STATUTORY LEAVE & HOLIDAY PAY LEDGER (HR-F025) Updates STATUTORY LEAVE & HOLIDAY PAY LEDGER Statutory Leave Request & Holiday Pay Calculation Ledger (HR-F025)SECTION 1: EMPLOYEE & CONTRACT BASELINETitle- Select -MrMrsMissMsMxOtherStaff Member NameStaff_IDOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherContract Type- Select -Fixed Hours - SalariedIrregular Hours - VariablePart-Year WorkerCurrent Accrued Leave BalanceSECTION 2: THE LEAVE REQUEST & HOLIDAY PAY CALCULATION FRAMEWORKType of Leave Requested- Select -Statutory Annual Leave (Paid)Statutory Carer’s Leave (Unpaid - Maximum 1 week per 12 months)Statutory Neonatal Care LeaveCompassionate / Bereavement LeaveUnpaid Leave / Career Break (Requires Director Approval)Time Off In Lieu (TOIL)Reclaiming LeaveFirst Day of AbsenceDate Returning to Work (First Available Shift)Total Number of Working Days / Hours RequestedCalculation Method Applied (HR/Payroll to Complete)- Select -Fixed Hours StaffIrregular Hours (Accrual Method)Irregular Hours (Rolled-Up Method)Fixed Hours with Variable Pay (e.g., regular overtime/commission)Payroll System Integration Check- Select -I confirm the correct statutory calculation framework above has been actively applied to this employee's profile in the payroll software.PendingSECTION 3: CONTINUITY OF CARE & ROTA MITIGATION (Safe QS6)Primary Worker Status: Does this employee act as the 'Primary/Key Worker' for any service users with highly complex or specific needs (e.g., advanced dementia, challenging behaviours)?- Select -YesNoN/ADelegation Transfer (HR-F041): Does the employee hold specific Delegated Healthcare Tasks (e.g., PEG, Stoma) for the service users they are scheduled to visit during this leave?- Select -YesNoN/ANamed Cover Staff Verification- Select -Cover staff identified and system confirms they hold active, validated HR-F041 competency sign-offs for these specific clinical tasks and Service Users.Cover staff identified, but HR-F041 competency is pending; urgent external professional assessment requested.Unable to source competent cover internally; urgent handover to external NHS District Nursing team required for this period.Digital Handover Protocol- Select -ConfirmedNot ApplicableSECTION 4: FATIGUE MANAGEMENT, STATUTORY CARRY-OVER, AUTHORISATION & SYSTEM INTEGRATIONIs the employee requesting to carry over statutory leave into the next leave year?- Select -No.Yes - Up to 4 weeks (WTD) carry-over due to statutory Maternity/Family Leave.Yes - Up to 4 weeks (WTD) carry-over due to Long-Term Sickness (Must be taken within 18 months).Yes - Up to 1.6 weeks (UK Domestic) carry-over subject to written management agreement.Employee Declaration- Select -I confirm the dates requested. I understand that leave is not granted until formally authorised by management and no financial commitments (e.g., booking flights) should be made prior to authorisation.Care Coordinator Review- Select -I confirm adequate cover is available to maintain safe staffing levels, clinical competency parameters, and continuity of care during this absence.Registered Manager / HR Authorisation- Select -Leave formally approved. Rota system updated to 'Leave' status to hard-block deployment. Payroll notified of the correct statutory calculation framework.Registered Manager / HR Officer NameNext Review Date:SUBMIT FORM
