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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Requesting Medical Reports for Staff Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} manages health information, Occupational Health referrals and requests for medical reports concerning staff lawfully, fairly, consistently and confidentially.

{{org_field_name}} must ensure, in accordance with Regulation 35 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, that persons working at the service are fit to do so. In relation to health, this means that the person must be able, by reason of their health and 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.

This policy is intended to ensure that:

• medical information is sought only where there is a lawful, necessary and proportionate reason for doing so;
• health enquiries during recruitment comply with the Equality Act 2010;
• reasonable adjustments are properly considered;
• medical reports are obtained in accordance with the Access to Medical Reports Act 1988 where that Act applies;
• staff health information is processed in accordance with the UK General Data Protection Regulation and the Data Protection Act 2018;
• decisions about fitness for work are based on relevant evidence and the requirements of the role;
• staff privacy, dignity and employment rights are protected; and
• the safety and well-being of individuals receiving care and support are maintained.

2. Scope

This policy applies to persons working, or being considered for work, at {{org_field_name}} where health information may lawfully be required in connection with their role.

This includes, where applicable:

• applicants who have reached the stage at which health enquiries are permitted by law;
• employees and workers;
• agency staff;
• persons engaged under a contract for services;
• volunteers; and
• other persons working at the service who may, in the course of their duties, have regular contact with individuals receiving care and support or with other vulnerable people.

This policy applies to health enquiries, Occupational Health referrals and medical reports connected with matters including:

• assessment of fitness to perform the intrinsic requirements of a role;
• fitness to continue working following illness, injury or a change in health;
• sickness absence management;
• return-to-work arrangements where further medical evidence is reasonably required;
• consideration and review of reasonable adjustments;
• health and safety concerns;
• consideration of restrictions or modifications to duties; and
• other circumstances in which medical information is necessary to meet a legal obligation or make a fair and informed employment decision.

3. Legal and Regulatory Compliance

This policy will be implemented in accordance with applicable legislation and regulatory requirements, including:

• The Regulation and Inspection of Social Care (Wales) Act 2016.
• The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, particularly Regulation 35 concerning the fitness of staff. A person must be able, by reason of their health and after reasonable adjustments are made, to properly perform the tasks intrinsic to the work for which they are employed or engaged.
• The Equality Act 2010, including the duty to make reasonable adjustments for disabled applicants and workers and the restrictions under section 60 concerning health and disability enquiries before an offer of employment.
• The Access to Medical Reports Act 1988, where applicable to a report sought for employment purposes from a medical practitioner who is or has been responsible for the clinical care of the individual.
• The UK General Data Protection Regulation and Data Protection Act 2018, because information concerning a person’s physical or mental health constitutes special category personal data and must only be processed where an appropriate lawful basis and special category condition have been identified.
• The Health and Safety at Work etc. Act 1974, where health information is necessary to enable {{org_field_name}} to comply with its duties concerning the health, safety and welfare of workers and others who may be affected by its activities.

{{org_field_name}} will also have regard to relevant statutory guidance issued by the Welsh Ministers and current Care Inspectorate Wales requirements relating to staff fitness, recruitment, staffing and safe delivery of regulated services.

4. Process for Requesting Medical Reports

4.1 Recruitment and Pre-Employment Health Information

{{org_field_name}} will not routinely require applicants to complete a health questionnaire or disclose information about their health or disability before an offer of employment has been made.

Before an offer of employment, health or disability questions will only be asked where permitted by section 60 of the Equality Act 2010. This may include questions which are necessary to:

• establish whether reasonable adjustments are required to enable an applicant to participate in the recruitment or assessment process;
• establish whether an applicant can carry out a function that is intrinsic to the work concerned, taking account of any reasonable adjustments that may be required;
• undertake permitted equality and diversity monitoring;
• support lawful positive action; or
• establish eligibility where having a particular disability is an occupational requirement permitted by law.

Information obtained for equality monitoring purposes must be kept separate from recruitment decision-making wherever appropriate.

Following a conditional or unconditional offer of employment, {{org_field_name}} may seek proportionate health information where this is necessary to determine whether the person is able, by reason of their health and after reasonable adjustments are made, to properly perform the tasks intrinsic to the role.

Where a post-offer health questionnaire or Occupational Health assessment is required:

• only information relevant and necessary to the role will be requested;
• the applicant will be informed why the information is required and how it will be used;
• reasonable adjustments will be considered before any conclusion is reached that the individual is unable to perform the intrinsic duties of the role;
• medical information will not be used to discriminate unlawfully against an applicant because of disability or another protected characteristic; and
• where additional information is required from a medical practitioner responsible for the applicant’s clinical care, the requirements of the Access to Medical Reports Act 1988 will be followed where applicable.

Any offer made subject to satisfactory health assessment must be considered fairly and individually. A medical condition or disability will not, by itself, constitute grounds for withdrawal of an offer. Before an offer is withdrawn for a health-related reason, {{org_field_name}} will consider the intrinsic requirements of the role, relevant medical or Occupational Health advice, any identified risks and all reasonable adjustments that may enable the person to undertake the role safely and effectively.

4.2 Fitness-to-Work Assessments and Medical Reports

Where there is a genuine concern that an employee’s physical or mental health may be affecting their ability to perform their role safely and effectively, or where medical information is reasonably required to support the employee or make an employment decision, {{org_field_name}} may seek Occupational Health advice or an appropriate medical report.

Before requesting a report, {{org_field_name}} will:

• identify the specific purpose for which medical information is required;
• consider whether the information can reasonably be obtained by a less intrusive means;
• explain the reason for the referral or request to the employee;
• explain the questions upon which medical or Occupational Health advice is required;
• explain how the information will be used and who will have authorised access to relevant information; and
• obtain any authorisation or consent required for the medical practitioner or Occupational Health provider to provide the report.

Requests will be limited to information relevant to the employment issue. Wherever possible, questions will seek professional advice about matters such as:

• whether the employee is fit to perform the intrinsic duties of their role;
• whether the employee is likely to be able to return to work and, if so, within what approximate timescale;
• whether temporary or permanent restrictions are recommended;
• whether a phased return or modified duties are recommended;
• whether workplace adjustments should be considered;
• whether the employee’s condition may amount to a disability for which reasonable adjustments should be considered; and
• whether further review is recommended.

{{org_field_name}} will not routinely request an employee’s complete medical record. Detailed diagnoses or clinical information will only be requested where genuinely necessary and proportionate to the purpose for which the information is required.

Where the report is requested from a medical practitioner who is or has been responsible for the employee’s clinical care and the Access to Medical Reports Act 1988 applies, {{org_field_name}} will follow the requirements of that Act.

4.3 Occupational Health Referrals

An Occupational Health referral may be considered where there is a reasonable and proportionate need for professional advice concerning an employee’s health and work.

Circumstances may include:

• long-term sickness absence;
• repeated or concerning short-term sickness absence where an underlying health issue may need to be considered;
• a health condition, disability or injury which may affect the employee’s ability to undertake the intrinsic requirements of the role;
• consideration or review of reasonable adjustments;
• concerns about whether work is adversely affecting the employee’s health;
• concerns about whether the employee can perform particular duties safely;
• consideration of a phased return, modified duties, altered working arrangements or workplace adaptations;
• a significant change in the employee’s health affecting work; or
• another employment matter where professional health advice is reasonably required.

The referral will provide the Occupational Health professional with relevant information about:

• the employee’s role and the intrinsic requirements of that role;
• the specific work-related concerns;
• relevant working arrangements or environmental factors;
• adjustments already considered or implemented; and
• specific questions upon which professional advice is requested.

The referral must not request medical information that is irrelevant or excessive for the employment purpose concerned.

Where appropriate, the employee will be provided with information about the matters to be included in the referral.

Managers should normally act upon functional Occupational Health recommendations, such as adjustments, restrictions or review arrangements, rather than seeking unnecessary details about diagnosis or treatment.

4.4 Return-to-Work Assessments

A medical or Occupational Health assessment will not automatically be required merely because an employee has been absent from work for an extended period.

Where an employee returns following sickness absence, {{org_field_name}} will initially consider the information reasonably available, including information provided by the employee, any fit note, relevant medical advice already available and the requirements of the employee’s role.

An Occupational Health referral or further medical assessment may be arranged where it is necessary and proportionate, including where:

• there is uncertainty about whether the employee can safely perform the intrinsic duties of the role;
• further information is required regarding recommended restrictions or adjustments;
• a phased return is being considered;
• there is a significant health and safety concern;
• the employee’s health has materially changed;
• existing adjustments require review; or
• reliable medical advice is required to support a fair employment decision.

Any assessment will focus on the employee’s functional ability in relation to the role and may consider:

• fitness to resume duties;
• temporary or permanent work restrictions;
• reasonable adjustments;
• a phased return;
• altered duties or hours;
• workplace adaptations;
• whether further Occupational Health review is required; and
• any work-related health and safety considerations.

Where an employee is disabled within the meaning of the Equality Act 2010, reasonable adjustments will be considered before determining that they are unable to return to, or continue in, their substantive role.

5. Employee Rights, Information and Consent

Employees will be treated fairly and transparently when medical information is sought.

Before a medical report or Occupational Health assessment is requested, the employee will be informed, as appropriate, of:

• why the information is required;
• the purpose of the referral or report;
• the questions upon which advice is being sought;
• how relevant information will be used;
• who will normally have authorised access to relevant employment health information;
• the possible implications if sufficient medical information is not available to enable an informed employment decision; and
• any applicable rights under the Access to Medical Reports Act 1988 and data protection legislation.

Where the Access to Medical Reports Act 1988 applies, {{org_field_name}} will obtain the employee’s consent to the application for the report and will inform the employee of their statutory rights.

Where the employee states that they wish to see the report before it is supplied to {{org_field_name}}, the statutory procedure will be followed. This includes, where applicable, the employee’s right to:

• arrange access to the report before it is supplied;
• request that information which they consider inaccurate or misleading is amended;
• request that a statement setting out their views is attached where the medical practitioner does not agree to make a requested amendment; and
• withhold consent to the report being supplied after accessing it.

These rights apply in accordance with the requirements and timescales of the Access to Medical Reports Act 1988.

An employee may decline to authorise a medical report or Occupational Health referral where their consent or authorisation is required. {{org_field_name}} will explain any reasonable employment consequences of doing so. The employee will not be disciplined merely for exercising a lawful right to withhold consent.

Where sufficient medical information cannot be obtained, {{org_field_name}} may have to make an employment decision on the information reasonably available. Any such decision will be fair, evidence-based and will take account of the Equality Act 2010, including the duty to consider reasonable adjustments.

Consent or authorisation for a health professional to disclose information must not be confused with the lawful basis relied upon by {{org_field_name}} for processing health information under data protection legislation. {{org_field_name}} will separately identify and document the applicable lawful basis and special category condition for its processing.

6. Confidentiality and Data Protection

Information concerning an employee’s physical or mental health is special category personal data and will be processed in accordance with the UK General Data Protection Regulation, the Data Protection Act 2018 and {{org_field_name}}’s data protection policies.

Before processing staff health information, {{org_field_name}} will:

• identify and document an appropriate lawful basis under Article 6 of the UK GDPR;
• identify and document an appropriate condition for processing special category data under Article 9 of the UK GDPR;
• comply with any applicable requirements of Schedule 1 to the Data Protection Act 2018;
• maintain an appropriate policy document where this is required by the Data Protection Act 2018; and
• provide staff with appropriate privacy information explaining how their health information is used.

Health information will be collected and used only where it is adequate, relevant and limited to what is necessary for the identified employment purpose.

Where possible, managers will be provided with information about:

• an employee’s fitness for work;
• relevant functional limitations;
• recommended restrictions;
• reasonable adjustments;
• return-to-work recommendations; and
• review arrangements,

rather than unnecessary clinical details, diagnoses or complete medical records.

Medical information and Occupational Health reports will:

• be treated as confidential;
• be stored securely;
• be kept separate from general personnel information where appropriate;
• only be accessible to persons who have a legitimate and necessary reason to access the information;
• not be routinely disclosed merely because a person holds a management or HR role;
• only be shared where there is a lawful, necessary and proportionate reason to do so; and
• be protected by appropriate technical and organisational security measures.

Relevant managers will normally receive only the information reasonably required to manage the employee’s work, adjustments, safety, absence or employment situation.

Health information will not be retained indefinitely. It will be retained in accordance with {{org_field_name}}’s documented retention arrangements and only for as long as necessary for the purpose for which it was obtained or for another lawful purpose.

When information reaches the end of its authorised retention period, it will be securely deleted or destroyed unless there is a lawful reason for retaining it for longer.

Employees may exercise their applicable rights under data protection legislation in relation to personal information held about them.

7. Reasonable Adjustments and Support

{{org_field_name}} is committed to complying with the Equality Act 2010 and to considering reasonable adjustments for disabled applicants and employees.

When a health condition or disability affects, or may affect, an individual’s work, {{org_field_name}} will consider whether reasonable adjustments would enable the individual to perform the intrinsic requirements of the role safely and effectively.

Reasonable adjustments will be considered before concluding that an individual is unable, by reason of their health, to properly perform the tasks intrinsic to their work.

Depending upon the individual circumstances, reasonable adjustments may include:

• modifying particular duties where reasonable;
• adapting working hours or working patterns;
• providing a phased return to work;
• making physical workplace adaptations;
• providing appropriate equipment or aids;
• modifying working practices;
• providing additional supervision, support or training;
• allowing reasonable flexibility connected with treatment, rehabilitation or disability-related requirements; or
• considering another appropriate adjustment recommended by Occupational Health or another suitably qualified professional.

Any recommendation from Occupational Health will be considered individually. The fact that a particular adjustment has been recommended does not automatically determine whether it is reasonable under the Equality Act 2010; {{org_field_name}} will consider the circumstances of the individual, the requirements of the role, the effectiveness of the proposed adjustment and all other legally relevant factors.

Where reasonable adjustments do not enable the employee to perform the intrinsic requirements of their existing role, consideration will be given, where appropriate, to whether there is a suitable alternative role or another reasonable means of retaining the employee.

Where no reasonable adjustment or suitable alternative enables the employee to perform work safely and effectively, any further capability or employment action will be considered under the appropriate organisational procedure and applicable employment and equality law.

8. Managing Non-Compliance

• If a staff member fails to cooperate with the medical assessment process, a formal capability process may be initiated.
• If an employee provides false or misleading medical information, disciplinary action may be taken in line with the Staff Conduct and Code of Ethics Policy (CHW28).

9. Related Policies

This policy should be read in conjunction with:

• Recruitment, Selection, and Retention Policy (CHW26)
• Staff Supervision, Training, and Development Policy (CHW27)
• Staff Conduct and Code of Ethics Policy (CHW28)
• Health and Safety at Work Policy (CHW16)
• Equality, Diversity, and Inclusion Policy (CHW30)
• Confidentiality and Data Protection Policy (CHW34)

10. Policy Review

This policy will be reviewed annually or sooner if legislative changes or organisational needs require it. Updates will be communicated to all staff, and relevant training will be provided where necessary.

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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}}
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