Access to Medical Reports

MEDICAL REPORTS FAQs: GUIDANCE FOR NUT MEMBERS

MARCH 2013

The purpose of this document is to address some of the most common issues arising in relation to medical reports prepared by GPs, occupational health physicians and other medical professionals on behalf of employers, pension scheme trustees and health insurers. Issues not addressed in this document should be referred to your NUT regional or Wales office.

Why do employers ask for medical reports?

Teachers can be subject to medical examination in the course of their employment. This can be for a variety of perfectly valid reasons. For example, a medical report can be requested if a teacher is still at work but having problems because of a medical condition, has been off sick for some time, is preparing to return to work after a period of sickness absence, or where consideration is being given to early retirement on grounds of ill-health.

What kinds of issues often arise in relation to medical reports?

The following issues are often reported by members:

• The member disagrees with the report;
• The report contains irrelevant information;
• The member accepts that the report is accurate but does not want it sent to the employer.

What are the benefits of involving my NUT representative at an early stage?

If any of the issues highlighted above arise in your case, your NUT representative will seek to address the underlying issues, which are usually concern over the consequences of the report. Simply refusing to consent to a report being sent to your employer, pension scheme trustee or health insurer is unlikely to be in your interests. Instead the Union will seek to negotiate the most favourable outcome achievable for you, which may require a degree of compromise on your part.

Should I be provided with information before I’m asked to go for a medical assessment?

Yes. Before your employer asks you to go for a medical assessment for any purpose, they should notify you of what the assessment is for, what it will entail and to whom the medical report arising from the assessment will be disclosed. The NUT believes medical reports should go initially to your employer’s HR services and that a redacted (i.e. edited) version should be issued to your headteacher. Seek to ensure that this is the case before you consent to the disclosure of the medical report to your employer (refer to the following FAQ below ‘Is my head teacher entitled to see the report?’).

What is a medical consent form and what should it say?

Before your interview with a health adviser, you will be asked to sign a medical consent form, which will enable the adviser to obtain a record of your medical history from your GP (assuming you are being assessed by someone other than your GP). It will also enable the adviser to send a copy of the completed medical report to your employer or some other third party. The content of the consent form may vary depending on whether the person asked to assess you is a medical practitioner (e.g. a GP or occupational health physician) or not.

What if the person asked to assess me is a medical practitioner?

If the person assessing you is a medical practitioner, the consent form must inform you of your rights under the Access to Medical Reports Act 1988, namely your right:

• To refuse to consent to the release of the report;
• To see the completed report before or after it is sent to your employer or other third party;
• To withhold permission for its release pending its correction/amendment.

What if the person asked to assess me is not a medical practitioner?

If the health adviser is not a medical practitioner, your rights under the Data Protection Act 1998 will instead be engaged. When creating the report, the health adviser must be mindful of the data protection principles, which include a requirement for personal data to be accurate, adequate, relevant and not excessive. If you believe the report fails to meet these principles, you should make your objections known in writing.

Although there is no express right under the Data Protection Act to see a completed report before it is sent to your employer, the adviser has an overriding obligation to process your personal data fairly and lawfully, and this may require him or her to put your wishes in this above your employer’s wish to see the completed report as soon as possible.

What can I do to ensure that I see the report first?

To ensure that a medical report is not released to your employer or some other third party before you have seen it first, make sure that any medical consent form you are asked to sign contains a clause expressly stipulating that the report will not be disclosed without your consent and before you have seen it. If the consent form contains no such clause, make its inclusion on the form a condition of your consent i.e. agree to sign the consent form only once such a clause is added to it.

What happens if I disagree with a report?

The first step is to talk it over with the author of the report. If the author’s opinion is based on incorrect facts you should discuss the matter with him or her. Most health professionals would be happy to reconsider their opinion. However, if the facts are correct the health adviser will not be able to change their professional opinion, but should take the time to explain it to you.

In the event that you continue to disagree with the health adviser, you can either ask for a note outlining your disagreement to be attached to the report or request a second opinion before agreeing to the report being sent. You will need to make your request in writing and your employer or pension fund trustee will of course need to be notified of this.

What if the report contains irrelevant information?

Sometimes a report will contain details that are not relevant to the employer or other third party i.e. pension fund trustee. Often all that is necessary is a recommendation of fitness to work along with any information directly relevant to that. There is no need for your full medical history to be attached, nor should information about any other conditions be disclosed unless directly relevant. If you are concerned about this, you should raise it with the author of the report in the first instance.

Can I withhold consent to the release of a report?

Yes, you can if the report is covered by the Access to Medical Reports Act 1988 i.e. because it is produced by a medical practitioner. If the report is produced by someone else and is covered by the Data Protection Act 1998 then unless there was a clause in the consent form entitling you to refuse disclosure, you will not be able to withhold consent. The author will be entitled to rely on other relevant factors (e.g. the vital interests of pupils) in deciding whether or not to disclose the report to your employer.

However, you should be aware that withholding consent will not prevent your employer from acting as s/he sees fit. Your employer will still be able to act without the medical information and if you are refusing access to a medical report, your employer may not be expected to make reasonable adjustments without it. In most cases, you are likely to put yourself in a worse position by refusing to release the report.

Is my headteacher entitled to see the report?

The Union takes the view that medical reports should not be made available to head teachers and other line managers in their entirety. You are entitled during your medical assessment to be frank about the issues arising in your workplace - including the behavior of individual colleagues - which you believe may be contributing or may have contributed to your health problems. You should not be made to hide your views for fear that you will be victimized once the report is disclosed to your head teacher.

The Union accepts, however, that in the majority of cases a head teacher will require an appropriately edited version of the report highlighting, for example, any reasonable adjustments recommended by the health adviser (please refer to the FAQ below).

If you are concerned that the medical report may be made available to your head teacher without appropriate ‘redaction’ (i.e. editing) beforehand, you should make this a condition of your consent to the report being sent to your employer (please refer to the FAQ above re. medical consent forms).

What sort of information should be removed from the report before it is sent to my head teacher?

Your fullmedical history is unlikely to benecessaryforyour head teacher to adequately assess any risks that your condition may pose to you, your pupils and your colleagues. If you have a history of depression for example, it will be sufficient for the medical health adviser to indicate either that you have depression which is likely to recur unless certain adjustments to your working environment can be accommodated, or that there is nothing that can be done in his or her view to facilitate your continued employment. This will provide your head teacher with sufficient information to determine whether the adjustments recommended by the adviser (if any) can be met by the school. There is no need for your head teacher to know that you have had bouts of depression in the past since such information is likely to take the focus away from your current level of fitness and what can be done to help remove or ameliorate any limitations on your ability to teach. A decision relating to your employment should never be based on past disability.

What sort of information should normally be incorporated in a report to my head teacher?

A medical report to your head teacher should normally incorporate the following:

• When you are likely to be fit to return to work or the minimum period for which you will continue to remain absent;

• Whether you will be fit for your full teaching duties when you are able to return to work, or whether there will be some limitations, what those limitations will be and whether they will be temporary or permanent;

• Whether you have a ‘disability’ within the meaning of the Equality Act ;

• Whether your work has caused or contributed to your state of health;

• Whether your employer can do anything to assist your return to work;

• The kind of adjustments which should be considered to help keep you in employment;

• A time-frame for further review.

FURTHER ADVICE

Further advice and support is available to NUT members from their regional office or, in Wales, from the Wales Office, NUT Cymru.

Related guidance on the NUT website

NUT guidance on absence monitoring procedures

NUT guidance on teachers’ sick pay and sick leave entitlements

Medical Assessments while in employment: Guidance for NUT Members

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