BMA demands end to ‘discriminatory’ sick leave policy for disabled doctors
Current approach drives higher rates of presenteeism and burnout
‘My own condition can wax and wane and there are days when I feel unable to work – but I have done, to my detriment, simply to avoid being called to an absence management panel.’
Clodagh Corrigan (pictured above), an emergency medicine specialty doctor with MS, spells out the reality faced by her and many colleagues in the NHS when asking for recovery time to help them manage their disabilities.
Dr Corrigan tabled a motion at the BMA annual representative meeting which calls for the BMA to lobby employing organisations to record disability-related absence separately to sick leave.
Currently, the NHS uses the Bradford Factor, a calculation that applies a weighting formula for unplanned employee absence, which is used to trigger absence management panels, warnings and dismissals. This formula considers each additional absence is increasingly impactful, so taking three separate days off would penalise someone more than taking three weeks sick leave in one go.
Dr Corrigan argues that the Bradford Factor is discriminatory towards those with disabilities, leads to presenteeism and burnout and impacts staff retention.
Inconsistent ruling
She told the BMA’s representative body: ‘I have a disability, I have the misfortune of being summoned in front of absence management panels. They have always been stressful and adversarial. I have had to justify my existence in the profession and attempt to quantify my worth in a way that an able-bodied colleague would never have to do.’
Dr Corrigan, who is based in Northern Ireland, added: ‘It is well-evidenced that presenteeism reduces productivity and increases burnout.
‘As a result of the absence management panel and detrimental presenteeism, I have had colleagues give me the “good advice” to use my annual leave to circumvent this process.
‘This reduces the leave that I have available to me for much-needed rest, relaxation and restorative time with my family. This then increases my likelihood of burnout.’
Dr Corrigan said disability positive practice ‘must be considered’ as part of efforts to improve NHS staff retention and said that quality standards introduced in 2019 have been shown to be insufficient given that a 2023 NHS England report found presenteeism was reported at 27.7 per cent among disabled staff – eight percentage points higher than among those without a disability.
Disproportionate penalties
She noted that NHS Employers and the Equality and Human Rights Commission both recommend a disability inclusive flexible and inclusive workforce policy.
‘Despite this, few NHS employers record disability absence separately,’ added Dr Corrigan.
‘This is not about allowing disabled people additional sick leave. This is simply a matter of coding. No additional cost, no additional losses but flexibility in approach and some breathing room for disabled staff to take requisite recovery time to reduce presenteeism, reduce burnout, increase inclusivity and retention of our valuable colleagues with added extras like me.’
Zeeshan Saeed, a core trainee 1-2 in Hove, agreed that the Bradford Factor ‘disproportionately penalises employees with disabilities’.
‘By treating all absences the same, the system unfairly targets those who already face significant challenges in their daily lives,’ he said, noting how disabled staff are more likely to face disciplinary or dismissal as a result of absences – because of how they are recorded.
He said: ‘This is a clear example of how systemic discrimination. This must be addressed immediately. By doing so we can ensure that disabled employees are treated fairly and that their absences are understood in the context of their individual circumstances.
‘It is a matter of justice and equality.’
Disability definition
GP John O’Driscoll spoke against the motion, which passed comfortably.
While he said the ‘spirit of it is entirely correct’ he warned: ‘The Bradford Factor is open to misuse, clearly something needs to be changed. The problem is people currently being defined as sick will inevitably change to become defined as disabled. And that will be to the detriment to the true disabled.
‘So be careful what you ask for, you may get something worse.’
However, a point of information was made in the room pointing out the Advisory, Conciliation and Arbitration Service (ACAS) definition of a disability, which states:
The law says someone is disabled if both of these apply:
- they have a 'physical or mental impairment'
- the impairment 'has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities'.
BMA deputy council chair Emma Runswick added that the government defines a ‘substantial’ disability as one that is ‘more than minor or trivial’, meaning that ‘it takes much longer than it usually would to complete a daily task like getting dressed’.
She pointed out that ‘long-term’ is defined as 12 months or more, that there are special rules about recurring and fluctuating conditions, and some conditions that qualify as a disability from the moment of diagnosis.
