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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 lawful and proportionate arrangements for determining whether persons working at the service are fit to undertake the duties of their role and for managing occupational health information appropriately.

In accordance with Regulation 35 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, {{org_field_name}} must ensure that persons working at the service are fit to do so. In relation to health, this means that the person must be able, after any reasonable adjustments have been made, to properly perform the tasks that are intrinsic to the work for which they are employed or engaged.

Occupational health screening, medical assessment or health surveillance will therefore only be undertaken where it is lawful, necessary and proportionate to the role, the risks associated with the work, an identified health concern or another applicable legal requirement. Occupational health screening is not automatically required for every employee solely because they work within a care home.

This policy aims to:

• ensure that staff are able, after any reasonable adjustments are made, to perform safely the intrinsic duties of their role;
• ensure that health enquiries and occupational health assessments are undertaken lawfully and only where necessary;
• identify and implement reasonable adjustments where required;
• protect the health and safety of employees, individuals receiving care and support, visitors and others who may be affected by the service;
• ensure appropriate arrangements for the prevention and control of infection;
• ensure that workers’ health information is processed lawfully, fairly, securely and confidentially in accordance with the UK General Data Protection Regulation and the Data Protection Act 2018, as amended; and
• comply with relevant health and safety, equality, employment and social care legislation applicable in Wales.

2. Scope

This policy applies to:

• employees and workers employed or engaged by {{org_field_name}};
• prospective employees where lawful health enquiries are necessary as part of the recruitment process;
• agency workers and other persons working at the service where {{org_field_name}} is required to satisfy itself that the individual is fit to undertake the work;
• volunteers where applicable;
• managers and members of staff responsible for recruitment, employment, health and safety or occupational health referrals; and
• occupational health professionals and other healthcare professionals engaged to provide advice concerning fitness for work.

Health enquiries during recruitment will be undertaken in accordance with the Equality Act 2010. Except where a statutory exception applies, applicants will not be asked general questions about their health or disability before they have been offered employment, whether conditionally or unconditionally.

Following a conditional offer of employment, {{org_field_name}} may obtain health information that is necessary and proportionate for determining whether the person is able, after reasonable adjustments are made where required, to perform the tasks intrinsic to the role.

Nothing in this policy removes {{org_field_name}}’s duty to make reasonable adjustments for a disabled applicant, employee or worker where that duty applies.

3. Related Policies

This policy aligns with:

• Health and Safety at Work Policy (CHW16)​.
• Infection Prevention and Control Policy (CHW17)​.
• Staff Supervision, Training, and Development Policy (CHW27)​.
• Confidentiality and Data Protection (GDPR) Policy (CHW34)​.
• Supporting Employees with Disabilities Policy.

4. Occupational Health and Fitness for Work

{{org_field_name}} will assess fitness for work in a lawful, proportionate and individualised manner.

Occupational health assessment, medical assessment, health surveillance or further medical advice will be obtained only where this is necessary because of:

• the intrinsic requirements of the person’s role;
• an identified workplace health and safety risk;
• an applicable statutory health-surveillance requirement;
• concerns about whether an employee can safely perform particular duties;
• a need to identify or review reasonable adjustments;
• work-related ill health;
• a significant change in the employee’s health which may affect their work; or
• a return to work where medical or occupational health advice is reasonably required.

A diagnosis, disability or long-term health condition will not in itself mean that a person is unfit for work. The assessment will consider whether the person can properly perform the intrinsic duties of their role after reasonable adjustments have been made.

4.1 Recruitment and Fitness for Work

{{org_field_name}} will comply with section 60 of the Equality Act 2010 when obtaining health information from applicants.

Before a conditional or unconditional offer of employment has been made, health or disability questions will only be asked where permitted by law, including where necessary to:

• establish whether reasonable adjustments are required for the recruitment or assessment process;
• establish whether an applicant can carry out a function that is intrinsic to the work, taking account of reasonable adjustments;
• monitor diversity, where the information is kept separate from the recruitment decision;
• take permitted positive action; or
• establish eligibility where having a particular disability is an occupational requirement permitted by law.

After a conditional offer of employment has been made, {{org_field_name}} may request proportionate health information where it is necessary to determine whether the prospective employee is able, after reasonable adjustments are made where required, to perform the intrinsic duties of the post.

Where further professional advice is necessary, the prospective employee may be referred to an occupational health professional. Any decision concerning fitness for work will take account of reasonable adjustments and will not be based solely on the existence of a disability, medical condition or diagnosis.

4.2 Health Assessment and Health Surveillance During Employment

Routine or periodic occupational health assessment will not be undertaken automatically solely because an individual is employed by {{org_field_name}}.

An assessment may be undertaken where it is necessary and proportionate, including where:

• health surveillance is required by health and safety legislation following an assessment of workplace risk;
• an employee develops symptoms that may be work-related;
• there is evidence that an employee’s health may affect their ability to undertake the intrinsic requirements of their role safely;
• an employee develops a disability or long-term health condition and reasonable adjustments need to be considered;
• there is a significant change in duties or workplace exposure relevant to the employee’s health; or
• occupational health advice is required to protect the employee or others from an identified health and safety risk.

Where statutory health surveillance is required because of exposure to a particular workplace hazard, {{org_field_name}} will provide the surveillance required by the relevant health and safety legislation.

4.3 Return to Work

Following sickness absence, injury, surgery or another significant health event, the manager will consider whether a return-to-work discussion, risk assessment, reasonable adjustment or occupational health referral is required.

Referral to occupational health will be based on the circumstances of the individual case rather than solely on a predetermined length of absence.

Where an employee is disabled within the meaning of the Equality Act 2010, {{org_field_name}} will consider and, where required, implement reasonable adjustments.

Pregnancy, maternity leave or another protected characteristic will not of itself be treated as a reason to require a medical or occupational health assessment. Where an employee requires an adjustment or where a specific health and safety assessment is required by law, this will be addressed in accordance with the relevant legislation and organisational procedures.

4.4 Role-Specific Health Risks

Where a role exposes an employee to a particular health risk, {{org_field_name}} will assess that risk and implement appropriate control measures.

Health surveillance, occupational health assessment, immunisation advice or other health measures will be arranged where required by applicable legislation, an assessment of occupational risk or current public health guidance.

Measures will be proportionate to the actual duties and exposures associated with the person’s role and will not consist of blanket medical testing of categories of employees unless there is a lawful and evidence-based justification for doing so.

5. Managing Medical Reports

Medical reports provide essential information on an employee’s fitness for work and guide reasonable adjustments.

5.1 Confidentiality and Data Protection

Information concerning an employee’s physical or mental health is personal data and will normally constitute special-category personal data.

{{org_field_name}} will process workers’ health information in accordance with the UK General Data Protection Regulation, the Data Protection Act 2018, as amended, and other applicable data-protection legislation.

Health information will only be collected, accessed, used, disclosed and retained where there is a lawful basis for doing so and where the information is adequate, relevant and limited to what is necessary for the specified purpose.

{{org_field_name}} will:

• identify an appropriate lawful basis under Article 6 of the UK GDPR and an applicable condition for processing special-category data under Article 9 before processing health information;
• provide employees with appropriate privacy information explaining how their health information will be used;
• restrict access to health information to authorised persons who require access for a legitimate work-related purpose;
• keep occupational health and medical information securely and, where appropriate, separately from general personnel information;
• ensure that managers are normally provided only with information necessary to manage fitness for work, restrictions, workplace risks and reasonable adjustments rather than unnecessary clinical detail;
• ensure health information is accurate and, where necessary, kept up to date;
• retain health information only for as long as it is required in accordance with the organisation’s retention arrangements and applicable legal requirements; and
• use appropriate technical and organisational security measures to protect health information.

Health information will not be disclosed to third parties unless there is a lawful basis for the disclosure. Where consent is legally required for a particular disclosure or application for a medical report, that consent will be obtained before the relevant action is taken.

5.2 Requesting Medical Reports

Where {{org_field_name}} considers that medical information from an employee’s general practitioner or another medical practitioner who is or has been responsible for the employee’s clinical care is necessary for employment purposes, the requirements of the Access to Medical Reports Act 1988 will be followed where that Act applies.

Before applying for such a medical report, {{org_field_name}} will:

• notify the employee that it proposes to obtain the report;
• obtain the employee’s consent to the application;
• inform the employee of their statutory rights under the Access to Medical Reports Act 1988; and
• explain the purpose for which the report is being requested.

The employee will be informed that they may withhold consent to the application.

Where the employee requests access to the report before it is supplied, the statutory procedure under the Access to Medical Reports Act 1988 will be followed. The employee may ask the medical practitioner to amend information which they consider incorrect or misleading. Where the medical practitioner declines to amend the report, the employee may ask for a statement setting out their views to be attached to the report in accordance with the Act.

Only information that is relevant and necessary for the employment purpose will be requested.

Where an employee does not consent to a medical report being obtained, {{org_field_name}} will not obtain that report unlawfully. The employee will be informed that employment decisions may need to be made on the basis of the information that is otherwise reasonably available.

A request for a medical report will not remove {{org_field_name}}’s duty to consider reasonable adjustments under the Equality Act 2010.

5.3. Using Medical Reports to Support Employees

Medical reports help managers:

• Identify reasonable adjustments (e.g., reduced hours, modified duties).
• Implement workplace adaptations (e.g., ergonomic equipment).
• Provide long-term support plans for employees with chronic health conditions.

6. Infection Prevention and Control in Health Screening

To prevent the spread of infectious diseases, employees are required to:

6.1 Immunisation and Vaccination

{{org_field_name}} will follow current Welsh Government, Public Health Wales and applicable occupational health guidance concerning vaccination and immunisation.

Vaccination will not be treated as a blanket condition of employment unless a specific legal requirement applies.

Where vaccination is recommended for health or social care workers because of occupational exposure, {{org_field_name}} will undertake an appropriate risk assessment and will provide, facilitate or signpost access to vaccination in accordance with current national guidance.

Seasonal influenza vaccination will be actively encouraged and supported or facilitated for eligible staff in accordance with the current Welsh national influenza immunisation programme.

Requirements or recommendations concerning COVID-19 vaccination will follow the current Welsh national vaccination programme and will not be described as mandatory for care-home employees unless legislation subsequently requires this.

Where occupational exposure may create a specific risk, including exposure to blood or body fluids, advice concerning hepatitis B or other relevant immunisation will be based on the employee’s duties, occupational risk assessment and current occupational health and immunisation guidance.

Tuberculosis screening or assessment will be undertaken where indicated by an individual occupational risk assessment, relevant clinical or public health guidance, or other applicable requirements rather than as a blanket requirement for all staff.

Information concerning an employee’s vaccination or immunisation status is health information and will be processed in accordance with Section 5.1 of this policy.

6.2 Infectious Disease Reporting and Management

Employees must promptly report to their manager, in accordance with the organisation’s sickness and infection prevention and control procedures, symptoms, diagnoses or exposures that may create a material risk of transmitting infection to individuals receiving care and support, colleagues or others within the service.

This includes, where relevant:

• acute respiratory infection symptoms;
• vomiting or diarrhoea;
• suspected or confirmed gastrointestinal infection;
• suspected or confirmed tuberculosis;
• significant infectious skin conditions or infestations; and
• any other communicable infection where attendance at work may present a risk to others.

Managers will respond in accordance with the service’s Infection Prevention and Control Policy and current Welsh Government, Public Health Wales and other applicable public health guidance.

An employee will not automatically be excluded from work solely because they have reported a health condition or infection. A proportionate decision will be made taking account of:

• the infection or symptoms concerned;
• current public health guidance;
• the employee’s duties;
• the vulnerability of individuals receiving care and support;
• whether the employee can safely work with temporary adjustments or alternative duties; and
• advice from occupational health, Public Health Wales, the relevant Health Board or another appropriate healthcare professional where necessary.

Where current public health guidance requires or recommends that a member of staff should not attend work, {{org_field_name}} will act in accordance with that guidance and the service’s infection prevention and control arrangements.

7. Supporting Employees with Health Conditions

Employees with long-term health conditions or disabilities will be supported through:

7.1. Reasonable Adjustments

• Flexible working arrangements.
• Ergonomic modifications (e.g., adapted desks, seating).
• Modified duties or redeployment, if required.

7.2. Employee Assistance and Support

• Access to Occupational Health Specialists.
• Mental health support services.
• Return-to-work plans for those recovering from illness or injury.

8. Training and Awareness for Staff

All employees and managers receive mandatory training in:

• Health screening requirements and why they are necessary.
• Infection prevention and control.
• Confidentiality and handling medical data.
• Supporting colleagues with health conditions.

9. Compliance and Monitoring

{{org_field_name}} will monitor implementation of this policy to ensure that persons working at the service continue to meet the applicable fitness requirements and that occupational health information is handled lawfully.

Monitoring arrangements will include, where applicable:

• checking that recruitment and fitness-for-work decisions comply with Regulation 35 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended;
• checking that reasonable adjustments have been considered and implemented where required;
• monitoring compliance with applicable health surveillance requirements arising from workplace risk assessments;
• monitoring infection prevention and control arrangements relevant to staff health;
• ensuring occupational health and medical information is processed securely and in accordance with data-protection legislation; and
• taking appropriate and timely action where there is evidence that a member of staff no longer meets the applicable fitness requirements.

Records required by legislation or reasonably necessary to demonstrate compliance will be made available to Care Inspectorate Wales or another competent regulatory authority where the authority is legally entitled to inspect them.

The service provider will keep this policy and associated procedures under review and will update them where required by changes in legislation, statutory guidance or relevant national guidance.

10. Declining an Occupational Health Assessment or Medical Report

Where an employee declines to attend an occupational health assessment, undergo health surveillance or provide consent for a medical report, the manager will first establish the reason for the proposed assessment or report and whether it is necessary and lawful.

The employee will be informed of:

• the reason the assessment, health surveillance or medical information has been requested;
• how the information is relevant to their work;
• how their information will be used and protected;
• any statutory requirement that genuinely applies;
• their rights in relation to the proposed assessment or medical report; and
• the possible employment or health and safety consequences of a decision not to provide information that is reasonably necessary for a lawful employment decision.

Where participation in health surveillance is specifically required under applicable health and safety legislation because of an identified occupational exposure, this requirement will be clearly explained to the employee.

Where no specific statutory requirement applies, an employee will not be informed that occupational health screening is a legal requirement merely because they work in a care home.

If an employee declines consent to an occupational health assessment or medical report, {{org_field_name}} will consider whether a decision can reasonably be made using the information already available, together with any reasonable alternative proposed by the employee.

Any management or employment action will be reasonable, proportionate and based on the circumstances of the individual case, including:

• the intrinsic requirements of the employee’s role;
• identified risks to the employee or others;
• the information reasonably available;
• whether reasonable adjustments could remove or reduce the identified risk; and
• the requirements of equality, employment, health and safety and data-protection law.

Disciplinary action will not be taken simply because an employee has exercised a lawful right to withhold consent to a medical report. Where separate conduct, capability or health and safety issues arise, they will be addressed under the appropriate organisational procedure and in accordance with applicable law.

11. Policy Review

This policy will be reviewed annually or sooner if:

• CIW or NHS guidelines change.
• New public health risks emerge.
• Employee feedback suggests improvements.

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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.