When you receive advice from occupational health professionals, or any other medical professionals about adjustments or accommodations that may help someone in the workplace, an employer needs to consider whether these adjustments or accommodations are reasonable and possible.

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.