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How to ... Deal with sickness absence

Practices need to take action when staff sick leave causes major disruption. By Rayner Jones, a partner and employment law specialist at solicitors Lester Aldridge LLP

If an employee is on long-term leave you may need to obtain a medical report before any proceedings (Photograph: getty)
If an employee is on long-term leave you may need to obtain a medical report before any proceedings (Photograph: getty)

Practices recognise that employees will be off sick from time to time. However, it is difficult to provide cover for an employee who is sick on a frequent but unpredictable basis or on a longer-term basis.

Dismissal is always a last resort. But sometimes it is the only option when you have done what you can to get the employee back to work but they are still on long-term sick leave or persist in taking a lot of short-term absence.

As solicitors, we are often asked to advise on sick-leave issues.

Separate the issues
In one case, a practice nurse had taken a lot of time off in the past year or so. She had been given a written warning for shouting at a patient and the GPs wanted to know if they could give her a final written warning for her ongoing absence problems.

The answer was no, because disciplinary and health procedures must be dealt with separately. If misconduct and sickness issues are combined and the employer dismisses a staff member, the dismissal is likely to be unfair and may result in an employment tribunal claim.

There are no time limits for starting a sickness absence procedure but it is perfectly reasonable to do this when the level of absence becomes a problem.

What this level is will depend on the employer. You might for instance look for patterns and trends of absence. Are certain days of the week or certain shifts being missed? Are days off sick taken before or after holidays?

Dealing with frequent short-term absence

Step 1

  • Hold an informal meeting with the employee.
  • Go through their absence record and the reasons given for absences.
  • Explain your concerns and ask for an explanation.
  • Are there any underlying medical concerns? If there might be, obtain their consent to ask for a medical report from their GP and/or consultant.
  • Write to the employee referring to the absence history, the problems this is causing and explaining that an immediate and sustained improvement is expected.

Step 2

  • If there is further sickness absence, move on to a formal meeting.
  • Go through the same discussions as in Step 1.
  • Following the meeting, issue a formal written warning.

Step 3

  • If there is further sickness absence, hold a further formal meeting.
  • Follow up with a final written warning.

Step 4

  • Hold a final meeting with the employee.
  • Dismiss them with the right to appeal.

Follow procedure
The sickness absence procedure is quite straightforward. It progresses from an informal meeting with the employee, explaining your concerns, asking for an explanation and any underlying medical reasons through a formal meeting and formal warning and, ultimately, to dismissal if the absence problem persists.

With a long, continuous period of sick leave that is causing problems, you will need to proceed differently. Another practice with a receptionist who had been off sick for three months asked if it could dismiss the person because it wanted to organise a permanent replacement.

There is no period of time to wait unless one is specified in the staff member's terms and conditions of employment. When you decide to take action is likely to depend on how urgent your need is to have someone doing the job on a reliable basis.

Certainly in the case of the receptionist off sick for three months, I saw no reason to advise waiting longer.

The procedure with longer-term sick leave involves contacting the employee for consent to obtain a medical report, holding an informal meeting to discuss their return to work and any measures you as the employer can take to facilitate this.

If the employee is unable to return to their job (or another job if you can offer one), within a reasonable time they can be dismissed with notice.

If, however, the practice operates a permanent health insurance scheme for staff, you may wish to proceed differently as the employee may lose benefits under the scheme if they are dismissed. In this case it might make sense to keep the employee and let the insurer take the necessary steps to facilitate a return to work.

Situations like these are unpleasant but must be dealt with. Follow a proper procedure and take account of any disability issues, and it will be hard for an employee to bring or succeed in a claim.

Dealing with long-term absence

Step 1

  • Write to the employee and ask for their consent to obtain a medical report from their GP and/or consultant.
  • Explain in the letter why you want the report.

Step 2

  • When you have the report write to the employee enclosing a copy and invite them to attend a meeting.

Step 3

  • At the meeting, discuss the medical report, the employee's prognosis and likely return to work and any adjustments that you might be able to make to facilitate a return to work.

Step 4

  • If the employee is unable to return to work within a reasonable time frame either to their old job or to any new job that might be available - taking into account any adjustments that you can reasonably make - you can dismiss them (on notice) and with the right to appeal.


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