Bradford Factor and Trigger Point Calculator for NHS Staff

The Bradford Factor formula, with examples

S is the number of separate absences (called spells or episodes) in the period, usually the last 52 weeks. D is the total number of days lost in those absences. Squaring S is what makes frequent short absences score so much more than one long one. These examples all have ten days lost in total:

The grid shows the score for other combinations. These are arithmetic examples only. They are not review points and do not say what any trust does.

Does the NHS use the Bradford Factor?

No national NHS policy requires it. The NHS Terms and Conditions of Service Handbook, England edition, Section 14 sets the sick pay scale and the rules for working out what is left, and paragraph 14.1 says the arrangements are supplemented by Annex 26. Annex 26 asks employers, with their staff side, to build local sickness absence procedures to a set of minimum standards: legal responsibilities, what employers and staff must each do, how absence is reported, a structured review process, and early interventions such as rehabilitation, phased return, redeployment and occupational health support. It does not set review points, and neither section mentions the Bradford Factor. The result is that each trust writes its own attendance policy. Some use a Bradford score. Others use simple triggers, for example a number of absences or days in a rolling period. Which approach to use is the trust's choice, provided it does not discriminate, which is why this tool never assumes a number.

Trigger points, and what ACAS says about them

ACAS calls them absence trigger points or review points: thresholds in an absence policy that prompt a review of someone's absence. It says they are usually based on the number of absences within a set period, or on the length of an absence. It also says there are no legal rules on how or when absence should be reviewed, so employers can choose what suits them, but they should be flexible and sensitive to individual circumstances.

• ✓ A review point starts a conversation. ACAS says reaching one should not automatically trigger disciplinary action.
• ✓ The review should be supportive. It should cover your wellbeing, the reasons for the absence and what support the employer can offer, and may involve occupational health.
• ✓ Rigid systems backfire. ACAS warns that if staff see the system as punitive, they may come back while unwell, which can increase absence.
• ✓ Employers must not discriminate. A disabled employee who needs regular treatment may reach review points faster, so the points should be adjusted, or disability and pregnancy related absence left out.

Disability, the Equality Act and your count

If your health condition counts as a disability under the Equality Act 2010, your employer must make reasonable adjustments. ACAS gives examples that relate directly to a counting system: not counting some or all disability-related sickness absence towards trigger points, raising the number of absences needed before a review, and recording disability-related absence separately. It stresses that adjustments are specific to the person, and that the employer should talk to you and may seek occupational health advice. Whether your condition is a disability is a legal question, and you do not have to settle it before you ask. Ticking an absence in the calculator shows what your figures would be without it, which you can take to a review meeting. See disability and reasonable adjustments at work and occupational health referrals.

If you have reached a review point

• ✓ Ask for your trust's sickness absence policy and find the stage you are at, who runs the meeting and what it can lead to
• ✓ Ask how the review point was calculated and which absences were counted, and ask to see the record the trust holds
• ✓ Check the record against your own diary, fit notes and payslips. Overlapping absences that are really one illness should be one absence
• ✓ Think about which absences were linked to a disability, pregnancy or your work, and raise them
• ✓ Ask about occupational health and any adjustments that would help you stay at work
• ✓ Contact your union rep before the meeting and ask to be accompanied. See NHS staff representation

Your sick pay is a separate matter from your review points. It follows the Handbook scale, so see the NHS sick pay calculator and NHS sick pay policy explained. For a meeting in prospect, the Sickness Absence Meeting Pack counts your absences from dates over a rolling 12 months and offers letters and a briefing note for your rep. If your trust moves from sickness absence towards a capability process, read the NHS capability procedure. If you are off sick long term and it may end in dismissal, read NHS ill-health dismissal and your pension.

How we calculate: method, assumptions and sources

• ✓ Score = S x S x D, where S is the number of absences you enter and D is their total days. Half days are allowed
• ✓ Compares your figures with the review points you type in. We do not supply or suggest any review point, and the examples on this page are labelled as arithmetic only
• ✓ Shows a second view with the absences you tick left out, so you can discuss them. It does not decide whether an absence is disability-related
• ✓ The what-if table adds one absence of 1, 2, 3, 5 or 10 days to your current figures. The line about one-day absences counts how many more it would take to reach the Bradford score you entered
• ✓ Does not use dates, so it cannot tell which absences fall inside your trust's rolling period. Enter only the absences your trust would count, or use the Sickness Absence Meeting Pack
• ✓ Runs entirely in your browser. Nothing is saved or sent anywhere

Sources: ACAS: absence trigger points, ACAS: disability-related absence, NHS Terms and Conditions of Service Handbook (Section 14 and Annex 26) and GOV.UK: reasons you can be dismissed.