Phased Return To Work Form Template for England and Wales

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Key Requirements PROMPT example:

Phased Return To Work Form

"I need a Phased Return To Work Form for an employee returning from long-term sick leave due to surgery, with a gradual increase from 3 to 5 days per week starting March 2025, including specific adjustments for reduced lifting and standing requirements."

Document background
The Phased Return To Work Form is a crucial document designed to facilitate a smooth transition back to work for employees who have been absent due to illness, injury, or other significant reasons. Used extensively across England and Wales, this document helps ensure compliance with employment legislation while protecting both employer and employee interests. It typically includes details of modified working hours, adjusted duties, support measures, and regular review points. The form serves as both a planning tool and a record of agreed arrangements, helping to manage expectations and monitor progress throughout the return-to-work period.
Suggested Sections

1. Employee Information: Personal details including name, employee ID, job role, department, and line manager details

2. Absence Details: Information about the absence period including start date, reason for absence, and medical certification details

3. Return Plan: Proposed return to work date and detailed phased working pattern including hours and days

4. Workplace Adjustments: Specific modifications required to duties, workspace, or working arrangements to facilitate return

5. Review Schedule: Planned review dates, monitoring process, and success criteria for the phased return

Optional Sections

1. Medical Recommendations: Section for documenting specific guidance from healthcare professionals or occupational health

2. Risk Assessment Summary: Overview of workplace risks identified and agreed mitigation measures

3. Support Measures: Additional support, training, or resources required to facilitate successful return

Suggested Schedules

1. Medical Documentation: Appendix for attaching relevant medical certificates, fit notes, or occupational health reports

2. Risk Assessment Form: Detailed workplace risk assessment document specific to the return to work plan

3. Working Pattern Schedule: Detailed week-by-week breakdown of working hours, duties, and progression plan

4. Review Meeting Template: Standard template for documenting progress review meetings and outcomes

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Industries

Equality Act 2010: Key legislation providing protection against discrimination for employees with disabilities, establishing the duty to make reasonable adjustments, and ensuring protection against discrimination during sickness absence and return to work process

Health and Safety at Work Act 1974: Primary legislation establishing employer's duty of care, risk assessment requirements, and obligations to maintain a safe working environment

Employment Rights Act 1996: Legislation protecting employment terms and conditions, establishing the right to return to work after sickness absence, and providing protection against unfair dismissal

Management of Health and Safety at Work Regulations 1999: Regulations detailing risk assessment requirements and special considerations for vulnerable employees returning to work

Access to Medical Reports Act 1988: Legislation governing rules regarding medical information, employee consent requirements, and rights to access medical reports

GDPR and Data Protection Act 2018: Legal framework for processing health data, maintaining confidentiality, and applying data protection principles in managing return to work information

Fit Note Guidance: Department for Work and Pensions guidance on implementing GP recommendations, may be fit for work advice, and graduated return arrangements

Working Time Regulations 1998: Regulations governing maximum working hours, rest break requirements, and considerations for adjusted hours during phased return to work

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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