Based on HSE HR Circular 024/2023, Department of Health Circular 14/2023, the Public Service Management (Sick Leave) Regulations 2014 (S.I. No. 124 of 2014), and HSE Guidelines on Terms and Conditions of Employment (September 2024).
ℹ️ Quick answer: The HSE sick leave policy sets out how paid sick leave works for HSE and public healthcare employees in Ireland. Depending on your situation, you may qualify for: The current scheme came into effect on 4 September 2023 under HSE HR Circular 024/2023. |
HSE Sick Leave: Complete Overview at a Glance
Leave type | Limit | Pay rate | Key condition |
| Self-certified | 7 days in 24 months | Normal pay | No cert needed (up to 2 consecutive days) |
| Ordinary sick leave – full pay | 92 days in rolling 12 months | Full pay | GP cert required after 2 consecutive days |
| Ordinary sick leave – half pay | 91 days in rolling 12 months (after full pay) | 50% of salary | Within overall 183-day rolling 4-year limit |
| TRR (ordinary illness) | 547 days in rolling 4 years | 37.5% of salary | Minimum 2 years’ service; reasonable prospect of return |
| CIP – full pay | 183 days (6 months) | Full pay | Occupational Health assessment; serious medical condition |
| CIP – half pay | 182 days (6 months) following CIP full pay | 50% of salary | Continues under CIP approval |
| TRR under CIP | 365 days initially, extendable by 730 days (max 1,095 total) | 37.5% of salary | After CIP full/half pay exhausted; reviewed every 6 months |
Legal Basis and Who the Policy Applies To
The HSE sick leave policy sits within the Public Service Sick Leave Scheme, which applies to all relevant public service employees under the Public Service Management (Sick Leave) Regulations 2014 (S.I. No. 124 of 2014). The scheme was revised with effect from 4 September 2023 under HSE HR Circular 024/2023 and Department of Health Circular 14/2023.
The policy applies to:
- Permanent HSE employees
- Fixed-term employees
- Public healthcare workers covered by the Public Service Sick Leave Scheme
- Certain trainees, students, and interns (on a pro rata basis during probation/training)
Employees on continuous sick leave before 4 September 2023 remain under the transitional arrangements (the sick leave conditions in place when their absence began) until that period of absence ends. After they return to work, the revised 2023 scheme applies to any new absence.
ℹ️ HSE HR Helpdesk: For queries about your individual entitlements, contact the National HR Helpdesk on 1800 444 925 or email [email protected]. For HR/Employee Relations Department queries, contact National Employee Relations, HR Directorate, 63-64 Adelaide Road, Dublin 2 | Tel: 01 662 6966 | Email: [email protected] |
Self-Certified Sick Leave in the HSE
HSE employees may take self-certified sick leave without a GP medical certificate, subject to a maximum of 7 days in a rolling 24-month period (pro rata for part-time employees).
For absences lasting up to 2 consecutive working days, employees do not need to provide a GP cert unless management specifically requests one. This is a practical accommodation – requiring a GP visit for a 1-day stomach bug imposes costs and delays on both the employee and the GP system.
Conditions that apply to self-certified leave:
- Notification requirement: Contact your line manager by phone before 10:00am on the first day of absence. Shift workers should give at least one hour’s notice before the start of their shift.
- Return-to-work form: On returning to work, complete a self-certification sickness absence form with your manager.
- Rolling period: The 24-month period looks back from the day before the current absence begins – not a fixed calendar period.
- Once the 7-day limit is exhausted: all subsequent absences require a medical certificate, regardless of duration.
Read our detailed guide to self-certified sick leave in Ireland.
| ⚠️ Self-certified leave cannot be used during annual leave. If you become ill during annual leave, a GP medical certificate is required – self-certification does not apply. |
GP-Certified Sick Leave in the HSE
If you are absent for more than 2 consecutive working days, you must provide a medical certificate (sick cert) from your GP confirming you are unfit to work. This is known as medically certified sick leave.
A valid HSE sick cert normally includes:
- The date your illness started
- The expected duration of absence
- Confirmation that you are not fit for work
Submit medical certificates to management promptly. Delays in submission can hold up payroll processing and may require retrospective corrections.
Online medical certificates from IMC-registered doctors are accepted in many cases. Check your specific HR guidance if you are unsure whether online certification is appropriate for your absence.
You may also want to read our guide on online sick certs in Ireland.
Ordinary Sick Leave Entitlements: The Day Counts
Under the revised 2023 Public Service Sick Leave Scheme, the maximum paid sick leave available under ordinary illness provisions is:
| Pay rate | Maximum days |
| Full pay | Up to 92 calendar days in a rolling 12-month period |
| Half pay | Up to 91 calendar days in a rolling 12-month period (after full pay is exhausted) |
| Overall ordinary limit | 183 days total in a rolling 4-year period (full pay + half pay combined) |
How the rolling periods work: To calculate your remaining entitlement, the HSE counts backwards from the day before your current absence begins. An employee’s entitlement is established at the start of the absence period and is not recalculated during that absence.
All periods of full pay, half pay, and TRR are included in the look-back calculation. Unpaid sick leave days are not included.
| ⚠️ Pension impact: Unpaid sick leave and TRR absences are non-pensionable service and do not reckon towards pension calculations. Annual leave, however, continues to accrue during TRR in accordance with the Organisation of Working Time Act 1997. |
Waiting Days: The First 3 Days
Most new sickness absences at the HSE include a 3-day unpaid waiting period before sick pay begins.
Which Days Count as Waiting Days?
Waiting days can include:
- Saturdays and Sundays
- Rest days
- Workplace closure days
However, there is an important nuance for weekends: rest periods and weekends are only counted when the absence spans both before and after them. In other words, the employee must be absent on sick leave both before the weekend and after it for the weekend to count as waiting days.
Example: if an employee calls in sick on Monday and returns on Wednesday, Saturday and Sunday are not waiting days. If they are sick from Friday through to the following Monday, the weekend is included in the waiting day count.
When Do Waiting Days Not Apply?
- When you move directly from full pay or half pay to TRR during the same continuous illness
- When you return from CIP sick leave and later use remaining CIP leave during the protective year
Temporary Rehabilitation Remuneration (TRR)
TRR is a reduced-rate payment that may apply when an employee has exhausted their ordinary full-pay and half-pay sick leave limits. It is designed to support employees who are recovering from longer-term illness and who have a reasonable prospect of returning to work.
TRR Eligibility Criteria
- Minimum service: at least 2 years of service in the public service.
- Reasonable prospect of return: there must be a genuine likelihood that you will return to work to deliver regular and effective service.
- Multiple employment periods: if you have had more than one period of public service employment, these can be aggregated toward the 2-year requirement, provided there are no breaks in service exceeding 26 weeks.
- TRR is not automatic: it is a management decision, and HR must approve it on a case-by-case basis.
TRR Rate and Duration (Ordinary Illness)
| TRR element | Detail |
| Rate | 37.5% of basic salary plus pensionable allowances and certain unsocial hours payments |
| What the 37.5% includes | Any DSP Illness Benefit you receive is counted as part of the 37.5% – it does not stack on top of it |
| Maximum duration (ordinary illness) | 547 days in a rolling 4-year period |
| Pension | TRR periods are non-pensionable service |
| Annual leave accrual | Annual leave continues to accrue during TRR under the Organisation of Working Time Act 1997 |
| ⚠️ TRR and Illness Benefit: TRR is inclusive of any Illness Benefit payable from the DSP. It does not add on top of it. Your net take-home is the 37.5% figure, with any Illness Benefit counted within it. Employees must apply for Illness Benefit correctly and inform management of the payment rate so payroll can process the offset accurately. |
TRR Top-Up (Transitional Period: 4 September 2023 to 3 September 2028)
A TRR top-up arrangement applies during a 5-year transitional period. It benefits employees who would have qualified for a higher TRR payment under pre-2023 pension scheme ill-health retirement provisions.
To qualify for the top-up:
- Minimum 20 years of full-time public service employment is required.
- The top-up represents the difference between the standard 37.5% TRR rate and the higher amount that would have applied under pension scheme rules.
- Application form: complete TRR Top-Up Payment Form HR118 and submit to the VHSS Unit in Manorhamilton for verification.
- Pre-4 September 2023 absent employees: if you were already on sick leave when the new scheme commenced, use form HR114 for TRR applications.
Critical Illness Protocol (CIP)
The Critical Illness Protocol provides significantly extended paid sick leave for employees with serious medical conditions. It is one of the most important aspects of the HSE sick leave policy – and one of the least understood.
CIP does not apply automatically. It requires a management decision, supported by an Occupational Health assessment.
CIP Sick Leave Limits
| Stage | Duration / limit |
| Full pay | Up to 183 days (6 months) |
| Half pay | Up to 182 days (6 months) following full pay |
| Overall CIP limit | 365 days of critical illness leave in any rolling 4-year period |
| TRR after CIP limits exhausted | 365 days initially, extendable by a further 730 days (maximum 1,095 days), reviewed every 6 months |
Who Decides Whether CIP Applies?
The decision to award CIP is a management decision. Employees applying for CIP must attend Occupational Health, who will carry out a medical assessment. Management and HR use that assessment, alongside other criteria, to decide whether CIP is granted.
Employees should ordinarily be under the current or recent clinical care of a medical consultant (as an inpatient or outpatient) – not just a GP. The treating consultant’s specialism must be relevant to the condition. Occupational Health may, in some cases, accept a presumptive diagnosis from the treating doctor.
CIP may be granted even where the full medical criteria are not met, in exceptional circumstances at management discretion.
Conditions That Typically Qualify for CIP
- Acute life-threatening physical illness
- Chronic progressive illness affecting life expectancy
- Major physical trauma requiring urgent surgical treatment
- In-patient or day-hospital care lasting 10 or more consecutive days
- Pregnancy-related or assisted-pregnancy illness involving 2 or more consecutive inpatient days
Common Conditions Approved Under CIP in Practice
While each case is assessed individually, conditions commonly approved under CIP include:
- Cancer (chemotherapy, radiotherapy, or post-surgery recovery)
- Serious cardiac conditions requiring surgery or intensive treatment
- Major organ failure
- Severe neurological conditions
- Serious mental health conditions requiring inpatient care
| ✅ The protective year after critical illness: When you return to work following CIP absence, you have a 1-year protective period. During this year, you may use any remaining CIP leave for subsequent non-critical illnesses or injuries – even if they are unrelated to the original critical illness. There is still an overall limit of 365 days of critical illness leave in any rolling 4-year period. |
How Weekends and Rest Days Are Counted in HSE Sick Leave
The treatment of weekends under the HSE scheme is a common source of confusion. The official rule in HSE HR Circular 024/2023 and DoH Circular 14/2023 is:
A Saturday, Sunday, or other rest day is only counted as a day of sick leave when the absence spans the rest period – i.e. the employee must be absent on sick leave both before and after the weekend/rest day. Example 1: Employee sick Monday, recovers by Thursday, returns Friday. Saturday and Sunday are not counted. Example 2: Employee sick on Friday, remains sick through to the following Monday. Saturday and Sunday are both counted within the continuous absence period. |
This rule affects waiting day calculations, the rolling day counts for full pay and half pay limits, and CIP/TRR duration calculations.
How HSE Sick Pay Interacts With DSP Payments
HSE sick pay at full pay, half pay, and TRR (at 37.5%) is inclusive of any Illness Benefit or Occupational Injury Benefit payable from the Department of Social Protection. These DSP payments are not a bonus on top of HSE sick pay – they are counted as part of it.
What employees must do when receiving DSP payments:
- Apply to DSP correctly and within the required timeframes
- Submit all required documentation to DSP
- Inform management of the DSP payment rate so HSE payroll can calculate the correct net payment
Failure to follow these steps can cause payroll errors that take time to correct and may result in overpayments that must be repaid.
You can also read our guides on Illness Benefit in Ireland, how to apply for Illness Benefit, and Illness Benefit payment rates.
Returning to Work After HSE Sick Leave
When returning to work after certified sick leave, you may be required to attend a return-to-work interview with your line manager. This is standard procedure and is not disciplinary in nature. Its purpose is to support a safe return, identify any adjustments needed, and review the circumstances of the absence.
Phased Return to Work
A phased return – working reduced hours gradually building up to full time – can be arranged with management agreement. Occupational Health may also recommend a phased return if they consider an immediate full return inappropriate given your condition.
During a phased return, sick pay entitlements may apply to the hours not worked, depending on your remaining sick leave balance. Confirm the arrangement in writing with HR before starting back.
Illness or Injury at Work: Separate Schemes
If your illness or injury occurs at work, separate occupational illness and injury schemes may apply. These are distinct from the ordinary sick leave scheme and may provide different protections and pay.
| Situation | Potentially applicable scheme |
| Workplace injury | HSE Occupational Injury scheme |
| Occupational illness | HSE Occupational Illness provisions |
| Assault at work | HSE Physical Assault Scheme (appeals board: management and union nominee) |
| Occupational Injury Benefit (DSP) | Separate DSP claim; rate may affect TRR calculation |
For appeals under the Physical Assault Scheme, submit in writing to: HSE National Employee Relations, 63-64 Adelaide Road, Dublin 2. Email: [email protected] for appropriate contact details.
Pregnancy-Related Sick Leave
Employees with certified pregnancy-related illnesses take sick leave under the normal HSE sick leave scheme. If full-pay and half-pay sick leave are exhausted before maternity leave starts, a special half-pay extension may be available.
In some circumstances, pregnancy-related sick leave used before maternity leave begins may later be restored at half pay, subject to normal sick leave limits. The mechanics are case-specific – speak with HR if this situation applies to you.
Under the CIP criteria, pregnancy-related or assisted-pregnancy-related illness involving 2 or more consecutive inpatient days may qualify for the extended sick leave provisions of the Critical Illness Protocol.
Sick Leave During Probation and Training
Employees on probation or training periods generally receive sick leave entitlements on a pro rata basis, scaled to the length of their probation or training contract.
Example: for a 12-month probation period:
- 23 days on full pay
- 23 days on half pay
These pro rata rules do not apply if you are serving probation following a promotion, provided you successfully completed your original new-entrant probation period. In that case, normal HSE sick leave limits apply.
Specific rules apply to trainee and student grades. For example, undergraduate nursing and midwifery students undertaking the 36-week year 4 internship are entitled to 16 days at full pay and 16 days at half pay.
Frequently Asked Questions (FAQs)
Under ordinary illness provisions: up to 92 days on full pay and 91 days on half pay, within an overall limit of 183 days in a rolling 4-year period. Under the Critical Illness Protocol, these limits are significantly extended.
For absences of 1-2 consecutive working days, self-certification applies unless management requests a cert. For absences of 3 or more consecutive days, a GP cert is required.
In many cases, yes – provided the certificate is issued by an IMC-registered doctor following a proper clinical assessment. Check your specific HR guidance to confirm what is accepted for your grade and absence type.
Most new sickness absences include a 3-day unpaid waiting period before sick pay begins. Waiting days can include weekends, rest days, and workplace closure days, but weekends are only counted when the absence spans both before and after them.
Annual leave can be converted to sick leave if you become ill during annual leave and provide a valid GP medical certificate. Self-certified leave cannot be used during annual leave.
You may potentially qualify for TRR (if you have 2 years’ service and a reasonable prospect of return), apply for CIP if your condition is serious, apply for DSP Illness Benefit, or be reviewed by Occupational Health for alternative arrangements including phased return or ill-health retirement.
In most cases, waiting days remain unpaid. An exception applies when you move directly from full or half pay to TRR within the same continuous illness, or when remaining CIP leave is used during the protective year.
No. TRR is paid at 37.5% of salary inclusive of any DSP Illness Benefit. You must apply for Illness Benefit separately and inform HSE payroll of the payment rate, so the correct net amount can be calculated.
Yes. The rolling period calculations look back from the start of each absence. Multiple periods of absence across different dates are all counted against the same rolling period limits. The entitlement is established at the start of each absence and is not recalculated during that period.
⚠️ Disclaimer: This article is for informational purposes only and does not replace official HSE guidance, HR advice, or professional legal or medical advice. Policies may change. For queries specific to your situation, contact the HSE National HR Helpdesk on 1800 444 925 or [email protected], or speak with your HR or Employee Relations team.
