Migraine absences = attendance review meeting

[Alwaystired80]

Hi there.

So I have worked for NHS 7 years. Being in my current dept 3 years. Made them aware when first started and when interviewee for current job I suffer from migraines.

So had 3 occasions of absence in 12 months, all because of migraine and months apart. On two occasions had one day off and other occasion 2 days. So 4 days off in 12 months.

Been told by my team leader my manager wants to have an Attendance Support Review Meeting. Never even heard of this. When I've looked at the policy it states "where monitoring identifies that recurring patterns of absence are emerging over time the manager may decide to address this by instigating the Short Term Sickness Absemce Procedure... would include prolonged periods of absence where the employee has returned back to work but has been unable to maintain their absence or several occasions of repeated or intermittent absences".
It states I would be told what a reasonable level of absence would be and would allow 2 absences in 6 months. I will be reviewed every 6 months.

Am I right to be annoyed and upset about this? All 3 absences were due to migraine which they know I suffer. Should they not take this into account? If I didnt suffer from migraines I would have gone 14 months without any absence. My absence over past 3 years is not bad.

For background I have suffered from migraines for 30 years, saw a neurology consultant in 2018 and diagnosed with chiaria malformation, been on 4 different types of preventative.

My meeting is tomorrow. Does anybody have any advice? Anyone suffers from migraines or dealtnwith employees with migraine?

Thank you 😊

Thanks this is really helpful. I've filled in a contact form for Migraine Trust so hopefully they will get in touch. Yes exactly stress causes migraine and this is not helping.

My migraines are quite severe - excruciating pain ,violent vomiting, vertigo, weakness. I cannot do anything, sometimes cannot sit up.

I've just read online a NHS was successfull at tribunal suing nhs as they had sacked her because of migraines (she had 300 days off!). The Judge said absence for migraines should be disregarded as it puts employee at disadvantage when it comes to absence procedures.

I'm hardly ever ill it's mainly migraines. But they are horrendous when I get them.

I'm sorry you suffer with them too 😔

Unfortunately I had a terrible time in the NHS due to migraine. I now solely do locums and whenever they ask me to go permanent I explain I just can't bring myself to trust them over sickness. Even though now I don't get paid if I have a migraine it's still better.

If I had my time again I would do the following:

Join the union and get them involved ASAP. If you have a choice of union, pick the one likely to be most aggressive about sticking up for you.

Get an Occ Health referral - they will be very aware of the issues surrounding migraine and reasonable adjustments, the most obvious is that you have different settings to trigger sickness absence meetings

If you have a neurologist still get them to write something in support. I recently saw one for my migraine and she said a lot of her time is taken up writing to patients' employers as understanding of migraine is so poor

The only other way round it is to work in a department where the boss has migraine. This was one of the happiest working experiences I've had - all of us would be off sick if there was a storm, total sympathy and understanding about migraine and disability.

@Alwaystired80 they sound grim as a manager!
Hopefully they’ll get one at some point and realise!!!

Thanks so much this is really helpful. I saw my Consultant in 2018 but still have the letters which I will pass to my manager and occupational health. Will defo look at joining union as well.

Yes it's much better working with people who suffer with migraines or knows someone who does. I once worked with someone who said "I hate people who say they have a migraine when it's just a headache". I said I hate people who say a migraine is just a headache.

I just wish I was seeing OH before this meeting. I might ask to see if meeting can be after I see OH. The thing is my manager knows nothing about migraines so that way forward may be best.

Thanks so much for your help 🙂

Oh you have no idea! Total control freak as well.
I wish people like that would! They don't have a clue!

I think you need to play along. This is just procedure to prevent absence issues getting worse.
BTW the case you refer to, where the nurse took 300 days off, is fact specific, e.g. involves tight fitting PPE, which contributed to the migraines, and temporary stress inducing factors. It was argued she was getting better but the employer still dismissed her hence why the employer lost. The case does not mean an employee can take as many sick days as they want/need and the employer cannot take action. Action just needs to be reasonable and proportionate that's all. After all, employment is about fulfilling a contract.

I get migraines and they are considered a disability as they have gone on for more than a year and disrupt my ability to work and live a normal life. (Wording from my work place policy).

I had to fill in some paperwork and now they can't count migraine absences in my attendance.

I did have occupational health involvement and reasonable adjustments made but not worrying about migraine absences has made life much easier.

OP, an absence review meeting is completely standard in the NHS when you trigger a certain amount of absence or are off for a certain amount of hours within a consecutive 12 months period. It's designed to look for underlying issues (such as migraines) and explore this isdue, including whether the employer needs to make any reasonable adjustments for this condition.

I'd try not to get yourself too stressed, and definitely don't be abrupt or uncooperative in the meeting- your manager is following a set policy and it's a matter of routine.

You're seeing occupational health soon, so make sure you mention this is in the absence review meeting. Make sure you familiarise yourself with the new sickness policy. You should leave the meeting knowing what stage of the sickness policy you are on and any actions that need to be taken. This should be outlined in a follow up letter or email.

Most of the NHS Trusts are more supportive of long term conditions nowadays, and occupational health may make some sort of recommendation about discounting episodes every so often etc (wording may vary, but they may increase your number of triggers or hours for example).

I manage a number of people in my department with migraines- occ health have been helpful and we've found ways to work around the absences without anyone risking a panel hearing or losing their job.

Unrelated, but if you are clinical, I strongly suggest you rejoin a union as they can be so helpful if a big problem ever does occur

Thanks. Yes when referring to the case about the nurse I was not inferring you could take as many days off as they want it was more about the Judge's comments that some of the absences for migraine should be disregarded as it puts you at a disadvantage. I've had 4 days off in 12 months which I don't think is unreasonable.
Hopefully the meeting is just a formality and the meeting with occy health will help as well.

This is really useful, thank you. Yes if just a small amount of absence could be disregarded that would be something.
I've suffered from migraines for 30 years and when they are bad I just cannot do anything, sometimes not even sit up.
Like you I just don't want to worry about getting another migraine and having time off work.

That's great thank you. Am hoping OH will be as helpful here. I'll just go to this meeting tomorrow and look at it as formality. I should have seen OH sooner but it's never been offered as my attendance has not been too bad (usually get migraines on my non working days or holidays) and I did not think there was much they could do.

Thanks so much for your reply 🙂

That’s ridiculous. It’s barely any sick leave at all!

The worst part is that being in the NHS you could goon long term leave for sone dubious reason with the way some GP’s write sick notes and be untouchable.

They can be ridiculous sometimes
I got pulled into a meeting because I had gone off sick on a day I was "refused holiday"
What actually happened was I was trying to use leave up, and every date I clicked was full, the sickness wasn't related. My union asked them to look and I had clicked on 42 other days to try and book off as well as the one I was off sick on

Oh and they tried to tell me my operation wasn't an emergency and could have waited. I had cauda equina!

How did your meeting go today @Alwaystired80? Hope you're ok

Thanks for asking. So I had spoken to my team leader how unhappy and upset I was and how I read the policy as it was managers discretion to instigate this meeting. She spoke to my manager who in turn spoke to another manager and it transpires that it is at managers discretion. It depends on individual circumstances. If I had had 3 weeks off or another absence then holding the meeting would be fair. They said in my circumstances meeting not appropriate.

The other manager was apparently concerned I was upset so the other manager called me to say they had been too hasty, that the policy is only a few weeks old but that she was supportive! I said definitely not.

I had also emailed HR and they said manager to follow procedure but they have discretion. They also said managers should be supportive when staff are off.

So it has gone OK. I am glad I spoke up rather than going to meeting and having it on my record. My line manager has sent referral to occy health so I will go over everything with them.

I also got reply from Thue Migraine Trust and some useful print outs I will pass to my manager.

Thanks for asking. It has been so stressful. Some.people don't really understand migraines at all.

That's terrible. This is what I told my team leader and then manager today - you do not choose when you are ill.

OMG caudal equina is so serious! Who are they to tell you that?! That's outrageous!

Yep I told my team leader and manager today - being treat like this makes you think we'll I'll just play the game as they don't care about me and get a sick note for 3 months.

In my last dept morale was on the floor and sickness, especially long-term, was through the roof. I understand in some circumstances absence does need to be monitored,.definitely, but they meed to look atmit on and individual basis and the reasons for the absence. When you have a genuine medical condition and told you can only be off twice in 6 months - its going to stress you put being scared you are going to be ill again.

Off topic, you've mentioned preventatives, but have you been prescribed anything to take when you have a migraine? Migraine is awful, but people who've never had a migraine or known someone close to them suffer have no understanding. I've had migraines since puberty, not as bad as yours, but they are awful, you have my sympathy.

I feel for you. I work for the NHS too and the sickness policy makes you feel ashamed for being ill. I'm off on maternity leave at the moment but struggled with some pregnancy related issues and was off for a month during the second trimester. First off they they put it was pregnancy related then when I came back, they'd changed it to a generic sickness term and told me I'd need a drs letter as my fit note wasn't good enough. My Dr wasn't happy to do this and then informed me if they wanted it they'd have to write to him and pay for it which my manager and HR didn't want to do. I had to beg my dr to add a little more in depth detail onto my sick note in the end and then begrudgingly changed it. I was also in hospital with sepsis, on a separate occasion had to attend eye casualty for a full week as I had a nasty infection then had a reaction to the eye drops so went blind in one eye for a short time and then I caught Covid during my pregnancy. They were really harsh with me even though I had medical documentation on every occasion to prove my diagnosis etc. I understand they have guidelines to follow to eliminate employees taking the pee but they can actually make the decision not to issue warnings etc when the sickness is real.

Ask your GP for pizotifen. For me, it is life-changing in how much it has reduced the severity and frequency of my migraines.

I cannot keep tablets down as I am so sick with migraines so take Imigran nasal spray. It doesn't always work but when it does it has stopped me being sick and taken the edge off the migraine (still feel dreadful).

The thing is I was planning to go back to GP to ask about maybe trying another preventative but now this has happened I am scared of having some effects whoch may affect my attendance or performance at work until I get used to the medication.

How they have treated you is disgusting but this is what the NHS seems to be like. Instead at looking at individual cases, the reasons for absence and applying some discretion they make you feel bad for being ill when it is out of your control.

Yes there are people who abuse the system but many of us don't. Twice I was off one day each absence - I could have had a week off each time like some other people do.

Managers need training on how to deal with staff, especially in relation to absence. It can make all the difference.

We have meetings like this at work but it’s not to reprimand us it’s to figure out if there is something at work that is triggering and to make adjustments.

go in with an open mind, they may surprise you.

I manage sickness at work and I work in the NHS. Health Roster automatically tracks absences and highlights when someone has triggered the absence meetings. Different Trusts may have different policies but the one I work for is very supportive of long term conditions. Migraine is most definitely covered. The meeting should be supportive - to find out what they can do to help facilitate you being able to work. A referral to Occ Health should be supportive and look into Reasonable Adjustments. In my Trust once a long term condition is recognised time off for medical appointments for that condition is allowed - including travel time.
My advice - go in with an open mind and be prepared to discuss how they can help you stay in work with a debilitating condition.

I first took pizotifen 20-odd years ago. Worked well the first time, then they took me off it. Went back on it a few years later and it did nothing at all.

I'm under neurology, not the GP now, with CGRP injections, botox etc.