Let’s consider what OH actually does.

There are two aspects to the purpose of OH; firstly there’s the clinical assessment (that’s the ‘health’ bit in ‘occupational health’). This means that primarily, these are assessments of employees’ health, including their medical history, medication, symptoms, functional ability, social context and much more. It’s what we, in the industry, call the biopsychosocial approach. Secondly, there’s the consideration of how the individual’s health affects them at work, if at all (that’s the ‘occupational’ bit).

So in other words, occupational health providers are assessing the impact of health on someone’s work.

Why do you need this in HR?

As an employer you have a duty of care to your employees. Legislation such as the Health and Safety at Work Act (1974), and the Equality Act (2010) make it clear that employers have an obligation to ensure that employee health and wellbeing is being protected wherever possible, and if someone has a disability that you’re doing what you reasonably can do to help the employee overcome any disadvantage suffered as a result of their disability. This is called ‘reasonable adjustments’.

Health can impact someone’s ability to work normally. This could be long-term, it could be short-term. It could be through something easily measurable, such as attendance rates or target-related performance, or something less measurable, like behaviour at work or attitude.

Whatever the case may be, you as an employer need the output from your employees to be of a certain standard. Regular absences, poor performance or unpredictable behaviour can be problematic for an employer, and in these sorts of cases they are typically managed via your internal procedures, such as absence management policies, performance improvement plans and even disciplinary procedures for instance.

However if health conditions, and perhaps even disabilities are part of the cause for this, then you need to consider these before doing any sort of ‘management’ action – the case law on this is very clear. And because you’re (presumably) not a medical professional, this isn’t really something you can do. And you certainly aren’t independent either unfortunately.

So seeking advice from a specialist independent clinician like an occupational health nurse will provide you an independent view on what impact (if any) their health condition is having on their work, and anything you can do to support the employee. It will give a view on what the employee needs (rather than what the employee wants), and help you to ensure you are providing the employee every opportunity to be successful within your organisation.

So in summary, occupational health is providing you independent, clinical advice, that helps to ensure the employee is being treated fairly in relation to their health conditions, whilst ensuring an employer isn’t inadvertently discriminating against an employee or making adjustments that may not even be required.  

This service is designed to provide more specialist clinical health advice to employers and employees who are experiencing mental health issues that may be impacting on them in the workplace, or affecting their ability to work normally.

The service is perfect for a wide range of mental health issues, regardless of whether there is a formal diagnosis or not’ It works in a similar way to our occupational health assessment service, but with three significant differences.

1. Two appointments

We will schedule an initial appointment with the member of staff. However as part of the price, we will also conduct a follow up review appointment with the individual some time later. This will typically be anywhere from 2 weeks, to 3 months after, depending on the current situation.

This is to check in with the member of staff and assess the progress, including any changes (and hopefully improvements) to their mental health, and therefore provide more up to date advice to the employer.

2. Psychometric screening

The service also includes psychometric screening relevant to the individual’s presenting condition(s) and symptoms. This could include screening for anxiety, depression, PTSD, drug and alcohol abuse, sleep issues and much more.

Where appropriate, the results of these screenings will also be presented on the management report to provide further background and evidence regarding the individual’s current mental health.

3. Mental health specific

This assessment is a specific mental health assessment. By focussing uniquely on any mental health concerns, we can explore any presenting conditions, symptoms and how they impact upon work in extensive detail.

Pricing

This service is priced at £250. This includes the screening(s), initial appointment and report, and follow-up appointment and report. We’ve worked hard to develop a service that represents exceptional value to our clients, and we hope you’ll agree this service is extremely competitively priced.

Non-attendance and late cancellation

With respect to any appointments that can’t proceed in instances such as non-attendance or late cancellation, the fee to rebook an initial appointment would be a further £160, and £90 for a review appointment (thereby saving you from having to pay the entire £250 again).

Packages

If your organisation is subscribed to our enhanced plus package, this service is available at no extra cost. Hooray!

The next few sections will hopefully answer some of your questions and give you a bit more information on what to expect from an occupational health assessment with Smart Clinic.

What’s the purpose of an occupational health assessment?

An occupational health assessment is an assessment of your health in relation to your job. It will provide your employer with relevant information about your health, functional abilities and any advice or suggestions about how they can support you at work.

Every occupational health referral is different, and if you have any questions about why your employer has referred you to occupational health then you would be best to ask them about this directly. It may help to put your mind at ease and ensure you’re fully comfortable before proceeding with an assessment.

Typically, the assessment and subsequent report will address factors such as fitness for work, any adjustments you may require, any support that may help, and responses to any questions that your employer may raise. Sometimes employers will ask about things like the Equality Act (2010), fitness to attend meetings, underlying health concerns or any future treatments or investigations.

What happens before the occupational health assessment?

Prior to undergoing an occupational health assessment, you will need to provide your consent to go ahead with this. This may be online, or via a paper form.

This ensures that you’re fully aware of the process, and will cover areas like confidentiality, what to expect and next steps.

You will also be asked to book an appointment with your occupational health provider, at which point you will be matched with a suitable clinical member of staff, typically an occupational health nurse, physiotherapist or physician (doctor).

The clinician will read all the referral information that has been sent to them, to ensure they fully understand the reason for referral and what is expected of them. If they have any questions for the employer, they may also ask them directly.

This may include other medical information or reports that your employer have that could help occupational health to conduct a comprehensive assessment.

The clinician will also review your job role to ensure they have a reasonable understanding of what your organisation does, and more specifically what you do. This will include any risks or hazards within your job role, and any areas that may be physically or psychologically demanding.

They’ll prepare for the assessment by deciding what they need to ask you in relation to your health and your work to ensure they fully understand the situation, and enable them to provide clinical advice to you and your employer.

What questions are asked during an occupational health assessment?

We understand you may feel a little anxious about your occupational health assessment, and pre-empting what might be discussed during the assessment beforehand can be helpful.

This will vary according to the reason for referral, and the situation, but some of the typical topics that the clinician will discuss with you are:

• Your job role. They’ll want to know a little about your wider organisation, as well as your role specifically.
• Hazards. They may discuss some of the hazards within the role, to understand if there are any safety critical tasks, or areas of particular risk.
• Working hours. They will probably want to know how long you’ve been doing your current role, and what your typical working hours are.
• Absences. It’s common to ask about your absence history, both in this job role and previous job roles.
• Health history. You will be asked to discuss your health history. This may be previous and seemingly irrelevant health conditions, but your clinician may ask about these anyway to understand where any health history could pose a risk, or there could be an inter-relationship between health conditions.
• Social context. It’s important to understand social context, as this can determine what support is available to you. For instance do you live alone or with others? Do you have any dependents? Do you drive? Do you have a second job?
• Current health situation. You will be asked about your current health status. This may include other peripheral questions such as whether you smoke, take recreational drugs or drink alcohol, or may including asking about your sleep or dietary habits for example. It will certainly include the health condition that your employer has referred you for. This may be something you’ve discussed with your employer, or could be described on your most recent fit note.
• Medication. You will be asked about any regular medication you take, as well as anything you’re currently taking temporarily due to your current health condition.
• Symptoms. You will be asked all about what symptoms you’re experiencing. This may include physical and psychological symptoms, pain levels, and any impact this could be having on your day-to-day functioning.
• Management of symptoms. As well as medication, you may be asked about anything else you do to manage your symptoms, such as exercise, therapy or pain reduction techniques.
• Day-to-day activities. You may be asked about some of your routine activities and how well you’re managing with these. For instance are you managing with washing and clothing yourself? Can you prepare and eat food? Are you able to leave the house?
• Support. Your view on any support you may feel you need that you aren’t currently getting.
• The clinician’s view. The clinician will also discuss their view on some of the above, including whether there’s any support that they would recommend and what advice their report is likely to contain.

This isn’t an exhaustive list, but helps to provide an indication of the types of things you may be asked to discuss during your occupational health assessment.

How long will it be?

There’s no fixed time on how long an appointment will take, as it can vary depending on your health condition(s), background, and how chatty you are! However we would typically suggest you allow up to an hour just to be on the safe side.

What happens after my occupational health assessment?

Once you’ve had your occupational health assessment, the clinician will go and review their clinical notes from your appointment, and use them to write a report for your employer.

This can take anywhere from 2 hours to 5 days. The average waiting time for this is about 1-2 working days.

You will be sent a copy of the report and asked to confirm if it is factually correct, and if you consent to release this to your employer. If there are errors on the report, you can ask for these to be corrected, but no advice or opinions would be changed.

Your report will not be sent to your employer without your permission, so please ensure that you are prompt with this part, and keep your employer informed if there is going to be any delay.

What about if I don’t agree with the report?

If there are parts of the report that you don’t agree with, we’d always encourage you to let your employer know about this so that they’re aware of your point of view. This may not be something that the clinician can change in the report, but it may be something that your employer takes into consideration.

If you would like to refuse to release the occupational health report as a result, this may also be an option, but again you should discuss this with your employer so that you’re aware of any next steps if don’t release the report.

Any factual inaccuracies within the report would always be changed, for instance any spelling mistakes, or wrongly listed information. At Smart Clinic we do our best to be accurate, but there is a lot of information to take in sometimes so we’re always very happy to correct something that we have noted wrongly.

If a member of staff suffers from a health condition that is classed as a disability under the Equality Act (2010) an employer is obliged to provide reasonable adjustments, but they would never be expected to provide adjustments that they don’t deem to be ‘reasonable’. You can find more information about this here.

However there will still be circumstances where an employer may consider making adjustments for an employee, even if they aren’t likely to be covered by the Equality Act. This is where a health condition is likely to impact an individual’s ability to perform their job role adequately.

Categorising fitness for work

In the scenario above, where an individual’s health condition may affect their ability to work normally, an organisation should make a referral to occupational health for assessment, advice and support.

The occupational health provider will provide advice that will place an individual into one of three categories:

1. Fit for work
2. Fit for work with adjustments
3. Unfit for work

This is a slight simplification, as the report should also detail approximate timeframes for this to make it clear whether this categorisation is short, medium or long-term. However taking this approach helps an employer to make pragmatic decisions on managing their employee.

But we can’t make the adjustments

If the employee is considered under the second category, fit for work with adjustments, but the employer can’t make those adjustments, then the employee should be considered to be under the third category instead, unfit fit for work.

This is because the employee is only fit to work under certain circumstances which may require temporary or permanent adjustments to their role.

A good occupational health provider will take into account a full health and social history, as well as the details of the job role, to determine realistically what can and can’t be considered as an adjustment. Nevertheless there will be instances in which suggestions for adjustments are made that an employer can’t accommodate. This doesn’t’ necessarily mean this is a bad, or ill-considered suggestion, it’s because an employer needs to be aware of what scenario would need to be true in order for the employee to continue or recommence working.

For example if a heavy goods vehicle (HGV) driver was considered fit for work with adjustments, and the only adjustment suggested was to work from home, this may leave an employer unsure what to do. Presumably the HGV driver can’t work from home, leaving the employer wondering why this suggestion has been made.

The occupational health provider doesn’t employ the individual, so can’t make assumptions on what the employer can and can’t accommodate. Perhaps the individual has some paperwork to complete, or needs to study for a test which could be done at home. Either way, this is for the employer to decide.

However in the likely event that an employer can’t accommodate the HGV driver working from home, this means that they’re unfit for work and should remain off sick.

The difference between adjustments and support

Try to think of adjustments and support as two different things, and be careful what language you use when you’re communicating this internally.

An adjustment should be something that you change about an individual’s role (temporarily or permanently) that enables them to continue working normally when they otherwise wouldn’t be able to.

Support, on the other hand, is providing additional measures to help the employee to be successful in their role. They may be of benefit, but aren’t medically crucial for an employee to be at work. They may of course be crucial for other reasons though.

Who determines all this?

Typically there are two routes to determine if an employee is fit for work or not; a GP fit note (statement of fitness for work) or an occupational health report. There’s more information about the difference between these here, but in summary occupational health is a more specialist and independent service, so an employer would typically prefer the opinion of occupational health.

This is an important read for the HR department, and data protection officer of any organisation in the UK, as it helps to provide clear guidance and structure.

The guidance recognises that in some instances, collecting health information is required as part of someone’s employment. However it also recognises that this is intrusive, so should be limited only to the minimum information required, and only when it is required, and that an employer should respect an employee’s privacy when handling their health information.

Here are some of the key features of the ICO guidance in relation to handling employee health information:

• You should consider how you will use the information, and why you need the information
• You should be clear and transparent about why you are handling the health information
• You must record your purposes for handling this information as part of your documentation
• You should not handle more information than is required, and should not request information just in case it could be useful in the future
• There should be a lawful basis for handling this information
• The information must be kept confidentially and securely
• The information must be accurate wherever possible
• It should not be kept for longer than you need it, and you should have a retention policy
• You should leave it to medical professionals to access and interpret detailed medical information, for example when making decisions about fitness for work

It is this final point that is commonly ignored, and subsequently dealt with ineffectively by employers.

The ICO guidance attempts to capture the essence of the relevant data protection law, by ensuring that employers are acting reasonably and responsibly when it comes to health information. Part of this involves ensuring that you aren’t collecting intrusive medical information with a view to making clinical judgements yourself, as this falls within the remit of your occupational health service.

An example that the ICO provide is about health questionnaires for workers to ensure they are medically fit to work in their job role, and states the following: “It is good practice for health professionals to design health questionnaires. This also means the questionnaires should be interpreted by those who are qualified to draw meaningful conclusions from the information supplied by the worker.”

So if part of your recruitment process involves fitness for work checks, do not use your own health questionnaires to make these decisions. You must use an occupational health provider such as Smart Clinic, who operates a service called a pre-placement screening, where an employee completes an assessment directly with the occupational health provider, so as not to reveal confidential medical information to their new employer, and so that any clinical decisions and advice can be made by a suitable qualified professional.

Similarly if you have a situation with an employee where their work is potentially impacting upon their health, or their health is potentially impacting upon their work, be careful not to explore this too deeply yourself, as you’re in danger of collecting unnecessary medical information, and then inadvertently making decisions on an employee’s ability as a result.

If you would like more advice or would like to begin using Smart Clinic for your occupational health service, please contact us today and our client team will be delighted to get you set up.

There are generally no upsides to staff absences.

So managing them effectively, and helping to reduce the volume and length of absences is vitally important to any organisation. But how do you go about that?

Here are a few tips…

Have an absence management policy

As part of your standard operating procedures, you must have an absence management policy. This should be available to all staff, to make it clear what your expectations are as an organisation, and what they can expect in the event of them being unable to work during their contracted working hours.

Some of the points this policy should cover includes:

• Your policy on sick pay and statutory sick pay
• The procedure for providing self-certifications and ‘fit notes’
• The procedure for informing the employer or their absence and ‘calling in sick’
• Levels of absence, trigger points and absence management stages
• Referral to occupational health
• Availability of any wellbeing support or company benefits

This absence management policy should become your ‘how to’ guide for managing staff absences, so ensure yours is robust and fit for purpose.

We have a free absence management policy written by our employment law partners at ‘Primed’, which you can use as a template to ensure you have all bases covered. Feel free to access it here.

Refer to occupational health

Probably the single most effective way of managing your staff absences is by proactively using occupational health. Hopefully this will already form part of your absence management policy, but even if not, engaging occupational health to support you with employee health issues is important.

Remember, in your role as a line manager or HR professional, you aren’t medically trained. So taking detailed information about someone’s health history, and trying to make a decision on someone’s working capacity based on medical factors probably isn’t appropriate.

So if you use occupational health proactively, this will help employees to remain supported in the workplace as much as possible, thereby reducing their need to be absent. It will also discourage any future absences because health concerns can be better managed.

You may wish to consider including referrals to occupational health within your absence management policy as part of your standard procedure. This could include for employees who have disclosed health concerns, employees who are evidently struggling whilst at work, employees with regular absences, employees with long-term absences, or employees who may have a disability.

To get setup with an occupational health service, get in touch with us today, and we’ll match you to the best and most cost-effective option for your organisation.

Conduct return-to-work interviews

There are loads of tutorials and templates available for conducting effective return to work interviews because they are such an effective tool.

Yet they are surprisingly infrequent amongst employers.

If an employee has been absent from work due to ill-health, then returning to the workplace can feel quite overwhelming, especially if they’ve fallen behind with work or there is uncertainty around anything.

However conducting an effective return to work interview will help you to alleviate any of the employee’s anxieties. You can also use it as an opportunity to set any expectations around absence levels, trigger points and support available. Additionally you can check-in with them from a wellbeing perspective, discussing any occupational health advice that has been received, and any short-term support measures you may be putting in place.

Not only will this improve the employee’s rehabilitation back into the workplace, it will have a positive effect on reducing any avoidable absences in the future too.

Provide access to wellbeing support

A small spend on corporate wellbeing can have a massive impact in your organisation.

All too often organisations will take an employee assistance programme as little more than a ‘tick-box exercise. Whilst this may be inexpensive, it may also be ineffective, making it a poor value option. Giving staff access to wellbeing support that actually works for them will make all the difference, because you can ensure they have the health support that will benefit them when they need it most.

This will help employees to feel supported in the workplace, mitigates the risk of absences and helps to keep staff in work wherever possible…not to mention fulfilling your duty of care as an employer.

Usually this is because your employer would like some medical advice from a specialist in their field about the best way to manage you whilst you’re experiencing a health concern.

This health concern could be something that you have raised with them directly, or it could be because you are absent from work. It could also be a mental health concern, a physical health concern, or a combination of both.

Your employer will not be a medical specialist, or an occupational health specialist. Therefore, they will not be trained in assessing and managing any occupational health related matters. Nor do they have the expertise to make decisions based on medical factors without the input of a relevant specialist.

That’s where occupational health assessments are used. They give your employer advice on medical issues to enable them to make informed decisions, such as managing and supporting you in the most appropriate way. For example, you may be suffering from a health condition that prevents you being able to complete some tasks at work, but you are still perfectly capable of completing other tasks.

Occupational health reports will advise your employer which tasks you can continue to complete, and which you should refrain from temporarily. They will also advise on whether you need any help in order to complete these tasks.  

Therefore, you don’t need to be absent from work to be referred to occupational health. If you are absent, this may be your first absence at the company, or you may have had multiple absences in the past. Either is perfectly normal.

If you are unsure as to why your employer has referred you to occupational health and what the next steps are, you should always ask them the question and have this conversation with them first. They may be happy to share the referral with you so that you can have sight of this, and gain a better understanding as to what questions they would like asking as part of the process.

You may also have questions about what the process of being referred for an occupational health assessment involves, or how this differs from the need to self-certify or issue a fit note from your GP.

If you would like more information about the process, or would prefer your employer uses Smart Clinic for your occupational health support, please get in touch with us today.

Remember, for many employees being referred to occupational health can be an intimidating experience. So it’s important to reassure employees that occupational health is a supportive measure, not a punitive one.

One of the primary intentions of occupational health is to provide advice to management, enabling them to manage an employee (and their health situation) effectively and appropriately. This could mean understanding what an employee can and can’t do and putting in the necessary support to help them at work.  

On the whole, work is good for us. Wherever possible it’s generally better for us to be at work than not, and you don’t need to be 100% fit in order to be at work. A referral to occupational health can help an organisation to ensure staff are working as much as possible, and that an employee is getting the support they need without being asked to do work that they’re unable to do for health reasons.

Below are five instances in which you may consider a referral to occupational health.

1. In the early stages of an absence

When an employee is absent, involving occupational health as early as possible is helpful. There are a few reasons for this, but primarily whatever you are going to do to support the employee is best done as soon as possible.

An early intervention from occupational health means that both the employee and the employer receive clinical advice early on. The employee has information on how to manage their own condition and can seek the appropriate medical care as required. This early intervention helps to prevent the condition deteriorating and speeds up the recovery process.

At the same time a manager can understand and support with a health condition immediately, making the support considerably more effective. This could be as simple as making the employee feel valued and cared for, or could help the employee to continue working with amended duties instead of being off work.

2. When an employee is considering a return to work

A common use for occupational health is for advice on when an employee is returning to the workplace following an absence.

Ideally you will have already had an occupational health assessment with the employee, but no drama if not. At this stage occupational health can confirm that an employee is ready to return to work in some capacity, and provide advice on what this return to work plan may look like. Does the employee require any temporary adjustments? Are they fit to do some or all of their role? Will they need a gradual build up of duties at all?

This use of occupational health covers you as an employer, because it demonstrates that you’ve taken the appropriate advice to ensure an employee is safe and healthy enough to do their job. It also promotes a more sustainable return to work by ensuring they aren’t taking on more than they can manage and subsequently going off sick again.

3. When an employee discloses a health condition and may need support

An employee has bravely confided in you about their health condition, and you aren’t sure what needs to be done to support them or whether they need any adjustments in the workplace. This could be a physical health concern such as asthma or back ache. It could also be a mental health concern; perhaps your employee struggles to manage their anxiety.

As a line manager it is highly unlikely that you will be qualified as a medical professional, which means you probably aren’t going to be best place to make decisions on what treatment or support would best help the employee to manage their condition.

This is where an occupational health referral can help. You will receive the advice and information you need to support the employee with managing their condition, ultimately helping them to continue successfully completing their job and preventing any future absences.

4. When an employee may not be able to do their job

In some unfortunate circumstances it can be possible that an employee can no longer do their job due to their health.

In such an instance there are any number of possibilities you could consider as a manager, such as dismissal, redeployment or retirement (see point 5). However you are unlikely to be able to make a judgement on an employee’s future ability to perform their job, so it’s important to ask for occupational health advice.

Case law has been very clear on this in the past. Employment tribunals and court cases will never side with an organisation who has made such a decision without obtaining the necessary medical input first – so use your occupational health provider!

5. When an employee is considering retirement due to their health

If an employee is unable to perform their role due to ill-health, and it seems likely that this will extend to their normal retirement age, then ill-health retirement can be an option.

The law surrounding ill-health retirement is complicated and not a decision that can be made by the employer alone. Most pension providers including local government pension schemes will insist on a decision from occupational health. So contact your occupational health service to help you through this difficult time!

A journal can help you to tell your story, to record the events of your day-to-day life, the challenges, the successes, your goals, your plans and might include anything at all that you find inspirational such as meaningful words, quotes, pictures, articles, photographs, recipes, drawings, compliments etc.  There is no need to worry about spelling or correct sentencing, the journal is just for you and can be written any time and at any point you choose to check in with your journal.  There are no rules. 

Starting to journal is easy, find a notebook of your choice, simple or decorative, just one that you feel suits you and begin.  Make it your own.  Digital journaling works just as effectively if this suits you better, however, remember to consider the security and storage of any digital or personal private items.   Make the decision about what you would generally like to achieve from journaling.  Is it simply to write down the events of your day, or do you want to explore the deeper thoughts and feelings of your story? 

The mental health benefits of journaling are well documented and journaling can lead to a decrease in emotional distress.  There are some criticisms too, such as journaling may encourage you to place your focus on any negative thoughts and feelings you may be experiencing, keeping you in that negative space for longer than needed which may be unhelpful, however if those thoughts and feelings are there, it may be beneficial to release them by journaling and balancing this by introducing a structure to your journal, hence enabling a section for offloading and reflection, a section noting things that have gone well, a section to mark achievements and successes (however small) a gratitude section, and a section which allows you to write about goals and things you are looking forward to.  

The choices are endless, be creative.  If you think that journaling may help you, give it a go! 

As you’ll know we avoid price increases wherever possible at Smart Clinic, however due to the ever-increasing cost of service delivery exaggerated by the current economic climate we’ve had to implement the increase. We want to minimise the impact this has on our existing clients who have been so loyal to us over the years, so we’d like to give you prior notice of this price increase and offer you the opportunity to renew your package prior to 1^st January 2023 to secure the existing price. Similarly if you would like to sign up to a longer contract with us, thereby securing the cheaper rate for a number of years to come, we would also be happy to arrange this for you. If you would like to discuss an early renewal or a multi-year contract, please get in touch with our client team who can help.