1. Managing ill health and disability at work Nicola Lee Adviser RCN Employment Relations and Welfare Rights and Guidance

2. Overview u Some facts and figures u Effective absence management u Supporting employment u Income maximisation – inc pension options

3. Lies, damned lies and statistics u Sickness absence costs UK plc £12 billion each year u Equivalent to £495 for each employed earner (direct costs) u £3 million per year in NHS u 9.6 million disabled people (DDA definition) – 15% of population u 1 in 4 households affected by disability u 70% develop impairment in working age u 21% of people with mental health problems are employed

4. Absence management – the usual route? u Problems at work – unreported or unresolved u Goes off sick – rings in and leaves a message u Sends sick note u No other communication u Trigger point passed – ref to OH (if you’re lucky) and summonsed to meeting with management at short notice u Or no contact until sick pay ends u Embattled and negative experience all round

5. Absence management- a better route? u Early intervention – may prevent absence? u Ref to OH within 2-8 weeks u Priority treatment? u Regular and appropriate communication u Case conference style meetings u Phased return to work u Rehabilitation u Redeployment u Supportive, empowering and solution focussed

6. Guidance and guidelines u For NHS – AFC handbook – Section 14 and Annex Z u DoH “Blue book” u NICE – recommended practice, proven to be cost effective

8. A word on sick pay u Contractual - entitlement should be written in policy/staff handbook/etc… u Statutory Sick pay - –paid after 4 day’s absence regardless of contractual entitlement –component part of full pay, usually paid on top of half pay –28 weeks (currently £79.15 per week) –Linking period = 8 weeks –Transfer to Employment and Support Allowance –SSP – Leavers’ statement form

9. Supporting employment u Early intervention - priority treatment u Communication and co-operation u Rehabilitation u Phased return u Redeployment u Reasonable Adjustments Utilise internal and external expertise

10. Access to work u Government money to support disabled people in work u Adjustments and adaptations u Travel to work u Coaching and occupational psychology support u Support workers u Accessed through local JobCentre Plus office – Disability Employment Adviser u Employer contribution expected if existing member of staff – but negligible compared to costs of losing staff member

11. Income maximisation u Statutory Sick Pay u Employment and Support Allowance u Injury benefits (DWP and NHS) u Disability Living Allowance u Tax credits u Occupational pension – ill health benefits

12. Ill Health Retirement from NHS Pension u Two tier system u Unable to do own job = Tier 1 (accrued service only) u Unable to do “regular employment” = Tier 2 (enhanced by 2/3rds prospective service to NPA or 4 years) u Future employment is possible under both tiers – with some restrictions

13. Working again after IHR u Tier 1 – income restriction only in NHS employment u Tier 2 – all employment over NI LEL* will reduce pension to T1 level. * currently £4940 pa –Can earn up to NI LEL every year in non-NHS employment but only for 1 year in NHS. –If pension reduced to T1 – 12 months to reclaim T2 entitlement. u For all – only “unearned portion” of pension can be abated

14. Health, work and wellbeing u Good work is good for us u Ill health needs to be effectively managed at work u Disability does not always equate to incapacity u Employer cost benefits are real and demonstrable