In our latest HR clinic, Robyn Clark (aka JacksonR) and Susi O’Brien (HR Help advisor) explored the issues of managing persistent short-term absence.

Here is a summary of the questions we received, and the answers given.

Let’s go over some basic principles first before we jump into the questions!

Firstly, we have to remember that all staff members are likely to go off sick at some point in their careers with us. And, as employers, we always have to assume that the sickness is genuine (unless we’re given pretty good evidence to suggest it isn’t!).

There is, within each organisation, what is deemed to be an acceptable level of absence. This is because we appreciate that not everyone stays well 100% of the time. So, all of our policies and targets do have an allowance for a certain level of absence. It’s down to you as individual employers to determine what is an acceptable level of absence for your practice. If someone goes above that acceptable level, it doesn’t mean they’ve committed misconduct or been a bad person – but it does mean their absence levels will be negatively impacting the practice’s work. Therefore, it’s reasonable to investigate matters, and impose warnings (or even dismiss) where appropriate and where policies have been followed in full.

Your strongest tool in tackling persistent short-term absence is active management – which means return-to-work interviews after every episode, having a policy that sets clear expectations and manages staff who breach targets, proactive support for staff with health conditions, engagement with Occupational Health to address any barriers to coming to work, and a clear reporting policy for staff when they call in sick. These are all important elements of a good sickness management process.

And a point about triggers: we’ll be talking a lot during today’s session about different types of absence management trigger, whether it be the Bradford Factor, percentage absence or whatever. I want to make it really clear that a trigger point is a trigger to investigate and formally consider someone’s absence. Your policy may give guidance on, say, a Bradford score of 250 ‘usually’ leading to a written warning. However, as with all aspects of good people management, situations must be considered individually. Issues like pregnancy, disability or workplace accidents should be taken into consideration.

Acute care staff see a lot of patients with viruses and seem to pick up a lot themselves despite enforcing infection control procedures. How reasonable is it to expect an improvement?

It’s an interesting way of putting that question – “How reasonable is it to expect an improvement?” I wonder why it would be different to any other member of staff? If the infection control procedures are in place and being carried out properly, who’s to say the illnesses are being contracted at work? You could also argue that any staff member would be at increased risk of exposure just by being in the same building as sick people. I can tell you for certain that respiratory ward staff don’t get different sickness targets to other hospital ward staff. What it comes down to isn’t about whether it’s someone’s ‘fault’ that they get ill – it’s about how much absence the organisation can withstand. You don’t want to get into the territory of what’s a ‘worthy’ illness to exclude from your management process.

What tools do you recommend to manage regular incidents of absence?

There are a few systems you can use which I’m sure most of us are familiar with by now. You can start simply by setting targets based on the number of episodes of sickness or the number of days lost. This tends to work well for smaller practices as more prevalent episodes can have a major impact on service provision, so keeping it simple can be helpful. However, the simpler the method (and here arises the cynic in me!), the easier it is to manipulate, which is something I expect most of you can relate to. It’s easy enough for those few chancers to think, “Okay, so I can have two episodes in six months and not trigger anything, and after that six months I can have another one and still be okay.” This is where the other methods come in.

Most common to us in the NHS is the Bradford Factor system. This system basically calculates a score based on the number of absences and the total time lost to sickness. Your trigger points are then based on whatever score your organisation deems to be an acceptable level of absence. If you’re super savvy, your trigger points won’t rely on the Bradford Factor alone but will also have a useful “and/or” included – so, for example, you’d trigger on three absences in six months “and/or” a Bradford Factor score of 180. This is beneficial as it makes the system harder to game.

The other one I’d recommend, and my personal favourite, is percentage attendance. You can calculate an employee’s percentage attendance simply by checking the amount of time spent off sick against the amount of time being scheduled to work. Organisations usually deem that anything between 94% and 96% attendance is an acceptable level. If you have someone who’s persistently off work, and has managed to play the Bradford Factor and the episodes system (and these people do exist, trust me!), percentage attendance is always a good one to consider, as they often don’t understand how it works. So, I like to use it alongside the Bradford Factor and the number of episodes.

You’ll often discover some useful figures that can really demonstrate how much time is spent off sick – for example, if you’ve got someone who has, say, three absences in six months, but each absence lasts for about three weeks, their percentage attendance is going to plummet. What time period you reference is up to you, but it needs to be clearly outlined in your sickness policy. If you’re at the point where you’re considering dismissal for poor attendance, percentage attendance calculations are great for giving an overall picture, and whether a picture is improving or getting worse. So, if you calculate it, say, over a three-year period, and then break it down into individual years, it can also provide you with an idea of trend.

Can you explain how the Bradford Factor score works and should be applied? Is sickness counted within the leave year or should it be a rolling year?

Essentially, it’s multiplying the number of episodes of sickness squared by the number of days or hours lost (depending on how you want to work it). You then get a score, and if the score is higher than your trigger point, then the employee in question hits the next stage of your policy. Always do it within a rolling 12 months – otherwise people have a strange tendency to go off sick in January… The rolling 12 months should start from the beginning of the latest absence, so go back 12 months from then and include everything that falls in that window.

What are the rules concerning counting non-working days as sickness days when calculating the Bradford Factor score, or does this depend on individual sickness policies?

Well, I’ve only ever seen it worked in one way, and that’s counting only working days in the calculation. I always used to have to train managers in this – it’s calendar days for certification, and working days for the Bradford Factor score. So, you need a sick note after seven calendar days, but if the staff member only works three days a week, you’d use the three days for the Bradford Factor score.

Put it this way; if you’re a part-time member of staff who works two days a week (Mon-Tues) and you’ve been sick for one of those days (just the Tuesday), how would you feel if your manager said they’d calculated your Bradford Factor score based on your having four days off work (Tues, Wed, Thurs, Fri)? It doesn’t sound reasonable. The manager is just inviting people to complain and accuse them of discrimination.

Do you have a policy that includes the Bradford system and what are the steps to change the current policy? I have a couple of members of staff who are sick often and for one or two days only at a time – the Bradford Factor would help a lot, I think.

Provided your sickness management policy isn’t contractual then you can amend it any time you like. If you only monitor the number of episodes, for example, then just amend it to include the Bradford Factor as well. Hopefully your staff will have clauses in their contracts or in the policies that state these can be amended at any time by the partners. Just ensure that you communicate any changes to the staff.

Practice Index has a great sickness management policy for Plus subscribers which you can adopt and include your chosen Bradford Factor triggers within. If you also use Holiday Manager, then you can record absences on it and it will calculate the Bradford Factor for you!

A new staff member (here for three months) has frequent, short-term absences (currently 20 days in three months). All but one absence has been due to an ongoing long-term condition. What can we do?

Regardless of how long the employee has worked for you, unless they’re in their probationary period and your probation policy says otherwise, you should manage this as you would for any other employee. If there’s an underlying health condition then you need to consider whether this might be a disability, and if so, you may need to make reasonable adjustments to sickness targets or to elements of the job.

The best thing to do is to refer to Occupational Health for advice. They can tell you whether the absences are due to a disability, what you can do to support good attendance, and you can even ask if you can expect the level of attendance to improve. If not, then you’re within your rights to dismiss – but you need to have followed your process to the letter.

A member of staff constantly rings in asking if they can work from home due to not feeling well. This doesn’t get registered as sickness but it’s starting to be a regular theme, weekly. The employee works from home then comes in late to do paperwork. Whilst the work is being done, we prefer that they come to the office. They say they aren’t feeling well, but we don’t want them to go off sick as the workload is difficult to cover. Should we ask for an Occupational Health review?

I mean, you can, but my first question here is what is your policy on home working? Do you allow it? If you do, and this person can do the job from home well, and you can strike a balance, then why not put a formal arrangement in place?

If you don’t allow it, then you need to stop allowing it – as that’s what you’re doing every time they ask; you put it down to not feeling well. You can’t record it as sickness because the staff member is working, just not where you want them to be working.

You also shouldn’t encourage a culture of presenteeism – i.e., turning up for work (whether at the surgery or at home) when feeling under the weather. It’s not healthy yet it’s something we allow too often in the NHS. If employees are too ill to come to the surgery to work, why would they be more able to do the job at home? Are you monitoring their performance and output when they’re at home? You need to ensure the work is actually getting done and if you don’t feel you have that supervisory ability when they’re working from home, this is a valid reason to refuse the request.

My view would be to get firmer and refuse the option if they’re saying they’re not well enough to come to work. If they’re not well enough to come to work then they should be off sick, and then you’d manage them in line with your sickness policy.

Can we alter the sick pay entitlement – say, only paying occupational sick pay after the fourth day of absence?

To alter anyone’s contractual terms and conditions will require a formal consultation. This can be a complex process, which I don’t have time to summarise now, but I recommend you read the Acas guide for managers on trying to change terms and conditions.

However, I would urge caution. Why are you looking to reduce entitlement? If it’s because the practice can’t afford it, then that’s a different kettle of fish but if it’s to discourage people from going off sick then, in my view, this isn’t the way to go about it. What may result is staff who don’t regularly have time off sick feeling penalised for the actions of others – or what they might perceive as management’s inability to deal with the problem. This can lead to staff leaving to find better terms elsewhere, which isn’t good news for you.

If this is the reason, again, active management of the sickness is what is needed. If you have people taking so much time off that it’s costing you more money than you can accommodate, then they need to be being escalated up the policy. You might look to tighten up the parameters of your sickness policy instead of reviewing pay entitlement, making it easier for people to trigger the next stage. Or you might seek to include another measure of attendance, as mentioned previously, to make it harder for staff to play the system.

I’m never a fan of changing a whole system to pick up issues caused by a minority; it doesn’t feel fair to me and it wouldn’t feel fair to the staff who are playing their part. However, if the problem is widespread then it would be a practice decision whether to move ahead, but formal consultation would still be required.

If there is case-by-case sick pay paid, are there risks associated with not paying those with persistent short-term absence?

I’m quite shocked that anyone would think it’s a good idea to apportion sick pay on a case-by-case basis in this day and age. And by this day and age, I mean this age of litigation. Disability discrimination claims are so frequent now and it’s a literal minefield in terms of what you should and shouldn’t do. I know some practices are considering this issue from a good place – e.g., you only pay SSP but a long-standing member of staff goes off for cancer treatment and you want to help them. I totally get that. But what happens if another member of your team goes off for some other curative or preventative treatment and you don’t pay them? It’s just really dodgy ground in my view.

With regards to short-term absence, you can never be sure that these aren’t related to disability as well. People with terrible endometriosis might be off sick for a week or a few days every month around their cycle, but this can be classed as a disability – so is it fair to not pay them sick pay?

This is what it boils down to: what is fair? And it’s hard to determine fairness when it comes to health problems as people can be impacted in a myriad of ways even with the same illness. My view has always been to have a consistent approach across all staff. How you manage the sickness process is what you can tweak and adjust depending on the nature of the illness, always with medical advice.

How do you deal with staff who are covering a colleague’s sickness but report seeing the sick person posting what a lovely time they’re having on social media? I don’t doubt the reasons for absence, but I can see where the staff are coming from.

This is a question we get asked a lot.

First of all, you need to dispel the myth with your staff that when you’re off sick, you’re meant to be housebound, completely isolated and not doing anything remotely enjoyable. This isn’t true and it definitely wouldn’t be recommended by a doctor to help make the employee get better. I would say to my team, especially if they knew why the employee was signed off, that hopefully the employee is feeling better and will be able to come back to work soon.

I’d then follow it up with a conversation to the employee, because we still do need to address this, and we wouldn’t want there to be growing resentment in the team. I would explain that it’s good to see them looking better but I would ask them to be mindful of what they post online, as their colleagues who are at work are able to see it and it may not come across in the way it’s intended.

I’d then ask how things are going, and if they have any idea of when they’ll be back at work. Any opportunity to manage the absence should be taken!

Obviously sometimes the things we see posted on social media aren’t in keeping with the reason for the employee being off sick. For example, when I worked in a large hospital trust, we had a midwife off sick with chronic back pain, which she claimed prevented her from standing for long periods or walking long distances. So, when she was discovered in a video on Facebook bouncing up and down on a trampoline at a children’s party, we obviously had a very different conversation!

What do you do about staff calling in sick when actually it’s their child who’s ill?

Technically, this isn’t about short-term sickness, because this only applies when it’s the employee who’s sick. When the dependant is sick, this becomes an issue of time off for dependants. You should never allow an employee to take time off sick if they’re not ill themselves. Time off to care for a sick dependant falls under other policies, and depending on what those policies say can either be paid, unpaid or staff can be given the option to use annual leave or make the time up. It should never be recorded as sickness.

If you then find staff claiming that they’re the ones who are ill, they run the risk of escalating themselves up your sickness policy.

I’d also make it clear to staff that they have to be honest about the reasons for their absence. I once took an employee to a final hearing for persistent absences, all unrelated self-limiting illnesses, and no underlying health condition, and at the hearing she claimed to the panel that the time off had actually been to look after her son and she wasn’t in fact ill herself. I think she thought this would save her – but instead it reinforced the panel’s decision to dismiss. They highlighted to her that, either way, her level of absence was unacceptable, and that she had also effectively admitted to being in receipt of sick pay that she wouldn’t have otherwise been entitled to!

How do you manage someone who’s off a lot but always for little things like stomach bugs or viruses? I don’t feel there’s much I can do to support them to improve their attendance.

If we bear in mind that, on average, we can expect staff to have around three or four short-term absences per year for conditions like these (especially now that Covid is in the mix as well), we shouldn’t be overly concerned if the absence levels are around this mark.

However, if the level is much higher, and we’re talking about every month or every other month, then you still have options. At your return-to-work interview, I’d highlight the number of absences and the reasons for the absence to the employee, and ask them if there’s any link they can think of or any underlying health condition they may be aware of that could make them more susceptible to picking up bugs. Sometimes this can lead to a disclosure you weren’t aware of, or it might make the employee consider getting checked out. Sometimes it can highlight someone suffering from stress, which can make them more rundown and therefore more susceptible to picking things up. Then you can consider referring them to Occupational Health for a medical opinion too, or think about doing a stress risk assessment with them.

This can help in one of two ways. If they’re taking the mickey a bit, the fact that you’re willing to go to bat for them, have shown that you’re concerned and you care, may make them pull their socks up and be less likely to take time off sick in the future. The other option is that it might actually highlight a health problem they didn’t know they had, or they may open up to you about something they’re struggling with, in which case you can then provide support.

If you’ve done this and the episodes keep happening and there’s nothing to suggest there’s anything else going on, then follow your usual process up to dismissal if necessary.

Do I have to make adjustments to sickness targets for disabled staff?

If they’re suffering from a disability that’s likely to cause them to have more absence than someone without a disability, then yes you should. This is one of the simplest reasonable adjustments you can make. However, it doesn’t mean that there should be no target for disabled staff, as that wouldn’t be reasonable. That would be like assuming you could run your service without that person ever being there – in which case, you wouldn’t have the role in the first place!

So, an adjustment is just that – an extra allowance before the disabled employee would trigger further actions. This should be set following discussion with the staff member, and ideally following an Occupational Health referral. You can just ask Occupational Health what they would recommend and then discuss it with the employee to see if their recommendation can be accommodated. If it can’t, explain why, but try to come to some sort of compromise.

You can also make adjustments in the form of discounting episodes of absence related to their disability. I would advise caution with this, however, as this could lead to your not counting any at all, in which case the reasonable aspect may have been removed. Each case should be looked at individually, taking into account the condition and the employee’s previous sickness record, as well as what the service can reasonably accommodate.

We have a staff member who’s off a lot and we suspect they might have some kind of alcohol problem. Do you have any particular advice for dealing with this?

This is a tricky one. What I would advise every time is a supportive chat with the employee. You may have to highlight what makes you think there might be a problem, or use probing questions to see if they divulge anything themselves. I’ve experienced this before myself with an employee whose episodes always started on a Monday, and the gossip from the staff was that they were always out drinking on a Sunday. So, when it was time to have a meeting under our sickness policy, I highlighted the pattern of absence and asked if they had any understanding of why that was. I was able to probe a bit more and asked them if there was anything they were doing over the weekend that might impact on their ability to attend work. Now this person wasn’t an alcoholic, just a bit of a binge drinker, so it’s a slightly different scenario, but the end result was still a disclosure of what was going on.

Your next step is to offer support. Alcoholism is a disease, and we manage staff in the same way as any other health problem – we see what we can do to help. And we encourage staff to help themselves. You also, however, have to reiterate your policy on alcohol at work, to ensure the staff member is clear that they cannot come to work if they’re under the influence, and that to do so may lead to disciplinary action. Occupational Health can still help, and you may want to support the employee in finding a local service where they can get help.

Just a final point on this; alcoholism as a single condition is excluded from the definition of disability under the Equality Act. Therefore, the usual rules about making reasonable adjustments don’t apply. However, a condition that’s related to someone’s alcoholism such as depression or liver disease may still be considered a disability, so manage these situations carefully.

There’s a staff member who I’d like to discipline for sickness, but I’m worried we can’t do this because we’ve not undertaken any previous return-to-work meetings (just too busy!). Am I best to leave it?

First of all, what does your policy say? Does it say that return-to-work interviews have to happen after every episode? If not, then you might be okay, provided you’re confident the employee is aware of the policy and the potential repercussions for persistent absence.

However, if your policy indicates that these interviews should have happened, then I would use caution. And it’s never too late to start, so make sure you hold these going forward! Within seven days of their return to work is best practice.

How do we manage staff who are going off sick because of the menopause? We never used to have this problem!

In the same way as any other health condition – an Occupational Health referral for advice (and make it a good referral; ask the right questions!). Then meet the staff member to discuss the report and the impact of their condition on their attendance. You can still manage their attendance in the same way as any other staff member and implement your policy. Just be mindful that you may need to adjust targets if the menopause has lasted long enough to potentially be classed as a disability. Also, it’s worth having a menopause policy for the practice – this in itself can open up discussions with employees about their symptoms and what can be done to support them to attend work!

How do I manage someone who has persistent absence and then when the policy kicks in, improves for a while? Very frustrating!

I think we’ve covered this one already to an extent. Make your policy harder to game. You also have the option of adding an element of “exceptional circumstances” to it – so, for example: “Should an employee’s absence become a significant cause for concern, the practice reserves the right to take a view on escalation to a higher stage of the policy or to set amended targets.”

This would allow you to meet the employee and highlight the pattern of absence you’ve noted, and then set an amended target or put them back on a higher stage of your policy. But you must ensure it’s recorded!

What if staff are always off around the same time each year, e.g., Christmas, summer holidays, etc?

This is what we’d call a pattern of absence, and the first thing I’d do is call it out for that. At the return-to-work interview, highlight the pattern and ask them if there’s anything contributing to this. Quite often, once you’ve shown that you’re keeping an eye on it, the pattern will stop. If not, highlight that you expect to see an improvement and that you may consider escalation in your policy if it continues.

How long do they need to be off for it to be classed as long-term sickness and trigger an Occupational Health referral?

Four weeks or a month is what we’d normally class as a long-term episode. You can send a referral off, though, as soon as you become aware that it’s likely to become longer term – e.g., if an employee has been signed off for two weeks and after the second week, they present you with a new sick note for a further two weeks. Obviously for things like operations or broken bones, where there’s a set recovery time, this may not be necessary.

Do you have a policy for managing staff with disabilities?

No, and I’ll tell you why! Disabilities are far too individual for one policy to cover everything you’d want it to consider. What you should do instead is review your existing policies and have a paragraph that highlights what you’d do in the event of employing a staff member with a disability. This should form part of the equality impact assessment that you carry out on your policies. So, for example, in my sickness policy, I just have a paragraph stating that reasonable adjustments will be considered for staff with disabilities – either in the form of adjusted sickness targets or in relation to the role/working environment where this would support a disabled employee’s attendance at work.

We had someone start with us a couple of months ago and they’ve already been absent four times – just saying coughs and colds. We were considering dismissing them for failed probation, but last Friday she notified her manager that she’s three months’ pregnant. The previous absences were nothing to do with pregnancy and so can we still dismiss?

First of all, you say the previous instances were nothing to do with coughs and colds – but can you be sure? She must have been pregnant at the time, but just hadn’t told you. Aren’t we all familiar with the notion that most people don’t announce their pregnancy until they get past the three-month mark? So, the thing to do is to review the sickness with her in light of her disclosure and ask the question whether the absences were related to her pregnancy. And you have to bear in mind that pregnancy is a time-limited health condition. So, what’s to say her attendance doesn’t get better as time goes on and she becomes a reliable and valuable member of your team? I’d be very careful about considering dismissal if there’s a chance she could claim the sickness was related to the pregnancy. You’ll be facing a discrimination claim if you do!

How do you decide on an improvement plan in respect of the number of days they need to improve by/target for attendance?

This is usually at the organisation’s discretion, but often the easiest thing to do is copy someone else’s! Most hospital trusts have an acceptable absence rate of about 4%, which I’ve mentioned previously, and this often equates to something like three or four absences in a 12-month period before the first trigger is met, or an appropriate Bradford Factor score. And that’s often worked out based on the idea that most people might have three to four short-term, self-limiting illnesses per year. So, three or four absences of about two to three days each, if you work that up as a Bradford Factor calculation, can give you an idea of a threshold to use. Normally, once the first stage has been triggered, the following stages have slightly tighter thresholds – so maybe only two episodes, and the Bradford Factor score is increased by 50 or 75% rather than doubling the first stage. And so on. The number of stages, in my view, shouldn’t be too many; I’ve always implemented an informal stage, then two formal stages (i.e., first improvement plan or warning, and then second improvement plan/final warning) and then a sickness hearing. But you need to consider what’s right for your practice. If you’re a small surgery and any absence has a significant impact, then you might be stricter. Larger practices might be able to absorb more. One thing to bear in mind is that an employment tribunal will look at what is reasonable, and given that we’re in the business of healthcare, we’re expected to be a bit more lenient than your average other small/medium enterprise.

We plan to change our sickness monitoring from a rolling 12-month period to a financial year – any tips or pitfalls we should be aware of?

Tips, no. Pitfalls, yes.

What happens on 1^st April each year? Are the attendance records wiped clean? Because what you might find is that, if this is the case, those few people who do take the mickey start afresh and start going off sick more. I would always advocate for a rolling 12 months as it takes into account all sickness that has fallen within that period, and nothing ‘escapes’ so to speak!

If you’re also considering changing the sick pay arrangements to follow a financial year and not a rolling 12 months, my question is the same. Does the sick pay allowance refresh on 1^st April? Because, say you have someone on long-term sick who has gone into half pay in December, if they’re still off on 1^st April, will their full pay come back in?

In short, it’s not something I would recommend!

One comment I’ve heard just recently is, “I haven’t used all my sick allowance yet.”

This is a good reason why it’s always best to have sick pay entitlements worked out on a rolling 12-month basis rather than based on January to December!

What is a reasonable trigger point score for Bradford?

There’s no one rule for this and it will be set out by your own practice policies, but employers (including NHS providers) tend to use triggers that start at the 150-200 mark.

Is a Bradford Factor score of more than 1000 okay?

A Bradford Factor score of 1000 is unusually high and should normally trigger further investigation, with a formal warning or improvement notice being likely.

I’ve recently started using the Practice Index Bradford Factor tool. I just wanted to check if this is up to date and acceptable to use.

If you’re not already using it, we recommend you move to Practice Index’s Holiday Manager to calculate the Bradford Factor. This is a great way to keep on top of Bradford Factor calculations automatically.

What about self-diagnosis?!

I assume this refers to people who are off sick persistently due to self-diagnosed medical conditions. The fact that no formal diagnosis exists doesn’t mean that no formal diagnosis could exist, but you’re entitled to seek evidence where you can. I’d suggest a referral to Occupational Health to get their opinion on whether the employee is likely to have a disability.

How do you treat staff wanting to take annual leave instead of sickness? 

If this were a long-term sick member of staff who requested the opportunity to take some annual leave whilst off, then I would generally agree to it – especially if the request is made in advance.

However, someone ringing up one morning to say that they won’t be in that day and they want to take it as annual leave is a whole different ball game. In the latter situation, I advise that you decline the request to take annual leave as the absence is unplanned and you need to be able to manage it through your sickness policies. Also, if the employee uses up large amounts of annual leave when sick, they may not have sufficient left for rest and recreation (which is the real purpose of annual leave) at a later point.

How to juggle staff who’ve exhausted sick pay but can’t afford unpaid leave? I believe there are regulations about salary being less than the minimum wage, so if we deduct sick pay, they’re on less.

If they’re not at work, then the minimum wage isn’t an issue, so don’t worry. Minimum wage rules only apply to time spent at work or on annual leave. Just ensure that you pay sickness in line with contracts, inform staff when they’re about to run out of sick pay, and comply with SSP rules.

What about when staff, who are covering the staff who are off sick, also go off sick? As we can’t record that on their record … as they were covering (or not, as they then also called in sick). 

I think this question is about sickness when someone is performing overtime. I’d advise treating overtime absence separately to absence in regular working hours. The reason for this is that if you’re sanctioning or dismissing someone for absence in the future, you’re doing so on the justification that the individual isn’t adequately performing the terms of their contract. Adding sickness from overtime into the mix makes this argument a bit more complicated.

Therefore, if you do have someone who phones in sick for overtime regularly, it’s best not to offer them any overtime in the future!

We have an employee whose Bradford score is well in excess of 1000. They have frequent absences for a variety of different reasons, often using foul language when explaining their reasons for being off.  We’ve tried to deal with this unsuccessfully, including reaching out to external HR providers. Any suggestions on how to deal with this one?

OK, there are two factors here. The first one is the persistent absence which you should manage in line with your internal policies – use return-to-work meetings, trigger points, formal hearings, and formal warnings or improvement notices.

The second factor is the foul language. This is most likely a misconduct issue which you can investigate further in line with your disciplinary policy. Just bear in mind factors such as if the employee is in pain when they phone up.

Does this mean menopause is a protected characteristic?

Menopause isn’t a protected characteristic in its own right, but if symptoms are having a noticeable impact on someone’s ability to carry out their day-to-day activities for over a 12-month period, they’re likely to meet the definition of disability under the Equality Act. And disability is a protected characteristic.

How do we deal with a nurse who has taken a week off with stress following the birth of her grandson? She said her daughter was unwell afterwards. Of note, she does not have a good sickness record.

Stress is a recognised reason for absence so unless you have evidence to doubt that she was unfit for work, it’s not worth challenging. However, if you have standard processes to manage persistent absence (as discussed in this session) then you can use these to deal with the situation fairly.

Do we have to pay a member of staff who produces a Fitnote stating they should have an afternoon off each week for the next four weeks due to anxiety? 

That’s a very unusual Fitnote! You should pay for any such absence in line with the employee’s contract and/or your sick pay policies.

Useful links 

Future HR Clinics 

Managing Conduct and the Disciplinary Process – Tuesday 23rd January at 12.30pm – Book here

Managing misconduct feels like a minefield – but it doesn’t have to be!
Our January HR Clinic will focus on managing conduct and the disciplinary process. From investigating, issuing sanctions and holding hearings to dismissal and appeal – we’ve got you covered!

Recruitment, Appraisals and Workforce Planning – Tuesday 20th February at 12.30pm – Book here

There’s nothing worse than hearing “I’m handing in my notice”.
It opens up a whole ton of processes that we then need to go through to get new staff in, train them and get them off and running.
But how often do we take time to consider the recruitment process itself, or whether we actually need to replace like-with-like? How often do we consider doing something differently?
How confident are we in our recruitment process? Do we understand what a good recruitment process looks like, and if not, how can we make it better?

Bullying and Harassment – Tuesday 19th March at 12.30pm – Book here

The thought of having to tackle potential bullying or inappropriate behaviour is enough to get the pulse racing of any practice manager. However, these things do crop up – and even more so these days when everyone is feeling the pressure and stress.
But what constitutes bullying? And what is the definition of workplace harassment? And where does victimisation fit in?
Navigating these scenarios can be a bit of a minefield, but they don’t need to be.