MA(Hons) CIHM FIHM
Independent Consultant in Practice Management
Fiona is an experienced primary care trainer and facilitator. She is the national RCGP QPA Adviser and has advised on both the original and the review of the Quality and Outcomes Framework of the 2004 GP contract
Staff absence can be a significant problem for practice managers. As well as managing attendance of the traditional staff complement of office/reception and nursing teams, many practices now employ GPs. The impact of absence in any of these groups can have a considerable effect on both the running of the practice and patient care.
Hilary Haman’s article on the preceding pages describes the steps practices should take in order to ensure that sickness absence is effectively managed. This is the most common cause of absence from the workplace and practices should have in place clear and explicit policies that are consistently applied.
However, sickness absence, whether short-term or long-term, is not the only cause of absence from the workplace. This year, managers have been provided with a fabulous array of reasons why staff may be absent from work for causes other than sickness: BA strikes, Eyafjallajokull, deep snow, travel company collapses, and the World Cup.
In addition, staff will have been absent because of reasons related to care of dependents, a death in the family and doctor/dentist/hospital appointments, to list some of the more obvious. Evidently, the list is not exhaustive.
Managers faced with any of the above situations who do not have in place a policy for managing it, or who are not aware of their staff’s employment rights, may inadvertently act unfairly, inconsistently or both and may breach staff’s legal entitlements, including rights under equal opportunities legislation.
In the absence of a clear policy, managers can and do respond to each set of circumstances on an individual basis. They may be influenced by the behaviour of the staff member or by their relationship with them or may make potentially discriminatory judgements. Many practice managers also find that managing attendance is complicated by the reaction of the GPs to the situation; kindly intentions by the GPs can backfire and the practice may put itself at risk of claims of discrimination.
Decisions made in the heat of the moment and in the absence of a policy in relation to compassionate leave are at the highest risk of being inconsistent. Practices should take the time to develop a compassionate leave policy. This is likely to include the following elements:
- Reporting mechanism – when, and to whom.
- The length of paid compassionate leave that will be granted and in what circumstances.
- The length of unpaid additional leave that may be granted.
- The circumstances in which additional leave may be granted.
- Arrangements for dealing with abuse of the policy.
Some practices find it useful to define varying lengths of paid compassionate leave for the sake of clarity. For example, the death of a close family member (parent, child, partner, sibling) may be felt to merit more paid days’ leave than the death of another relative. Alternatively, this could be dealt with by a policy that grants additional leave on an unpaid basis in “exceptional circumstances”.
Practices should take care to ensure that the policy is as clear as possible and that they apply it in a consistent manner. The policy must also state what steps will be taken if it is found that the policy has been abused; this will normally take the form of disciplinary action, and this should be explicitly stated.
Practices who do not already have a policy for handling staff who are unexpectedly absent because of being delayed or stranded would be well advised to give this some thought.
Across the UK, responses by employers to stranded staff have been inconsistent this year. The recruitment company Badenoch and Clark surveyed 1,000 workers during the volcanic ash cloud disruption. More than 40% of delayed or stranded staff were docked pay or lost holiday entitlement. About 30% were given extra holidays.
Even if the travel delays were unavoidable, there is no legal right of pay if an employee does not turn up for work. This is technically a disciplinary matter, but disciplinary action would be unreasonable if employees are able to demonstrate that they took all reasonable steps to attempt to get back home.
Practices should consider whether unplanned absences of this kind are paid or unpaid. It is possible that a series of options may be available in sequence. Staff should not be compelled to use holiday days to cover the absence after the event. Staff may be given the first option of using any accumulated time in lieu (if any) to “pay back” the lost time followed by the option of either taking remaining holiday days (if any) or finally taking the leave as unpaid. The practice should also have a clear policy on whether staff can owe them time or take days from the next holiday year.
Staff unable to go on holiday due to their flights being cancelled may also find themselves in an unclear situation, and may request that the annual leave booking be commuted to another time instead. There is no obligation on the practice to agree to this, but to agree to do so would be seen to be reasonable and in the interests of good working relations.
Days when your staff have to do a spot of digging in order to get to work are relatively common in some parts of the country and more unusual in others. However, the importance of a policy on “snow days” was underlined last winter. These should be treated as above under “travel disruption” so that staff are clear whether the time is unpaid or may be paid back.
Sporting and other special events
Some practices experienced requests for holidays during the World Cup and many will do so again at the time of the Olympics in 2012. A policy for handling this kind of special event is important to have in place before issues begin to arise in the run-up to the event.
Under the Working Time Regulations, if there is no provision for holiday leave notice in the contract, then staff should give notice to the employer that is equal to twice the number of days’ leave that he or she wishes to take.
Employers are allowed to turn down the dates requested provided that they give notice equal to the number of days requested. This may be on the basis of being unable to grant the request for reasons of business operation. However, an event such as the World Cup may generate late requests for half-days and the policy should state how these will be treated. A first-come, first-served basis will avoid claims of discrimination.
Similarly, the practice may wish to consider whether staff could use their hours flexibly to accommodate a special event by moving lunch hours, finishing early and other options. This will need to be on the basis of having received appropriate permission, with clarification of action to be taken in the case of unauthorised absence.
Short-term sickness absence during special events may well be genuine and the practice’s policy should be clear how sickness absence will be treated. Staff members should attend a back-to-work interview and, if appropriate, be able to provide evidence that the absence was genuine, in accordance with the practice’s absence management policy. If the practice has reason to believe that the absence was not genuine (for example, they were witnessed watching event coverage in the pub), then this is a disciplinary matter.
Dentists, GPs and hospitals
The practice should have a policy to handle absences from work for this kind of appointment. In general, it is not unreasonable to encourage staff to make appointments out of working hours when they can, especially if they are part-time. However, this is not always possible.
The practice may decide to allow a small amount of paid time off for appointments of this kind, perhaps one hour. Hospital appointments requiring a half-day or day’s absence could be regarded as a day’s sickness absence. This is also the case for appointments involving a procedure after which returning to work would be inappropriate because of pain or discomfort. Staff should be able to produce an appointment card as evidence for the absence.
Finally, a reminder about dependant leave. Your staff have the right to unpaid leave to deal with an emergency situation involving a dependant. A dependant is defined as:
“A spouse, partner, child or parent, or a person who lives with the employee but not as a lodger, or someone else who reasonably relies on the employee for care, eg, an elderly neighbour.”1
Confusion can arise around the purpose of dependant leave. The purpose is not to allow the staff member to look after the dependant, but to put measures in place and make suitable emergency arrangements. This includes:
- When the dependant is ill, injured or assaulted.
- When the dependant goes into labour.
- Making long-term care arrangements for a dependant who is ill or injured.
- Arranging and attending a dependant’s funeral.
- Dealing with an unexpected problem with a care arrangement, eg, childcare is not available.
- Dealing with an emergency in school hours, eg, suspension.
The employee is entitled to a reasonable amount of time off to deal with the immediate problem and there is no limit to how many times dependant leave can be taken. Employees should take the minimum time necessary to deal with the emergency and timescales are not defined. There is no qualifying period of employment to be entitled to this right.
Taking the time to define the practice’s policy for managing attendance and management before the absences occur will mean that staff are treated in a fair and consistent manner, and will be clear about what their rights are.
1. Business Link. Parental leave and time off for dependants [internet homepage]. Available from: http://www.businesslink.gov.uk/bdotg/action/detail?itemId=1080914311&typ…