defined and appropriate time period, through interim flexible working arrangements whilst receiving their normal pay.

Redeployment- enabling the retention of staff unable to do their own job through ill health or injury as an alternative to ill health retirement or termination. Staff should be made aware of the provisions within the NHS Pension scheme to assist this process through “step down and wind down” arrangements.

Sick Pay Entitlements- review and decision dates should be determined taking account of the individual’s sick pay entitlements and there should be a review before their sick pay ends. Procedures should make reference to the NHS Injury Benefit Scheme and in particular the circumstances when NHS Temporary Injury Allowance should be paid.

Occupational Health Support- Occupational health services have a responsibility to provide advice and support to both the individual and the employer. Line managers should seek advice on long term sickness cases from their occupational health service as early as reasonably practical. Individuals may also self-refer for advice and support about the best way of seeking a return to work.


Where termination of the contract of employment on the grounds of incapacity is considered, all reasonable efforts should be made to obtain appropriate medical evidence via the occupational health service, including occupational health advice on the likely outcome of a successful ill health retirement application. Before a decision to terminate is made all other options should meaningfully be considered, including:

  • Rehabilitation
  • Phased return
  • A return to work with or without adjustments
  • Redeployment with or without adjustments

Contractual notice must be given to a member of staff whose contract is being terminated on grounds of ill-health.