Reckonable service and NHS sick pay: what counts

Your sick pay scale in the NHS depends on reckonable service, and under Section 12 of the NHS Terms and Conditions of Service Handbook that means continuous previous service with any NHS employer. Moving between trusts does not send you back to the start of the scale. A gap of up to 12 months between NHS jobs does not wipe out earlier service either. What you have already been paid for sickness in the last 12 months then reduces the allowance you can use. The scale itself is in our NHS sick pay guide.

What counts as reckonable service

Paragraph 12.1 says an employee’s continuous previous service with any NHS employer counts as reckonable service for redundancy, maternity, sick pay and annual leave agreements. The wording is “any NHS employer”, so a move from one trust to another, or from a trust to another NHS body, keeps your service intact.

The handbook text we read has no separate trust-to-trust rule beyond that wording. If your move involved an unusual gap or a change of employer type, ask HR to confirm in writing how your service date was set. Our guide to moving between NHS trusts covers the practical side.

Service outside the NHS is a matter of discretion. Paragraph 12.2 lets employers take into account periods of employment with employers outside the NHS, including service inside or outside the United Kingdom, where they judge it relevant to NHS employment. Nothing obliges them to, so a care home or private hospital job may or may not be counted. Ask HR before you sign a contract.

Transfers out of the NHS and breaks in service

Some staff are transferred out of NHS employment to a non-NHS provider. Under paragraph 12.3, if they later return to NHS employment, their continuous service with the new employer counts as reckonable for sick pay, annual leave and pay step progression, provided that employer was providing NHS funded services.

Breaks are dealt with in paragraph 12.5. When you return to NHS employment, your previous NHS service counts towards sickness absence entitlement where the break, or breaks, in service came to 12 months or less. The handbook text we read does not say what happens to sick pay service after a longer break, so check with HR if yours was longer. For service in general, see continuous service in the public sector.

The 12-month look-back

Each illness draws on the same allowance. Paragraph 14.7 says the period and rate of sick pay is calculated by deducting from your entitlement on the first day of sickness the aggregate periods of paid sickness absence in the 12 months immediately before that day.

Say you have more than five years’ reckonable service, so the scale gives you six months on full pay. Suppose you were paid for two months of sickness absence in the 12 months before your next absence starts. Your employer takes those two months off, which leaves four months of full pay for the new absence. The example is invented.

Because the look-back runs from the first day of each new absence, a period of sick pay drops out of the calculation once it is more than 12 months old.

Absences that are disregarded

Paragraph 14.7 lists some past absences that do not reduce your allowance:

• unpaid sickness absence
• absence from an injury, disease or condition wholly or mainly attributable to your NHS employment, sustained in the discharge of your duties (the handbook refers to paragraph 22.3)
• absence from an injury caused by a crime of violence connected with your employment, where the injury was the subject of a payment from the Criminal Injuries Compensation Authority (or the Northern Ireland Compensation Agency)
• absence from such a crime injury that did not lead to an award because the loss of earnings criteria were not met, or because compensation above the minimum would not arise

Work-related injury also has its own allowance, which we cover in the injury allowance guide. Separately, paragraph 14.16 says that if you receive damages from a third party after an accident, the absence is not counted for the purposes of the scale once the sick pay advance has been repaid.

When your employment ends

Under paragraph 14.3, entitlement to sick pay ceases from the last day of employment. Unused months do not carry on after you leave, whether you resign, are dismissed or reach the end of a fixed-term contract. Statutory Sick Pay follows its own rules, which are on GOV.UK and in our Statutory Sick Pay guide.

Extending pay and reinstating half pay

Employers have discretion under paragraph 14.13 to extend full or half pay beyond the scale. The handbook gives two situations: where a short-term return to work is expected and an extension would support return or recovery, and “in any other circumstance that the employer deems reasonable”. It is a discretion, so you cannot demand it, but you can ask for it, ideally with occupational health or your manager supporting the request. If your pay is close to running out, see what happens when NHS sick pay runs out.

Separately, paragraphs 14.10 to 14.12 provide for half pay to be reinstated after 12 months of continuous sickness absence for people who have used up their entitlement. For staff with more than five years’ reckonable service, it applies if entitlement runs out before a final review meeting for long-term absence. For staff with less than five years, it applies if no final review takes place within 12 months of the start of the absence. Reinstatement runs until the final review meeting, and it is not retrospective for any period of zero pay in the preceding 12 months.

It applies only where the failure to hold the review is due to employer delay, in line with local procedures under annex 26. If you think a review is overdue, ask HR for the date, and a union representative can help you press for it.