Health Management & Return-to-Work Medicals

A referral may be appropriate for an employee in various situations, including:

Employees on Long-term sickness absence

Employees having recurrent short term sickness absence

Employees with new or existing medical conditions which they needs help, advice and support to manage their health conditions whilst continuing to work and provide good attendance and performance

Employers who have concerns that medical conditions may be impacting on an employees attendance or performance

Following a significant injury or diagnosis, to plan a safe return to work.
To assess if workplace adjustments are needed to support an employee with a disability or health condition.

Yes, an employer can make it a reasonable management request for an employee to attend a fit-to-work medical assessment, particularly after a period of sickness absence.

This is usually to understand the employee’s fitness for their role and to identify any support or adjustments required. This is often explained in an employees contract.

Fit-to-work and management referral assessments are conducted by qualified Occupational Health professionals, such as OH physicians or specialist OH nurses.
An Occupational Health physician should have a full GMC registration plus an additional Occupational Health Qualification  such as a Diploma of Occupational Health from the Faculty of Occupational Health Medicine (FOM)

Assessments can be conducted in various formats depending on the clinical need and the OH provider’s service model. These include:
– Face-to-face consultations.
– Telephone consultations.
– Video consultations.

At Occupational Health Bristol we perform all of these.

The cost of a fit-to-work medical is covered by the employer. Prices vary between OH providers and depend on the complexity and type of assessment required.
At Occupational Health Bristol these medicals typically cost 230 pounds but can increase with very complex cases

A standard assessment typically lasts between 45 and 60 minutes. More complex cases may require a longer appointment.

You should bring photographic identification, such as a passport, or driving licence. It is helpful to bring a list of any medication an employee is taking and also any letters from GPs or Specialists that may help explain to the Occupational Health doctor what pre-existing conditions the employee has or is being investigated for.

Yes, an employee is entitled to be accompanied by a companion, such as a friend, family member, or trade union representative. It is sensible to inform HR and the Occupational Health team if you wish to bring someone along with you to the assessment.

Under the Access to Medical Reports Act 1988 and UK GDPR, you have the right to see the OH report before it is sent to your employer. You can request factual corrections but cannot change the OH professional’s clinical opinion. You also have the right to withhold consent for the report to be released, but this may mean your employer has to make decisions based on the limited information they have. Some contracts state that your employer is entitled to see the report and you should ensure that you are not in breach of contract if you decide to withhold the report.

An employer are encouraged to consider the advice and recommendations provided in an Occupational Health report  this is to help support the employee but also to help to try and reduce sickness absence and improve performance and productivity if appropriate. Adjustments must be “reasonably practicable”  for an employer to implement this. An employer should also have a justifiable business reason for not implementing it.

The Equality Act 2010 is a key piece of UK legislation that provides a legal framework to protect the rights of individuals and advance equality of opportunity. In the context of employment, it makes it unlawful for an employer to discriminate against an employee due to a “protected characteristic,” including disability. The Act places a duty on employers to make reasonable adjustments for disabled employees to ensure they are not substantially disadvantaged at work. Employees must have a medical condition which is substantial, affects activities of daily living and has been or is likely to be present for more than 12 months for an employee to fulfil the criteria of the Employment Equality Act. This can only be ultimately decided upon by an Employment tribunal.

Yes, if an employee is found to be no longer medically fit to continue in their current role, even with reasonable adjustments, redeployment to a suitable alternative role is an option that should be explored.

Yes, if you have a new medical condition, you can discuss this with your employer. Requesting changes to your hours or duties would be considered a request for reasonable adjustments, which your employer is legally obliged to consider under the Equality Act 2010 if your condition meets the definition of a disability

Positives for Employers and Employees:
– Provides a clear, impartial medical opinion on an employee’s fitness for work.
– Helps identify specific, practical adjustments to support an employee in their role.
– Facilitates a safe and structured return to work.
– Ensures the employer is meeting its legal duty of care and obligations under the Equality Act 2010.
– Can improve employee engagement and demonstrate that the employer is supportive.

Negatives/Potential Concerns:
– The process may cause anxiety for an employee who may feel their job is at risk, this can be reduced with good communication.
– If communication around the referral is poor, it can be perceived as a lack of trust and we encourage the process to be clearly explained to the employee prior to attending the medical and the reasons for the medical.
– The cost of the referral and any subsequent recommended adjustments is a business expense.

Refusing to attend a reasonable request for an Occupational Health assessment may be seen as a breach of your employment contract. An employer may proceed with a capability or disciplinary process based on the information available to them, which could ultimately lead to dismissal. It is always advisable to engage with the process and seek advice from HR, a manager, or a trade union representative if you have concerns.