VELINDRE NHS TRUST BLACK 37

Transcription

1 VELINDRE NHS TRUST BLACK 37 SUBSTANCE MISUSE AT WORK POLICY & PROCEDURE Policy Lead: I Sharp, Executive Director of Workforce and OD Approved by: Trust Board Page 1 of 25

2 EXECUTIVE SUMMARY SUBSTANCE MISUSE AT WORK POLICY & PROCEDURE Overview: This policy and procedure is designed to ensure that the Trust complies with legal requirements in this area, provides appropriate protection to staff and service users and appropriately manages problems of substance misuse within the workforce. Who is the policy intended for: All managers, staff and trade union representatives. Key Messages included within the policy: Substance misuse problems are treated as health problems Managers etc should adopt a caring, supportive attitude to staff with problems relating to substance misuse. The use of this policy and procedure is interconnected with other key Workforce and OD procedures The responsibilities of all managers and staff in relation to the operation of this policy and procedure (see guidelines) PLEASE NOTE THIS IS ONLY A SUMMARY OF THE POLICY AND SHOULD BE READ IN CONJUNCTION WITH THE FULL POLICY DOCUMENT Approved by: Trust Board Page 2 of 25

3 CONTENTS 1. Policy Statement 4 2. Purpose 4 3. Objectives 4 4. General Principles and Guidelines 5 5. Promotion of Awareness 6 6. Associated Trust Policies and Procedures 6 in Relation to this Policy 7. Procedure 8 Page No 8. Various Roles in the Use of the Policy and Procedure Monitoring & Evaluation 12 Appendix I - Organisations Offering Counselling 15 Appendix II National Sources of Help and advice 17 Appendix III - Problems at Work Caused by Substance Misuse 19 Appendix IV - Some Legal Implications 21 Appendix V Guidelines for Staff and Workforce 23 Approved by: Trust Board Page 3 of 25

4 1. POLICY STATEMENT Velindre NHS Trust recognises that it is beneficial to the Trust to have this policy and to implement it successfully as this will improve Health and Safety Standards, reduce absence levels, enhance productivity and improve staff retention. The Trust treats substance misuse and problems related to this condition as a health issue that requires treatment and help rather than as a disciplinary issue. Velindre NHS Trust is a provider of healthcare services and promotes the highest standards of awareness, health, safety and recognises the importance of the welfare of its staff in all matters and issues relating to substance misuse (in or out of work). For the purpose of this policy substances are defined as alcohol and illegal or prescribed drugs. 2. PURPOSE 2.1 To help protect employees and others by raising awareness of the consequences of substance misuse and to encourage those with a problem to seek help. 2.2 To ensure that employees use of substances do not impair the safe and efficient delivery of services or results in risks to the health and safety of themselves or others. 2.3 To comply with relevant legislation. 3. OBJECTIVES 3.1 To minimise and ultimately eliminate risks and complaints concerning the standards of health, conduct and capability of its staff. 3.2 To protect and maintain the health, safety and welfare and wellbeing of its staff, service users and the public under its care. 3.3 To promote a positive, supportive and caring approach amongst the managers, supervisors and staff to address potential and actual problems of substance misuse within the workplace. 3.4 To promote the health and well being of employees and raise awareness of ; (i) The effects and implications of consuming alcohol - in moderation and in Approved by: Trust Board Page 4 of 25

5 excess. (ii) The effects and implications of substance misuse including prescribed and over the counter medication (iii)to make staff with a potential or actual problem aware of the range of help facilities within and outside the Trust and to encourage their use and aid any subsequent rehabilitation. (iv) To publish a comprehensive procedure, management guidance notes and information for staff to help achieve the objectives. (v) To identify and address the training needs of staff and managers as appropriate. (vi) To enlist the assistance and co-operation of staff and their representatives in seeking to secure these aims. GENERAL PRINCIPLES AND GUIDELINES 4.1 This policy is applicable to all employees of the Trust, irrespective of band/grade and position held and to include secondees, contractors and agency staff working on Trust premises. There may be local policies for specific Divisions which vary from this policy e.g. Welsh Blood Service, therefore must be used in conjunction with this policy. 4.2 The policy covers the misuse of illegal drugs, misuse of alcohol and prescription drugs where there is an effect on the individual s employment with the Trust. 4.3 All staff dealt with in accordance with this policy and procedure, and any individual concerned with substance misuse referrals, will be treated in the strictest of confidence. 4.4 It is recognised that for some employees substance misuse are medical conditions. 4.5 Staff must not drink alcohol or use drugs, other than prescribed medication, whilst on duty. Should a member of staff feel that prescribed medication could or is affecting their performance they should bring this to the attention of their manager. 4.6 Staff should not be under the influence of drink or drugs at the commencement of duty or drink alcohol or use drugs, (other than prescribed medication) whilst on duty, including during a break following which they will return to work, including when on call or stand-by. They should be aware of the time required for the body to recuperate from the effects of alcohol and Approved by: Trust Board Page 5 of 25

6 drugs. 4.7 No alcoholic drinks are to be made available for and/or consumed by staff on any Trust site at any time. 4.8 In any event where a member of staff attends for work under the influence of alcohol and/or other drugs, the Trust will make arrangements to ensure that they are taken home safely. 4.9 All jobs within the Trust involve the use of skill and judgment and a large proportion involve staff in face to face contact with patients, donors, carers, relatives, staff and the general public. As such staff should be aware of the potential impact on these people of their smelling of drink. This can relate to concerns over their actual/potential performance, their professional image and the image of the Trust Any employee who is required to discuss allegations of drug/alcohol use with their manager/investigating officer, etc. will be entitled to be accompanied by his/her Trade Union representative or a work colleague not acting in a legal capacity. 5. PROMOTION OF AWARENESS The philosophy of this policy is that education on alcohol and other substances should be part of a wider ongoing programme of health promotion and Health and Wellbeing at work for the whole work force. It is not only aimed at those who are identified as having problems with drugs or alcohol, but to raise staff awareness and interest in their health to the extent that alcohol and drug problems may be prevented from occurring or may be prevented from developing into a worse problem. Messages about healthy lifestyles should be continually repeated for the benefit of all staff. 5.1 In practical terms this means working towards retaining the Corporate Health at Work Standard and the continual promotion of healthy living messages about reducing alcohol consumption, smoking etc. by means of events, displays, leaflets, posters, newsletters and s, which will include factual information on the effects of drugs and alcohol. The Trust s Board and Partnership bodies will ensure that the Corporate Health Standard is given a high profile and will stimulate discussion and action within the Trust. 5.2 The main responsibility for health promotion lies with managers at all levels within the Trust. They should ensure that in addition to general health Approved by: Trust Board Page 6 of 25

7 information, appropriate messages regarding alcohol and drug use are targeted at their staff. 5.3 Appropriate training will be made available to all Trust managers. 6. ASSOCIATED TRUST POLICIES AND PROCEDURES Disciplinary, Sickness absence, Rehabilitation (Phased return to Work), Capability, Dealing with Staff/Service Users who are Victims of Domestic Abuse/Violence, Dignity at Work. 6.1 The above procedures are interconnected and when handling a substance misuse case it is often necessary to move between the various procedures providing continual support. 6.2 In all cases where any of the above procedures are used in connection with substance misuse the person concerned will be offered help with any potential problem at each stage. Each individual situation will be managed on its merits. 6.3 Whilst problems associated with substance misuse will normally be treated as sickness issues and managed using the Sickness Absence Policy. In certain circumstances the use of the Capability/Disciplinary/Dealing with Staff/Service Users Who are victims of Domestic Abuse/Violence policies may be appropriate. Where a member of staff is identified as having a substance misuse problem, via the application of the above policies, they will be offered the opportunity for help under the. 6.4 Staff will not be subject to disciplinary action solely on the grounds that they have declined to accept offers of help or withdraw from the help offered, provided work performance is satisfactory and there is no alcohol or drug related incidents in the workplace. If however, help is refused or the individual withdraws from the help offered and unsatisfactory work performance in terms of capability and/or conduct continues, the issues of concern may be managed in accordance with the appropriate Trust policy e.g. Capability or Disciplinary policies. 6.5 If treatment seems effective but a lapse occurs, each case will be considered on its merits. If appropriate, further help may be offered, but the individual could also be subject to any one or more of the above policies, although their application in these circumstances will not be taken without a further offer of help being made. 6.6 Staff who may have problems associated with substance misuse cannot be excused from complying with the accepted standards of conduct and safety in the workplace. Any individual who behaves contrary to these standards will be dealt with in accordance with the Trust Disciplinary Policy. Approved by: Trust Board Page 7 of 25

8 6.7 The use of the Disciplinary Policy is seen as appropriate in all cases of excessive alcohol consumption or other substance misuse leading to behaviour contrary to accepted standards of safety and conduct. In any event where a member of staff attends for work under the influence of alcohol and/or other drugs, the Trust will make arrangements to ensure that they are taken home safely. Suspension from work may be appropriate in such cases. Due consideration will be given to all relevant factors and circumstances, including any underlying problems associated with substance misuse. Examples of substances misuse and consequent misconduct are: (i) (ii) instances where the individual s responsibility for Health and Safety have been breached and unacceptable behaviour, including violence and aggression (in or out of work), unauthorised absence, lateness, drug misuse/drinking at work (or close by) during working hours, state of inebriation on duty. In cases of substance misuse the normal response will be use of this Policy. Only in exceptional circumstances such as those identified at 6.7(i) and (ii) above will the Disciplinary Policy can be used in isolation. Where a member of staff is found to be in possession or trafficking drugs on Trust premises, the Trust will report the matter to the Police and operate the Trust Disciplinary Policy. 6.8 Employment may be terminated in cases of substance misuse where subsequent action taken leads to the loss of qualifications required to do the job, e.g. professional registration, loss of driving license or loss of liberty due to the staff member being required to serve a custodial sentence. 7. PROCEDURE 7.1 Research suggests that the workplace is a particularly appropriate place to create an environment in which potential and actual substance users and abusers can be encouraged to make and sustain decisions about their behaviour. Job loss or retention can be a prime motivating factor. 7.2 It is therefore crucial that employees are confident that if they do acknowledge that they have a problem they will be offered support and to help them overcome it. At the earliest appropriate stage of a substance misuse being identified, a support plan should be agreed with the member of staff and a schedule of meetings agreed. Approved by: Trust Board Page 8 of 25

9 7.3 All managers/supervisors should be alert to the possibility of elements of substance misuse when a member of staff is experiencing personal problems. 7.4 Staff with potential problems of substance misuse may be identified by their supervisor / manager. Supervisors / managers will therefore be made aware of the possible symptoms of substance misuse in the workplace and an understanding that these symptoms may not necessarily be those of substance misuse, but may have some other cause. 7.5 It is important that staff are made aware that they do not need to wait to be advised by their supervisor/manager/counsellor before seeking help or support with substance misuse problems. Where staff self identify that they have a problem, the Trust will encourage them to seek help voluntarily. Staff may wish to discuss their situation with their manager or a member of the Workforce and OD Department or the Occupational Health department, so that appropriate support can be made available in the workplace. Should a member of staff be unsure how to seek and obtain appropriate help, this information is available, in strictest confidence from the Occupational Health Department, (details available from the Workforce and OD Department and intranet site) or from any of the agencies listed in Appendix I. Any individual requesting such information can retain their anonymity, if they so wish. 7.5 Where a manager detects during the utilisation of a Trust policy, e.g. Sickness absence or Capability, that the member of staff may possibly have a substance misuse related problem, they should immediately offer them help and support and refer them to the Occupational Health department. This will not however preclude the use of these other appropriate policies in relevant cases. (See pages 5 and 6 above). It is important that the approach taken at the initial meeting with the individual is supportive The offer of help will be made on the clear understanding that if necessary the staff member will be granted leave and/or reasonable time off to undergo counselling, treatment or rehabilitation. Such leave will be treated as sick leave within the terms of the Sickness Absence policy The treatment record of the staff member will remain strictly confidential with no access to its contents by management. Reports from Occupational Health, however will be made available to management, with the consent of the individual In all referrals, the Workforce Officer involved will need to be advised of the attendance at counselling of the individual and the effectiveness or otherwise of any help offered in order that appropriate support can be given in the Approved by: Trust Board Page 9 of 25

10 workplace. Work will be performance assessed in context where this is possible and does not adversely impact on health and safety or service delivery. It is therefore desirable that such staff share relevant information about his/her progress with an appropriate member of the Workforce and OD Department If a member of staff has been absent from work due to problems related to substance misuse, on resumption of duties the staff member will be able to return to the same job unless resumption of the same job would be inconsistent with the long term resolution of the staff members substance misuse problem. When the same job cannot be resumed, every consideration will be given to modifying the existing job or finding suitable alternative employment in accordance with the Trust Redeployment policy Having accepted help and fully resolved the substance misuse problem, the staff members normal promotional prospects will not be impaired If there is no improvement over an agreed period of time a counselling session will take place. This session will normally involve their manager, a Workforce Officer and the staff members representative or work colleague, if they so wished. At this stage, the individual would be presented with the observed facts, the possible disciplinary consequences and the possibility that they may have a problem of substance misuse. The individual would be given the opportunity to be referred to other agencies for help and support. In all cases, fitness to work or otherwise during or after any period of substance misuse, will be made by the manager following a discussion with a member of the Workforce and OD Department, taking account all relevant information available from any referral agencies and Trade Union Representative, if appropriate. 7.6 The Trust has the following services and support mechanisms which it can offer and provide to staff with potential substance misuse problems. (i) (ii) (iii) NB. Occupational Health Department Employee Assistance Programme Workforce department can provide information on local organisations that can provide confidential advice and support All of the above services are available to any member of staff who wish to seek help on a voluntary basis before the matter comes to the attention of their manager. 8. VARIOUS ROLES IN THE USE OF THE POLICY AND PROCEDURE Approved by: Trust Board Page 10 of 25

11 8.1 Role of the Workforce and OD Department (i) To oversee the implementation and use of the policy and procedure. (ii) (iii) (iv) (v) (vi) (vii) To co-ordinate education and training activities. To monitor and review the operation of the policy and procedure. To keep relevant records. To act as a resource centre for training information. To consult with and enlist the support of Trade Union and staff organisations with regard to the formulation and implementation of the policy. To stimulate interest in personal health and wellbeing matters among all staff groups and to encourage managers to promote health messages in their own departments. (viii) To input and update health leaflets, posters etc. for use by staff on the Workforce Intranet site. (ix) (x) (xi) To obtain information on any particular health topics as suggested by staff representatives, staff, managers or individuals. To support related actions to maintain the Trust s Corporate Health at Work award. Provide support to managers with regard to application or all relevant policies that would apply 8.2 The Role of Managers (i) To familiarise themselves with the policy and procedure. (ii) (iii) (iv) (v) To make staff aware of the policy and the support that is available. To be aware of the signs of substance misuse, the effect on performance, attendance and health and to take appropriate and sympathetic action. To ensure that staff understand what is expected of them with regard to attendance, work performance and safety. To be alert to and to document changes in work and attendance patterns. Approved by: Trust Board Page 11 of 25

12 (vi) (vii) To ensure that a member of staff can return home safely if they attend work under the influence of alcohol and/or other drugs. To undertake interviews regarding work performance as necessary. (viii) To ensure that staff understand the policy and recommend members of staff for counselling as appropriate. (ix) (x) (xi) (xii) To continue to monitor performance and attendance patterns thereafter. To stimulate interest in personal health and wellbeing matters among staff in their department and to raise health issues if appropriate in departmental meetings. To inform the Workforce and OD Department of interest in any particular health topics expressed by staff. Be aware of additional Support and Guidance within other Trust policies e.g. Capability, Disciplinary, Dealing with Staff/Service Users who are Victims of Domestic Abuse/Violence and Dignity at Work. 8.3 Role of the Occupational Health Department (i) To provide advice and guidance on how best to help an individual who has a problem with behaviour or work performance which might be related to substance misuse. (ii) (iii) (iv) (v) To provide counselling and assessment of individuals who refer themselves or are referred for help; this may include interview and medical examination. To offer and initiate help and guidance where appropriate including facilitating referral to external organisations. To provide effective and appropriate communication between staff and all those concerned with recovery. This includes the general practitioner, any therapeutic agency and the Workforce and OD Department. Too keep records as appropriate 8.4 The Role of the Employee (i) To be aware of the policy and procedure. (ii) (iii) To abide by the policy. To aid the implementation of the policy. Approved by: Trust Board Page 12 of 25

13 To cooperate with support and assistance offered by the Trust or support bodies to address a substance misuse issue. (iv) (v) (vi) (vi) To report any concerns they may have immediately to their Line Manager or the Workforce and OD department and not cover up for a colleague. To be aware of their responsibilities under Health and Safety legislation, public interest disclosure/clinical governance and their personal responsibility to report where safety of staff or service users may be at risk. To assist and encourage workplace colleagues to seek help in cases of possible substance misuse. To be aware of the potential implementation of other related Trust policies e.g. Capability, Disciplinary, Dealing with Staff/Service Users who are Victims of Domestic Abuse/Violence and Dignity at Work. 9. MONITORING AND EVALUATING THE POLICY A method for monitoring the effects of the policy needs to be designed but the following considerations may be appropriate. The monitoring process will consider (i) (ii) Are staff aware of the policy and its procedure? Are the procedures easily understood and being followed? (iii) Do managers and relevant staff feel equipped to deal with their responsibilities? (iv) Do staff feel they will be provided with support should they self referral? (v) Are staff more aware of sensible drinking and basic facts about substance misuse? (vi) Are rates of incidents involving substance misuse reducing? (vii) Are staff clear about the rules governing drinking at work? (viii) Are only non-alcoholic drinks available at Trust related functions? (ix) Are staff aware of the additional Support and Guidance within other Trust policies e.g. Capability, Disciplinary, Dealing with Staff/Service Approved by: Trust Board Page 13 of 25

14 Users who are Victims of Domestic Abuse/Violence and Dignity at Work. These are suggested criteria upon which an initial review and evaluation of the policy should be based. It is recognised that precise quantitative information may not be available. Any review/evaluation will be carried out by the Workforce and OD Department Division. Approved by: Trust Board Page 14 of 25

15 Appendix 1 ORGANISATIONS OFFERING ADVICE ON ALCOHOL AND SUBSTANCE MISUSE AND COUNSELLING Adfer Unit (Ward W1) Whitchurch Hospital Park Road Whitchurch Cardiff CF4 7BX Tel: ext. 6340/1 Fax: Inroads - Cardiff Street Drugs Project 94 Neville Street Riverside Cardiff CF11 6LS Tel: Fax: Cwm Taff Local Health Board Community Drug and Alcohol Team Llwyn-Yr-Eos Clinic Main Road Church Village Pontypridd CF38 1RN Tel: Fax: Community Drugs and Alcohol Service Swn-y-Coed Grove Road Wrexham LL11 1DY Tel: Fax: Vale Alcohol and Drug Team 26Newlands Street Barry CF63 8EA Tel: Fax: Cardiff Community Addictions Unit House 56 Cardiff Royal Infirmary Newport Road Cardiff CF24 0SZ Tel: Fax: Community Care Team (Drugs and Alcohol) 7 Romilly Road Canton Cardiff CF5 7FH Tel: Fax: Pen-yr Enfys Council on Alcohol Fitzhamon Centre 53b Fitzhamon Embankment Riverside Cardiff CF11 6AN Tel: Fax: Pen-Yr-Enfys Council on Alcohol Visiting Alcohol Support Team (VAST) c/o Fitzhamon Centre 53b Fitzhamon Embankment Pen-Yr-Enfys Council on Alcohol c/o Dyfrig House 53a Fitzhamon Embankment Riverside Approved by: Trust Board Page 15 of 25

16 Riverside Cardiff CF11 6AN Tel: Fax: MIDAS Drugaid Merthyr Oldway House Merthyr Tydfil CF47 8UX Tel: Fax: Powys Drug and Alcohol Centre (Substance Misuse Integrated Team) 1 st Floor Crescent Chambers South Crescent Llandrindod Wells LD1 6HD Tel: / Fax: Powys Drug and Alcohol Centre 47 Commercial Street Ystradgynlais SA9 1JH Tel: Fax: steve@pdacystrad.freeserve.co.uk Hywel Dda Local Health Board Derwen Community Drug Team East Dyfed Jobswell House Jobswell Road Carmarthen SA31 3HP Tel: Drugaid 1 st Floor St Fagan House St Fagans Street Cardiff CF11 6AN Tel: Fax: Merthyr Home Detox Oldway House Merthyr Tydfil CF47 8UX Tel: Fax: Taff-Ely Drug Support (TEDS) Engine House Depot Road Aberdare CF44 8DL Tel: Fax: teds@teds.org.uk Cyswllt Ceredigion Contact 49 North Parade Aberystwyth Ceredigion SY23 2JN Tel: Fax: office@recovery.org.uk Website: Prism Mid and West Wales Alcohol and Drug Advisory Service Forestry House Brewery Road Carmarthen SA31 1TF Tel: Fax: support@prismcarmarthenshire.org.uk West Wales Substance Misuse Team Europa House 115 Charles Street Approved by: Trust Board Page 16 of 25

17 Caerphilly CF83 1FZ Tel: Fax: Milford Haven Pembrokeshire SA73 2HW Tel: Fax Drugaid 59 Commercial Street Abertillery NP13 1DQ Tel: Gwent Council on Alcohol and drug Abuse 19 Armoury Terrace Ebbw Vale NP23 6BD Tel: Gwent Drug Service 139 Lower Dock Street Newport NP9 1EE Tel: Fax: Ogwr Drug and Alcohol Self Help 74 Nolton Street Bridgend CF31 3BP Tel: Fax: Minicom: West Glamorgan Council on Alcohol and Drug Abuse 40 St James Crescent Uplands Swansea SA1 6DR Tel: Fax: Gwynedd Community Alcohol Service Ynys Mon mental health team Hafod Las Llangefni LL77 7TS Tel: Fax: Gwent Alcohol Project 1 Palmyra Place Newport NP20 4EJ Tel: Fax: Bridgend Community Drug and Alcohol Team 18 Derwen Road Bridgend CF31 1LH Tel: Fax: Swansea Drugs Project (SAND) 8 Calvert Terrace Swansea SA1 6AR Tel: Fax: Gwynedd Community Alcohol Service 3 Llys Gwynedd Ffordd Gwynedd Bangor LL57 1DT Tel: Fax: Approved by: Trust Board Page 17 of 25

18 Gwynedd Community Alcohol Service Arfon mental Health team 26 College Road Bangor LL57 4AN Tel: Fax: Substance Misuse Service Town Hall Newry Street Holyhead Tel: Community Drug and Alcohol Service Deeside Counselling Service Rowleys Drive Shotton Flintshire CH5 1PU Tel: Fax: Betsi Cadwallader Local Health Board Drug And Alcohol Service 7 Brighton Road Rhyl Denbighshire LL18 3EY Tel: Betsi Cadwallader Local Health Board Gwynedd Substance Misuse Service Bron Castell Segontium Terrace Caernarfon Gwynedd LL55 2PH Cyngor Alcohol Information Services (CAIS) Trinity Square Llandudno LL30 2RA Tel: Gwynedd Community Alcohol Service Dwyfor Mental Health Team Cilan Pwllheli LL53 5DH Tel: Fax: CAIS I/P Unit Hafen Wen Wrexham Maelor Hospital Watery Road Wrexham Tel: Fax: Approved by: Trust Board Page 18 of 25

19 NATIONAL SOURCES OF HELP AND ADVICE Appendix II Help for the substance using employee: Drinkline a government-funded free service. Can provide advice to the alcohol drinker or anybody concerned about the drinker has a database of local support and treatment services that can help the drinker. Helpline: Tel: Fax: Website: Talk to FRANK a government-funded free service, previously named the National Drugs Helpline can provide advice to the drug user or anybody concerned about the drug user has a database of local support and treatment services that can help the drug user. The focus of the helpline is for young people and concerned parents, but will also assist adult drug users. Helpline: Website: The website provides detailed information on drugs that the non-specialist can understand. Alcoholics Anonymous the largest self-help group for people who acknowledge they cannot handle alcohol and want a new way of life without it. Services are free. Helpline: Website: The comprehensive website explains the philosophy of AA, what to expect, and local groups. Narcotics Anonymous the largest self-help group for people who want to stop using drugs. Services are free. Helpline: / Website: (includes details of local groups) Approved by: Trust Board Page 19 of 25

20 Cocaine Anonymous national self-help group specifically for cocaine users. Helpline: or open 10:00am to 10:00pm Website helpline: Adfam National the largest non-statutory organisation that works with and on behalf of families affected by drug and alcohol problems. Helpful for the family of the alcohol or drug user. Helpline: Website: Approved by: Trust Board Page 20 of 25

21 Appendix III PROBLEMS AT WORK CAUSED BY SUBSTANCE MISUSE Given the wide variety of jobs within the Trust, some of the following will be relatively more important than others, dependent on the task undertaken. However, any alcohol/drug misuse can cause severe problems, not only for the individual and his/her family, but also for colleagues, patients, and service users. These problems can occur not just in the more obvious area of health and safety, but also in unsatisfactory work performance, sickness and absence, conduct and poor relationships at work. It is important to recognise that problems can be caused by misusing substances, occasionally, in excess and also due to chronic use and dependency. Problems can be manifested in some or all of these ways but it is important to be aware that those indicated can also be caused by other factors such as stress, mental health problems, physical illness or the use of prescribed drugs:- 1.. Work Performance (i) Poor decision making. (ii) Absences from post - more than normally expected. (iii) Overlong breaks. (iv) Decrease in concentration - jobs take longer, require greater effort. (v) Difficulty in recalling instructions and details. (vi) Decline in quality and quantity of work - effort cannot be sustained. (vii) Increase in errors of judgement. (viii) Increased fatigue. (ix) Loss of interest in work. (x) General unreliability and unpredictability. (xi) Improbable excuses for poor performance. 2. Accidents All Trust staff have responsibilities under the Health and Safety at Work Act to take reasonable care for their own and others safety. Evidence suggests that drug/alcohol misusers can be between 3 to 4 times more likely to have or cause an accident at work than someone without a problem of this nature. Also, it should be noted that even sensible limits of drink can have significant effects on judgement and application of motor skills. Problems can manifest themselves via:- (i) (ii) High accident rate in work. Accidents off the job, i.e. at home or travelling to/from work. Approved by: Trust Board Page 21 of 25

22 3. Poor Relationships with Fellow Employees (i) Over reaction to real or imagined criticism (ii) Unreasonable resentment (iii) Irritability or aggression (iv) Complaints from fellow workers (v) Borrowing money from colleagues (vi) Avoidance of manager and/or fellow workers All of these can subsequently lead to poor performance and grievances in the workplace. 4. Individual Behaviour (i) Reporting to work smelling of drink. (ii) Increasingly unkempt appearance (iii) Decline in personal hygiene (iv) Sudden mood changes (v) Depression 5. Non Attendance This is perhaps the most obvious area which causes problems for fellow workers and ultimately service users. The cost to industry and business throughout the UK of alcohol abuse has been estimated at up to 6.4 billion per year through sickness, unemployment, early retirement and premature death. Between 8-14 million days a year are lost at work because of heavy drinking. This non attendance manifests itself in a number of ways:- (i) Unusually high sickness levels, often accompanied by imprecise reasons on certificates, e.g. flu-like symptoms, colds, gastric problems, fatigue, nervous debility. (ii) Multiple instances of unauthorised weekends or days off. (iii) Late applications for half or one day s annual leave. (iv) Excessive lateness at start of duty and after lunch breaks. (v) Leaving early. (vi) Unauthorised breaks. (vii) Frequent short term absence from duty (with or without explanation). Approved by: Trust Board Page 22 of 25

23 Appendix IV LEGAL ISSUES AND IMPLICATIONS 1. Substance misuse can trigger a number of different issues for managers and Workforce Departments department to deal with including misconduct, sickness, performance, health and safety and health and well being. As a result a reasonably flexible approach is required but consistency in managing similar cases is important, although each case should be dealt with on its merits. 2. The Trust has a duty of care to its employees regarding their health and safety at both common law and via the Health and Safety at Work Act This involves using reasonable care to provide a safe system of work, effective supervision and competent fellow employees. Breach of this duty makes the employer liable to pay damages and is also a criminal offence. 3. Under common law and the Health and Safety at Work Act 1974 the employer also has to take reasonable care that its employees do not cause injury and damage to third parties e.g. patients. Damages could also be payable in this situation and again it is a criminal offence. 4. Under the Management of Health and Safety at Work Regulations 1999, employers have a duty to conduct a risk assessment of the risks to the Health and Safety of employees and other affected by the organisation. 5. Employees also have a statutory obligation to take reasonable care for the health and safety of themselves and also others and to co-operate with their employer to enable the employer to carry out its own legislative responsibilities. 6. Employees who are under the influence of drink or drugs, or who fail to report colleagues who are, may be in breach of their own common law or statutory duties of care. 7. Substance misuse, either on or off duty, may be a potentially fair reason for dismissal on grounds of either capability or conduct. 8. Off duty substance misuse is generally not a sufficient ground for discipline including dismissal unless there is a link with the employment relationship e.g. it affects the employee s suitability to carry out their job or damages the reputation of the Trust, or undermines the Trust s confidence in the employee or adversely affects the employee s relationship with colleagues. Approved by: Trust Board Page 23 of 25

24 9. To dismiss an individual as soon as a problem of substance misuse comes to the attention of the employer will almost certainly be considered to be unfair. 10. The Courts and Employment Tribunals do distinguish between substance misuse as a misconduct issue and as an illness. In any event, the employer must always be seen to have acted reasonably. 11. The Data Protection Act 1998 sets out rules to make sure that any personal information held on employees is managed properly. Also article 8 of the Human Rights Act 1998 sets out the right to respect for private and family life and how organisation hold and use information about employees. 12. Any information about an employee s health must be kept in strictest confidence. It is particularly important to consider this, with the individual when they may have significant periods of leave. 13. Employees may have claims under the Equality Act 2010 for reasons related to a dependency on alcohol or drugs, e.g. alcohol misuse (not a disability under the Equality Act) may result in or be a symptom of, depression, which may potentially be a disability. 14. Substance misuse may be linked to domestic abuse/violence which may affect the employee s suitability to carry out their job or damage the reputation of the Trust or undermines the Trust s confidence in the employee which may lead to disciplinary action being taken and/or criminal conviction. Approved by: Trust Board Page 24 of 25

25 Appendix V GUIDANCE FOR STAFF If a member of staff has any concerns that another member of staff may be in work under the influence of alcohol or any other substance, they should take the following actions 1. Inform their manager immediately but if the manager is unavailable, seek guidance from the Workforce Department. 2. If the employee who has the concerns is in a managerial position and it is one of their staff members, seek guidance from Workforce Department immediately. 3. If outside of normal office hours, inform the most senior manager on site. If there is no senior manager on site then use the emergency telephone list to contact a senior manager. GUIDANCE FOR WORKFORCE DEPARTMENT If a member of staff/manager informs the workforce Department that they have concerns that a member of staff is under the influence of alcohol or other substances, they must: 4. Refer to and Procedure Black 37 located on the Trust intranet site. 5. Refer to the employee s personal file to ascertain whether there is a history of alcohol or other substance misuse or a medical condition or a record of taking prescribed medication which may influence how they present. 6. Contact the staff member s manager to discuss appropriate action in line with the policy. 7. After discussing with the manager, the staff member should be contacted to attend a meeting with their Manager and the Workforce Officer. (The member of staff must be informed that they may have union representation or a workplace colleague not acting in a legal capacity at this meeting in line with Policy Black 37). 8. The Workforce Officer and the Manager must ascertain whether or not the staff member is fit for work, and decide the next course of action in line with Policy Black 37. Approved by: Trust Board Page 25 of 25