Frequently Asked Questions What is Occupational Health? Occupational Health (OH) is a medical specialty that is concerned with the effects of health on work and work on health whilst considering an individual’s health, ability and fitness to perform certain jobs/workplace tasks. OH is a medical advisory service aimed at supporting people in the workplace, looking at both physical and mental aspects of employee health. It’s designed to keep employees healthy and safe whilst in the workplace by advising both the employee and employer about health issues that could have the potential to increase work related ill health. Occupational Health is designed to support both employers and employees, offering advice and guidance to support a proactive approach to managing the health of individuals. Everyone seeing Occupational Health will be treated fairly with privacy and dignity. What is an Occupational Health Advisor/Physician? OH Advisors and OH Physicians are qualified Nurses and Doctors who have also undertaken further specialist training, and qualifications in the field of Occupational Health Medicine. They also have the appropriate background knowledge of Health and Safety and Employment Legislations. Most importantly they have experience in dealing with workplace related health. What services are offered by OHS? OHS offer a wide range of service highlighted in the link below. Occupational Health - Services What do I do if I want to be seen by the Occupational Health service? You can submit a self-referral to the Occupational Health Service. Further information can be found on the following link: Occupational Health - Referral Am I able to make an appointment with the Occupational Health Doctor instead of my GP? No, we do not provide a G.P or an accident and emergency service. Is Occupational Health able to expedite hospital appointments? No, unfortunately we are unable to expedite hospital appointments, or have any influence over these. Referral Can I self-refer to OHS? University employees are encouraged to discuss concerns directly with management and local health and safety in the first instance to seek intervention or clarification. However, those who have not been referred by their School/Unit but who would like advice on a health matter that affects work can self-refer to Occupational Health if they are unable to discuss these with management. Occupational Health - Referral We suspect our employee is misleading management, will an assessment confirm this? No. An OH Assessment is NOT a forum to prove whether an employee is misleading the employer or to decide whether the reported diagnosis is true (see next question). It is unrealistic for the clinician who does not have access to full NHS records nor access to diagnostic test/results to be able to comment with certainty on such a topic. Is occupational health simply a management tool when dealing with ill employees? No. Occupational Health is about keeping people healthy at work, and supporting employees if they have a medical condition that could have an impact on their workplace activities; these medical conditions may affect them or the work they undertake. It is a support mechanism for an employer to access and support employees with health problems. In some cases, employers have a duty under the disability legislation to make reasonable adjustments or accommodations to the role or workplace, to accommodate an employee’s underlying medical condition under the Equality Act 2010, Occupational Health can provide advice and guidance on such adjustments. Why has my employer referred me to Occupational Health? A referral into OH gives you the opportunity to talk over, in confidence, any concerns you might have about your health in relation to your work with an experienced OH professional. There are several potential reasons and the most common being: dependent on risk assessment and the employees H&S requirements requiring health surveillance; having been absent from work due to a health condition, injury or illness; attending work but a health condition, injury or illness is affecting performance. What happens after my employer has made a referral? We will contact you directly to arrange the assessment or your employer may liaise with you to confirm the assessment. The assessment may be conducted over the telephone, via a computer virtual meeting, or face to face and this will be specified at the time of referral. We will obtain your informed consent to conduct the assessment and issue a report to your employer following this. Consent will be obtained formally by signing a consent form and we will also verbally re-confirm your consent at the time of assessment. The report generated by a referral will be based on the information you provide at the time of assessment and the questions on the referral form asked by your employer at the time of the assessment. The report may include the following information: • Opinion on your fitness for work. • Nature of your reported health condition, injury or illness. • Expected time frame for recovery and/or return to work. • Potential modified duties and/or workplace adjustments. • Return to work plan. • Recommendations to address any identified issues/barriers. • Functional education and guidance on health condition management. • Opinion on applicability of Equality Act provisions. Following the assessment we may recommend further occupational case management/review assessments to help aid your recovery and/or return to work. Can a manager talk to the clinician before the referral or consultation? Yes. Manager’s need to ask the right questions of occupational health to get the right help. If the situation and questions are unclear then the report back from OH may not be what the employer or employee wanted to know. Therefore if there was a request to generally discuss a fictitious or anonymised situation to ascertain how best to make a referral, this can be discussed in general terms but not for specific cases. The general approach is that anything significant that needs to be covered in a consultation MUST be in writing and the employee should be aware of anything included. We will need a job description and a completed referral form. Clinicians cannot and will not introduce random information that is not documented and so essentially anything verbally discussed cannot be used in the consultation. Can the employee see the referral form? Yes; All documentation connected with the case including the referral form would have to be copied to the employee if they request to see them. This is both true under the GDPR subject access request process and under GMC medical/ethics guidelines. The referral form will form at least part of any discussion during the process, and there should be no surprises for the employee in the document. It is good practice for the employee to know (and/or even see a copy) what is included in the referral form ahead of the consultation. Will my employer see my medical records? No. Any clinical information taken during the consultation will be stored securely and confidentially and your employer has no access to them. However, you will have complete access to all files, records, reports and notes pertaining to you. We only include medical information directly related to an employee’s fitness for work and the reported medical condition, injury or illness. This will generally include such information as the nature of the condition and its impact on your functional work capability. All medical information will remain confidential. The only exception to this rule will be if the OHA/OHP considers it is necessary to breach medical confidentiality, because there is a significant risk or threat to the safety of others or that you may be a risk to yourself. This would be in line with the safeguarding guidance provided by the General Medical Council and Nursing and Midwifery Council. Do I have to consent to the referral? Yes; we require your explicit and informed consent to conduct the assessment and signed consent to issue any report to your employer. If you do not consent to our assessment, and/or the provision of our report, your employer must use other information available to them when managing a health concern. This may mean that they do not have the best available information to make decisions that may affect you and your health at work. Can OHS determine fitness to attend a meeting? OHS acknowledges it is in everyone’s best interests to get issues resolved as quickly as possible. Often employees claim that they are unable to attend formal meetings e.g. disciplinary, capability, grievance because of ill health. OH follow The Society of Occupational Medicine guidance when assessing and recommends that an employee is fit to attend a formal meeting if able to meet the following criteria: Understand the issues being addressed, Distinguish right from wrong, Instruct another to represent their own interests (e.g. trade union representative), Understand and follow the proceedings, if necessary with extra time and written explanation. What should I do to prepare for an OH assessment if I have been referred? It helps to have the following information to hand during the assessment (if applicable): • Details of any medications being taken (name and dosage). • Names and addresses of your treating doctors and/or specialists. • Copies of any relevant correspondence or reports from your GP or specialist if available. Appointment date and time: In the event that you are late for your appointment, or the clinician is unable to contact you on the telephone number provided, it may not be possible for your appointment to go ahead. If you are more than 15 minutes late, your appointment will be automatically cancelled and your employer may be charged a cancellation fee. If you feel unable to proceed with your appointment or you need to cancel please notify your employer at the earliest opportunity. Does the OHS Clinician have access to any medical records? No. The OHS clinician only has access to what is provided at the referral stage or from previous contact or anything the subject may take along to the consultation. Should there be any need for access to information held in medical records then OH will have to follow a set procedure to gain relevant information, including getting written consent from the subject prior to any application for information from treating Physicians. Is the medical information held confidentially? Yes. All clinical information you give to the OH Advisor/OHP or the medical information obtained from your treating doctor and/or specialist is confidential: clinical and medical details are not given to anyone else outside the OH Service, without your prior informed, signed consent. The report back to your manager or HR deals with the effects of your health on your fitness to work. Clinical and medical information is only included in a report where your Manager needs to know the detail, e.g. for safety reasons and only after you have given your express permission for this. Only in exceptional circumstances will details be disclosed for health and safety reasons where there could be a risk to you or others and this is likely to be in terms of restriction and not medical detail. You will be informed of this if it is felt this becomes necessary. Do I need to be seen more than once after a referral to OHS? Sometimes it is not possible to give a clear opinion on your fitness after a single assessment. The OH Clinician may need information from your treating doctor or want to look at where you work. They may also need to review you again to assess your progress before being able to judge when you might be ready for full duties or a return to work. When further information from your treating doctor or specialist is required, occupational health will discuss this with you and ask you to sign a form giving your informed consent to approach these. You have the right to see the report your treating doctor or specialist generates before it is sent to Occupational Health. Can I withdraw or change my consent options at any stage in the process? Yes. You can withdraw or change your consent at any stage of the process and then the process stops. Once your assessment has been completed, the OH professional will write a report for your Manager and/or HR. The OH professional will discuss with you at the appointment what they intend to write in your report. You are entitled to see the OH report before it is sent to the Manager and/or HR to check for accuracy of factual content, not medical opinion. You have the right to refuse the OH report being sent to your Manager and/or HR. In this situation, an OH Advisor will explain the risks of refusing consent to ensure you are fully informed of the possible implications. Is the clinician’s opinion on whether the Equality Act provisions on disability binding? No. The OHS trained staff are medical/nursing specialists who will give their view on whether the Equality Act provisions will apply. However, whether the Disability provisions of the Act apply or not is a legal decision (and not a medical decision) made in a tribunal or higher court. Legal decision would almost certainly have considered any medical opinions offered and therefore the OHS opinion should count in this respect. Are the OHS recommendations binding? No. The advice is given by an expert medical professional and an employer should give them serious consideration, however, recommendations are not binding and are simply advice. It is for the employer to assess whether the advice or recommendations are practical and reasonable to implement for their organisation and circumstances. Is an OHS Assessment report biased? No. The medical professional (Doctor or OHS Adviser) are specialists in their field, they will conduct the referral and with consent from the individual produce a report in a neutral manner. The assessment is geared to offering the employer appropriate advice addressing any specific management concerns raised at the referral stage. The medical professional/clinician will inevitably not have a full knowledge of the background details or circumstances, relying upon the information provided in the referral, observations during the consultation/examination and what the subject of the referral tells them. The individual will be given opportunity to provide their perspective during the consultation, but OH are not there to take sides or act as advocate for either party. It is therefore very important for the referring Manager to provide sufficient, factual and clear information during the referral process so the clinician has a balanced viewpoint. Can I request a copy of my Occupational Health Report? Yes. Under the Access to Medical Records Act & the Data Protection Act, you are entitled to request a copy of the report at any time, you may also request any/all other records that Occupational Health possess of yours. Once you have consented to the report being written you have several options: • You can choose not to receive a copy of the OH report. • You can choose to receive a copy of the report at the same time it is sent to your employer, via email or a printed copied in the post. • Or you can have access to the report before it is sent to your employer. However, you cannot ask for the report to be amended unless the report contains factual inaccuracies. Does an Employee have to attend and appointment at OHS after a referral? No. In short, an employee cannot be compelled to attend any OH assessment. It is therefore essential to fully explain to and engage your employee in why you wish to go down this route and what you want to achieve by doing so. There may however be restriction to duties without this assessment, and the employer can make decisions without the benefit of this assessment where an employee refuses such assessments. What happens to a confidential report when it is issued by OHS following a management referral? Confidentiality in the workplace is a sensitive issue, and this is particularly true in relation to information about health and medical conditions. The law on confidentiality about health and medical data applies to everyone in the workplace and is covered under the General Data Protection Regulation (GDPR) 2018. This classes medical data as “special category” and the processing of this data is not allowed unless you give specified and informed consent to sharing the information (unless in exceptional circumstance there is legitimate risk identified and a need to protect your interests/safety at work). In OHS following a referral, a confidential report will be written in answer to the questions raised in the referral document. This will usually give details about your ability to function, whether or not and when the state of health will improve, it does not need to have any medical details unless this is agreed. Such a report is only issued with the full and informed signed consent of the individual the report is about (the data subject). A record of when and how consent was received and of the information provided to data subject at the time of consenting must be kept. The consent document indicates who the report can be provided to e.g. usually but not always the referring manager and a named individual in HR with copy for the individual the report is about. Specific and informed consent means you must first be aware of the identity of who is processing your personal data (the staff in the OHS), and those who will be receiving the information will need to be expressly named (the manager and member of staff in HR). It is not enough to simply define a category of third parties (e.g. HR mailbox). As GDPR also applies to those who receive the report, they need to ensure this report is stored securely including that this information cannot be further shared without consent. There is no specific time limit for consent however, consent will need to be reviewed regularly to check the relationship, processing and purposes have not changed. Processes must be in place to refresh consent at appropriate intervals e.g. if at a future date there is any further request for copy of the report, OHS will not share this information without further consent to do so. Data Protection | The University of Edinburgh Professional Standards | The University of Edinburgh Health Surveillance How often do I need to complete statutory health surveillance forms/attend statutory health surveillance appointments? The requirement for completion of questionnaires and/or attendance at a statutory health surveillance clinic is as follows: • Baseline – prior to/ or on commencement of exposure, then; • 6 weeks later, then; • 3 months later - If all results are acceptable, then; • Annual recall There may be deviation from this schedule, dependant on the outcome of any assessment. The recall period is always stated on your Notification of Fitness letter which is emailed to you and your manager immediately after surveillance has taken place and this is also available on your CHPS record. Do OHS administer or keep copy of the required CoSHH Health record, (CHPS passport system)? No. OHS only provide the ‘fitslips’ produced as a result of assessment for health surveillance, these are provided for information and record purposes to the CHPS system. For all queries relating to this system, please contact The Occupational Hygiene Unit. You can log on to the secure part of the web pages if you have log in rights, follow the links below. Health and Safety Department Occupational Hygiene Will an assessment at OHS give management/HR a diagnosis? No (not usually). There are a few specialist Health Surveillance / Medicals such as for Hand Arm Vibration Syndrome (HAVS) and/or Asbestos where an OH Physician is expected to make a diagnosis. However, to be officially diagnosed many illnesses can take weeks or even months, a battery of tests and require specialist Consultants to give an opinion. An Occupational Health Service assessment is simply not meant for this purpose; its primary aim is to inform Management about the situation and in particular about the employee's capabilities in respect of working safely in their role. What do I do if I have a Needlestick / Body Fluid Contamination? In the case of a Needlestick or Contamination Injury you should please refer to the following University Policy and guidance for further information: Sharps, Glasses and Splashes from substances Travel Do OHS provide vaccines and offer health advice about travelling on University business? Yes. If you are travelling for work purposes the OHS can assist following your completion of a risk assessment form which can be found on the following link: Occupational Health - Travel Please note the school will be charged for the full price of the vaccine/s. The Occupational Health Service does not provide vaccines for general travel or for families of those travelling. Where Edinburgh University employees are potentially exposed to infections through the course of their work, and where a suitable and sufficient risk assessment has been undertaken, if there is an effective vaccine available immunisations will be offered. Your management should have confirmed or advised of your need for vaccination, in which case one of the advisers will be able to discuss your needs and advise on actions you need to take including arranging an appointment if necessary. Guidance - What to do if... What do I do if I have an Accident at work? The OHS does not provide an accident and emergency, or treatment service. Inform your line manager and seek medical attention from your first aider or Accident & Emergency if required. Ensure you complete an incident form via the Accident and Incident Reporting system, which can be accessed on the University Health & Safety webpage. What do I do if work may be affecting my health? Inform your line manager and seek medical advice from your G.P. Contact Occupational Health for advice. What do I do if I develop a health problem that affects my capacity to work? Inform your line manager. Seek medical advice from your G.P and contact Occupational Health for additional advice if required. What do I do if I have a Musculoskeletal Disorder e.g. neck, arm or back pain You are advised to seek medical advice from your GP, in the first instance. You are also able to access the University Physiotherapy service (FASIC) by completing a self-referral which can be found on their webpage. You are also advised to ensure you complete the relevant Display Screen Equipment or Laboratory Ergonomics self-assessments on Cardinus, for advice on posture and to ensure you have the correct equipment. Occupational Health can also be accessed for advice, by either a management referral or a self-referral. What do I do if I am Pregnant? Inform your Line Manager and refer to the Risk Assessment for New and Expectant Mothers Procedure. You can contact Occupational Health if further advice is required, after specific risk assessment has been carried out. What do I do if I have a skin problem that could be work related? Inform your line manager and local H&S advisor, and then contact Occupational Health for advice. What to do if you have hearing or visual impairment OH understands that staff working with sensory impairment may have additional specific workplace challenges. Prior to any referral to OH we would expect any individual experiencing a sensory loss to have received a thorough workplace assessment accessed and outlined within the link below: Support for Sensory Impairment Services provided elsewhere Do OHS provide initial assessment for Neurodiverse Disabilities (i.e.: Autism, dyslexia, dyspraxia, ADHD)? No. The Occupational Health Service (OHS) is unable to undertake such assessments. The University recognises that Neurodiverse conditions can require alternative support mechanisms. Before any referral to OH is made regarding any Neurodiverse condition, we would hope that all workplace adjustment and strategies to support neurodivergent staff have been considered and implemented as appropriate. Equality, Diversity and Inclusion has specific advice on how individuals can access services, and assessments, specific to their condition. Disabled Staff Support Neurodiversity Support Do OHS undertake Display Screen Assessment? No. We would advise that if not already done, you should ensure you carry out a work station risk assessment in conjunction with your local safety advisor - this may well flag up things that you haven't previously considered. This will help identify areas of concern with regard to any computer screens and workstation issues and highlight advice on how to resolve many of these. Issues arising from this assessment should be discussed with your manager and resolved locally where possible in the first instance. Display Screen Equipment (DSE) Risk Assessment: DSE Assessment Form Do OHS administer the CoSHH Passport system? No. The Occupational Health Service does not administer the CoSHH health passport system. A nominated member of staff from your School or Department uploads notifications of fitness locally. OHS suggest if there are any queries contact with the local ‘uploader’ in the first instance. Further information on the CoSHH Health Passport system can be discussed with Occupational Hygiene. Occupational Hygiene How do I access Counselling? The University provides a confidential counselling service for staff and students, but this is not through the OHS: Staff Counselling Service This article was published on 2024-07-22