What is the difference between an occupational health advisor and physician?

An occupational health advisor (OHA) is a nurse, with specialist training and qualifications in occupational health. An occupational physician (OHP) is a doctor with specialist training and qualifications in occupational health. Within the profession of occupational health, the difference in qualification between an OHA and an OHP is similar to that of most other medical professions.

What is the difference in role between an OHA and an OHP?

The difference in role and responsibility between an OHA and OHP can be likened to the difference between a solicitor and a barrister. A solicitor will do the majority of the work on your case file and will act as your legal representative and advocate in most ‘routine’ matters. However when matters become more complicated or severe it can be advisable (and sometimes mandatory) to take advice and representation from a barrister.

Fundamentally the role of an OHA and an OHP is the same. They are both there to provide advice and recommendations around occupational health and fitness for work. Like a solicitor, an OHA should be able to handle most of your case load, so beware of occupational health providers who are referring high volumes of cases to OHPs – given an OHP service is more expensive, scepticism can be healthy. In fact generally, we find it is better to keep cases with an OHA wherever possible for a few reasons:

1. It is more cost effective for a client, meaning they can use occupational health more frequently
2. The caring nature of the training that nurses go through can lend itself well to an empathetic assessment, particularly in sensitive cases
3. Nurse availability is usually better, meaning a faster turnaround

However, like a barrister, an OHP can be required to step in for more complex or severe medical issues. There are times where we are obliged to recommend an OHP assessment, and there are times where it is our clinical opinion.

What difference will I see in an OHA and an OHP report?

There is a common misconception that an OHP assessment and report will be more detailed. This is not the case, so please be aware of this before making your decision on which service you wish to use.

Both types of assessment will take all the necessary health background and explore the issue in detail. However due to the nature of the reason a case is being handled by an OHP, not an OHA (see below), it can be more important to provide a simplified report with clear, actionable advice that provides a longer-term solution and resolution with OHP cases. Therefore an OHP report may sometimes be shorter than an OHA report – it is important to issue clear, direct advice that an employer could action and that would protect them in the event of a legal dispute or tribunal.

Why would you recommend an OHP not an OHA?

We will generally use an OHA to assess your case wherever possible (please see above). There are some instances where we will recommend an OHP assessment instead. If you are unclear as to why we are recommending this, please don’t hesitate to contact us for clarification and we will be pleased to provide you a clinical justification.

The most common scenarios for recommending an OHP instead of an OHA would be:

1. The issue may end in a longer-term employment decision being made, such as a capability based dismissal. In such an instance, an OHP assessment is advisable. This is because we employ doctors with consultant status in occupational health. Therefore these are the most senior and qualified professionals available to provide advice, and would demonstrate that you have sought the best possible advice in the event of a legal dispute or tribunal.
2. The member of staff is applying for ill-health retirement. All pension providers require an assessment with a physician, who will need to provide the final recommendation regarding eligibility.
3. There are possible safeguarding concerns. An example may be a job role involving interaction with children (such as a teacher) where they are suffering from a condition that could impair their judgement (such as schizophrenia). In some instances this may also be required under ‘fitness to teach’ guidelines.
4. The matter is clinically beyond the skillset of a nurse. This is unusual, but in some instances a member of staff may be suffering from a condition so rare, severe, or complex that it falls outside of the clinical competencies of a nurse.

What’s the difference in cost?

If you are on a pay-as-you-go service or a package where one or both of these services aren’t included, then the prices are as follows:

• An occupational health nurse assessment is £140
• An occupational health physician assessment is £400