Guidance on Referrals to the Occupational Health Nurse

Referral Procedure

Guidance on Referrals to the Occupational Health Nurse

It is not the intention that the employee should be referred to the nurse for every day illnesses such as headache, colds. However if the employee suffers from a number of such illnesses within a short period of time and their overall attendance or performance is causing concern to the manager then the manager should consider a referral to the nurse.

Managers should consider referrals to the nurse for the following reasons:

q Where an employee has an ongoing pattern of sickness but has not met the trigger for formal action.

q Where an employee has persistent absence for the same reason but has not met the trigger for formal action (an example may be an employee has a number of 1 or 2 days off sick for a headache or stomach complaint).

q Where an employee has indicated they wish to self-refer. Managers may wish to receive initial advice (although the employee may also be referred to the occupational health consultant) to assist with the management process.

q Where an employee is returning to alternative duties or as part of a phased return to work following a period of sickness. In such circumstances managers should advise the nurse of the range of duties the employee would be expected to carry out and how long the duties will continue (note normally phased returns should last a maximum of 4 weeks).

1 Where an employee commences an absence due to stress or a stress related illness.

This list is not exhaustive, managers may wish to seek advice from departmental staffing officers/absence co-ordinators or Human Resources.

Procedure

Having decided that an employee should be referred to the occupational health nurse than the manager should complete the necessary documentation and forward to the Departmental Absence Co-ordinator.

q If a manager intends to submit an employee to the nurse for a consultation then a M31 should be completed and forwarded to the departmental absence co-ordinator. This form can be printed and completed manually or can be completed online and emailed to Occupational Health Unit).

q The manager on receipt of the appointment date and time should send to the employee the Occupational Health Appointment letter.

q The nurse will complete the M29 and provide any additional advice to managers by letter. The M29 and any correspondence will be returned directly to (Managers/departmental absence co-ordinator).

q If necessary the nurse should refer the employee directly to the occupational health consultant.

Occupational Health Appointment – sample letter

I wish to inform you that an appointment has been made for you with

Occupational Health on [date and time] at [venue].

As you are aware Occupational Health works alongside the Authority in

helping to address, more effectively, the management of absence and the

service provides positive support both to you and to the organisation in

pursuing the outcome.

As part of the process you are required to attend an appointment with an

Occupational Health practitioner as noted above. Should you be unable to

attend you must advise Occupational Health on [tel no.] and your line

manager on [tel no.] at least 48 hours in advance of the appointed date and

time to discuss any alternative arrangements that may be necessary.

I enclose relevant extracts from the Local Government National Conditions of

Service for your attention which form part of your contract of employment. You

will note that the Council as your employer can require you under the terms of

your Contract of Employment to attend a medical examination.

I would also draw your attention to paragraph 10 of the Sickness Scheme

which provides that if an employee abuses the Sickness Scheme, the Council

may suspend sick pay.

If you do not attend the appointment arranged above, and fail without

reasonable excuse to contact your Line Manager in advance to make

alternative arrangements, then the Council may decide that you are abusing

the Sickness Scheme and suspend your sick pay.

The Council would also seek to recover from you the cost of the missed

appointment.

I should emphasise that I have no reason to believe that you will not attend

the appointment fixed above. I am, however required by law to notify you in

advance of the Council’s right to suspend sick pay in the event of any abuse

of the Sickness Scheme by an employee.

Should you require any further information please contact [name and tel no].

Extracts from the NJC for Local Government Services-Green Book

Sickness Scheme

Part 2 paragraph 10

“If an employee abuses the sickness scheme or is absent on account of

sickness due or attributable to deliberate conduct prejudicial to recovery or the

employee’s own misconduct or neglect or active participation in professional

sport or injury while working in the employee’s own time on their own account

for private gain or for another employer sick pay may be suspended. The

authority shall advise the employee of the grounds for suspension and the

employee shall have a right of appeal to the appropriate committee of the

authority. If the authority decide that the grounds were justified then the

employee shall forfeit the right to any further payment in respect of that period

of absence. Repeated abuse of the sickness scheme should be dealt with

under the disciplinary procedure.”

Part 3 paragraph 4

1. An employee shall not be entitled to claim sick pay under the scheme

unless:

i. notification is made immediately to the person identified for this

purpose by the authority;

ii. further notification is made as required by the authority;

iii. a doctor’s statement is submitted to the authority not later than

the eighth calendar day of absence;

iv. subsequent doctor’s statements are submitted as necessary;

v. in cases where the doctor’s statement covers a period

exceeding fourteen days or where more than one statement is

necessary, the employee must, before returning to work submit

to the authority a final statement as to fitness to resume duties;

vi. on return to work the employee signs a statement detailing the

reasons for absence for all absences up to and including seven

days.

2. An employee shall, if required by the authority at any time, submit to a

medical examination by a medical practitioner nominated by the

authority, subject to the provisions of the Access to Medical Reports

Act 1988 where applicable. Any costs associated with the examination

should be met by the employing authority. Where it is necessary to

obtain a second medical opinion, it should be provided by an

independent medical referee.

M29 Occupational Health Report

This form is to be completed by the Occupational Health Consultant

and passed to the Departmental Occupational Health Co-ordinator

Name of Employee / Mr/MrsMs/Miss
Department
Job Title / Place of Work
Personal No / Date of Birth
Date the above employee attended an interview/medical
In my opinion, the employee is suffering from a permanent incapacity which means they are unable to discharge the full duties of their post / Yes / No
If YES
(i)What is the nature of the incapacity
(ii) Is the incapacity due to an industrial injury? / Yes / No
(iii)Is ill health retirement recommended / Yes / No
(iv)If alternative employment is to be considered, what restrictions arise from the permanent incapacity
If NO
(i)What is the nature of the incapacity
(ii)A return to work date cannot be defined. However, in my view the maximum period the individual will remain incapacitated is: / weeks
months
(iii)In my opinion, the employee will be able to return to full duties on
(iv)In my opinion, the employee could undertake “Light Duties” from
(v)Duties to be avoided include:

Any additional information required as a result of the referral form should be detailed overleaf.

Signed
Occupational Health Consultant / Date
/ M31
Referral to Occupational Health Unit

Section 1-3 to be completed by Manager:

Section 1. Employee Details
Name: / Title: MrMrsMissMsOther If other please specify
D.O.B. / Employee No:
Job Title: / Post No:
Department: Adult Social ServicesChildren & Young People'sCorporate ServicesFinanceLaw, HR and Asset ManagementRegenerationTechnical Services / Section:
Workplace: / Work Tel:
Date employment commenced:
Home Address: / Tel. No
Is the employee a member of the Local Government Pension Scheme?
YES NO
Name and address of GP:
Section 2. Information required by Occupational Health Unit
Is the employee currently absent from work due to sickness?
YES NO
Please confirm date when current absence commenced:
Has the employee been made aware that a Referral to Occupational Health is to be made?
YES NO
Unless there are exceptional circumstances, employees must be informed that a referral has been requested and the reasons for referral.
Employees must be made aware that failure to attend their appointment may result in them being charged
The employee’s signature should be obtained if possible
What are the reasons for the referral?
N.B. The Employee Assistance Programme (EAP) is currently not available to Teaching and Support Staff within school
Long Term Sickness Absence
(>4 weeks) – Employee not presently at work / Employee Assistant Programme
Has the employee been advised about EAP?
Poor Attendance
Employee at work, attendance difficulties attributed to health issues / Counselling
Please contact employee to assess for counselling
Specific Health Concerns
Management concerns for an individual still at work / Physiotherapy
Please contact employee to assess for physiotherapy
Resumption after Sickness Absence
Management concerns regarding capability or safety issues. / Accident at Work
Employee has had accident at work.
Other (Please provide details)
Additional Information
Please provide any relevant information to support the above. Please include information about the health condition the employee is currently suffering from, if known and provide details of any support that has been put in place for the employee.
Please indicate what advice/information you want from the referral:
Information about the employee’s current medical condition, health and well-being.
The prospect of a return to work and a likely timeframe for doing so
The cause and appropriate support for stress related illnesses.
Whether the medical condition falls under the definition of the DDA:-
Occupational Health Physician to address the following questions:-
Does the employee have a physical or mental impairment?
If so, has it lasted for twelve months?
If not, is there a substantial possibility that it will last for twelve months
To what extent is the impairment having an adverse effect upon the ability of the employee to carry out normal day to day activities
If there is such an effect, please explain how the impairment has caused it?
If you are unable to answer any of these questions with confidence, please indicate what further information you are likely to need before being able to do so.
If any reasonable adjustments to the job role can be made under the provisions of the DDA that may assist a return to work.
Advice on the nature of duties that the employee may be able to undertake upon a return to work, including any restrictions and whether they are temporary or permanent adjustments.
Advice on whether a phased return to workplace is appropriate and if so, advice on the working hours/duration of the phased return and duties to be undertaken.
Advice on Statement of Fitness for Work (fit note)
Assessment of the employee’s fitness to continue in their substantive role.
Advice on whether temporary or permanent redeployment into another role should be considered and the nature of roles that may be considered or avoided.
Advice on whether the employee meets the criteria for ill health retirement.
Advice on whether other support/interventions are appropriate (eg physiotherapy, Employee Assistance Programme, counselling, etc)
If there are any underlying health reasons contributing to frequent short-term occasions of sickness.
Advice on the potential impact of changing job requirements/transfer to a different job
Advice where absence has been caused by an accident at work, on the nature of the injury and implications for work role.
Other (please provide details of any specific questions that you wish to ask or issues that you wish to be addressed at the referral:
Please ensure that a copy of the job description / M23 / Risk Assessment (if applicable are attached).
Job Description (M3) Yes No
Employee Specification (M23) Yes No
Risk Assessment Yes No
Has there been a previous referral to Occupational Health Yes No
If Yes, please state the date of last referral
Section 3. Job Details /Absence and Medical History
This work is:
Full-time Part-time Job-share

M311

Nature of Employee’s Duties – Please tick as appropriate
Using Display Screen Equipment / VDU Work/Keyboard / Safety Critical Work
Shift Work / Working at Heights
Night Worker / Manual Handling
Lone Worker / Working with vibrating Tools
Driving on Company Business / Working with hazardous substances
Management responsibility / High / Medium / Low / None
Tasks mostly undertaken / Seated / Standing / Mobile / Various
Physical effort req / Heavy / Medium / Light / Minimal
Work Pattern / Days / Nights / Twilights / Shifts
Driving Activities / Emergency / LGV / PSV / Other
Contact with Service Users/ Public / High / Regular / Sometimes / Never
Please provide a brief overview of the employee’s duties and attach job description and risk assessment as appropriate
Sickness Absence Record:
The absence record for the past 12 months is summarised as follows:
Sick From / Sick To / Sickness Reason

M311

Manager Details:-
Managers Name: / Manager’s Signature * :
Job Title: / Manager’s Contact Tel No:
Mobile:
Email Address: / Location/Postal Address
Most convenient contact time if telephone contact required: / Dept Charge Code:
Employee Details:-
Name of Employee: / Signature:
Absence Co-Ordinator:-
Name: / Date:

* If sending this form by email, the email itself will satisfy as the manager’s signature.

M311