Workplace and employment FAQs

We have developed the following responses to questions we have received from members. We will continue to add to these where it is helpful to provide more specific advice not covered elsewhere.

NHS terms and conditions

The NHS has also developed information on a range of terms and conditions for its staff in response to the pandemic. Many are the same or similar across the four countries. A number of the FAQs below reference the England terms and conditions for the NHS, but further information and FAQs for all the countries can be found on our page of NHS guidance and general employment resources.

The CSP urges members to follow the advice given by your employer and public health agencies. 

Protecting yourself at work

Please also see our FAQs on Protecting yourself from infection.

How can I protect myself at work

Your employer should carry out risk assessments in line with the HSE and PHE infection prevention control guidance.  They should put in place the necessary procedures, including identification of potential patients with Covid-19 symptoms, safe systems of work including isolation, staff training, monitoring protocol and sufficient supply of suitable personal protective equipment (PPE) for health workers. 

Review the NHS Staff Council Workplace health and safety standards,  for best practice on protecting staff from injury and illness.  The standards' criteria on dealing with hazardous substances,  covers safe systems of work and control measures, such as ensuring: 

  • Visual checks and observations at appropriate intervals.
  • Where more than one item of PPE is being worn, the different items are compatible with each other.
  • Supervising employees to ensure that the defined methods of work are being followed.
  • Prompt remedial action where necessary.

For further guidance on what appropriate PPE should be provided when treating Covid-19 patients please refer to our  Clinical Practice FAQs.

(Last reviewed 23 July 2021)

How do I know ventilation at work is sufficient and what can I do about it?

The Health and Safety Executive advice is good ventilation is important to limiting staff’s exposure to the virus. Their recent spot checks of 17 NHS acute hospitals concluded many trusts’ risk management processes failed to review and monitor their ventilation requirements.

HSE called on employers to consider how ventilation could be improved. Could windows be unsealed to open, are doors left open, how are rooms with no windows or air conditioning being ventilated?

(Last reviewed: 5 August 2021)

Examples of good practice

The HSE’s examples of good practice, included where employers:

  • Engage a competent ventilation contractor to assess air changes in work spaces to determine how to modify to improve air flows.
  • Undertake a site wide survey of all mechanically ventilated spaces to identify issues and to rebalance their ventilation system.
  • Do regular checks covering velocity, dilution and dwell times.
  • Implement a schedule of cleaning and maintenance of their mechanical ventilation systems.

Examples of improvement being required

The HSE examples of where improvements was required:

Action points for you

  1. Ask to see your employer’s risk assessment.
  2. Talk to colleagues about ventilation and decide where you think improvements is needed.
  3. Notify your line manager, service lead and CSP safety rep or steward about your concerns.  Do it in writing.  

What can the CSP do to help?

For serious breaches of health and safety in the workplace the CSP, according to procedures arranged with the HSE, will undertake the following with active involvement of members. 

  • Contact the employer directly, advising of members' concerns and request for suitable and sufficient risk assessment or urgent review of the current assessment.
  • If the matter is unresolved and the CSP considers there is a breach of H&S regulations, a  formal complaint (utilising the employer's procedures) is submitted.
  • If the complaint is not resolved then the CSP contacts HSE, providing required information for their assessment and intervention.

In circumstances where the situation is clearly urgent, the CSP may bypass the employer's complaint procedures and contact the Health and Safety Executive directly. 

(Last reviewed 15 Oct 2020)

What does the law say?

With respect to what legal remedy is available for individual employees (and now also workers from 31 May 2021) on health and safety grounds, we refer you to the Employment Rights Act 1996, Sections 44 and 100. If successful in a claim, an employment tribunal may rule against an employer to pay out financial compensation to an employee, worker or accredited safety rep for raising serious health and safety matters with the employer, that failed to act or take action that is to their detriment.

If dismissed because of leaving or refusing to return to a workplace due an imminent danger that you couldn't avert, or for taking steps to protect yourself or others in these circumstances, you may have potential grounds to argue an automatic unfair dismissal claim at an employment tribunal.

(Last reviewed 7 June 2021)

Self-isolation and sick pay

How do I inform my employer about my self-isolation?

If you are self-isolating either because you live with someone who is displaying symptoms, or you are displaying symptoms, you should submit a self isolation note.  

You do not need to get a fit note from the GP.

(Last reviewed 8 Feb 2021)

I am employed in the NHS and have been required to self-isolate. What will I be paid?

During any period in which you are required to self isolate, you will receive full pay, including any pay enhancements such as cost of living supplements or unsocial hours payments that you would have received if you had worked your planned shifts.

Covid-19 related absence will be recorded separately from other absences and will not be managed under your NHS organisation’s existing Sickness Absence Policies. (Read more about recording Covid-19-related absences on the Electronic Staff Record.) 

This means the following will apply for any absences caused by your sickness due to Covid-19 or due to a requirement for you to self-isolate in line with Public Health Advice:

  • They will be recorded separately as Covid-19 related absence.
  • The pay you receive will not be affected by or be counted towards your existing entitlements to paid sick leave.
  • Absences due to self-isolation will not be counted towards any sickness absence related policy triggers.
  • Entitlement and access to other forms of special leave will not be affected.

Any sickness absence not due to Covid-19 will be treated in line with your NHS organisation’s existing Sickness Absence Policies.

If you are well but are being required to self-isolate, you may be asked to work from home and your line manager may a have a discussion with you to explore this option. If you cannot work from home, it will not affect your pay.

Further information is available on the NHS Employers website.

(Last reviewed  8 Feb 2021)

I am an employee or worker outside of the NHS or I am working for a private sector employer that normally provides NHS services. What am I entitled to be paid if I need to self-isolate?  

Check with your employer and review your contract of employment to see what entitlements you have to sick pay. It may also be the case that you can work from home or negotiate with your employer to pay you as normal for the period of time you are required to self-isolate.

If this is not possible and you do not have contractual sick pay, so long as you regularly earn £118 or more a week, you should be entitled to Statutory Sick Pay (SSP). You can check your eligibility on the website.

From 13 March 2020, SSP is available for all eligible employees diagnosed with Covid-19 or who are required to self-isolate in line with public health advice. It is payable from the first day you are unable to attend work.   

You do not need a fit note from you GP but should access a self-isolation certificate available on-line from the NHS 111 website.  

(Last reviewed  8 Feb 2021)

Returning to the NHS

See also our page on Joining the temporary NHS workforce which summarises the process for different types of returnee across the four countries.

And see the NHS Employers website for guidance for returning to work in England.

What routes are available for me to return to the NHS?

You can register your interest throughNHS England and NHS Improvement which has created a survey for those who want to return to the NHS across all four countries. Advice on returning is available through NHS England.

(Last reviewed 15 Oct 2020)

Can I undertake a bank or agency role if I am only able to do a few shifts?

Yes, you can also apply for one of the many agency or bank roles currently available. Individual Trusts and Boards will have their own bank arrangements. You can search for these on your local Trust’s website or Facebook page for their current vacancies or search on NHS jobs.

There is also NHS Professionals (NHSP)which is the largest NHS Staff Bank in England, working with 55 Trusts to provide staff to the NHS and they have also produced Covid-19 related FAQs for bank staff.

(Last reviewed 15 Oct 2020)

What employment rights do I have as a directly employed NHS staff member?

If you are appointed to a permanent or fixed term directly employed role, you will be engaged on an employment contract which will reflect standard terms and conditions in the usual way. All NHS appointments should reflect Agenda for Change terms and conditions, with minimal local variation. You should also receive appropriate induction and refresher training.

(Last reviewed 15 Oct 2020)

What employment rights do I have as an agency or bank worker or with NHS Professionals?

As a bank or agency worker you will have fewer employment rights than if you were directly employed, either permanently or temporarily.

A basic comparison of worker v employee v self-employed employment rights can be found on the ACAS website.

Bank work in the NHS is usually closely linked to NHS pay scales with the work for qualified Allied Health Professionals (AHPs) usually linked to Agenda for Change Pay Bands 5 or 6. 

If you are undertaking bank or agency work, there are specific terms and conditions in England if you need to self-isolate.

(Last reviewed 15 Oct 2020)

What pay am I entitled to if I return to the NHS in a directly employed role?

During the emergency period, the Returning to work guidance sets out that for substantive staff in roles covered by Agenda for Change terms and conditions they should be paid at the top of the appropriate pay band for the role they are fulfilling, providing they previously worked in that pay band or higher. This is currently only set out for England but the other countries are likely to agree similar arrangements.

(Last reviewed 15 Oct 2020)

I am returning from retirement and would rather go into a more junior role. What should I be paid?

If staff want to return to a more junior role than the role they retired from, they should be paid the top of the pay scale in the more junior role. This is currently only set out for England but the other countries are likely to agree similar arrangements.

(Last reviewed 15 Oct 2020)

What are the pension payment arrangements for staff returning to the NHS to assist in the response to the Covid-19 outbreak?

Staff who have not retired but return to NHS service are automatically enrolled into the NHS Pension Scheme when they re-enter NHS employment with an NHS organisation. Membership of the NHS Pension Scheme is voluntary and staff can opt out if they wish. If an individual opts out within the first pay period after starting NHS employment, the individual is treated as having never joined the scheme. 

If staff have already taken their pension, the government is removing any restrictions on the amount of work they can do without losing any of their pension during the emergency. 

If they retired from the 1995 NHS Pension Scheme, they will no longer be limited to having to work no more than 16 hours a week in the first four weeks after retirement. 

For staff who want to take partial retirement from the 2008 and 2015 pension schemes, they will not be required to reduce their pay in order to claim their pension. 

If staff are a Special Class scheme member with the right to take their pension unreduced at age 55, they will no longer be subject to the current restrictions, called abatement, in the amount of work they are allowed to do before losing their pension between the ages of 55 and 60. This new rule will apply both to retired staff returning to the NHS and those who have already returned to work. Special Class status can be held by nurses, midwives, physiotherapists and mental health officers. This factsheet defines Special Class eligibility.  

Taken together, these measures will allow skilled and experienced staff who have recently retired from the NHS to return to work, and retired staff who have already returned to work to increase their commitments if required, without having their pension benefits suspended.

(Last reviewed 15 Oct 2020)

What will happen when these measures are no longer required?

A six-month notice period will be given to staff and employers before these measures will cease to apply, at which point the relevant sections of the scheme regulations will take effect again. Staff and employers will therefore have six months’ notice to readjust their working patterns.

(Last reviewed 15 Oct 2020)

What are the tax arrangements for NHS Staff and those returning to the NHS?

Many NHS staff will be experiencing changes in their employment, including those taking on additional shifts or returning to the NHS, as well as individuals volunteering to support the health service.

For those NHS staff choosing to take on additional work to help with the response to the Covid-19 outbreak, HMRC has been working with tax agents and employers, who organise tax arrangements on behalf of employees, about ensuring they put people on to the correct tax code. Find out how to check if you’re on the right tax code.

HMRC has also published new guidance on how staff returning to work for NHS trusts and local authorities will be taxed, and guidance for local authorities and NHS trusts supervising unpaid volunteers.

We are aware of an unfortunate increase in tax avoidance schemes and scams being targeted at NHS staff. Find out more about tax avoidance schemes.  

(Last reviewed 15 Oct 2020)

Will I need a DBS/PVG check before starting to work in the NHS?

Yes, though if you have a recent DBS Certificate or have maintained a subscription to the DBS Update Service, then it may not be necessary for a further application to be submitted. An assessment will be done by your employing organisation, using guidance from NHS Employers, to determine if a further check is required.

Where a new DBS application is required, the DBS have extended the scope of their services to include a new fast track check against the adults' and/children's barred lists. These arrangements will enable employers to recruit into a regulated activity before receiving the full disclosure certificate, where they have undertaken a risk assessment and put in place appropriate monitoring and supervision.

You will not be required to pay for a DBS check.

(Last reviewed 15 Oct 2020)

Childcare arrangements and carers leave

What are my rights to time off to look after a dependent?

Employees are entitled to time off work to look after dependents (children or adults) in an unexpected event or emergency. This could apply to situations connected to coronavirus. It normally covers only the first few days that are needed to manage the emergency situation.

There's no statutory right to pay for this time off, but some employers might offer pay depending on the contract or workplace policy. In the NHS, most trusts have a policy that allows for a certain amount of paid time (special leave) followed by using annual leave and/or unpaid leave if further time is needed. Your CSP Steward will be aware of local and national policies that will support you in relation to coronavirus and carers leave.

(Last reviewed 11 Jan 2021)

I work in private practice; am I a critical worker and therefore is my child eligible to attend school/an education setting?

The government  has provided a definition of critical health and social care workers for the period of the current lockdown.

The CSP recognises that members in all sectors and settings will be making a contribution to easing pressures in the health and care system at this time. However, schools and education settings will be required to make local decisions on critical worker status and subsequent access to school/education attendance for certain children.

It is anticipated schools/education settings may need to prioritise with the following considerations:

  • The extent to which a health worker’s current work is preventing patients from being admitted to hospital or presenting to primary care, including supporting patients recently discharged from hospital.
  • Teaching/support staff capacity – noting the number of vulnerable children required to attend and additional capacity issues as a result of staff illness, isolating or shielding.

We propose members self-assess against these parameters to determine the strength of their case and discuss with their local school/education facility.

Please see our full range of guidance and information for private practitioners during Covid.

(Reviewed 11 Jan 2021) 

What are my options for childcare?

Depending on your role, you may be classed as a key worker for the purpose of accessing school and childcare places. There is government guidance on determining key worker status. Check the criteria and discuss with your local school/childcare provider. It is important to note that only one parent needs to be classed as a critical worker. The provision of childcare, access to schools and interpretation of this guidance differs between the four countries and on a local authority basis. Refer to governmental advice from the devolved nations and local authority advice to understand current provision, the process for accessing places, and future plans for reopening schools in your area.

If you have ongoing issues with childcare, you can discuss options with your line manager, such as working flexibly, or from home, or temporarily changing your working hours. It is hoped that employers will be flexible when considering these requests. NHS guidance makes it clear that employers should be as supportive as possible to staff while balancing the needs of the service at that point in time. Where possible, we would advise discussing the situation with your local CSP representative as this may help in discussions with your manager.

(Last reviewed 11 Jan 2021)

What rights do I have if my caring arrangements have broken down?

If you require time off because your child or a dependent has symptoms of coronavirus, it is important that you follow the guidance on household isolation.

The current government advice is that children should follow the same social distancing principals as adults. Therefore, children should limit their contact with vulnerable groups and those following stringent social distancing and/or shielding. In addition, children may have to self-isolate due to contact with someone who has coronavirus. The NHS has information on your rights to pay for time off related to caring for children who are required to isolate, depending on coronavirus contact status. This may lead to a breakdown in caring arrangements either on a short-term or long-term basis. If there has been an immediate breakdown in the arrangements, then dependents' leave can be used to help manage this. In the NHS, and some other employers, this is likely to be paid for the first couple of days at least. If appropriate, and if childcare provision for essential workers is available in your local area, this should be used to enable you to return to work.

As shielding and travel advice changes, this may enable a return to normal childcare provision. However, for longer term breakdown of arrangements and if measures create issues during school holidays, then you will need to discuss with your line manager options such as working flexibly or from home, or temporarily changing your working hours.

The same principles will apply if you are caring for an adult dependent.

(Last reviewed 11 Jan 2021)

Annual leave and bank holidays

For staff working in the NHS in England, please also refer to the Annual leave guidance document.

What are my entitlements around annual leave?

Most employers will have annual leave policies that will still apply even in the current circumstances unless an alternative Covid-19/pandemic-related policy has been specifically agreed with unions or determined through the normal route for policy development within the organisation. These policies will contain any rules about taking annual leave and should be the first port of call for staff.  

There is also a statutory framework around booking annual leave.

NHS staff annual leave provisions are covered in Section 13 of the Agenda for Change Terms and Conditions Handbook.

There are also two areas on the NHS Employers website covering the approach to leave during Covid-19.


Northern Ireland

NHS staff Council Guidance

NHS Staff Council Guidance (July 2020) to support the management of annual leave

Staff Guidance relates to England. The guidance in the other countries is broadly similar but it is always worth checking country-specific information.

Guidance on annual leave for Scotland

Guidance on annual leave for Wales

(Last reviewed 8 Feb 2021)

Can my employer require me to take annual leave?

The statutory framework around annual leave and working time does allow employers to require staff to take annual leave providing the proper notice is given. They need to give at least twice as many days notice as the number of days they are requiring you to take as annual leave.

However, you should also check both your own contract and any local annual leave policies to see if there is any reference to this as, if so, there may be an argument that the contract takes precedence if it differs from the framework and is more favourable. It is always good practice for employers to discuss with employees if they do wish them to take annual leave to see if there are alternatives and to ensure they are treated fairly.

Employers should also consider any health and safety implications for staff if this would mean they would not be able to take proper breaks when needed throughout the year.

For members in the NHS, we would expect employers to work in partnership with staff/trade unions to discuss and agree on any proposals to move away from the established ways of booking and taking annual leave.  The annual leave section on the NHS Providers website endorses this partnership approach.

The most recent NHS Staff Council Guidance (Re-issued Jan 2021) to support the management of annual leave also endorses the partnership approach.

(Last reviewed 8 Feb 2021)

My employer is refusing to let me cancel my annual leave, but I would rather take it later?

Annual leave can only be taken with the agreement of the employer and similarly in respect of cancellation. As the leave year progresses, employers may be reluctant to allow cancellation now as it will potentially create more staffing problems later. The government has legislated to relax the rules around carry-over of leave (see "How much leave can I carry over?" below), but the relaxation relates to statutory leave only and only if you are unable to take your leave due to Covid-19.

The NHS provisions are more generous than statutory allowances, and this is also true of other employers within healthcare. Therefore, this relaxation may not help if you have taken the statutory amount by the end of the year and have only the contractual leave remaining. Some employers have reached agreement with unions about more generous carry over arrangements, but members will need to check carefully and in good time.

Many people have been saving annual leave in the hope of using it later in the year, but with the uncertainties around travel abroad, the impact of quarantine and the possibilities of continued lockdowns the situation is very fluid. It is therefore important, as far as possible, to book time off and take it before the year-end to avoid losing it.

(Last reviewed 8 Feb 2021)

Am I still able to take my annual leave?

In accordance with the statutory framework, employers are able to determine when an employee takes their leave and can cancel it as long as they give appropriate notice. This is to enable them to manage the needs of the business although there are some safeguards for the employer to ensure they can take holiday, see statutory framework around booking annual leave.

Employers will generally have annual leave policies which set out local arrangements and employees should familiarise themselves with that. Recent guidance issued in the NHS reinforces the importance of time off for staff, but does also state that in exceptional circumstances employers may have to ask some staff to delay/cancel pre-booked leave and/or advise that leave cannot be booked during particular periods.

On the NHS Employer’s website it states, in relation to the cancellation of holidays: “You will need to give the individual the appropriate statutory notice and consider whether compensation is appropriate for any out of pocket expenses that the individual may sustain as a result of cancelling their holiday plans.” 

(Last reviewed  8 Feb 2021)


Can my employer force me to take annual leave during self-isolation?

It is not appropriate for employers to ask staff to use annual leave to cover a period of isolation when they are acting on public health advice. See also FAQs on pay during self-isolation and find out more about self-isolation terms and conditions in the NHS on the NHS Employers website.

(Last reviewed 8 Feb 2021)

How much leave can I carry over if I am not able to take it?

The current regulations that limit how much annual leave you can carry over have been relaxed.

The government is introducing a temporary new law allowing employees and workers to carry over up to 4 weeks’ paid holiday over a 2-year period. This law applies for any holiday the employee does not take because of coronavirus, for example if:

  • They’re self-isolating or too sick to take holiday before the end of their leave year.
  • They’ve been temporarily sent home as there’s no work (‘laid off’ or ‘put on furlough’).
  • They’ve had to continue working and could not take paid holiday.

ACAS have produced advice for employees and employers with further information on these issues. 

It is important to understand that the relaxation of leave carry over applies only to the statutory element of leave. It doesn’t affect the carry-over rules for the additional contractual leave that many employees, including NHS staff, enjoy. 

The most recent NHS Staff Council Guidance (Re-issued Jan 2021) to support the management of annual leave does urge employers to work with unions to agree local arrangements regarding the carry-over of leave.

Our advice is still for members to prioritise booking time off this leave year to avoid the risk of losing it at year-end. Time away from work to rest and recover is particularly important when service pressures are significant.

(Last reviewed  8 Feb 2021)

I can’t reach agreement with my employer on my annual leave?

Having clarified the current legal and policy framework, it is important to point out that healthcare providers and health workers are facing unprecedented pressures. Employers are already relying heavily on staff to go the extra mile and hopefully will be keen not to undermine their goodwill. 

Workers should try to reach agreement about sensible annual leave arrangements in the circumstances described above. If it isn’t possible to do this on an individual basis, it is worth speaking to your local CSP steward to see if this is a problem with an individual manager or an employer-wide issue. It may be that a mutually acceptable agreement can be reached with the involvement of the rep. If it is a wider problem, unions collectively may need to be involved. 

It wouldn’t be helpful for employers to refuse all annual leave for the duration of the outbreak for two reasons:

  • The current pressures on health workers means regular breaks are more important than ever to avoid staff suffering physical and mental health problems and going off sick.
  • On a practical level it will be difficult for all staff to take their leave entitlement within the financial year if the pandemic continues over an extended period and if all staff carry-over large amounts, this will create problems later.

In workplaces without a local rep, members would need to approach the CSP directly for individual advice.

(Last reviewed  8 Feb 2021)

We have been asked to cover the bank holiday as a normal working day. What does this mean?

Some Trusts have decided they need to provide a full level of service on bank holidays due to the current pressures. This may mean for physiotherapy services, instead of the usual emergency cover, there would be a change to providing a seven-day service giving the same level of cover each day. We would advise that discussion should take place, involving local stewards and managers, as to the appropriate level of cover needed and that a commitment is given to ensure this is a temporary arrangement only in response to the current crisis. 

If you do work on a bank holiday, your contractual rights to relevant pay enhancements under Agenda for Change terms and conditions will still apply. 

If you are being asked to work bank holidays and weekends as part of a move to a full seven day service during the pandemic, you will be entitled to unsocial hours payments as set out in Section 2 of the handbook.
If you are being asked to cover the bank holidays or weekends as overtime, then Section 3 of the handbook will apply.

All staff are entitled to the full allocation of bank holidays, so if you are asked to work a bank holiday then you will be entitled to that day back as set out in the handbook.

(Last reviewed 8 Feb 2021)

Pay and expenses in the NHS

How should part-time staff be paid for any additional hours worked above their contracted hours to support with the Covid-19 pandemic?

For Agenda for Change staff, any additional hours worked up to 37.5 per week (standard hours) will be paid at plain rate plus any applicable enhancements as set out in section 2 (England). This applies in instances where part time staff work in excess of their contracted hours, but who may not have worked in excess of 37.5 hours.

Where staff are contractually entitled to receive overtime for any hours worked in excess of 37.5 hours per week per contract, this should be paid at the correct overtime rate (paragraph 2.9, section 2 (England)).

Note that for all staff, any hours worked up to full time are pensionable, but any hours that attract overtime pay are not pensionable.

Find out more about pay terms and conditions on the NHS Employers website.

(Last reviewed  8 Feb 2021)

Should AfC staff in bands 8 and 9 receive overtime for any additional hours they work in excess of 37.5 per week?

Staff in bands 8 and 9 are not eligible to receive contractual overtime payments in line with section 3 of the NHS terms and conditions for any additional hours they work in excess of standard hours (37.5 per week). Employing organisations can, however, make a local decision to pay overtime rates for Covid-19-related activities, where they deem this to be appropriate.  There is guidance available to support local discussions in England.

In Scotland, staff in AfC bands 8 or 9 and executive and senior managers can receive overtime, at normal rates and at the discretion of the employer, where this is deemed helpful for the provision of clinical or other services necessary to the continued operation of NHS Scotland.

In Northern Ireland similar provisions to those in Scotland have been agreed.

(Last reviewed  8 Feb 2021)

What happens to High Cost Area Supplements (HCAS) payments if a staff member is temporarily reassigned to a different base due to the COVID-19 pandemic?

The expectation is that the staff member would not suffer a financial detriment as a result of being temporarily reassigned due to operational Covid-19-related decisions.

(Last reviewed  8 Feb 2021)

Are NHS staff eligible for travel expenses when they move base on a temporary basis?

Yes. Agenda for Change (AfC) staff who use their vehicle for business purposes and accrue excess miles as a result of a temporary change in base, reimbursement should be made in line with paragraph 17.17 (section 17) of the NHS terms and conditions of service (TCS) handbook.  

For non-NHS staff this will be in accordance with your employment contract or local discussions with the employer.

Find out more about travel terms and conditions on the NHS Employers website.

(Last reviewed  8 Feb 2021)

Advice for pregnant workers

I am pregnant and concerned about going into work. What is the current guidance?

Every pregnant worker should have a risk assessment with their manager, which may involve occupational health. This risk assessment should specifically address the risk presented by Covid. With changing levels of lockdown across England and in Scotland, Northern Ireland and Wales, the risk assessment should also be guided by any local changes to advice.

The CSP expects employers and occupational health to carry out a pregnancy risk assessment for all pregnant staff and to put in place any systems needed to protect you at work. This may include redeployment to another area, allocating different duties, changing hours of work and also considering working from home. The Health and Safety Executive guidance for pregnant workers includes information of what employers’ risk assessments should cover to keep you safe. 

Please do speak to your local CSP steward or safety rep if you require further support.

The department of health and social care (DHSC) updated their guidance  on the 2nd November 2021 

The guidance still advises that all pregnant women should undergo a risk assessment in the workplace and only continue to work if it is safe to do so.  However it also now advises that pregnant women who are unvaccinated at any gestation should take a more precautionary approach in light of the increased risks.  

(Last reviewed 26th November  2021)

What if there is no alternative role? Can my employer enforce unpaid leave or maternity leave?

If it is found that an employee or their pregnancy would be at risk were the employee to continue with their normal duties, the employer should provide suitable alternative work for which the employee will receive their normal rate of pay. Employers must take into account the risks to new and expectant mothers when assessing workplace hazards and remove, avoid or control the associated risk.

If a risk cannot be removed or controlled, the employee must be provided with suitable alternative work. Where this is not possible you should be suspended on full pay until your maternity leave starts.

It is normally up to you to decide when you wish to start your maternity leave. However, if you are off sick with a pregnancy-related illness or suspended on health and safety grounds in the last four weeks before your expected week of childbirth, your employer can start your maternity leave and pay automatically.

There is further guidance on maternity leave and entitlements on the Maternity Action website. Speak to your CSP Steward or Safety Rep if you are unsure about your entitlements.

(Last reviewed 26th November2021)

My partner is pregnant. What should I do?

It is really important that you try to keep yourself and those around you safe. Take all of the infection control procedures, use effective personal protective equipment as advised and maintain social distancing as far as you are able at work. According to current guidance, healthcare workers who have a pregnant family member do not need to self-isolate and can continue to work clinically. 

(Last reviewed 26th November 2021)

I am pregnant / planning to get pregnant / breastfeeding – should I get the vaccine? 

The latest advice from the Joint Committee on Vaccinations and Immunisation (JCVI) is that Covid-19 vaccines should be offered to pregnant women at the same time as the rest of the population, based on their age and clinical risk group.  

The Royal College of Obstetricians and Gynaecologists have updated guidance

The advice, published in Public Health England's green book , a clinical professional guide for vaccinators in the UK, still advises that pregnant women should discuss the risks and benefits of vaccination with their clinician, including the latest evidence on safety and which vaccines they should receive. 

Maternity action have run two webinars on the Covid-19 vaccination and pregnancy and fertility. 

(Last reviewed 26th November2021)

Further advice on coronavirus and pregnancy

Current government advice

General advice for pregnant workers

(Last reviewed  26th November 2021)

Changes to working patterns

My NHS employer is proposing changing working patterns to assist in the response to Covid-19. What should I expect?

The principle within the NHS is that with any organisational change proposals, there should be full consultation with staff and with their trade union representatives before any significant decisions are taken.  Therefore, during the current pandemic, if there are long-term proposals for change being taken forward, it is likely at the very least that more time will be required for consultation. 

It is also recognised that changes to working practices may be needed, specifically in response to Covid-19. Where these are required, it has been agreed they should be temporary and should be done with the agreement of trade unions and in consultation with staff. If there are proposals in your workplace you should contact your CSP steward.

(Last reviewed 8 Feb 2021)

    My employer has told me that my working pattern will need to change to assist in the response to Covid-19. What are my rights?

    Proposals to change the working patterns of staff both in the NHS and within other healthcare providers are a common element in the response to Covid-19. However, wherever you are employed, this does not mean that significant changes to existing working patterns should be introduced without consulting affected employees. 

    You need to look at your contract of employment to see what your contractual rights are, but as a minimum, most will impose the following contractual obligations on an employer: 

    • To not change the number of hours an individual is contracted to work.
    • To not change working patterns to a pattern that an individual cannot successfully or sustainably meet.   

    While the expectation is that staff will be flexible in terms of where and when they work during the pandemic, if someone is unable to meet the new patterns (for example due to childcare, health or disability reasons), an individual should not be forced to work them.  

    It is hoped that in most cases individual needs are supported during the consultation process and an agreement can be reached that meets the needs of the service and the individual. However, if an employer tries to impose a change, including using the threat of disciplinary action, they would potentially be in breach of their contractual obligations. 

    If you do need further advice or support contact your CSP steward, or the CSP directly if there is no steward in your workplace. 

    (Last reviewed  8 Feb 2021)

    I have agreed to a change in working patterns as part of the response to managing Covid-19. Could this be made permanent?

    If you have agreed to change your working patterns as a temporary response to Covid-19, before you formally agree and start to work the new pattern, you should do the following:

    • Ask for a written agreement that the change to working patterns will be temporary, that they will be reviewed regularly in terms of sustainability and health and safety and they will revert to your previous working patterns.  
    • Ask for a date to be given when the new working patterns will cease and your usual working pattern will be restored.  
    • Check and get written confirmation that all enhancements for working weekends or evening/night work will continue to be paid. 
    • Write to your employer and state that you will agree to the changes as a temporary response to Covid-19 changes but do not accept a permanent change to your contract. 

    If you are unable to sustainably work the new proposed patterns you should inform managers, discuss the issues through with them and reach agreement on the patterns of work you are able to do.  

    If you continue to have any concerns then do contact your CSP steward, or the CSP directly if there is no steward at your workplace. 

    (Last reviewed  8 Feb 2021)

    I work in the NHS and I am temporarily working extended hour shifts of up to 12 hours.What do I need to be aware of?

    The following NHS terms and conditions should be applied as appropriate:

    Pay for unsocial hours

    Agenda for Change pay supplements for unsocial hours must be honoured. Find out when rates of pay and when unsocial hours are applicable.


    All hours worked in excess of 37.5 hours attract applicable overtime rates.

    For Agenda for Change staff who work part time hours any additional hours worked up to 37.5 hours per week will be paid at plain rate plus any applicable enhancements.

    Annual leave 

    If you are on long-shift patterns then leave must be calculated in hours. When you apply for your leave, if it is on a day you would normally be working a long shift e.g. 10 hours, then 10 hours of paid leave hours will be deducted from your total annual leave entitlement. 

    When you return to normal working patterns, if your annual leave is normally calculated in days and half days, you may have an odd number of hours that do not equal a half or a full day. In this instance the CSP believes that your leave entitlement should be adjusted upwards to the nearest half day. 

    Pensionable pay

    Unsocial hours payments are included in your pensionable pay calculations. Overtime worked in excess of 37.5 hours is not included in pensionable pay calculations. If you are part-time all overtime hours worked up to 37.5 are included in pensionable pay.

    Sick pay calculations

    Unsocial hours and regular overtime payments are included in pay for staff who are absent with Covid-19 sickness or who are self-isolating. This is classed separately from sick pay and recorded as Covid-19 special leave. Non-Covid-19-related sickness will be paid as part of the normal Agenda for Change sick pay provisions.

    Compensatory rest

    When the relevant rest periods are not provided in line with Working Time Regulations then compensatory rest must be given. Your local policy will set out how compensatory rest is provided but at a minimum it should replace the hours of rest missed and should allow for it to be taken as soon as possible.

    (Last reviewed  8 Feb 2021)

    Changes to roles and responsibilities

    Can I refuse to treat Covid-19 patients?

    You should discuss with your line manager and follow employers protocol. This would include appropriate PPE, any exclusion criteria, any isolation protocols and other guidance. Where that does not apply you should use public health advice relevant to your region. The CSP website resource on Covid-19 has the appropriate links for these organisations. If you feel your circumstances are such that you are unable to comply with an employer's instruction to treat then you should seek further advice from your local CSP representative.

    (Last reviewed 15 Oct 2020)

    What job roles could an employer reasonably ask me to do in response to the outbreak?

    The CSP would advise that discussion and planning take place at a local level between employers and health unions, including CSP stewards, as soon as possible. As part of that planning and response, it may be reasonable to move staff from other clinical areas to support work on Covid-19. However, work should still be within the grade and professional scope of practice and/or competencies of the member of staff. For example, a physiotherapy service may be required to reduce some services such as out-patients in order to increase support to the physiotherapy respiratory service. It may also be reasonable for employers to request more flexibility around patterns and times of work.

    The NHS Staff Council statement provides further advice on the importance of agreeing any changes with individual staff, taking into account their own health and wellbeing. If changes are agreed and put in place, it is then essential that staff receive adequate training, for example on the use of equipment, and are paid appropriately for any shift work. Although the statement has been produced for the NHS, the good practice principles it outlines would be relevant in any similar environment.

    If you are concerned you are being asked to undertake a role that is not reasonable, please discuss with your local CSP steward in the first instance.

    (Last reviewed 15 Oct 2020)

    My private hospital/clinic is refusing to allow us to switch to remote consultations. What should I do?

    CSP members who are employed by private providers should continue to follow government advice at all times. From a workplace perspective, members should have full regard to their employer’s legal obligations under COSHH (Control of Substances Hazardous to Health Regulations) to adequately control the risk of exposure to hazardous substances where exposure cannot be prevented. It is difficult to see how an employer could comply with this, and comply with social distancing measures for the protection of patients and staff without utilising measures to assess patients via remote access. Remote access would be a reasonable measure in these circumstances.

    The CSP would expect and urge all employers to comply with Covid-19 Guidance for Infection and Control in Healthcare Settings, outlining a hierarchy of control measures. A blanket refusal to utilise remote working to assess risk and mitigate against it is likely to place employers in breach of their duty of care and Health and Safety obligations to staff.

    CSP members should also be mindful of their individual circumstances. If they fall within the 'vulnerable' categories for social distancing measures, 'stringent' measures are required, including options to work from home or remotely. Furthermore, under government guidance for employers and businesses on Covid-19, businesses and workplaces should encourage their employees to work at home, wherever possible.

    We encourage any CSP members affected by such blanket refusals to contact CSP ERUS for advice and support.

    Musculoskeletal services should ensure:

    • Orthopaedic and rheumatology planning must prioritise triage to enable continued referral of emergency and urgent MSK conditions to secondary care services (guidance to be provided).
    • Rehabilitation must prioritise patients who have had recent elective surgery, fractures or those with acute and/or complex needs, including carers with a focus to enable self-management.
    • All other rehabilitation work, including rehabilitation groups, is stopped with patients enabled to self-manage.
    • Where appropriate, virtual and telephone consultations are to be implemented.
    • Telephone triage is introduced to assess risks of serious musculoskeletal complications e.g. Cauda Equina syndrome.

    Ref: Covid-19 prioritisation within community health services

    (Last reviewed 15 Oct 2020)

    Do I need to be fully vaccinated against Covid-19 to deliver physiotherapy services in care homes?

    From 11 November 2021, care homes must only allow individuals who are fully vaccinated against Covid-19 (or exempt) entry into a care home. This requirement will apply to healthcare workers visiting a care home in a professional capacity. Healthcare professionals must provide the care home with satisfactory evidence that:

    • they have been vaccinated with the complete course of an authorised Covid-19 vaccine, or
    • they are exempt for medical reasons.

    Find out more about the DHSC guidance issued to care homes. NHS England and Improvement are due to issue specific guidance for healthcare professionals who visit care homes.

    (Last reviewed 11 Aug 2020)


    Support from the CSP Members Benevolent Fund

    How can the Members Benevolent Fund support CSP members experiencing financial difficulties?

    The CSP Members Benevolent Fund (MBF) is an independent registered charity that supports past and present members of the CSP who are experiencing financial hardship.

    Support can take a number of forms:

    • A financial monthly allowance.
    • A one-off grant.
    • An interest-free loan.
    • CSP membership subscription.

    The MBF can also support access to:

    • Advice on benefits, financial planning, and debt management.
    • Support for applications and tribunals.

    The coronavirus pandemic is likely to put increased financial pressure on many members of our profession. The MBF is working with their partner organisation, Auriga Services, to fast-track applications from all members experiencing hardship including those self-employed who are waiting for government financial support to come through. Read the MBF's Covid-19 update.

    (Last reviewed 15 Oct 2020)

    Your health and wellbeing

    What is available to support my health and wellbeing?

    As a physiotherapist, the current pandemic will have meant huge disruptions to how you do your job and how you function day to day. Inevitably this may be a cause of stress and anxiety.

    One of the best ways to get through this period is to turn to family, friends and colleagues to talk about what is on your mind. Right now this isn’t always going to be possible, but fortunately there is a whole raft on online support available to see you through this period.

    General health and wellbeing

    The CSP website has dedicated advice for members about maintaining good mental health and wellbeing during the pandemic.

    The taking care of your mental health resource includes top tips for managing anxiety, such as reducing your media exposure and creating a safe space for yourself at home and at work. For more, see the page on dealing with anxiety.

    Mindfulness can help you to focus on what's happening in the present moment, which can reduce anxiety and restore balance at work and at home. For more information and a list of recommended apps to access guides and resources, go to the page on mindfulness and breathing.

    The NHS Employers website also has details of support available for NHS staff. Information is provided on how to access:

    • Discounts and priority shopping times for NHS staff.
    • Wellbeing apps such as Unmind, Headspace, Sleepio and Daylight, which can help with a range of issues from anxiety and sleeplessness to ways of coping.
    • Guidance to improve physical activity.
    • A bereavement support line.
    • Advice on financial wellbeing.

    Mental health resources and helplines

    If you are in distress or need immediate help, the CSP has collated a list of useful websites and helplines.

    During the coronavirus pandemic, an NHS staff support hotline, operated by the Samaritans and free to access, is available to offer psychological support. It is open between 07:00 and 23:00 every day, while the text service is available 24/7. Call 0300 131 7000 or text FRONTLINE to 85258. For more information, visit

    NHS Employers has created a wellbeing toolkit with mental health charity Mind. To access it, go to the Mental Health at Work website.

    (Last reviewed 15 Oct 2020)

    Can I request a reduction in my hours as my family needs me?

    Yes. Right now you may need to spend more time at home caring for family members.

    Any request to change your hours will be covered by your employer’s local policies – for example, on special leave and carer's leave.

    During the pandemic, NHS Employers is encouraging employers to be as supportive as possible to employees requesting flexible working hours, although it warns that this needs to be balanced against the needs of the service at that time.

    It advises against staff being made to use up existing entitlements to annual, special or carer's leave at this time and asks that Trusts consider other ways to help staff struggling to cope with family responsibilities.

    Find more information about family leave during the coronavirus outbreak on the NHS Employers website.

    Your employer can agree informally to a temporary change in your working hours to help you get through a specified period of time. Whatever you agree, make sure it is set out clearly in writing, so that everybody knows where they stand.

    Go to our page on working hours for full guidance on your right to request flexible working.

    (Last reviewed 15 Oct 2020)

    I'm not getting adequate breaks. What can I do about it?

    Taking regular breaks is essential to your wellbeing and your ability to do your job properly. If you are not able to have regular breaks, report this to your line manager, and if the issue remains unresolved, contact your CSP representative for support. Under the Working Time Regulations, employers have a legal responsibility to ensure staff get sufficient rest and do not work excessive hours.

    As well as a minimum rest break of 20 minutes after working for six hours, you have the legal right to a daily rest break of at least 11 consecutive hours between working days. You also have the right to a weekly rest break from work of not less than 24 hours, which can be averaged out over two weeks. In addition, health and safety law states that you should be able to access drinking water and somewhere to rest, away from your immediate work environment.

    During the pandemic, you may be working longer shifts than usual. NHS Employers suggests that it may be necessary to repurpose offices into rest spaces. Guidance from the Health, Safety and Wellbeing Partnership Group (HSWPG) on safe shift working includes information on provisions for ‘power naps’ and the safety of staff driving home after long shifts.

    If you are regularly missing breaks:

    • Keep a log of the breaks you have missed.
    • Inform your line manager.
    • If you are unable to easily access drinking water or food, raise it with your line manager.
    • Fill in an incident form and ask your manager how they intend to respond.
    • Inform your CSP rep if no action is taken.

    Go to the working hours section of the CSP website for full details of your working rights.

    (Last reviewed 23 July 2021)

    I'm worried about my colleague's mental health. What should I do?

    Look out for signs that someone is struggling to cope and may need support. Don’t be afraid to ask a colleague if they are OK. Make sure you have at least 10 clear minutes to be with them and that you are able to give them your full attention. If they do open up to you, listen carefully and be respectful of what they say.

    Have sources of support to hand. During the pandemic, an NHS staff support hotline, operated by the Samaritans and free to access, is available to offer psychological support. It is open between 07:00 and 23:00 every day, while the text service is available 24/7. Call 0300 131 7000 or text FRONTLINE to 85258. For more information, visit

    For other resources and advice, go to the Frontline article on suicide awareness.

    A TUC webinar led by the Mental Health Foundation recommends that if you are concerned about a colleague, you should:

    • Suggest they contact the Samaritans straight away, either via the NHS hotline above or on 116 123.
    • Help them to call their doctor, or a trusted partner or friend.
    • If you are concerned for someone’s immediate safety, or they tell you that they plan to end their life imminently, you can call 999 and ask for the police, or take them to an A&E department.
    • If you are worried that someone is a risk to themselves, or to others, or unwell to the point that they are losing touch with reality, you have a duty of care in the workplace to see that they get help. It’s not enough to send somebody home alone.

    Go to the TUC website for the full webinar.

    Visit the Mental Health Foundation's website for further advice on supporting a colleague.

    (Last reviewed 15 Oct 2020)

    I'm feeling stressed and anxious that my employer is not doing enough to protect my health and safety at work. What can I do about it?

    Under the Health and Safety at Work Act 1974, employers have a duty of care not to place their staff in harmful situations, and the current pandemic highlights just how important this duty is. If you are unhappy about the level of protection you are receiving, raise this as soon as possible with your line manager, head of department and/or infection control department, if possible highlighting the CSP’s position on this issue. You can do this either in person or in writing. Ensure that you keep records of the process, in case they are needed for future reference.

    The CSP recommends looking at the NHS Staff Council Workplace health and safety standards, as they set out how your employer should meet their legal duties to protect you from injury and illness. The standards also highlight the importance of agreeing any changes with individual members of staff, and that individuals' health and wellbeing and levels of training should be factored in.

    If you feel your concerns have not been adequately addressed by your employer:

    • Contact your local CSP representative for support and intervention. Your CSP safety rep has rights under legislation to investigate and request remedial action.

    • If there is no CSP representative at your Trust, please call the CSP enquiries team on 020 7306 6666 - they will refer you to the Senior Negotiating Officer for your region.

    • If you have an injury (such as skin abrasions or pressure sores on the face as a result of your PPE), as well as notifying your manager and infection control lead, follow your Trust’s reporting processes for this injury, and make and keep a copy of your report.

    • If the matter is unresolved and the CSP considers there is a breach of health and safety regulations, the CSP will submit a formal complaint (following the employer's procedures).

    • If the complaint is not resolved, then the CSP will contact the Health and Safety Executive (HSE), providing required information for its assessment and intervention.

    • In circumstances where the situation is clearly urgent, the CSP may bypass the employer's complaint procedures and contact the HSE directly.

    Further advice

    (Last reviewed 15 Oct 2020)

     Working at home – your health and wellbeing

    Since lockdown began, I'm doing more remote consultations from home. I'm working long hours using my personal laptop at my kitchen table. I'm concerned about the long-term effects this is having on my body. What can I do about it?

    Sitting down for hours puts strain on your body, and you are at heightened risk of developing an injury to your hands, wrists, arms, neck and/or back if your workstation is not set up properly.

    Employers still have a duty of care to employees working at home and this includes making sure they have the appropriate health and safety arrangements. 

    Employer recommendations

    NHS Employers recommends that home workers should, where possible, have suitable equipment and a dedicated workspace. This includes the employer providing the necessary IT equipment to carry out the job and the employee having a work area with appropriate furniture where they can have confidential conversations with patients or colleagues.

    Carrying out a risk assessment

    The Health and Safety Executive (HSE) has web resources on how to protect home workers, including advice on how to complete your own basic risk assessment at home.

    It suggests these simple steps to minimise the risks of being stuck in front of a screen for long stretches of time:

    • Take regular breaks away from your screen (at least 5 minutes every hour).

    • Regularly change position and avoid awkward positions.

    • Move regularly and do stretching exercises.

    • Avoid eye fatigue by switching tasks or blinking from time to time.

    For more detailed information, go to the HSE toolbox for home workers.

    Display screen equipment

    Your employer has a duty to apply the Display Screen Equipment (DSE) Regulations 1992. The HSE has a checklist of issues to consider and lists risks factors in six areas: keyboards; mouse and trackball; display screens; software; furniture; and work environment.

    Among other issues, the workstation checklist asks you to consider:

    • The position of your keyboard. It recommends pushing the display screen further back to create more room for the keyboard, hands and wrists.

    • Whether you are supporting your wrist and forearm, for example on the desk or chair arm.

    • Adjusting your chair and ensuring that the small of your back is supported.

    • Whether your feet are comfortably flat on the floor or if you need to use a footrest.

    • If you have suitable lighting so that the room is not too bright or too dim for you to work comfortably.

    Go to the HSE website to complete the full workstation checklist.

    Rest and exercise

    You must take regular breaks throughout the day and also have whole days away from work. This is essential if you are to stay physically and mentally healthy.

    The CSP website has resources available to help you work well at home. Watch this video about exercising at your desk or try these easy working from home exercises.

    (Last reviewed 23 July 2021)

    I've been working from home for an extended period and I feel quite isolated and unsupported by my employer. What are my rights? What can I do to improve the situation? 

    Working from home can cause people to suffer from work-related stress. However, the Health and Safety Executive (HSE) warns that being away from managers and colleagues can make it difficult to get proper support.

    Your employer’s duty of care

    Your employer should be keeping in regular contact. They still have a duty of care to you when you are working from home. They may have a home working policy, although it may not be realistic for all the usual procedures to be followed at present.

    In its guidance on home working, NHS Employers recommends that line managers should be in regular contact with team members working from home either through phone calls or virtual team meetings. They should also ensure that you are included in all staff communications and that you are made aware of any support available to you. You could, for example, be offered a change of hours or duties if you are also having to juggle caring or childcare responsibilities.

    What can you do?

    Call colleagues or managers to discuss your work instead of always relying on email. If you are feeling isolated, call your line manager and talk about how you are feeling. NHS Employers also suggests that when working from home you should:

    • Have a routine with regular hours, planned in discussion with your manager.
    • Ensure that the people you live with know your work hours and when not to disturb you.
    • Maintain a healthy lifestyle, eat well and get plenty of sleep.
    • Take regular breaks from your desk and screen, and have a proper lunch break.
    • Keep active – go outside if you can or, if this is not possible, exercise or stretch at home.

    Online resources

    The CSP has a range of resources to help members maintain good mental health and wellbeing during the Covid-19 outbreak. Go to our section about taking care of your mental health.

    The CSP website also has resources available to keep you active at home. Watch this video about exercising at your desk or try these easy working from home exercises.

    MIND website offers useful advice on good mental health when working from home.

    (Last reviewed  23 July 2021)

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