OCCUPATIONAL HEALTH POLICY A document prepared by Pauline Slade and Joyce Scaife in liaison with Joanna Hattersley, Sheffield Health & Social Care NHS Foundation Trust, Human Resource Department, and the Occupational Health Department, Northern General Hospital. Updated 2008 These proposals embody the principles that selection should be undertaken in such a way as to maximise the probability that accepted candidates will have health status appropriate to facilitate their successful completion of the Course. In addition, for those candidates accepted onto training, the aim is to create a context of trust and openness facilitating access to appropriate health facilities and support, whilst ensuring that trainees are equipped to fulfil their role as qualified clinical psychologists at the end of their training. The DClin Psy operates via the Clearing House and accepts the guidelines sent out to referees within this scheme. As part of the selection process of Sheffield, candidates are interviewed about major stressors pr personal circumstances in their lives and their responses to these. In addition, all candidates undergo health screening by the Northern General Hospital Occupational Health Service. Throughout the process of selection and training the DClin Psy aims to comply with the requirements within the Disability Discrimination Act. 1. At Clearing House stage: A statement of the health clearance procedural requirements for the Sheffield DClin Psy Course is included with the Course details published in the Clearing House Handbook. 2. At Shortlisting: Shortlisters should consider the appropriateness of choice of referees. Where there is concern about this choice, e.g. most recent employer not included, this would be noted for exploration at interview. 3. At interview: a) The panel considering personal suitability considers candidates experiences in the role of client and the impact of personal events on motivation to train. Such experiences would not be considered to disadvantage candidates, and could be considered a strength. b) Candidates are informed of the necessary health clearance. 4. At the stage of offering a training place: a) Offers are subject to satisfactory health clearance. The clinical psychology health declaration form is sent to individuals being offered places, together with a form to be taken to and completed by their general practitioner. This is accompanied by a letter signed by Occupational Health, outlining the reasons for this, the individual s rights within the Medical Reports Act and the fact that in the absence of a report from the GP, health clearance could not be given. Applicants have a right to see the completed GP form, and to challenge it if they see fit, and procedures in the event of candidates being dissatisfied with the content are outlined in the accompanying letter from Occupational Health. The form asks specific questions about 1 4.7
consultations for particular conditions but does not ask the GP for any opinion about suitability. The candidate would return their health declaration form and the GP report to Occupational Health. (SHSC pays for each report.) If there are any issues that need further exploration, the Occupational Health Department may require a meeting or telephone conversation with the individual. b) The admissions tutor on behalf of the Selection Sub-Committee indicates to Occupational Health any concerns about health-related issues arising at shortlisting or interview stage. c) A clear understanding has been developed with Occupational Health about the nature of training and the role of clinical psychologists in order to facilitate appropriate recommendations. This includes an understanding already established that some previous experience of psychological difficulties does not preclude health clearance, and difficult personal experiences with a satisfactory resolution can be an asset. In addition, an appreciation of the many varied reasons (including motivation for personal development) underlying seeking psychological help or counselling would be emphasised. Current trainees are welcome to contribute to this dialogue. Finally, a report from a clinical psychologist (independent of the Course) is routinely sought when mental health issues are under consideration, in addition to reports from other relevant professionals. d) The Occupational Health decision as regards suitability is made as a recommendation to the Course. Information provided to Occupational Health is not passed on to Course staff; only the outcome is conveyed. It would be very exceptional for the recommendation to be ignored. e) At acceptance, applicants are required to complete a form stating that they will declare any hospital attendances and accidents requiring treatment that occurred during training. Non-declaration is potentially subject to disciplinary action. 5. During training: For each placement a letter is forwarded to the relevant Human Resources Department notifying them of the trainee s placement in their organisation in order that the relevant health and safety procedures may be implemented. Arrangements with respect to sick leave As employees, it is a requirement of trainees that they or their representative notify absence through illness as early as possible on the first day of absence and notify the day of return on that day. The reason for the absence must be declared and is recorded on the trainee s file. All sick leave is notified to SHSC payroll services (Victoria Pay Services) through the statutory sick pay procedure. There are, additionally, procedures to be followed with respect to Carer Leave. Procedures for both sick and career leave follow the policies provided by SHSC. One to three days of sickness absence need not be certified, four to seven days is selfcertified and more than seven days requires a medical certificate. On return from sick leave, the Clinical Tutor may meet with the trainee to discuss health needs, particularly if the trainee has had a number of absences, triggering the SHSC policy. The general approach adopted is to ensure that trainees are fit and well enough to return to work and, where possible, to address any issues arising from training which might be 2 4.7
contributing to ill health. Where relevant, any implications for meeting Course requirements will also be addressed. For periods of absence of up to a month, dependent on circumstances, the Clinical Tutors may discuss the period of illness and its implications for training with the trainee. In consultation with other Course Team members, this could involve the rescheduling of coursework and placement deadlines. Where a period or periods of sickness may result in serious disruption to training, discussions take place between the Clinical Tutor and other members of the Course Team, including the Course Director and Personal Tutor, and the trainee, and a course of action is agreed to best suit individual circumstances. This would also be discussed, where relevant, with staff at Sheffield Health & Social Care NHS Foundation Trust and the purchaser including the financial implications of particular courses of action. Principles Where training is disrupted through ill health the following principles pertain: A desire for flexibility to meet the needs of the trainee within the constraints of the needs of other trainees, the implications for funding and staff workloads. The need to re-negotiate the training plan and manage implications for timing, for example through rescheduling of deadlines and placement extension. To ensure the fitness of the trainee to practice as a clinical psychologist in the NHS. Patterns of sickness absence A full sickness record is maintained on file, and patterns of absence are reviewed periodically. In all instances where the Course Team is concerned about the implication of a trainee s health status for training and future practice, the opinion of Occupational Health is sought, irrespective of the duration of the illness or absence. In such instances, the reason for the concern is fully discussed with the trainee by her/his Clinical Tutor. This process ensures that advice is sought about any reasonable adjustments to training and/or sources of support that may need to be organised to try to ensure completion of training For periods of absence totalling up to 20 days in an academic year, new work schedules are arranged as necessary in conjunction with the trainee, addressing any implications for training. For periods of absence totalling between one month and three months in an academic year, the greater disruption to training involves a rescheduling of placements and deadlines, which needs to take into account supervisor availability, the requirements of the remainder of the trainee cohorts and the enduring or acute nature of the illness. A flexible approach is taken on the part of the trainee, the Course Team and the funding body. In this instance an extension to training may be necessary. Trainees can make a case to the funding body for additional funding for any extension to training, but this may or may not be agreed. For periods of absence which result in serious disruption to training (for example over three months in a year or where there are implications for ongoing health needs e.g. following a chronic illness or injury, or where serious mental health issues pertain), the opinion of Occupational Health with respect to fitness to practice will be sought. 3 4.7
FITNESS TO PRACTISE STANDARDS The University of Sheffield has a policy of ensuring fitness to practise for those completing professional training courses including the DClin Psy. This policy is outlined in the General Regulations relating to Fitness to Practise in the University Calendar. Trainees must also uphold appropriate standards of behaviour in all aspects of their training as indicated below. Where trainees fail to meet these standards they will not be allowed to complete the Course and enter the profession. (i) (ii) (iii) (iv) (v) (vi) During the Course, trainees must liaise in a positive and constructive way with many different people including clients, supervisors, other staff on placement, Course staff, teachers, administrative staff, peers and others. This is a fundamental requirement of clinical psychology practice and must be consistently shown by individuals in training. Where fitness to practise concerns are raised in relation to this aspect then interpersonal difficulties should be clearly demonstrated with a variety of different individuals and typically across several different settings. Training as a clinical psychologist requires individuals to acquire new skills and knowledge and take on new roles. It requires respect for others opinions, an openness to learning and an ability and willingness to use feedback constructively. Concerns relating to fitness to practice may involve an inability or unwillingness to acknowledge and use feedback on practice issues or interpersonal difficulties in a constructive way. Any feedback given and the responses of the trainee should be clearly documented. Trainees are required to demonstrate throughout their training, attitudes and behaviour in keeping with the statements of values and standards of psychologists as outlined in the British Psychological Society Code of Ethics and Conduct, March 2006. The main domains of responsibility are respect, competence, responsibility and integrity. In addition to (iii) there are specific additional implementation issues in the training context. In particular the domain of integrity requires that honesty must underpin all aspects of training in relation to documentation, assessed work and liaison with staff and supervisors. Concerns may be raised about fitness to practise under any of the above areas where a trainee s behaviour on placement may not itself have contravened the specific BPS Code of Practice at a level of gross professional misconduct. However, a series of more minor events may have occurred usually across settings and with more than one person which call into question the suitability of a candidate through their attitudes or behaviour to continue their training to enter the profession of clinical psychology. Such difficulties may lead to significant problems in training which by themselves have not led to repeated placement failure or failure of a resubmitted piece of work but may indicate lack of fitness to enter the profession. As a condition of acceptance onto the Course, Trainees have received a satisfactory Criminal Records Bureau (CRB) check. It is a condition of continued registration that any police cautions or criminal convictions occurring after offer of a place but prior to termination of the Course are notified to the Course Director as soon as possible and within seven days of occurrence. Failure to do so will be considered as a concern about fitness to 4 4.7
practise. The content of any disclosure may lead to University Fitness to Practise or Disciplinary Procedures being invoked (www.shef.ac.uk/govern/calendar/fitness.html). (vii) The Course, wherever possible, attempts to ensure that candidates successfully complete their training. The Course Team is committed to helping trainees who encounter difficulties through clear communication about the identification of problems and provision of support to a trainee in their attempts to meet the requirements of change. (viii) Should concerns be raised about a trainee s fitness to practise then procedures outlined in General Regulations relating to Student Fitness to Practise will be followed. (ix) (x) Where the University upholds concerns over Fitness to Practise, a trainee may be excluded from the Course and their registration terminated. University registration by the DClin Psy Course at the University of Sheffield is a contractual requirement with NHS trusts and any decision which upholds the recommendation for termination of registration will normally lead to the termination of the trainee's contract of employment and discontinuation of financial support. In the event of termination of the contract of employment, the usual NHS appeals procedures will be available to the trainee. The University has a duty of care to inform current and subsequent supervisors of any referrals for Fitness to Practise and their outcomes, since the NHS Trust is liable for the clinical work conducted by trainees. Disciplinary Procedures Where there is evidence that a trainee may have engaged in actions deemed to be Gross Professional Misconduct within the BPS Code of Practice, the Director of the Course in liaison with a senior member of Course staff may take action to have the trainee s registration immediately suspended prior to investigation and any subsequent referral to the University s Discipline Committee. If the investigation is upheld, this will result in the contract of employment with SHSC being terminated. University procedures relating to disciplinary issues are outlined in the Regulations as to the Discipline of Students (http://www.shef.ac.uk/govern/calendar/discipline). 5 4.7