On the ground: work pressure

by Neil Hallows

A doctor who was absent due to long COVID faced increasing pressure to return to work despite debilitating symptoms

Location: UK
Last reviewed: 17 February 2022

Long COVID can have a terrible effect on a doctor’s health.

At the very least, those who suffer from it should expect the support of the health service for which they have toiled during the pandemic.

A GP trainee was debilitated by the condition. Having treated a patient while immunosuppressed, long COVID affected his heart, caused significant respiratory symptoms, ‘brain fog’, and led to him using a wheelchair for a time because multiple joints were inflamed.

Absent from work for 18 months, the employer and Health Education England managed his absence informally, with regular contact, and with support from his associate dean.

But it seemed a change in lead employer caused the onset of a much less sympathetic approach. The doctor was informed that his absence was to be reviewed at a formal stage of the absence management policy.

This meant the matter could escalate, via – horrible phrase – ‘absence management triggers’, up until the point of dismissal. This put him under considerable additional stress during what was already a very difficult time. He had struggled with his physical recovery for months, and recovery from long COVID is rarely linear.

The prospect of having to either return to work or face dismissal only served to heap on psychological pressure. Many would find this approach callous, and pointless too, given the doctor was in no position to return to work at that time.

But it was also against NHS Employers guidance, which could hardly be clearer on the subject: ‘Any sickness absence related to COVID-19 for [Agenda for Change] and medical staff should not be counted for the purposes of any sickness absence triggers or sickness management policies.’

With guidance such as that, resolving the case should have been straightforward, but the BMA senior employment adviser supporting the doctor still needed to be persistent and persuasive. The adviser raised concerns during the first formal meeting, stage one of the process, with the employer.

The employer said that it planned to use the absence management triggers and if the member had not returned to work within eight weeks, another meeting would be convened under stage two of the policy.

The adviser told them that not only was it contrary to national guidance, but out of step with the approach being taken by neighbouring trusts.

The adviser then contacted the BMA industrial relations officer who covers the trust, and established that another adviser had also raised concerns, that the policy most definitely had not been agreed with staff, and that the issue had been raised with HR.

An HR representative then contacted the BMA adviser and asked for more information about the neighbouring trusts, all of them major employers, who were following the national guidelines. Following this exchange, the trust finally did the right thing.

The outcome form from the stage-one meeting was retracted. The meeting itself would be regarded not as a formal step in the absence process but a sickness-review meeting.

There was a commitment that, in holding such meetings, the purpose was to follow the occupational health report and recommendations, and not make decisions which affected pay or absence triggers. The trust apologised – the result of misunderstanding and miscommunication, they said.

The doctor said of the BMA’s intervention: ‘It means more than I can probably express.’ This should never have happened. Employment policies can sometimes be obscure or ambiguous, but this was neither. Other doctors in a similar position with the same employer should also benefit.

Some details have been changed to protect confidentiality