What is an occupational health assessment?
An employee may be referred to occupational health for an independent occupational health assessment (also known as sickness absence referral, return to work assessment or management referral) where there is concern about their health, performance (where there may be health implications) or level of sickness absence.
The employee’s General Practitioner (GP), whilst understanding the health issues and their patient, may not understand the work processes or the hazards present in the workplace. More importantly though is the patient/Doctor relationship which is primarily based on the GP being supportive of their patient, making decisions about employment difficult due to conflicting interests between the work and health.
An independent occupational health assessment, by a qualified nurse or doctor who has an additional qualification and experience in occupational health, is a way of obtaining a work-focused, objective and medically competent opinion. This is particularly important for high-risk work, and long-term capability is in question, or the situation is complicated with domestic issues and/or conflicts with management.
When should we organise an occupational health assessment appointment?
An occupational health assessment can be organised at any time including where:
- There is concern that the employee may have work related health problems or that their health is being aggravated by work tasks
- There are difficulties coping on return after being absent, following a serious illness or injury or due to a disability
- There may be underlying ill health or disability contributing to performance issues
- There is long term or frequent sickness absence
The assessment can take place via secure video link, telephone, or face to face; it depends on the nature of the health issue. For example, many conditions can be discussed over secure video link.
How do we make a referral to occupational health?
- The reason for the referral must be discussed with the employee, and where possible, their signed consent obtained. If it is not possible for the employee to sign the consent form, but they have agreed to the referral, e.g., if they are absent from work, a copy should be sent to the employee at the same time as confidentially forwarding it to occupational health.
- Discussion and agreement with the employee regarding who else may require access to the occupational health report once received should take place prior to the referral.
- An occupational health Assessment Referral Form, provided by MCL Medics’ booking team, must be completed by the referring manager, and returned to the booking team.
- Once the completed referral form is received, the appointment details are sent to the employee. If you would like the appointment details to be routed through you, then it is essential that you let us know.
How do we get the best from an occupational health assessment referral?
To get the best advice from the occupational health clinician, the referral will need to include enough detail for an appropriate assessment to be made. This will help the clinician understand the nature of the employee’s work, advise whether any aspects might be affecting their health and consider any modifications or adjustments which may enable the employee to safely do their job.
Completion of the occupational health referral form provides the clinician with essential information, and you should ensure that you include:
- Information on the problem and how it is affecting the employee’s work/duties
- The questions you would like answered
- A clear description of the employee’s job and the main tasks within this. Different jobs require different capabilities. For example, think of the physical requirements needed to be a scaffolder as opposed to a receptionist?
- A copy of the employee’s job description
Our occupational health assessment referral form has been designed to assist in providing the information necessary for the clinician to carry out a comprehensive occupational health assessment and communicate the required information back to the referring manager, with a copy to the employee.
Can the employee see the referral form?
All documentation connected with the case including the referral form will have to be copied to the employee if they request to see them. This is both correct under the GDPR subject access request process and under GMC medical/ethics guidelines. It is good practice for the employee to know (and/or even see a copy) what is included in the referral form ahead of the consultation.
What information should NOT be in a referral form?
Specific contractual/non-medical questions (for example, whether an employee should be dismissed) should not be included in the referral form. Occupational health clinicians provide advice in relation to health issues within the workplace, but the contractual implications of these health issues are a matter for management.
MCL medics will not provide clarification on policy, procedures and processes of your business practices:
- Questions, such as, ‘Should this employee now be taken down the capability/disciplinary
- route?’ would be better phrased: ‘Are there any medical considerations that need to be taken into account should the business decide to follow a capability/disciplinary route?’
- Anything that you would not be happy for us to share with the employee
Is an occupational health assessment independent?
The function of an occupational health assessment is to offer the employer appropriate advice and to address any specific management concerns raised at the referral stage. The assessment also provides the employee referred an opportunity to discuss any health concerns in confidence with an occupational health clinician and receive advice on what they can do to improve their health and/or attendance at work.
The occupational health clinician will conduct the assessment and produce a comprehensive, unbiased report.
The assessment can provide a clear opinion on:
- Whether the employee has an underlying health condition or disability that may affect attendance or performance at work, and if so, the likely effects on future attendance/performance
- Measures to support the employee during their absence
- Whether time off work will be required for appointments/treatments
- When the employee may be likely to return to work
- Recommendations on how to assist over a return to work
- Advice regarding any workplace restrictions/adaptations
- Whether the disability provision of the Equality Act is likely to apply
This should enable the employer to deal with any problems in a fair, consistent manner balancing the needs of the employee with work requirements.
Any recommendations on adjustments to duties etc are advisory only. It is for management to decide whether or not to implement them.
Can we talk to the clinician before the consultation?
The general approach MCL Medics takes is that anything significant that needs to be covered in a consultation must be in writing and the employee should be aware of anything included. Our clinicians cannot introduce random information that is not documented and so anything verbally discussed cannot be used in the consultation and therefore we generally discourage verbal exchanges of information.
Will the report I receive be one sided?
The occupational health clinician will conduct the assessment and produce the report in an impartial manner. However, the clinician will not have a full knowledge of the background details or circumstances and will have to rely upon the information provided beforehand, observations during the consultation/examination and what the employee tells them.
The employee will provide their own perspective during the consultation, so it is therefore very important for the referring manager to provide sufficient and clear information during the referral process, so the clinician has a balanced viewpoint.
Reports concentrate on the effects of the health problems on work. Medical details are not usually disclosed unless necessary for managing the employee in their work and when they have given consent for disclosure.
Recommendations on variation to tasks or hours worked will usually be discussed with the line manager before a report is issued.
In line with the General Medical Council guidance, prior to the report being issued, the employee will be offered the opportunity to view a draft copy of the occupational health assessment report. Further consent will be obtained from the employee by the occupational health clinician and that consent can be withdrawn at any stage of the process.
Occupational health records are maintained to the same high standard of confidentiality as hospital or GP medical records, in accordance with the Data Protection Act (DPA) 1998. An employee’s occupational health record will not be disclosed to anyone else outside occupational health without the employee’s informed consent.
Does the occupational health clinician have access to medical records?
The clinician only has access to what is available and provided at the referral stage or anything the employee may take along to the consultation, for example, details of any medications they’re taking (name and dosage), names and addresses of any treating doctors and/or specialists, etc.
In some instances, it may be necessary to request further information from the employee’s GP and/or hospital specialist. If this is the case the reason will be explained to the employee, and they will be asked to sign a consent form allowing occupational health to approach their GP and/or hospital specialist for this information. Additional clinician time and cost would be incurred in this instance.
Under the Access to Medical Reports Act 1988 the employee has a right to see this report before it is sent to occupational health. Sometimes and with consent, the occupational health clinician may write to the employee’s GP giving information about the outcome of the occupational health assessment. This can be particularly helpful where there are clinical findings or work arrangements that the occupational health clinician believes their GP should be informed of.
Do we have to follow the clinician’s recommendations?
Recommendations in the report are not binding. It is for the employer to assess whether the recommendations are practical and reasonable to implement for their organisation and circumstances. However, the advice is given by an experienced occupational health clinician and an employer should give them serious consideration.
Is the clinician’s opinion on whether the Equality Act provisions on disability binding?
The clinician will provide an opinion on whether the Equality Act provisions will apply. However, it is a legal decision, and not a medical decision, made in a tribunal or higher court whether the Disability provisions of the Act apply or not. Legal decision would almost certainly have considered any medical opinions offered and therefore the clinician’s opinion should count in this respect.
Does an employee have to attend an occupational health assessment appointment?
An employee cannot be forced to attend an occupational health assessment. It is therefore very important to explain in full to and engage your employee in why you wish to refer them for an occupational health assessment and what you want to achieve by doing so.
What can we do if an employee refuses to attend an occupational health assessment?
We would recommend that you try your best to encourage your employee to attend. Thereafter you need to explain clearly that any management decisions you will be making will therefore have to be made without expert occupational health clinician advice.
It is also advisable that this communication is clearly documented.
What happens next?
Once you have received the report, you should arrange to discuss the content of report and any recommendations that have been made, with the employee. You can then decide what to action and agree on processes that will prompt a return-to-work programme that is in the best interests of both the employee and the employer.
Approaching an occupational health assessment positively helps to ensure that it will benefit both employer and employee.
We can assist you today and complete all your occupational health assessment requirements.