Lothian Occupational Health Service undertakes the following responsibilities relating to management referrals:-
1. An independent assessment of an individuals fitness to carry out the duties of a particular post as well as:
Advice on:-
i. Rehabilitation back to work.
ii. The likelihood of an individual giving regular attendance at work.
iii. Adaptations to the workplace where appropriate
iv. Adaptations to hours of work
v. Consideration of the Equality Act 2010 particularly in relation to iii and iv.
vi. Shift Patterns
vii. The diagnosis of occupational illness/disease
2. An initial appointment within the timescales agreed.
3. Notification to management of any delay relating to point 2 above, i.e. postponements/cancellations for whatever reason.
4. Report to Human Resources/Management as appropriate, after each consultation, with a timescale/date for review if necessary.
The Referral
In order to help us comply with these responsibilities it would be helpful if managers could be aware of and/or undertake the following:-
a) Early referral, as per the sickness absence policy is always preferable.
b) Management should give as full a history as possible and ask the right questions – please give an indication of the advice required in any given circumstances. It would be helpful if a job description is included. Formatted statements such as ‘usual duties of a care assistant’ or ‘general admin duties’, are not particularly helpful.
c) The employee must be made fully aware of the reasons for the referral by the manager. Confirmation of this is required on the Referral Form (See attached).
d) When discussing referral with employees managers should ensure that employees are aware of the independent nature of the Occupational Health Service and that Occupational Health is not part of any disciplinary process.
e) It would be helpful if managers could state whether the referral is being made under the sickness absence policy and/or if there is a specific concern.
f) A detailed list of sickness absences giving dates, reasons and whether or not the absence was certificated should be sent with the referral. This will help to indicate any developing patterns of absence. Any performance issues should also be noted.
g) Dialogue between managers and the Occupational Health Service staff is vital. It must be remembered that the referral form/letter is filed in the Occupational Health record and as such is a legally recoverable document. Employees have certain rights under the Access to Health Records Act 1990. Anything that management do not wish to come to the attention of the employee should not be included or referred to in the referral.
h) Managers must be aware that Lothian Occupational Health Service can only advise on an individual’s fitness for the duties of their post. Therefore, whilst it is sometimes of interest for the Occupational Health Service to be aware of individuals who have second jobs or of unsubstantiated information, such as ‘he was seen digging the garden’ they can make no comment on the effect these would have on the individuals post. These are management issues and as such should be dealt with by managers themselves.
i) When requested by the Occupational Health Physician (OHP), progress reports on individuals are of great value and should be prepared and sent prior to the review appointment.
j) Verbal dialogue should be encouraged.
k) Managers should also consider the Equality Act 2010 where appropriate.
Occupational Health Service Reports
An acknowledgement will always be made following a consultation but managers must be aware of the following:-
a) Detailed reports may take some time because:-
i) GP’s and Consultants do not always respond to requests for reports as speedily as we would wish.
ii) If an individual wishes to see a report from their GP prior to it being sent they have 21 days after the GP receives the request in which to do so.
iii) There is a legal requirement for doctors to sign their own letters (confirmed by the Central Legal Office and Medical & Dental Defence Service, (MDDUS).
b) In certain circumstances it may be possible to fax a report.
c) Diagnosis or confidential medical information will not normally be disclosed. Unless Managers are already in possession of this information it will be withheld as “Medical in Confidence Information”. When it is considered important for managers to know confidential personal data, consent from the individual will be sought.
d) If managers are to have a meeting with employees to discuss an Occupational Health Medical Report, all of the above should be considered when making an appointment for that meeting.
e) Managers must be aware that an employee may express contrasting views and opinions at their appointment with the OHP which may require further dialogue.
f) Meetings can be arranged with appropriate individuals/managers as required, in conjunction with Human Resources/referring manager. Case conferences including OH, the individual, their representative, management and/or HR can also be arranged.
Notes for the Attention of Managers
It is important that managers understand the following points:-
1) Occupational Health cannot speed up out-patients appointments.
2) Occupational Health cannot instigate medical investigations.
3) Occupational Health cannot insist upon referrals to specialists.
4) The General Practitioner has legal responsibility for the health of his/her patients and his/her decision is, at the end of the day, final. Occupational Health does not have a treatment role.
5) Occupational Health can only advise
- the employee
- the manager
- the GP
If managers require further clarification/advice please do not hesitate to contact the Occupational Health Service Management.
