Employment issues and sick pay

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This wiki is intended for healthcare professionals and should not be considered medical advice.

Healthcare worker COVID-19 prevalence

A table showing number of healthcare worker deaths by country adjusted for by population and total number of healthcare workers

Mutambudzi M, Niedwiedz C, Macdonald EB, et al (Online pub: 09 Dec 2020) Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants Occupational and Environmental Medicine. doi: 10.1136/oemed-2020-106731

  • Healthcare workers had a more than seven-fold higher risk of severe COVID-19; those working in social care and transport occupations had a two-fold higher risk.
  • Non-white essential workers had the highest risk of severe COVID-19 infection.

Raymond M Agius, Nathalie MacDermott. (18 Mar 2021) Covid-19 and workers’ protection: lessons to learn, and lessons overlooked. Occupational Medicine, 2021; kqab034, https://doi.org/10.1093/occmed/kqab034

"Research commissioned by the HSE long before the pandemic and showing the overwhelming superiority of FFPs over surgical face masks in protecting against viral aerosols was not acted upon [7]. The HSE’s extant guidance before the pandemic recommending FFPs as minimum protection against biological agents seems to remain tacitly eschewed [8] in spite of calls to apply precautionary principles [8,9] in PPE especially in respect of HCWs."

March for Change Petition: Recognise long Covid as an occupational disease

NHS Employer COVID sickness absence policy

NHS Staff Council Executive, NHS Employers (June 2021). Management of long-term COVID-19 sickness absence

"Any sickness absence related to COVID-19 for AfC and medical staff should not be counted for the purposes of any sickness absence triggers or sickness management policies."[1]

For further information, see this reference [2]

A guidance dated 21 September 2020 stated "This scheme allows COVID-19 sickness to be paid at full pay for a period of 365 days without any consideration for previous non-COVID sickness or length of service entitlement." [3] However, this may be subject to change.


The above policy initially applied to Wales too, as confirmed in a letter written by Vaughan Gething on 19 October 2020 [citation needed].

UPDATE initially published 27.01.21, revised 07.07.21 (applies from 1st Dec 2020) NHS CONFEDERATION FAQS link below. Covid no longer special absence, but now considered sickness absence with special provision,full pay 12 months. Longer potentially if start of absence predates Dec 2020. After 12 months, emplyers discretion if materially supports returning to work and/ or assist recovery. Longer phased return provision, on full pay (see A1e). There is also provisions set out if employees are requiring subsequent sick leave following a return to work having been initiated, when the full/half pay entitlements have been exhausted (see A1g). NHS Wales Frequently Asked Questions for NHS Managers and Employees Updated 25 August, 2021

If the above link doesn’t work, please see the main page on the NHS Confederation website here Frequently asked questions for NHS managers and employees

UPDATE 2 - November 2021 The above policy was updated in November 2021, extending full pay to all NHS employees who are on sick leave due to Long Covid until March 31st 2022. Long COVID - Post virus sickness absence – Health & Wellbeing and rehabilitation support

To facilitate the development of a comprehensive approach to case management and to maximise the rehabilitation opportunities, the current arrangements for the full pay “top up” will be extended by 4 months to the 31st March 2022. This will apply to all individuals whose full pay was extended to 30th November 2021 and for any individual with a 12 month full pay “top up” end date, between 1st December 2021 and 31st March 2022.

The NHS Wales FAQ has been updated to reflect the November policy update. See above for link to main page, or find the FAQ PDF here.

Question 1f states “[…] the full pay “top up” will be extended by 4 months to the 31st March 2022 […]”.

Regarding pay and use of annual leave during a phased return, question 1e states: “[…] This extended period will be on full pay (what the individual normally receives when in work) and the individual will not be expected to use annual leave.

1 April 2022 onwards

This document covers arrangements in place after 31st March 2022. In brief:
Half pay will therefore be re-instated for this group of staff with effect from 1st April 2022 for the length of time corresponding to each individual’s contractual entitlement to half pay i.e. based on their length of service. In addition, organisations should explore, on a case by case basis, whether the level of sick pay should be increased in line with the provisions in place to extend sick pay i.e. under paragraph 14.13 in the AfC terms and conditions of service and paragraph 225 of the M&D handbook, which allow discretion to extend sick pay up to full-pay.


"The Cabinet Secretary for Health and Sport has confirmed that all employees who have contracted COVID-19 and are off sick should be on COVID Special Leave and should receive full pay until they return to work, for as long as these arrangements are in place."[4]


GP online articles:

  1. Haynes L and Bostock N. Practices can use £150m COVID fund to hire locum GPs, BMA confirms - Requires registration
  2. Haynes L (19 Feb 2021) BMA backs MPs pushing for financial compensation for NHS staff with long COVID.
"Practices are able to apply for reimbursement to cover staff with long COVID via the £150m COVID fund. However, this funding has been allocated for several different purposes and only applies until the end of March. Guidance from NHS Employer states that clinicians with COVID-19 should receive 'full pay inclusive of all enhancements', but practices aren't contractually obliged to do this."

If PCR test negative

“The sensitivity is contested with reports suggesting that it may be as low as 60–78%” [5]

Early retirement on health grounds

Ill health retirement: What are the qualification criteria? Unbiased (website).

Further Resources

Occupational Medicine journal articles:

An evidence review, ‘Return to work after long COVID: Evidence at 8th March 2021’ , undertaken by an international group of experts states that return to work for an individual with long COVID often needs involvement of the recovering worker, employer, line manager, health professionals and (where available) occupational health professionals to facilitate appropriate return to work and support at work.

Leaflets on returning to work:

The Society of Occupational Medicine (SOM):


  1. https://www.nhsemployers.org/covid19/staff-terms-and-conditions/sickness-absence NHS Employers
  2. NHS Employers
  4. Scottish Government
  5. [1] When to rule out COVID-19: How many negative RT-PCR tests are needed?