Using the Occupational Health Report
A copy of the occupational health (OH) report prepared for management will be provided to the employee. The report for management is for the manager to consider and to take action on as they feel appropriate in the circumstances of the case, taking into account both any OH advice provided, as well as other operational or other circumstances known to the manager. OH’s role is not to make management decisions, so we will provide information, opinions and advice, to which the manager should give careful consideration, before making decisions about the case.
What might the report contain?
OH reports are individually prepared but follow a common pattern. They may include, to give some examples, a summary of the presenting situation, answers to specific questions asked on the referral form, an opinion about fitness to work, and advice about potential adjustments to enable the employee to either stay in work or make an earlier return from absence. Please read the report carefully. It may well include reference to information or opinion offered by the employee, and reported to you as what was discussed. That sort of information should not be confused with the advice or opinion offered by the OH adviser.
Will I have access to medical information?
Our OH staff are bound by strict codes of medical confidentiality and will not discuss personal medical information without the prior consent of the employee. Detailed clinical information and specific diagnoses may be withheld, but such information is rarely central to informed advice to managers on the workplace implications of the employee’s health and well-being.
What might I have asked to get the most from the OH referral?
The written report can usually cover matters such as:
- An estimate of the likely duration of the absence or impairment
- An opinion on fitness to undertake the full or a more limited range of duties
- Possible recommendations on further medical opinion or OH review
- Reference to disability or other impairment likely to affect their work role (functional limitations rather than clinical details)
Though OH cannot guarantee to answer all questions, it is recommended that the referring manager gives careful thought to what advice they wish to receiveand can reasonably expect OH to provide, and phrase questions on the referral form accordingly. Bear in mind that unless you give relevant information on the employee’s role and working environment, the OH advisor is likely only to have the information provided by the employee on the work context when framing the report. The information you should consider providing to OH includes:
Relevant employment details, such as the nature of the working environment, working hours, specific workplace pressures or current or recent challenges the employee may be facing
Details of the employee’s absence record and any known medical information impacting on this or otherwise on their performance at work
Any management concerns that may be relevant, such as a decline in work performance and any discussion there has been with the employee on these concerns
Concise information of this sort should enable the OH adviser to give a more balanced opinion following the consultation with the employee. Managers may call the OH helpline prior to submitting the referral form.
‘Typical’ referral questions include, by way of example:
- Is there an underlying or substantive health problem that affects attendance/performance at work/fitness to work?
- When is the employee likely to be able to return to work?
- What health related adjustments could be considered to enable a more effective performance at work?
- Is the employee likely to provide a regular and effective service on return to work?
- Would a temporary adjustment to working arrangements assist a return to work?
What if the employee doesn’t give their consent to the release of an OH or medical report?
You will be informed in writing if this is the case. You will have to explain to the employee that you will then only be able to proceed on the basis of the information available to you, however limited that is. You may wish to seek further advice from HR.
What should I do if the report doesn’t give all the information I had hoped for?
Sometimes the medical situation or prognosis is unclear, or the opinion/advice sought is actually a management rather than a medical issue. We have a helpline available for managers and it is recommended that if you are unsure after receiving an OH report, you give us a call and one of our OH advisors will be happy to discuss the report and may be able to provide clarification. Remember, OH advice is just that, advice. The manager will then consider the possible application of this advice in the light of the operating context of the service.
What if the problem is not primarily a medical one?
The OH report may advise that the employee presents as having workplace, interpersonal or other ‘managerial’ issues outside of the OH remit. Such workplace issues may generate health related symptoms, but interventions that may ameliorate or eliminate such health issues may need management intervention where more relevant advice could be obtained from HR. Such advice may be along the lines of a statement like ‘The impairment to effective working appears to be more related to workplace concerns than medical issues. I am not optimistic that...... will return to work or their symptoms will resolve unless management issues are addressed’. OH can only advise on the medical aspects of the presented case and any functional limitations arising from any medical condition.
Disability
The OH report may advise that the employee could be regarded as having a long term condition that potentially brings them within the scope of the Equality Act 2010 and that adjustments may need to be considered in the light of this. Decisions on ‘reasonable adjustments’ for employees with a disability are ultimately legal and managerial rather than medical. HR may be able to offer additional advice if the manager needs it.
Recommendations on work adjustments
The OH adviser may include reference in the report to the views of the employee on work circumstances but such information will be clearly differentiated from any advice from the OH adviser. Such OH advice could cover timescales, potential phased returns to work, workplace adjustments or future review. OH cannot and will not decide or dictate work adjustments, only recommend steps that would be medically appropriate and explain the reasons why. The manager will need to put such advice together with their own knowledge of the work circumstances and context to form a balanced view of what is possible and desirable, from the perspective of both the employee’s well being and of service requirements.
Next steps
In most cases the manager will want to discuss the OH advice and information with the employee concerned as part of the process of assisting either a return to work or increasing the employee’s ability to stay at work and perform their job effectively. Realistic timeframes, taking into account any OH advice and the service’s operational context, can be proposed for action steps or case review. Reference to the organisation’s Absence Management and other health and well being policies should guide this follow up action. Any rehabilitation plan, phased return or workplace adjustment should be flexible enough to cope with changes in the employee’s condition and alterations in work circumstances.
The manager may wish in some cases to take advice from HR. In exceptionally complicated or challenging situations the OH adviser may suggest a ‘case conference’ with participants such as the manager (of course), anOH adviser, HR and the employee or, very exceptionally, the employee’s representative. Such a meeting might provide an opportunity to identify and explore support mechanisms and options for a resolution.
Re-referral to OH
Sometimes an initial OH referral and report will not enable a full resolution of a medical situation’s work impact. Particularly in cases of continuing or additional sickness absence, the manager may wish to consider a further referral to OH in due course. In so doing, however, consideration should be given to any previous information and advice received from OH and the likelihood of any significant change in the circumstances of the case. A further referral form should include any information known to the manager in respect of alterations to the employee’s circumstances and of changes to the service/workplace context.