NHS sick pay for staff working on an Agenda for Change (AfC) is based on length of service.

The amount varies from one months full pay plus two months half pay for new starters with less than a year’s service and goes up to six months full pay plus six months half pay for people with five years of service or more.

Staff can self-certificate for up to seven calendar days. After that, they will usually need to get a fit-note (the new name for sick notes) from a doctor.

Unless otherwise noted, the NHS occupational sick pay entitlement outlined in this article applies to all Agenda for Change staff – regardless of whether they are based in England, Wales, Northern Ireland, or Scotland.

Staff working outside of Agenda for Change – for example, doctors and many staff working at GP practices – should refer to their contract of employment as provisions may be different.

NHS Sick Pay Entitlement Table

Year of serviceSick Pay Entitlement
0-1one month’s full pay + two months’ half pay
1-2two months’ full pay + two months’ half pay
2-3four months’ full pay + four months’ half pay
3-5five months’ full pay + five months’ half pay
5+six months’ full pay + six months’ half pay
Table listing NHS sick pay entitlement by years of service

Statutory Sick Pay in the NHS

Statutory Sick Pay (SSP) is payable from the fourth day of sickness and can continue for up to 28 weeks.

While you are receiving NHS sick pay, SSP is paid to you by your employer as a part of (not on top of) your sick pay, so you do not need to apply for SSP separately.

London weighting / HCAS

Sick pay for staff working in London and receiving the High Cost Area Supplement is calculated in the same way as for staff outside of London.

This means that any HCAS payments are included in sick pay.

Do Unsocial hours Supplements count for sick pay

Employers should continue to pay supplemental payments while a staff member is receiving sick pay.

Payments which vary, such as unsocial hours supplements, are usually calculated based on payments over an agreed reference period – in practice, this often means the previous three months.

Arrangements for this will vary slightly based on which country you are in, and on your employer, so refer to your organisation’s policies for exact details of how unsociable hours sick pay is calculated.

The goal is to ensure that the sick member of staff receives exactly what they would have received while they were at work (or half of that amount when half-pay comes into force).

What happens when NHS sick Pay Ends? Can it be Extended?

When the contractual period of sick pay (see table above) comes to an end, your employer can – at their discretion – extend your sick pay on a half-pay basis.

This decision will depend on your organisation’s sickness absence policy, and can be for any reason they deem reasonable.

For example, sick pay is often extended is where a member of staff is likely to return to work shortly, and an extension would help to ensure they can do this.

Returning to work after sickness absence

Staff who have been absent are normally be asked to attend a return to work interview with their manager – even if they have only been off for one day.

These meetings are designed to support you in returning to work and can include talking about reasonable adjustments that might be necessary to help you return to work.

These meetings can also be used to assess whether there are any patterns in your sickness absence that would trigger an attendance review meeting. These meetings can also be used to discuss reasonable adjustments that might be needed.

Ongoing discussions can be helpful during a long term sickness absence (and should not just be undertaken on return to work).

They can be used to discuss in advance what reasonable adjustments might help staff in returning to work. For example, it might be useful to gradually return to work over a period of weeks or months, rather than launching straight back into full-time hours.

How are Multiple sickness absences calculated?

If you are off sick more than once, your sick pay entitlement is counted back across the 12 months before you are absent.

So, at the point you are absent, your HR department will look back at the past 12 months of your employment to see if you have taken any sick leave during those 12 months and, if so, how much. If you have already taken sick leave, this amount will be ‘deducted’ from your remaining allowance.

For example, if you have worked in the NHS for two and a half years and your basic sick pay entitlement is four months of full pay:

  • If you are off sick for three months, you use three months of your full pay sickness allowance.
  • If, two months after returning, you are unwell and off work for a further three months you would receive one further month of full pay, followed by two months of half-pay.
  • You would have two months of half-pay remaining.

After returning from sick leave, a staff member’s entitlement gradually goes up again until it returns to the maximum level for their number of years service.

Sick leave and annual leave

Annual leave continues to accrue while an employee is on sick leave.

However, staff who are sick on bank holidays (referred to in Agenda for Change as general public holidays) are not entitled to a replacement public holiday day.

If you are on sick leave and have already booked annual leave, you can usually cancel this leave.

Similarly, if you are on annual leave and become sick, you can also usually cancel this leave. You should speak to your line manager about this, and refer to your organisation’s absence policy.

If you are on sick leave and want to go on holiday during your sick leave (this usually applies to people who are on long-term sick leave) then you should discuss with your line manager, and refer to your organisation’s absence policy.

This can be allowed at your employer’s discretion, although they will want to make sure that it won’t impact your recovery and may ask you to meet with an occupational health specialist before approving the annual leave.

Further reading

Sickness absence is always covered in your contract and terms and conditions.

For agenda for change staff, this means the Agenda for Change Terms and Conditions which are published on the NHS England website.

Staff who are not on an Agenda for Change contract (including doctors) should refer to their own employment contract, and can get a copy of this from their HR department.

Staff should also refer to their organisation’s sickness leave policy, which will contain more detail of local arrangements – for example, those covering payment of supplements, or arrangements for returning to work.

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