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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Occupational Health Screening and Medical Reports Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} has effective arrangements for assessing and managing the occupational health of workers so that people employed or otherwise engaged to provide regulated activities are able, by reason of their health and after any reasonable adjustments have been made, to properly perform the tasks that are intrinsic to their roles.

This policy supports compliance with the requirements relating to safe care and treatment, fit and proper persons employed, infection prevention and control, health and safety at work, equality and data protection.

{{org_field_name}} will:

• ensure that persons appointed to roles involving regulated activities meet the health requirements relevant to their role;
• ensure that confidential health assessment forming part of recruitment takes place only after a conditional offer of employment, except where a health-related enquiry is specifically permitted by law before that point;
• identify occupational health risks through suitable and sufficient risk assessment and arrange health surveillance where required by law;
• consider and implement reasonable adjustments for disabled workers where required by the Equality Act 2010;
• manage communicable-disease risks and staff occupational health in accordance with applicable infection prevention and control requirements and current national guidance;
• process workers’ health information lawfully, fairly, transparently, securely and only to the extent necessary for a specified purpose;
• obtain and use medical reports in accordance with applicable confidentiality requirements and the Access to Medical Reports Act 1988 where that Act applies; and
• retain occupational health and health-surveillance records for the period required by applicable legislation and the organisation’s approved retention schedule.

The purpose of occupational health assessment is to determine fitness in relation to the requirements and risks of the role and to identify measures, including reasonable adjustments, that may enable a person to work safely. A diagnosis or disability will not, of itself, make a person unsuitable for employment.

2. Scope

This policy applies to:

• All employees, including full-time, part-time, agency, and volunteer staff.
• Job applicants, as part of the pre-employment screening process.
• Management and HR teams, responsible for coordinating occupational health assessments.
• External occupational health providers, where medical assessments are required.
• People we support, ensuring they receive care from staff who are fit and capable of delivering safe care.

3. Legal and Regulatory Compliance

{{org_field_name}} will operate this policy in accordance with applicable legislation and regulatory requirements, including:

• Health and Social Care Act 2008 and the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as amended, including:
  • Regulation 12 – Safe care and treatment, including requirements to assess and mitigate risks to the health and safety of people receiving care and to prevent and control infection;
  • Regulation 17 – Good governance, insofar as it requires effective systems and processes, including appropriate records, for assessing, monitoring and improving the quality and safety of the regulated activity;
  • Regulation 18 – Staffing, including ensuring that staff receive appropriate support, training, professional development, supervision and appraisal necessary for their duties; and
  • Regulation 19 – Fit and proper persons employed, which requires persons employed for the purposes of carrying on a regulated activity to be able, by reason of their health and after reasonable adjustments have been made, to properly perform tasks which are intrinsic to the work for which they are employed. Recruitment procedures must be operated effectively to establish that this requirement is met.
• Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance, including the requirement for appropriate arrangements to manage staff occupational health in relation to infection prevention and control.
• Equality Act 2010, including:
  • the duty to avoid unlawful disability discrimination;
  • the duty to make reasonable adjustments where applicable; and
  • the restrictions under section 60 on asking applicants questions about health or disability before an offer of employment, except where a statutory exception applies.
• Health and Safety at Work etc. Act 1974, requiring the employer, so far as is reasonably practicable, to protect the health, safety and welfare of employees and others affected by its undertaking.
• Management of Health and Safety at Work Regulations 1999, including requirements for suitable and sufficient risk assessment and health surveillance where identified as appropriate by the risk assessment.
• Control of Substances Hazardous to Health Regulations 2002, as amended (COSHH), including health surveillance where the statutory conditions are met and the maintenance and retention of required health-surveillance records.
• Working Time Regulations 1998, including the requirement to offer qualifying night workers a free health assessment before assignment to night work and at appropriate regular intervals thereafter.
• Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), requiring specified work-related injuries, diseases and dangerous occurrences to be reported to the relevant enforcing authority where the statutory reporting criteria are met.
• UK General Data Protection Regulation and Data Protection Act 2018, as amended, under which information concerning a person’s physical or mental health is special category personal data and must only be processed where an appropriate lawful basis and special category condition have been identified and documented.
• Access to Medical Reports Act 1988, where applicable to a medical report requested for employment purposes from a medical practitioner who is or has been responsible for the clinical care of the individual.

{{org_field_name}} will also have regard to current CQC guidance for providers and current national infection prevention and control and occupational health guidance relevant to adult social care in England.

4. Managing Occupational Health Screening Efficiently

4.1. Pre-Employment Health Screening

A confidential health assessment will be completed after a conditional offer of employment and before the individual begins duties where this is necessary to establish that the requirements of the role can be performed safely and to identify any occupational health measures or reasonable adjustments that may be required.

Health or disability questions will not normally be asked before a job offer has been made. Questions may only be asked before that stage where permitted by section 60 of the Equality Act 2010, for example where information is required to establish whether an applicant needs a reasonable adjustment to participate in the recruitment process or whether the applicant can carry out a function that is intrinsic to the work, taking account of reasonable adjustments.

Following a conditional offer, the health assessment will be proportionate to the role and may include:

• a confidential health declaration relevant to the person’s ability to undertake the intrinsic requirements of the role safely;
• relevant information concerning previous or current illness where necessary for occupational health purposes;
• information concerning residence or work overseas where relevant to assessment of communicable-disease risk;
• consideration of the person’s immunisation status where relevant to the infection risks associated with their duties;
• occupational health assessment or specialist advice where identified as necessary;
• consideration of risks associated with exposure to biological agents, hazardous substances, manual handling or other occupational hazards;
• assessment of whether reasonable adjustments are required; and
• confirmation of fitness for the proposed duties, with restrictions or recommended adjustments where applicable.

Vaccination requirements will be determined by applicable national guidance, the risks associated with the worker’s duties and the individual risk assessment. Vaccination against influenza, hepatitis B, COVID-19, MMR or other infections will not be described or applied as a universal condition for all care-home workers unless a specific legal requirement applies.

Where occupational health advice is required, managers should normally be provided only with information necessary for employment purposes, such as whether the individual is fit for the role, any functional restrictions, recommended adjustments or the need for review. Detailed clinical information should not routinely be provided to management.

Where an applicant declines to provide health information or participate in an assessment that is necessary and proportionate for establishing their ability to carry out the intrinsic functions of the role safely, {{org_field_name}} will explain why the information or assessment is required and will consider whether sufficient information is otherwise available to establish fitness for the role. Any subsequent employment decision will be based on the requirements and risks of the role, the available evidence and consideration of reasonable adjustments, and will comply with the Equality Act 2010.

4.2. Health Assessment and Health Surveillance for Existing Staff

Health assessment or surveillance of existing workers will be undertaken only where there is an identified occupational health need, a statutory requirement, a material change in risk or a reasonable need to assess fitness for particular duties.

The fact that a worker has a disability, long-term health condition or history of sickness absence does not, by itself, justify routine or intrusive medical monitoring.

Occupational health assessment may be appropriate where:

• a risk assessment identifies a need for health surveillance;
• health surveillance is required under COSHH or other applicable health and safety legislation;
• a worker reports symptoms which may be associated with occupational exposure;
• there has been actual or suspected exposure to a biological agent, hazardous substance or other occupational hazard;
• a worker’s health may materially affect their ability to perform the intrinsic requirements of their role safely;
• a worker is returning following sickness absence and a proportionate assessment is required to identify safe duties, restrictions or reasonable adjustments;
• a worker requests an assessment or reasonable adjustment because of a disability or health condition;
• occupational health advice is required to manage work-related illness or injury; or
• another specific statutory requirement applies.

Where statutory health surveillance is required, {{org_field_name}} will ensure that it is carried out by a competent person at appropriate intervals and that workers cooperate with surveillance required by law and provided at the employer’s expense.

Where workers meet the statutory definition of night workers, {{org_field_name}} will ensure that they have the opportunity to undertake a free health assessment before being assigned to night work and at appropriate regular intervals while undertaking night work. Where a registered medical practitioner advises that a night worker has health problems connected with night work, the organisation will comply with the applicable requirements concerning transfer to suitable day work where this is possible.

Health assessments will be proportionate to the identified purpose and will not collect clinical information that is unnecessary for that purpose.

4.3. Management of Medical Reports and Occupational Health Information

Health information is special category personal data. Before collecting or otherwise processing occupational health information, {{org_field_name}} will identify and document an appropriate lawful basis under Article 6 of the UK GDPR and an applicable condition for processing health information under Article 9 of the UK GDPR and the Data Protection Act 2018.

Consent will not automatically be treated as the data-protection lawful basis for processing employee health information. Because of the relationship between employer and worker, consent may not always be freely given for data-protection purposes. Where processing is necessary to comply with employment, social protection, health and safety or occupational medicine obligations, the appropriate statutory basis and special category condition will be identified.

This does not remove the separate requirements concerning medical confidentiality or consent to the disclosure of confidential clinical information.

{{org_field_name}} will ensure that:

• occupational health referrals clearly identify the purpose of the referral and the questions on which management requires advice;
• only health information that is adequate, relevant and necessary for the identified purpose is requested;
• workers are informed about what information will be collected, why it is required, how it will be used, who may receive it and how long it will be retained;
• confidential clinical records held by an occupational health professional are distinguished from occupational health management information held by {{org_field_name}};
• managers normally receive only information necessary to manage employment safely, such as fitness for work, functional capability, restrictions, recommended reasonable adjustments and review requirements;
• diagnoses or detailed clinical information are not routinely disclosed to managers unless there is a lawful and necessary reason for disclosure;
• occupational health information is held securely and access is restricted to persons who have a legitimate need to know; and
• occupational health information is not subsequently used for an incompatible purpose unless there is a lawful basis for doing so.

Where {{org_field_name}} applies for a medical report that falls within the Access to Medical Reports Act 1988, the worker will be informed of their statutory rights before the application is made. These include the right to withhold consent to the application, the right to indicate that they wish to see the report before it is supplied, and, where they have seen the report, the right to request correction of information they consider inaccurate or misleading or to request that a statement of their views is attached where the medical practitioner declines to amend it.

Where consent to disclosure of confidential medical information is refused, {{org_field_name}} will make any employment decision on the information reasonably available and will not assume that refusal, of itself, establishes that the person is unfit for work.

Where a report identifies restrictions or recommends adjustments, the manager will consider those recommendations promptly and will comply with the organisation’s obligations under the Equality Act 2010 and health and safety legislation.

4.4. Managing Work-Related Illnesses and Injuries

Where a worker develops or reports an illness, injury or symptoms that are or may be associated with work, {{org_field_name}} will take appropriate action to protect the worker and others who may be affected.

Action will include, where applicable:

• providing or arranging immediate medical assistance where required;
• recording the incident, injury, occupational exposure or reported illness in accordance with organisational procedures;
• reviewing the relevant risk assessment and identifying whether further control measures are required;
• considering whether the worker should temporarily cease or modify particular duties;
• obtaining competent occupational health advice where appropriate;
• arranging any health surveillance required by law;
• considering reasonable adjustments or temporary modified duties;
• supporting an appropriate and safe return to work following illness or injury; and
• reviewing whether other workers have experienced, or may have experienced, the same occupational exposure.

The responsible person will determine whether an injury, occupational disease, dangerous occurrence or other event is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.

Where the statutory criteria are met, {{org_field_name}} will ensure that the required RIDDOR report is submitted to the appropriate enforcing authority within the applicable statutory timescale.

A diagnosed disease will only be reported as an occupational disease under RIDDOR where it falls within the specified reportable categories and is linked to the occupational exposure specified by the Regulations.

Information concerning work-related illness and injury will be handled confidentially and only information necessary for health and safety management, statutory reporting or another lawful purpose will be disclosed.

4.5. Infection Prevention and Control and Communicable Diseases

{{org_field_name}} will maintain occupational health arrangements that support the prevention and control of infection and comply with the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and current national guidance for adult social care in England.

Occupational health arrangements relating to infection will include:

• confidential health assessment following a conditional offer of employment;
• proportionate screening for communicable disease where indicated by the person’s role, relevant exposure, risk assessment or current national or public health guidance;
• arrangements for managing occupational exposure to infectious diseases and biological agents;
• risk assessment of the need for immunisation according to the worker’s duties, susceptibility, current national vaccination guidance and identified occupational risks;
• arrangements for workers to report symptoms, diagnosis or exposure to communicable disease where this may present a risk to people receiving care, colleagues or others;
• clear arrangements for determining when a worker should be excluded from work, restrict duties or work with additional precautions;
• access to appropriate occupational health, infection prevention and control or public health advice where necessary; and
• arrangements for responding to an outbreak or other significant infection risk.

Testing for COVID-19, influenza, norovirus or another communicable disease will not automatically be required solely because an outbreak has occurred. Testing or additional health screening will be undertaken where it is indicated by current national or local public health guidance, a clinical or occupational health recommendation, a suitable and sufficient risk assessment or a specific legal requirement.

Workers will be supported and encouraged to receive vaccinations for which they are eligible in accordance with current national guidance. Vaccination requirements will be based on the risks of the particular role and applicable legal or public health requirements rather than being applied as an automatic universal condition of employment.

Workers have a responsibility to report promptly any illness, symptoms or exposure that may create a significant infection risk at work and to comply with lawful infection prevention and control measures.

4.6. Confidentiality, Access Rights and Retention of Occupational Health Records

All occupational health and medical information will be treated as confidential and processed in accordance with the UK GDPR, the Data Protection Act 2018, applicable medical confidentiality requirements and other relevant legislation.

Access to occupational health information held by {{org_field_name}} will be restricted to authorised persons who require the information for a legitimate and lawful purpose.

Workers will be provided with appropriate privacy information explaining:

• what health information is collected;
• the purposes for which it is processed;
• the applicable lawful basis and special category condition;
• who may receive the information;
• applicable retention arrangements; and
• their data protection rights.

Workers may exercise their applicable rights under data protection legislation, including the right of access to personal data held about them, subject to any lawful exemption.

Where the Access to Medical Reports Act 1988 applies, workers will also be informed of the separate statutory rights applying to the relevant medical report, including rights concerning consent, access before the report is supplied and correction of information considered inaccurate or misleading.

Occupational health records will not be kept for an arbitrary or universal six-year period following employment. The retention period will be determined by:

• the purpose for which the information is held;
• any applicable statutory retention period;
• health and safety requirements;
• the organisation’s approved records retention schedule; and
• the UK GDPR principle that personal data must not be retained for longer than necessary.

Where a worker is subject to health surveillance under COSHH, {{org_field_name}} will maintain the statutory health record and retain it for at least 40 years from the date of the last entry, as required by the Regulations.

The statutory employer health-surveillance record will be distinguished from confidential clinical records held by the occupational health practitioner. Clinical information will not be copied into management records unless it is necessary and lawful to do so.

Records that are not subject to a statutory minimum retention period will be retained only for as long as there is a documented and lawful need to retain them and will thereafter be securely destroyed or anonymised.

4.7. Reasonable Adjustments and Disability Support

{{org_field_name}} will comply with its duties under the Equality Act 2010 and will not treat a worker as unsuitable for employment merely because they have a disability, long-term health condition or history of illness.

The duty to consider reasonable adjustments is not dependent upon an occupational health report being obtained. Where {{org_field_name}} knows, or could reasonably be expected to know, that a worker is disabled and is placed at a substantial disadvantage because of a workplace provision, criterion, practice, physical feature or absence of an auxiliary aid, reasonable adjustments will be considered in accordance with the Equality Act 2010.

In accordance with Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, assessment of a person’s health-related fitness for work will consider whether they are able, after reasonable adjustments are made, to properly perform the tasks that are intrinsic to the work for which they are employed.

Reasonable adjustments may include, depending upon the circumstances:

• modification of particular duties or working methods;
• changes to hours or working patterns;
• provision of suitable equipment or auxiliary aids;
• changes to the physical working environment;
• additional supervision or support;
• adjustments to training or communication arrangements;
• temporary or phased return-to-work arrangements; or
• other appropriate measures which remove or reduce a substantial disadvantage.

Occupational health advice may be obtained where it will assist {{org_field_name}} and the worker to understand functional limitations, likely duration, occupational risks or possible adjustments. The final decision about whether an adjustment is reasonable is an employment decision for {{org_field_name}}, taking account of the individual circumstances and the requirements of the Equality Act 2010.

Where an adjustment cannot reasonably be made, or where a worker remains unable to perform an intrinsic requirement of the role safely after reasonable adjustments have been considered, {{org_field_name}} will consider any other appropriate options before making an employment decision.

Decisions will be documented and based on relevant evidence rather than assumptions about a diagnosis or disability.

4.8. Staff Well-being and Mental Health Support

Occupational health extends to mental health and emotional well-being, ensuring that:

• Counselling services are available for staff experiencing work-related stress.
• Stress risk assessments are conducted to prevent workplace burnout.
• Flexible working arrangements are considered for employees facing personal or medical challenges.

5. Monitoring, Compliance and Audit

{{org_field_name}} will maintain effective governance arrangements to demonstrate that occupational health processes are lawful, proportionate and effective.

Monitoring will include:

• auditing compliance with the health-assessment requirements applicable to recruitment;
• checking that occupational health referrals are made only where there is a legitimate and proportionate need;
• ensuring that statutory health surveillance is identified through risk assessment and completed at the intervals required by the relevant legislation or competent occupational health advice;
• checking that workers undertaking night work are offered health assessments where required by the Working Time Regulations 1998;
• monitoring occupational exposures, work-related illness and injury and reviewing whether additional control measures are required;
• checking that reportable incidents and occupational diseases are notified under RIDDOR where the statutory criteria are met;
• auditing the security, access controls and retention arrangements applying to occupational health information;
• checking that statutory health-surveillance records are retained for the required period;
• monitoring compliance with infection prevention and control arrangements affecting staff occupational health; and
• reviewing whether occupational health recommendations and reasonable adjustments are appropriately considered and implemented.

Routine review of a worker’s medical information will not be undertaken solely to confirm continued fitness for employment where there is no identified occupational health, health and safety, regulatory or legal need.

Audit findings, incidents, occupational exposures and identified deficiencies will be reviewed by the responsible manager and appropriate corrective action will be implemented and recorded.

6. Related Policies

This policy should be read alongside:

• CH18 – Risk Management and Assessment Policy​.
• CH19 – Emergency and Business Continuity Plan​.
• CH17 – Infection Prevention and Control Policy​.
• CH27 – Staff Supervision, Training, and Development Policy​.
• CH34 – Confidentiality and Data Protection (GDPR) Policy​.

7. Policy Review

This policy is reviewed annually or sooner if required due to legislative updates, changes in health risks, or recommendations from regulatory bodies.

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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.