Registration Number: {{org_field_registration_no}}

Occupational Health Screening and Medical Reports Policy

1. Purpose and Commitment

The purpose of this policy is to outline how {{org_field_name}} manages occupational health screening and medical reports efficiently. We are committed to ensuring the health, safety, and well-being of all employees while maintaining a high standard of care delivery. This policy promotes a proactive approach to health management, ensuring employees are fit to perform their roles without compromising their own health or the safety of service users.

This policy supports compliance with the Health and Safety at Work etc. Act 1974, the Management of Health and Safety at Work Regulations 1999, the Equality Act 2010, the Data Protection Act 2018, the UK General Data Protection Regulation, the Access to Medical Reports Act 1988, the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013, the Control of Substances Hazardous to Health Regulations 2002, the Manual Handling Operations Regulations 1992 and, where applicable, the Working Time Regulations 1998.

It also supports compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, particularly Regulation 12, safe care and treatment; Regulation 17, good governance; Regulation 18, staffing; and Regulation 19, fit and proper persons employed.

The organisation will ensure that every person deployed for the purposes of carrying on a regulated activity is able, after any reasonable adjustments have been made, to perform the tasks that are intrinsic to their role. Occupational health information will be used to support lawful, fair and evidence-based decisions and will not be used to discriminate against an applicant or worker because of disability, pregnancy, maternity, age, race, religion or belief, sex, sexual orientation, gender reassignment, marriage or civil partnership, or any other protected characteristic.

Occupational health advisers provide independent professional advice. Responsibility for employment, deployment, risk control and reasonable-adjustment decisions remains with {{org_field_name}}. No manager may ask an occupational health professional to make a dismissal, disciplinary or recruitment decision on behalf of the organisation.

1.1 Definitions

For the purposes of this policy:

Health assessment means an assessment undertaken to identify whether a person requires support, risk controls or reasonable adjustments in relation to work.
Occupational health assessment means an assessment by a suitably qualified occupational health professional who provides advice about the relationship between a person’s health and work.
Health surveillance means a planned programme of repeated health checks required where workers remain exposed to specified health risks despite appropriate control measures.
Fitness for work means the person’s functional ability, after reasonable adjustments have been considered, to undertake the tasks intrinsic to their role without creating an unacceptable risk that cannot be adequately controlled.
Intrinsic tasks means duties that are fundamental to the role and cannot reasonably be removed without changing the nature of the role.
Worker includes employees, agency workers, temporary workers, contractors, volunteers and any other person deployed to carry out work on behalf of the organisation.
Health information means personal data concerning a person’s physical or mental health, including occupational health reports, sickness records, medical certificates, immunisation information and reasonable-adjustment records.
Reasonable adjustment means a reasonable step taken to remove or reduce a substantial disadvantage experienced by a disabled applicant or worker.

2. Scope

This policy applies to employees, applicants who have reached the appropriate stage of recruitment, agency workers, temporary workers, contractors, volunteers, apprentices and any other person deployed by or on behalf of {{org_field_name}}.

It covers:

Post-offer and pre-deployment health assessment, where proportionate and relevant to the intrinsic requirements and identified risks of the role.
Risk-based occupational health assessment, statutory health surveillance where legally required, and health review following a relevant change in health, work or exposure.
Medical reports and confidentiality.
Reasonable adjustments and return-to-work processes.
Communication with healthcare professionals and external agencies.
Management of both physical and mental health conditions.

The policy applies across all domiciliary care settings, ensuring consistent implementation and adherence to best practices. It ensures that all employees, regardless of role or contract type, receive appropriate health support and that workplace risks are effectively managed.

This policy does not authorise indiscriminate medical questioning, routine medical examinations of all workers or the collection of health information that is not necessary and proportionate. Different arrangements may apply to agency workers and contractors, but {{org_field_name}} remains responsible for satisfying itself that any person deployed into the service can perform the role safely and meets applicable CQC requirements.

3. Policy Statement {{org_field_name}} is committed to:

Promoting employee health and well-being.
Identifying and managing health risks proactively.
Ensuring safe working practices for employees and service users.
Making recruitment and deployment decisions by reference to the intrinsic requirements of the role and individual risk assessment.
Considering reasonable adjustments before deciding that a person cannot perform a role because of health or disability.
Ensuring that occupational health processes do not replace safe staffing, training, supervision, competency assessment or workplace risk controls.
Collecting only the minimum health information needed for a defined and lawful purpose.
Reviewing risks presented by work in people’s homes, including lone working, moving and handling, infection exposure, environmental hazards, challenging behaviour and travel between visits.
Escalating any concern that may affect the safety of people receiving care, while maintaining the worker’s confidentiality as far as possible.
Maintaining confidentiality and respecting employees’ rights.
Providing support for both physical and mental health conditions.

We believe that a healthy workforce enhances service quality, promotes retention, and contributes to a positive work environment. Our approach includes preventative health measures, timely interventions, and continuous support to ensure staff can perform their duties safely and effectively.

4. Recruitment, Post-Offer Health Assessment and Pre-Deployment Checks

4.1 Purpose and timing of health enquiries

{{org_field_name}} will not normally ask an applicant questions about their health or disability before making a conditional offer of work, except where a question is permitted by the Equality Act 2010. Permitted purposes may include establishing whether the applicant requires reasonable adjustments for the recruitment process, determining whether the applicant can carry out a function that is intrinsic to the work, undertaking lawful positive action, or monitoring diversity.

Once a conditional offer has been made, proportionate health information may be requested where it is necessary to:

establish whether the applicant is able, after reasonable adjustments, to perform tasks intrinsic to the role;
identify reasonable adjustments;
assess risks to the applicant or people receiving care;
determine whether specific health surveillance is required; or
meet a specific statutory or regulatory requirement.

A health condition or disability will not automatically prevent appointment. Decisions will be based on the applicant’s functional ability, the intrinsic duties of the role, available risk controls and whether reasonable adjustments can be made.

4.2 Post-offer and pre-deployment assessment process

Before requesting health information, the recruiting manager must ensure that an up-to-date role profile and risk assessment identify:

the tasks that are intrinsic to the role;
foreseeable physical, psychological and infection-related risks;
moving and handling requirements;
lone-working and travel requirements;
night-work requirements, where applicable;
exposure to hazardous substances or biological agents;
the need to use personal protective equipment or respiratory protective equipment; and
any safety-critical duties.

A confidential health questionnaire may be issued after a conditional offer where this is necessary and proportionate. The questionnaire must be reviewed only by an authorised person or occupational health provider in accordance with the organisation’s privacy arrangements.

Where further advice is needed, an occupational health referral must:

explain the role and its intrinsic duties;
identify the specific management questions requiring advice;
include relevant risk information;
avoid requesting a full medical history unless this is clearly necessary;
inform the applicant why the referral is being made and how the information will be used; and
obtain any consent required for the assessment or release of a report.

Occupational health advice should normally state whether the person:

is able to undertake the role without adjustment;
is able to undertake the role with specified adjustments or restrictions;
requires further assessment or a time-limited review; or
is not currently able to perform identified intrinsic tasks, after reasonable adjustments have been considered.

Managers should not normally receive diagnoses, complete medical histories or unrelated clinical information. Advice should focus on functional effects, foreseeable risks, adjustments, restrictions and review arrangements.

4.3 Recruitment decisions and withdrawal of a conditional offer

A conditional offer must not be withdrawn solely because an applicant has disclosed a disability or health condition.

Before withdrawing an offer or restricting deployment for a health-related reason, the recruiting manager must document:

the intrinsic task or material risk in question;
the occupational health or other competent advice considered;
the applicant’s views;
the reasonable adjustments considered;
why any proposed adjustment would not be reasonable or would not adequately control the risk;
whether an alternative role or amended deployment is available; and
the reason for the final decision.

The decision must be reviewed by the Registered Manager and the Human Resources lead before it is communicated to the applicant. The applicant must be given an explanation of the decision and an opportunity to provide relevant additional information or request a review.

4.4 Confidentiality, transparency and data protection

Health information is special-category personal data. {{org_field_name}} will identify and document:

an Article 6 lawful basis under the UK GDPR; and
an Article 9 condition permitting the processing of health information.

Depending on the purpose, this may include processing necessary to meet legal obligations or exercise rights in employment law, assess working capacity, provide occupational health support, protect vital interests in an emergency or establish, exercise or defend legal claims.

Consent will not normally be relied upon as the sole UK GDPR lawful basis for routine employment processing where the imbalance of power means that consent may not be freely given. This does not remove the requirement to obtain explicit permission where access to a medical report or disclosure by a medical practitioner is governed by the Access to Medical Reports Act 1988.

Applicants and workers will receive clear privacy information explaining:

what information is collected;
why it is required;
the lawful basis and special-category condition;
who may access it;
who it may be shared with;
how long it will be retained;
their information rights; and
how to raise a concern.

Access will be restricted to people who need the information for an authorised purpose. Managers will normally receive only the functional advice necessary to manage work, risk and reasonable adjustments.

5. Occupational Health Referrals, Health Surveillance and Health Reviews

5.1 Circumstances in which a health review may be considered

A health review or occupational health referral may be considered where there is a legitimate and proportionate need, including:

a worker reports that their health is affecting work or work is affecting their health;
there is a pattern of sickness absence that may indicate a need for support;
a worker has sustained a work-related injury or exposure;
there is objective evidence of a possible health-related safety concern;
the worker is returning after significant illness or injury;
the role, working pattern, workplace or exposure changes materially;
a reasonable adjustment requires review;
pregnancy, recent childbirth or breastfeeding requires an individual risk review;
a night worker requests or is due a health assessment under the Working Time Regulations 1998; or
statutory health surveillance is indicated by a risk assessment.

Referrals must not be automatic, punitive or based on assumptions about a particular diagnosis or disability. The worker must be told the reason for the referral, the questions being asked and the possible outcomes.

5.2 Statutory health surveillance

Health surveillance will be introduced only where a suitable and sufficient risk assessment identifies that:

workers are exposed to a substance, process or activity associated with an identifiable disease or adverse health effect;
there is a reasonable likelihood that the disease or effect may occur under the conditions of work;
valid techniques are available to detect indications of the disease or effect; and
surveillance is required by applicable health and safety legislation or is otherwise necessary as part of the risk-control system.

Health surveillance will not be used as a substitute for eliminating or controlling workplace risks. The organisation will first apply the hierarchy of controls and reduce exposure so far as is reasonably practicable.

Examples relevant to domiciliary care may include surveillance for:

occupational dermatitis arising from repeated wet work, glove use, cleaning products or other hazardous substances;
respiratory sensitisation where exposure is identified;
musculoskeletal symptoms where risk assessment and competent advice indicate that a monitoring programme is appropriate; or
other identifiable work-related health effects arising from a specific exposure.

General stress, routine manual handling and ordinary infection-control duties do not automatically require statutory health surveillance. They require appropriate organisational risk assessment and preventive controls. Where health surveillance is required, it will be conducted by a competent person, with clear arrangements for recall, follow-up, referral, anonymised trend analysis and review of risk controls.

5.3 Health surveillance records

Where statutory health surveillance is undertaken, {{org_field_name}} will retain the health record required by the applicable legislation. The management health record will normally contain:

the worker’s identifying details;
the type of surveillance undertaken;
the date and outcome, expressed in terms of fitness or action required;
any work restrictions;
the date of the next review; and
confirmation of any action taken.

Detailed confidential clinical records will be held by the occupational health professional and will not form part of the ordinary personnel file.

Health surveillance records will be retained for the period required by the applicable legislation. Where the Control of Substances Hazardous to Health Regulations 2002 require health surveillance, relevant health records may need to be retained for 40 years from the date of the last entry. The records-retention schedule must identify the correct retention period for each category of record.

5.4 Reporting health concerns

Workers must inform their line manager, Human Resources or another designated manager where:

a health condition, medication side-effect or functional change may materially affect safe performance of their duties;
they believe work is causing or aggravating ill health;
they develop symptoms that may be linked to a workplace exposure;
they are involved in a sharps, blood, body-fluid, chemical or other hazardous exposure;
they require a reasonable adjustment;
they are pregnant, have recently given birth or are breastfeeding and wish the organisation to undertake the required individual risk assessment; or
a professional regulator or healthcare practitioner has imposed a restriction relevant to their work.

Workers are not required to disclose unrelated diagnoses or their entire medical history. Managers must seek only the information necessary to understand functional effects, risk and support requirements.

No worker will be subjected to detriment for raising a genuine health or safety concern.

6. Medical Reports and Confidentiality

6.1 Requesting a report from a medical practitioner

A report from a worker’s general practitioner, consultant or other medical practitioner responsible for their clinical care will be requested only where:

occupational health advice cannot adequately answer the relevant management questions;
the information is necessary and proportionate;
the purpose has been explained to the worker;
the questions are limited to matters relevant to work; and
the requirements of the Access to Medical Reports Act 1988 and data protection legislation have been followed.

{{org_field_name}} will normally seek occupational health advice before requesting information directly from a treating practitioner. A request must not seek the worker’s entire medical record unless there is an exceptional, documented and lawful reason.

6.2 Worker’s rights under the Access to Medical Reports Act 1988

Before applying for a medical report, {{org_field_name}} will obtain the worker’s written consent and notify the worker of their statutory rights. These include the right to:

withhold consent to the application;
indicate that they wish to see the report before it is supplied to the organisation;
contact the medical practitioner to arrange access to the report;
ask the practitioner to correct information that the worker considers inaccurate or misleading;
ask the practitioner to attach a statement setting out the worker’s view where the practitioner declines to amend the report; and
withhold consent to the report being supplied after viewing it.

The worker must be given the applicable statutory time limits and practical instructions for exercising these rights.

Where consent is refused or withdrawn, {{org_field_name}} will not compel disclosure. The organisation may make a decision using the information reasonably available, but only after considering the reason for the refusal, the worker’s representations, possible alternatives, reasonable adjustments and the requirements of fairness and non-discrimination.

6.3 Storage, access and retention

Occupational health reports, health questionnaires, sickness information, immunisation information and reasonable-adjustment records are confidential health information and will be protected by appropriate technical and organisational measures.

Access will be role-based and limited to authorised personnel with a genuine need to know. A line manager will normally receive only information about:

functional capacity;
restrictions;
workplace risk;
recommended adjustments;
likely duration;
review dates; and
whether the condition may meet the legal definition of disability, where occupational health can provide a professional opinion.

Detailed clinical information and diagnoses will not be routinely disclosed to managers.

Records must not simply be retained “for the necessary period”. Each category must have a documented retention period in the organisation’s retention schedule. Retention decisions will take account of:

statutory retention requirements;
employment and limitation periods;
safeguarding or regulatory requirements;
the continuing need to manage adjustments or exposure; and
the data-minimisation and storage-limitation principles.

Records will be securely deleted or anonymised when the retention period expires, unless a documented legal reason requires continued retention.

6.4 Disclosure and information sharing

Health information will not be disclosed to colleagues, people receiving care, commissioners or other third parties merely because they may be interested in it.

Information may be shared where:

the worker has given valid permission;
sharing is necessary to meet a legal obligation;
limited information is necessary to protect the worker or another person from a serious and imminent risk;
sharing is necessary for safeguarding;
sharing is required for the establishment, exercise or defence of legal claims; or
another lawful basis and special-category condition applies.

Wherever possible, only the minimum necessary information will be shared. Decisions to disclose without the worker’s agreement must be documented, authorised by a senior manager and supported by appropriate data protection or safeguarding advice.

7. Reasonable Adjustments and Support

7.1 Identifying Reasonable Adjustments

{{org_field_name}} will consider reasonable adjustments whenever it knows, or could reasonably be expected to know, that an applicant or worker is disabled and is placed at a substantial disadvantage by a provision, criterion, practice, physical feature or lack of an auxiliary aid.

These may include:

Flexible working hours to accommodate medical appointments or treatments.
Adjusted workloads or responsibilities to reduce strain.
Provision of ergonomic equipment, such as adjustable desks and chairs.
Remote or hybrid working for duties that can genuinely be performed away from service users’ homes, where this does not remove an intrinsic requirement of the care role.
Modified shift patterns to align with health needs.
Additional or adapted training.
Modified communication arrangements.
Additional supervision or mentoring.
Adapted moving and handling arrangements.
Restrictions on particular tasks for an agreed period.
Temporary redeployment.
Changes to travel areas or visit allocation.
Adjustments to lone-working arrangements.
Additional breaks.
Assistive technology or auxiliary aids.
A disability or health-related emergency plan where appropriate.

7.2 Reasonable-adjustment decision process

Adjustments will be considered in consultation with the worker. Occupational health, Human Resources, health and safety advisers or other specialists may be consulted where necessary.

A reasonable-adjustment record must document:

the disadvantage or work-related barrier;
the worker’s views and requested adjustment;
occupational health or other advice;
the adjustment agreed;
responsibility for implementation;
the implementation date;
any confidentiality arrangements;
the review date; and
the outcome of each review.

Where a requested adjustment is refused, the manager must record the objective reasons, including the effectiveness, practicality, cost, service impact, health and safety implications and availability of external assistance. A refusal must be reviewed by Human Resources or a senior manager.

Adjustments must not be withdrawn merely because a worker has been able to perform well while the adjustment is in place.

7.3 External Support and Access to Work

We support employees in accessing external resources, such as the Access to Work scheme, which provides funding for workplace adjustments and specialist equipment. HR facilitates applications and ensures employees receive timely support.

7.4 Workplace adjustment or health passport

Where helpful and with the worker’s agreement, {{org_field_name}} may use a workplace adjustment or health passport to record agreed support. The passport belongs to the worker and should contain only information relevant to workplace support.

It may include:

the effect of the condition at work;
agreed adjustments;
signs that additional support may be needed;
emergency arrangements;
communication preferences; and
review arrangements.

A health passport does not replace an individual risk assessment or the employer’s duty to consider reasonable adjustments.

8. Sickness Absence and Return to Work

8.1 Managing Sickness Absence

Sickness absence is managed through:

Prompt reporting and accurate recording of absences.
Regular communication between employees and line managers.
Early intervention to prevent long-term absence.
Supportive measures to facilitate recovery and return to work.
Distinguishing between absence management, capability, conduct and health and safety concerns.
Considering whether absence may be disability-related, pregnancy-related or connected with an injury or exposure at work.
Maintaining appropriate contact without pressuring the worker to return before it is safe.
Considering fit note recommendations, although the employer remains responsible for determining whether proposed work can be carried out safely.
Recording agreed contact arrangements and review dates.
Avoiding automatic triggers or sanctions that fail to consider disability-related or pregnancy-related absence.
Considering RIDDOR reporting and investigation where the absence follows a work-related incident or diagnosis.

8.2 Occupational health referral during absence

A referral may be appropriate during short-term or long-term absence where there is a clear management question that occupational health is competent to address. A referral must not be delayed merely until an arbitrary duration of absence has elapsed.

Appropriate questions may include:

whether the worker is currently able to carry out their substantive role;
the functional effect of the condition;
whether the condition may be work-related or aggravated by work;
whether the worker may be disabled for the purposes of the Equality Act 2010;
recommended adjustments or restrictions;
whether a phased return may assist;
the likely duration of restrictions;
whether further review is recommended; and
whether rehabilitation or specialist support may assist.

Occupational health should not be asked to determine whether the worker should be disciplined, dismissed or selected for redundancy.

8.3 Phased Return to Work

A phased return-to-work plan may include:

Reduced hours and gradual workload increase.
Temporary adjustments to responsibilities.
Regular review meetings with line managers to monitor progress.
Flexibility to extend or modify the plan based on recovery progress.

A phased return plan must be documented and must identify the worker’s duties, hours, visit allocation, moving and handling restrictions, lone-working arrangements, travel requirements, medication-related considerations where relevant, supervision, review dates and arrangements if the return is unsuccessful. The organisation must also explain how pay will be managed during the phased return in accordance with the worker’s contract and applicable policy.

8.4 Capability decisions

Dismissal or other formal capability action on health grounds will be considered only after a fair process has been followed. Before reaching a decision, {{org_field_name}} will consider:

current medical or occupational health evidence;
the worker’s representations;
the likely prognosis;
reasonable adjustments;
a phased return;
temporary or permanent redeployment;
whether further information or a trial period is appropriate;
the impact on safe service delivery; and
any applicable pension or ill-health retirement arrangements.

The worker will have the right to be accompanied at formal meetings and to appeal in accordance with the organisation’s applicable procedures.

9. Health and Safety at Work

9.1 Risk assessment in domiciliary care

{{org_field_name}} will undertake suitable and sufficient assessments of risks to workers and people receiving care. Assessments must reflect that domiciliary care is delivered in environments that are not controlled by the provider and may change between visits.

Assessments will consider, where relevant:

moving and handling of people and objects;
lone working and personal safety;
violence, aggression, harassment and abuse;
pets, smoking, weapons, illegal substances and unsafe visitors;
slips, trips, poor lighting, restricted space and unsafe access;
infection and exposure to blood or body fluids;
sharps and clinical waste;
hazardous substances and cleaning products;
occupational dermatitis and repeated wet work;
use, suitability and availability of personal protective equipment;
travel, driving, weather and fatigue;
work-related stress and emotional demands;
medication-related tasks;
pregnancy, recent childbirth and breastfeeding;
night work;
work equipment;
environmental temperature and ventilation; and
any risk arising from the person’s care needs, behaviour or home circumstances.

Risk assessments will be reviewed following a significant change, incident, occupational health recommendation, worker concern or evidence that controls are ineffective.

9.2 Preventive Measures

Preventive measures include:

Providing appropriate training and resources.
Promoting healthy work practices.
Ensuring access to occupational health support.
Implementing ergonomic solutions to reduce strain and injury risks.
Eliminating hazardous activities where reasonably practicable.
Avoiding hazardous manual handling where reasonably practicable.
Assessing unavoidable moving and handling and reducing risks to the lowest reasonably practicable level.
Providing suitable equipment and ensuring it is available in the person’s home.
Ensuring two-worker visits are provided where the assessment shows they are necessary.
Ensuring care workers have access to current risk information before attending a visit.
Providing lone-worker escalation, emergency and missed-contact arrangements.
Investigating work-related ill health, near misses and exposure incidents.
Reviewing risk controls when occupational health surveillance identifies an adverse trend.

9.3 Individual health-related risk assessment

Where a worker’s health condition may interact with a work hazard, an individual assessment will be undertaken in consultation with the worker. The assessment must focus on functional effects and work risks, not assumptions based on diagnosis.

The assessment must consider:

whether the risk can be removed;
whether work can be adapted;
whether equipment, training, supervision or changes to deployment are required;
whether lone working remains appropriate;
whether emergency arrangements are needed;
whether temporary restrictions are proportionate;
whether occupational health advice is required; and
when the assessment will be reviewed.

9.4 Pregnancy, recent childbirth and breastfeeding

Where {{org_field_name}} has been notified in writing that a worker is pregnant, has given birth within the previous six months or is breastfeeding, an individual risk assessment will be undertaken and kept under review.

The assessment will consider, where relevant:

moving and handling;
prolonged standing;
lone working;
violence and aggression;
exposure to infection, hazardous substances or body fluids;
night work;
fatigue, travel and rest breaks;
access to welfare facilities; and
any medical advice provided.

Where a significant risk cannot be adequately controlled, {{org_field_name}} will follow the legally required sequence of considering temporary adjustment of working conditions or hours, suitable alternative work and, where necessary, suspension on appropriate terms.

9.5 Infection risk, immunisation and occupational exposure

Infection prevention arrangements will be based on role-specific risk assessment. Workers will receive information, instruction, training, equipment and access to competent advice relevant to their duties.

Where immunisation is recommended because of occupational exposure, workers will be offered appropriate information and access arrangements. Immunisation information will be treated as confidential health data. A worker will not automatically be excluded from work because they decline or cannot receive an immunisation. The organisation will undertake an individual risk assessment and consider alternative controls, adjustments or deployment.

There must be an immediate reporting and response procedure for:

needlestick and sharps injuries;
bites and scratches;
blood or body-fluid exposure;
significant infectious-disease exposure;
splash exposure to eyes, mouth or broken skin;
chemical exposure; and
personal protective equipment failure.

The procedure must provide first aid, prompt clinical risk assessment, access to post-exposure treatment where indicated, confidential follow-up, incident investigation, RIDDOR consideration and review of risk controls.

9.6 Reporting occupational injuries, diseases and dangerous occurrences

The Registered Manager or designated competent person will consider whether a work-related incident, injury, diagnosis, exposure or dangerous occurrence is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.

Potentially reportable events must be escalated promptly. The decision and reasons must be documented, including where the conclusion is that a report is not required.

A RIDDOR report does not replace:

safeguarding action;
CQC notification where applicable;
internal incident reporting;
duty of candour;
workers’ compensation or insurance notification; or
review of risk assessments and control measures.

10. Mental Health and Well-Being

10.1 Promoting Mental Well-Being

We promote mental well-being through:

Access to counselling services and employee assistance programmes.
Mental health awareness and, where adopted by the organisation, appropriately supported mental health first aid arrangements. Mental health first aiders do not diagnose, treat or replace professional mental health services.
Regular well-being check-ins with line managers.
Stress management workshops and resources.
Organisational assessment and management of work-related stress.
Review of workload, visit scheduling, travel time, staffing, lone working, violence, traumatic events, supervision and management support.
Access to debriefing and support following distressing incidents.
Clear escalation arrangements where there is an immediate risk to the worker or another person.

10.2 Support for Mental Health Conditions

Employees with mental health conditions receive tailored support, including:

Reasonable adjustments such as altered hours, predictable rotas, additional breaks, temporary changes to caseload or visit allocation, additional supervision, reduced lone working, time for treatment, modified communication or remote working for duties that can genuinely be carried out remotely.
Access to occupational health services for specialist referrals.
Regular well-being reviews and open communication channels.
Guidance for managers on supporting employees with mental health conditions.

Managers must not seek detailed clinical disclosures unless they are necessary. Where a worker appears to be in immediate danger or presents a serious and imminent risk to another person, the manager must follow emergency, safeguarding and information-sharing procedures.

11. Communication and Collaboration

11.1 Internal Communication

Effective communication ensures:

Employees understand their rights and responsibilities.
Line managers are aware of support pathways.
Health concerns are addressed promptly and sensitively.
Open dialogue between HR, managers, and employees.
Workers are told the purpose and possible outcomes before an occupational health referral is made.
Workers are given an opportunity to comment on factual information included in the referral.
Managers receive guidance on maintaining confidentiality and implementing adjustments.
Relevant risk restrictions are communicated only to those who need them for safe deployment.
Occupational health recommendations are tracked until completed, declined with documented reasons or superseded by later advice.

11.2 Working with occupational health and medical practitioners

{{org_field_name}} may work with occupational health professionals, general practitioners, specialists or other competent advisers where necessary. Information will be requested and shared only in accordance with the worker’s rights, the Access to Medical Reports Act 1988 where applicable, professional confidentiality and data protection law.

Treating practitioners are responsible for clinical care. Occupational health advisers assess the relationship between health and work. Managers remain responsible for operational and employment decisions.

11.3 Disagreement with occupational health advice

A worker may raise concerns about factual accuracy or the interpretation of occupational health advice. The manager will consider:

clarification from the original occupational health professional;
relevant evidence supplied by the worker;
whether the report answered the questions asked;
whether a further assessment or specialist opinion is proportionate; and
whether temporary measures are required pending review.

A second opinion will not be obtained merely to secure a preferred outcome. Where medical opinions differ, the organisation will assess the quality, relevance and currency of the evidence and document its decision.

12. Monitoring and Continuous Improvement

12.1 Regular Policy Reviews

This policy will be reviewed at least annually and earlier where there is:

a change in legislation, CQC guidance, HSE guidance or ICO guidance;
a significant occupational health or safety incident;
a RIDDOR report;
an adverse employment tribunal, regulatory or safeguarding finding;
evidence that adjustments are not being implemented;
an emerging pattern of work-related ill health;
a change to the service model or regulated activity; or
evidence from workers that the procedure is inaccessible, discriminatory or ineffective.

12.2 Employee Feedback

We encourage employees to provide feedback on health management practices, promoting continuous improvement. Regular surveys and forums allow staff to voice concerns and suggest improvements.

12.3 Audit and assurance

The Registered Manager will ensure that periodic audits examine:

whether health enquiries are made at the correct recruitment stage;
whether referrals are necessary, proportionate and properly authorised;
whether Regulation 19 decisions address intrinsic tasks and reasonable adjustments;
whether occupational health recommendations are implemented and reviewed;
whether statutory health surveillance is correctly identified and completed;
whether exposure and needlestick incidents receive timely follow-up;
whether health records are access-controlled and retained correctly;
whether pregnancy and individual risk assessments are completed;
whether sickness and capability processes consider disability and pregnancy;
whether work-related ill-health trends identify unsafe systems of work; and
whether agency and contractor arrangements provide appropriate assurance.

Audit findings will be reported through the organisation’s governance arrangements. Personal health information will be anonymised or aggregated unless identifiable information is strictly necessary.

Improvement actions must identify an owner, deadline, evidence of completion and review outcome.

13. Compliance and Legal Framework

13.1 Legal and regulatory framework

This policy will be implemented in accordance with, where applicable:

Health and Safety at Work etc. Act 1974;
Health and Social Care Act 2008;
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, particularly Regulations 12, 17, 18 and 19;
Management of Health and Safety at Work Regulations 1999;
Equality Act 2010;
Data Protection Act 2018;
UK General Data Protection Regulation;
Access to Medical Reports Act 1988;
Control of Substances Hazardous to Health Regulations 2002;
Manual Handling Operations Regulations 1992;
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013;
Working Time Regulations 1998;
Personal Protective Equipment at Work Regulations 1992 and the Personal Protective Equipment at Work (Amendment) Regulations 2022, where applicable;
Health and Safety (Display Screen Equipment) Regulations 1992, where applicable;
Employment Rights Act 1996;
relevant CQC guidance;
relevant HSE guidance; and
relevant ICO employment and worker-health information guidance.

References to legislation include subsequent amendments, replacement provisions and applicable statutory guidance.

13.2 Worker rights

Workers have the right to:

fair and non-discriminatory treatment;
reasonable adjustments where the Equality Act 2010 applies;
information about why health information is being requested;
confidentiality and secure handling of health information;
exercise their data protection rights;
exercise their rights under the Access to Medical Reports Act 1988;
receive information about workplace risks and control measures;
raise health and safety concerns without detriment;
be consulted about occupational health recommendations and adjustments;
receive an explanation of health-related employment decisions; and
use applicable grievance, review and appeal procedures.

13.3 Worker responsibilities

Workers are expected to:

take reasonable care of their own health and safety and that of others;
follow training, safe systems of work and infection-control arrangements;
use equipment and personal protective equipment correctly;
report defects, hazards, injuries, symptoms and exposure incidents promptly;
provide accurate information when participating in an occupational health assessment;
engage reasonably with risk assessment and adjustment processes;
inform the organisation where a relevant restriction or functional change may materially affect safe work;
attend statutory health surveillance where this is a lawful requirement of the role; and
comply with agreed restrictions and adjustment plans.

Workers are not required to disclose health information that is unrelated to their work or to provide unrestricted access to their medical records.

14. Roles and Responsibilities

14.1 The provider or nominated individual will:

ensure adequate resources and competent advice are available;
oversee legal and CQC compliance;
receive assurance about significant occupational health risks; and
ensure identified deficiencies are addressed.

14.2 The Registered Manager will:

implement this policy;
ensure workers deployed in regulated activities meet Regulation 19;
ensure identified restrictions and adjustments are reflected in deployment;
ensure serious health and safety concerns are escalated;
monitor audit findings; and
maintain oversight of agency and contractor compliance.

14.3 Line managers will:

make referrals only where necessary and proportionate;
discuss referrals with workers;
implement adjustments and restrictions;
maintain confidentiality;
review return-to-work and health plans;
report incidents and work-related ill health; and
seek advice when concerns exceed their competence.

14.4 Human Resources will:

advise on fair process, equality and employment law;
support lawful health-information processing;
monitor capability and absence procedures;
support review and appeal processes; and
ensure templates and privacy information remain current.

14.5 The competent health and safety adviser will:

advise on risk assessment and statutory health surveillance;
support incident investigation and RIDDOR decisions;
monitor occupational health trends; and
advise on the effectiveness of controls.

14.6 Occupational health professionals will:

act within their professional competence;
obtain informed agreement for assessments and reports;
maintain clinical confidentiality;
provide objective, evidence-based functional advice;
explain any limits to confidentiality; and
retain clinical records in accordance with professional and legal requirements.

15. Refusal, non-attendance and failure to engage

Participation in an occupational health assessment will usually require the worker’s co-operation. Where a worker declines, withdraws consent or does not attend:

the manager will establish the reason;
barriers such as disability, communication needs, appointment timing, travel or misunderstanding will be considered;
the purpose and potential consequences will be explained without coercion;
a rearranged appointment or alternative means of obtaining relevant information will be considered;
the worker may provide information from another appropriate source; and
any decision will be based on the information reasonably available.

Formal action will not be automatic. It may be considered only where the request was lawful, necessary, proportionate, clearly explained and material to safe employment or deployment, and where the worker has been given a fair opportunity to engage.

16. Urgent and Emergency Health Concerns

Where a worker appears to require urgent medical attention, emergency services or appropriate clinical assistance must be contacted.

Where there is a serious and imminent risk to the worker, a person receiving care or another person, the manager may take proportionate steps including:

removing the worker temporarily from a particular duty;
arranging safe transport or emergency assistance;
securing immediate clinical or occupational health advice;
arranging alternative care for affected service users;
initiating safeguarding procedures;
preserving relevant evidence;
notifying relevant authorities where required; and
sharing the minimum information necessary to manage the emergency.

Any temporary restriction must be reviewed promptly and must not be treated as a disciplinary finding.

17. Associated Records and Documents

This policy should be read with the organisation’s:

recruitment and selection policy;
equality, diversity and inclusion policy;
reasonable-adjustment procedure;
sickness absence policy;
capability procedure;
data protection policy and employee privacy notice;
records-retention schedule;
infection prevention and control policy;
needlestick and body-fluid exposure procedure;
moving and handling policy;
lone-working policy;
work-related stress policy or risk-assessment procedure;
pregnancy and new-parent risk-assessment procedure;
RIDDOR and incident-reporting procedure;
safeguarding policy;
disciplinary and grievance procedures;
agency-worker and contractor assurance procedure; and
business continuity arrangements.

The following records must be available where applicable:

post-offer health-assessment record;
occupational health referral and outcome;
Access to Medical Reports Act consent documentation;
reasonable-adjustment record;
individual health-related risk assessment;
pregnancy or new-parent risk assessment;
health-surveillance record;
return-to-work plan;
exposure incident record;
RIDDOR decision record;
audit record; and
evidence that recommendations and corrective actions have been completed.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

DC107-Occupational Health Screening and Medical Reports Policy