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Occupational Health

 

Where there are concerns that work could be affecting a member of staff’s health or that a health problem could be affecting an employee’s ability to do their job, a referral to OH for advice and assistance in managing such concerns effectively, should be made.

The purpose of a referral to an occupational health practitioner [doctor or nurse] is to provide advice and support to the employee and where agreed with the employee, their managers.

This may be done by:

Management referral

Purpose of referral

When to refer

How to make a referral

Making the appointment

The assessment appointment

Consent and confidentiality

Reports to management

Rehabilitation plan

Time frames

Missed appointments

Employee information leaflet

 

Purpose of referral

An individual may be referred to occupational health (OH) where there is concern about their health, performance (where there may be health implications) or level of sickness absence. An assessment by an OH practitioner (doctor or nurse) can provide objective information that can assist management in addressing these issues.  

When to refer

An individual should be referred for an assessment where

  • There is concern that they 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.

    If you are unsure whether a referral is appropriate please contact OH for further advice. In addition, the referral may be discussed with or initiated by the Human Resource Schools Team for your department.

    Following discussion with the individual, the originator of the request must complete a management referral form containing full details of the individual, their job description, an outline of the problem and the matters on which opinion is sought.

    How to make a referral

    To get the best advice from OH, 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 individual's work, advise whether any aspects might be affecting their health and consider any modifications or adjustments which may enable the individual to do their job.

    The information should include:

  • the reasons for the referral

  • the specific questions to be answered

  • the individual’s previous two years attendance record

  • current job description  - PD33

  • any relevant risk assessments (e.g., DSE, individual stress tool, pregnancy)

    The management referral form has been designed to assist management in providing the information necessary to carry out a medical assessment and communicate the required information back to management with a copy to the individual and where appropriate the individual’s GP and/or treating specialist.

    Making the appointment

    On receipt of the completed management referral form the earliest available appointment will be sent to the individual as indicated on the referral form and copied to the referrer.  If this appointment is inconvenient this will be changed to a suitable alternative.

    The assessment appointment

    An initial assessment usually lasts about 45 minutes and aims to collect sufficient information to provide an accurate, objective and useful opinion regarding fitness to perform the job.

    The individual will be asked about

  • The health problem or disability and any concerns that they have as well as any treatment that they may be receiving

  • The work that they undertake and any difficulties arising from health or other reasons

  • Any activities out of work that they are involved with

    In some instances it may be necessary to request further information from the individual’s general practitioner (GP) and / or hospital specialist.  If this is the case the reason will be explained to the individual and they will be asked to sign a consent form allowing OH to approach their GP and / or hospital specialist for this information. Under the Access to Medical Reports Act 1988 the individual has a right to see this report before it is sent to OH.  Sometimes and with consent, the OH professional may write to the individual’s GP giving information about the outcome of the OH assessment.  This can be particularly helpful where there are clinical findings or work arrangements that the OH professional believes the GP should be informed of. 

    The individual may be referred for therapy that would facilitate a return to work e.g., physiotherapy and it may be necessary to review the individual to assess their progress as well as any medical  reports received, before a firm opinion can be made about any return to work or to full duties.

    Consent and Confidentiality

    The reason for the referral must be discussed with the individual and where possible their signed consent obtained - see section 10 of the Management Referral Form.

    If it is not possible for the individual to sign the form, but they have agreed to the referral, e.g., if they are absent from work, a copy should be sent to the individual at the same time as confidentially forwarding it to OH. 

    Discussion and agreement with the individual regarding who else may require access to the OH report once received should take place prior to the referral being sent. 

    The report should be stored securely within the department and with the Schools HR Team in line with the Data Protection Act: https://www.information-compliance.admin.cam.ac.uk/data-protection .  If there are any concerns regarding this please contact OH or your HR Schools Team for further advice. 

    In line with the General Medical Council guidance [http://www.gmc-uk.org/guidance/ethical_guidance/30665.asp] prior to the report being issued, the individual will be offered the opportunity to view a draft copy of the management report.  Further consent will be obtained from the individual by the OH practitioner and that consent can be withdrawn at any stage of the process.  If the individual feels that the report contains incorrect factual information this should be highlighted to the OH practitioner.  If the individual feels that the OH practitioner’s opinion is incorrect this is unlikely to be amended and the individual may withdraw consent to the report being issued, in which case the OH practitioner will inform the referrer that consent has been withdrawn or agree to the report being issued unchanged.     

    OH 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 individual’s OH record will not be disclosed to anyone else outside OH without the individual’s informed consent.  For full details of how personal information is used by the University Occupational Health Service, please see http://www.oh.admin.cam.ac.uk/general-information/confidentiality-statement

    Reports to management

    OH reports are advisory only.  The content of a report will depend on the reason for the referral, the specific questions that have been asked and any necessary specific recommendations. Medical details are not usually disclosed unless this is deemed necessary when managing the individual in their work and when the individual has given their informed consent for disclosure.

    Information provided may cover

  • Whether the individual has an underlying health condition or disability that may affect attendance or performance at work

  • If so, the likely effects on future attendance / performance

  • Measures to support the individual during their absence

  • Whether time off work will be required for appointments / treatments

  • When the individual 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

    Copies of the report will be sent to the individuals named on the management referral form only.  This is likely to be the referrer, the individual and where indicated the relevant HR contact.  The OH practitioner may recommend a copy of the report is sent to the individuals GP and / or Specialist for information

    Rehabilitation Plan

    A rehabilitation and / or phased return to work plan may be recommended by OH to allow the member of staff to gradually build up to their contracted duties. This can be beneficial to the individual returning to work after certain illnesses and can also facilitate an earlier return to work. 

    Recommendations for a phased return may include

  • Amended duties and / or temporary redeployment

  • Reduced working hours

  • Assistance with some tasks, especially if physically demanding

  • Temporary restrictions on tasks undertaken

  • A combination of the above

    Where indicated a workplace visit may be advised to ensure that recommendations are appropriate and can be accommodated. The individual will be reviewed regularly during this period. 

    Time Frames

    Initial appointment

    The referred individual will usually be contacted within 4 working days of receiving the referral form (allowing for all mail deliveries), and an appointment offered within 20 working days.

    Report

    This will be sent within 2-7 working days of the appointment depending on whether or not the individual wishes to see the report before it is sent.  Where relevant an initial report will advise whether further information is being sought from a GP / hospital specialist.

    In cases where the individual has asked to see a copy of the management report prior to it being sent, a five day period will be given in which to do so, before it is sent.   Should an individual subsequently withdraw their consent to release the report, OH will be unable to issue the report. In such circumstances managers may seek further advice about managing the case from HR using the information available to them.

    Once a report has been received it should be discussed with the individual.  If other managers / HR contacts need to be involved this should only be done with the individuals consent.  If there are any questions about the report please contact the occupational health practitioner initiating the report in the first instance or if unavailable the occupational health manager.  If seeking advice via email the email subject line must not contain any confidential information about the individual, and not forwarded on to any other person.  Please note that the OH practitioner can clarify the report and advice given verbally, but will not answer any new or additional questions without first consulting with the individual.  A record of this discussion will be documented in the individuals OH record.

    Missed appointments

    Should the individual fail to attend an appointment then an alternative will be offered and the referrer will be informed. If they fail to attend a second time the referrer will be informed but no further appointment offered. OH should be contacted if further advice is required.

    Further information

    The following leaflet gives important information about the management referral process for individuals Occupational health referral – employee information

 

Self-referral

By contacting OH the employee can gain telephone advice and/or request a confidential consultation with an occupational health practitioner about any work aggravated health problem or concern that they may have. It is helpful but not essential that the employee’s manager is aware that advice from OH is being sought particularly if it is likely that reasonable adjustment at work need to be considered to accommodate a health problem.  Self referrals do not normally result in written reports to an individual’s supervisor / department and if written recommendations from OH are required a management referral should be completed.

To arrange an appointment a self-referral form should be completed and sent confidentially to the Occupational Health.  On receipt of the completed self-referral form the earliest available appointment will be sent to the employee and if inconvenient changed to a suitable alternative.

 

On-offer referral

The purpose of an on-offer referral to OH is to enable new employees and those undertaking studentships or their managers/supervisors to seek medical advice or support from Occupational Health, where necessary, when accommodating a new employee with a health condition or disability. Explicit consent from the individual concerned must be obtained before making a referral using the ‘on offer’ referral form.

Please see HR recruitment guidance for information about the on-offer referral process.