1. QIPP Medical Workforce ATTENDANCE MANAGEMENT THE WAY FORWARD

2. ATTENDANCE MANAGEMENT THE FACTS  The average absence level in the NHS is 4.12% (15.56 million days lost)  The average absence level across UK is 2.2% (131 million days)  Every % point in absence costs us in St Helens and Knowsley £1M – since introduction of the policy we have saved £1M  Absence for Doctors (especially those in training) is massively under reported  At an average daily replacement cost of £500 doctors’ absence is hugely costly WE ALL HAVE A SERIOUS & COSTLY PROBLEM

3. ATTENDANCE MANAGEMENT Why the differences? Differences between the public and private sector Institute for Employment Studies Report (2010) ‘Without the commercial imperative to drive costs down and productivity up, the business case for managing absence effectively is harder to sustain in practice. Whilst there may be the policy ambition to reduce absence, there is equally forceful deep seated cultural resistance to its aggressive implementation. Seen in this context, it is unsurprising that successful absence management has been patchy.’

4. ATTENDANCE MANAGEMENT Policy in operation in St Helens and Knowsley since April 2011 – Now being rolled out by us as Lead Employer Objectives of the New Policy To reduce real levels of sickness absence & thereby  Reduce costs  Reduce the negative impact on the individual employee & their colleagues  Improve patient care  Improve the well being of Trainees

5. ATTENDANCE MANAGEMENT PRINCIPLES  Employees are responsible for their own attendance at work, absence & compliance – failure to do so will adversely affect their training  Managers/Clinical Supervisors are responsible for managing the level of absence of their staff & adherence to the policy  HR are responsible for robustly ensuring that the policy is fully & promptly adhered to by coaching, monitoring & enabling.  Heath, Work and Well Being Service is responsible for the provision of clear information & advice + ensuring an early return to work or regrettably an early exit ALL MUST WORK AS A TEAM

6. ATTENDANCE MANAGEMENT SICKNESS ABSENCE REPORTING & RECORDING  Employee must ring daily unless otherwise agreed  Absence recorded in real time on ESR by manager self service – to be rolled out across Hosts for 85% of Doctors in Training by March 2013  On return to work they must complete & sign a Trust self cert. – applicable from day one – self cert contains a ‘anti-fraud’ statement  For periods in excess of 7 days two self certs required (+’Fit Note’) – one re SSP (first 7 days) & one re the anti fraud statement on return.  Manager/Clinical Supervisor must conduct a return to work interview NB Accurate and prompt reporting & recording is absolutely key

7. ATTENDANCE MANAGEMENT SHORT TERM SICKNESS ABSENCE Two separate processes  Where no significant underlying medical cause of the absences exists  Where there is a significant underlying medical cause of the absences

8. ATTENDANCE MANAGEMENT SHORT TERM SICKNESS ABSENCE No Significant Underlying Medical reason  Just one trigger point to enter process for most employees – 3 occasions in 12 months  A three stage process  HR to monitor & escalate to ensure robust compliance

9. ATTENDANCE MANAGEMENT SHORT TERM SICKNESS ABSENCE Significant Underlying Medical Reason or Intermittent Absences  If hit a trigger point or have intermittent absences  A three level process  HWWB involvement  HR to monitor & escalate to ensure robust compliance

10. ATTENDANCE MANAGEMENT LONG TERM SICKNESS ABSENCE  If employee is likely to be off work for 4 weeks + or has stress/ depression/muscular skeletal problem consider early intervention  Health, Work & Well Being objective is to speed up the return to work and provide timely, clear & decisive management information & advice  Manager/Clinical Supervisor will maintain contact at least monthly face to face & every fortnight on the phone  An escalation process in place to engender a more proactive and business focused approach NB This is our toughest challenge!

11. ATTENDANCE MANAGEMENT In summary:  A more assertive approach being taken with short term & intermittent absence  A more decisive, less risk averse & more business focused approach being taken with long term absence  An auditable, consistent & transparent approach to all absence management

12. Any Questions