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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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Fitness to Work and Occupational Health Policy

1. Purpose

The purpose of this Fitness to Work and Occupational Health Policy is to ensure that temporary workers supplied by {{org_field_name}} are able, having regard to any reasonable adjustments that may be required, to undertake the intrinsic functions of their assigned roles safely and effectively.

{{org_field_name}} operates as a temporary staffing agency and employment business and does not itself carry on regulated care activities. Temporary workers may nevertheless be supplied to client organisations operating in health and social care settings, including CQC-registered providers. Those client organisations may be subject to separate regulatory requirements applicable to the regulated activities they carry on.

This policy is intended to protect the health and safety of temporary workers, colleagues, service users and client organisations by establishing proportionate arrangements for assessing and managing fitness for work, occupational-health concerns and work-related health risks.

Fitness for work will be considered in relation to the requirements and intrinsic functions of the particular assignment, the relevant workplace risks and any reasonable adjustments that may be required. A disability, long-term health condition or medical diagnosis will not, by itself, be treated as evidence that a person is unfit for work.

This policy operates in accordance with the Equality Act 2010, the Health and Safety at Work etc. Act 1974, the Management of Health and Safety at Work Regulations 1999, the Control of Substances Hazardous to Health Regulations 2002, applicable employment-agency legislation and applicable data protection legislation.

2. Scope

This policy applies to:

• All temporary workers of {{org_field_name}}, including registered nurses, healthcare assistants, and support staff employed under zero-hours or casual contracts
• All office and administrative staff responsible for recruitment, placement, and ongoing monitoring of temporary workers
• All care settings where {{org_field_name}} provides services, including but not limited to nursing homes, residential care homes, and supported living services

This policy also applies to both pre-employment and in-employment periods, including when a worker returns to practice following illness, injury, or prolonged absence.

3. Related Policies

• Recruitment and Selection Policy
• Supervision and Appraisal Policy
• Staff Wellbeing and Mental Health Policy
• Absence Management Policy
• Safeguarding Adults and Children Policy
• Infection Prevention and Control Policy
• Health and Safety Policy
• Code of Conduct for Temporary Workers

4. Legal and Regulatory Framework

This policy is underpinned by the following legislation and regulatory requirements, insofar as they apply to {{org_field_name}} and the activities covered by this policy:

• Employment Agencies Act 1973.
• Conduct of Employment Agencies and Employment Businesses Regulations 2003, as amended.
• Health and Safety at Work etc. Act 1974.
• Management of Health and Safety at Work Regulations 1999.
• Control of Substances Hazardous to Health Regulations 2002.
• Equality Act 2010, including the restrictions on pre-employment health and disability enquiries and the duty to make reasonable adjustments.
• UK General Data Protection Regulation.
• Data Protection Act 2018, as amended.
• Data (Use and Access) Act 2025, insofar as its provisions amend or otherwise apply to the processing of personal data under this policy.
• Care Act 2014, where relevant to safeguarding responsibilities arising from placements in adult social care environments.
• Applicable professional regulatory requirements, including the NMC Code and NMC registration requirements for registered nurses.

{{org_field_name}} does not itself provide a regulated activity and is not a CQC-registered care provider. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and CQC Fundamental Standards may apply directly to client organisations to which workers are supplied but are not treated in this policy as direct CQC regulatory requirements imposed upon {{org_field_name}}.

Where temporary workers are supplied to roles requiring professional qualifications, registration, authorisation, particular experience or additional safeguards because the work involves vulnerable persons, {{org_field_name}} will undertake the checks and enquiries required by the Conduct of Employment Agencies and Employment Businesses Regulations 2003 before supply.

5. Principles

Temporary workers must:

• Be fit for work at the point of recruitment and throughout their employment with {{org_field_name}}
• Not knowingly accept or attend placements if unfit to carry out their duties safely
• Be supported by {{org_field_name}} in managing health needs to promote safe, effective, and dignified care to clients
• Notify {{org_field_name}} immediately if their health or circumstances change in a way that may impact their ability to work safely
• Engage proactively with fitness to work assessments, occupational health referrals, and reasonable adjustments where necessary

6. Fitness to Work Standards

For the purposes of this policy, fitness for work means that a temporary worker is able, taking account of any reasonable adjustments that are required, to perform the intrinsic functions of the particular assignment without creating an unacceptable health or safety risk to themselves or others.

Fitness for work will be determined on an individual and role-specific basis. {{org_field_name}} will not regard a worker as unfit merely because the worker has a disability, long-term health condition, mental health condition, history of illness or other medical condition.

When relevant to a particular assignment, consideration may include whether the worker:

• is physically and mentally able to undertake the intrinsic functions of the assignment, taking account of reasonable adjustments;
• can undertake the work without an unacceptable risk to their own health and safety or the health and safety of others;
• has any temporary or ongoing restriction that needs to be taken into account before or during an assignment;
• can comply with infection prevention and control requirements applicable to the assignment;
• meets any lawful and proportionate occupational-health, immunisation or health-screening requirement that is necessary because of the particular work, exposure risk or client setting; and
• can meet any applicable professional requirements relevant to the work they will perform.

A communicable disease, disability, medical condition or absence of a particular vaccination will not automatically result in a worker being declared unfit for work. {{org_field_name}} will consider the circumstances of the individual, the actual requirements and risks of the assignment, current applicable public-health or occupational-health requirements and whether reasonable adjustments or an alternative suitable assignment can be provided.

Where there is uncertainty about a worker’s fitness for a particular assignment, {{org_field_name}} may obtain appropriate occupational-health or other competent medical advice before making a decision.

7. Pre-Employment Fitness to Work Checks

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

Before an applicant has been offered work, whether conditionally or unconditionally, or, where applicable, before the applicant has been included in a pool of successful applicants from whom work will subsequently be offered, {{org_field_name}} will not ask general questions about the applicant’s health, disability, sickness history, medical history or other health-related matters unless the question falls within a statutory exception.

Before that stage, a health or disability question may only be asked where and to the extent that the question is lawfully necessary, including:

• to establish whether the applicant needs a reasonable adjustment in connection with an assessment or recruitment process;
• to establish whether the applicant will be able to carry out a function that is intrinsic to the work concerned, taking account of any reasonable adjustments that would be required;
• for permitted diversity monitoring, provided that the information is collected and used appropriately and is not used unlawfully in the selection decision;
• for lawful positive action concerning disabled persons; or
• where having a particular disability is a lawful occupational requirement.

Once an applicant has been given a conditional or unconditional offer of work, or has lawfully been included in a pool of successful applicants from whom work will be offered, {{org_field_name}} may obtain health information that is necessary and proportionate for determining fitness for the relevant work, identifying reasonable adjustments, complying with health and safety obligations or meeting lawful role-specific occupational-health requirements.

At that stage, {{org_field_name}} may, where necessary and proportionate:

• require completion of an appropriate confidential health declaration or health questionnaire;
• obtain information concerning functional restrictions relevant to the proposed role;
• request evidence of occupational-health screening or immunisation where this is genuinely required for the particular assignment;
• seek occupational-health advice where specialist assessment is required; and
• discuss reasonable adjustments or restrictions necessary to enable the worker to undertake the assignment safely.

Health screening will be related to the requirements and risks of the particular role and will not be used as a blanket mechanism for excluding persons with disabilities or health conditions.

A worker will not be rejected, removed from consideration or denied an assignment merely because they have disclosed a disability or health condition. Any decision will be based upon whether the person can safely perform the intrinsic functions of the relevant work after consideration of reasonable adjustments and any other lawful risk-control measures.

Workers must:

• provide accurate information where a lawful health enquiry is made;
• provide relevant evidence of occupational-health clearance, screening or immunisation where this is lawfully and proportionately required for a particular assignment;
• cooperate with reasonable occupational-health assessments where required; and
• inform {{org_field_name}} of any adjustment or restriction that needs to be considered so that the work can be undertaken safely.

All health information obtained under this section will be processed in accordance with Section 11 of this policy.

8. In-Employment Fitness to Work

Temporary workers must:

• Notify {{org_field_name}} immediately if they develop a health issue that may affect their ability to work safely
• Report any illness, injury, or incident that may temporarily or permanently impair their capacity to perform duties safely
• Refrain from attending placements if unwell with a condition that could endanger themselves or others (e.g., diarrhoea, vomiting, respiratory infection)
• Engage with occupational health assessments where appropriate
• Follow guidance provided by {{org_field_name}} regarding return-to-work procedures following illness or injury

9. Return to Work After Illness, Injury, or Absence

The director will:

• Review the circumstances of the absence with the worker to assess their fitness to return safely
• Require temporary workers to complete a Return to Work Declaration
• Refer workers to occupational health where appropriate to confirm fitness to work
• Adjust placements or duties temporarily or permanently if necessary to ensure safety
• Document all decisions and assessments relating to fitness to work

Temporary workers returning to work after an illness or injury must:

• Disclose any limitations or ongoing health concerns that may affect their duties
• Follow any temporary or permanent adjustments as agreed with {{org_field_name}} or the client organisation
• Refrain from working against medical advice

10. Occupational Health Referrals

The director may refer a temporary worker to an occupational health provider when:

• Health concerns arise during recruitment or employment
• There is uncertainty about a worker’s fitness to perform duties safely
• Reasonable adjustments are being considered
• The worker is returning to work after a prolonged absence or serious illness
• There has been repeated sickness absence where health issues are contributing factors

Occupational health referrals will be:

• Confidential
• Managed sensitively and respectfully
• Used to support, not penalise, workers
• Considered carefully alongside the worker’s role, rights, and preferences

11. Confidentiality and Processing of Health Information

Information concerning a worker’s physical or mental health, medical history, disability, occupational-health assessment, sickness, vaccination or immunisation status is personal data and, where it concerns health, is special category personal data.

{{org_field_name}} will process health information only where the processing is lawful, fair, transparent, necessary and proportionate to the purpose for which the information is required.

Before processing 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 special category data under Article 9 of the UK GDPR. Where required, {{org_field_name}} will also satisfy the applicable condition and safeguards contained in Schedule 1 to the Data Protection Act 2018.

{{org_field_name}} will:

• collect only health information that is adequate, relevant and limited to what is necessary for the stated purpose;
• provide workers and applicants with the information required by applicable data protection legislation about how their personal data will be used;
• ensure that health information is accurate and, where necessary, kept up to date;
• keep identifiable health information only for as long as it is required for the lawful purpose for which it was collected or for another lawful retention requirement;
• protect health information through appropriate technical and organisational security measures;
• restrict access to persons who genuinely require the information for authorised purposes; and
• maintain health or occupational-health information with an appropriate degree of separation and confidentiality from routine personnel information.

Health information will not be disclosed to a client organisation merely because it has been collected by {{org_field_name}}. Where information must be provided to a client for a lawful and necessary purpose, {{org_field_name}} will disclose only the minimum information reasonably required.

Where possible, client organisations will be informed of relevant functional restrictions, necessary adjustments or occupational-health clearance rather than being provided with a worker’s diagnosis or detailed medical history.

Any disclosure of health information to a client organisation must have an appropriate lawful basis and special category processing condition. Consent will only be relied upon where consent satisfies the legal requirements for valid consent and is genuinely appropriate in the circumstances. Consent will not automatically be treated as the required or default lawful basis for processing or disclosure.

Medical or occupational-health information will not be used to discriminate unlawfully against an applicant or temporary worker.

12. Reasonable Adjustments

{{org_field_name}} will:

• Make reasonable adjustments under the Equality Act 2010 to support temporary workers with disabilities or long-term health conditions
• Discuss and agree adjustments with the worker and, where appropriate, the client organisation
• Review adjustments regularly to ensure they remain appropriate and effective

Temporary workers must:

• Engage in discussions about adjustments and support needs
• Notify {{org_field_name}} if adjustments are not effective or if further needs arise

13. Director’s Responsibilities

As {{org_field_name}} does not have a registered manager, the director will:

• Take full responsibility for the application, monitoring, and review of this policy
• Ensure pre-employment and ongoing fitness to work checks are conducted thoroughly
• Refer to occupational health where appropriate
• Maintain accurate records of fitness to work assessments, adjustments, and health declarations
• Respond promptly and sensitively to fitness to work concerns raised by clients, workers, or other stakeholders
• Ensure all temporary workers are familiar with this policy during induction and through regular supervision

14. Working with Client Organisations

Before supplying a temporary worker to an assignment, {{org_field_name}} will take the steps and make the enquiries required by the Conduct of Employment Agencies and Employment Businesses Regulations 2003 and applicable health and safety legislation to establish that the proposed placement is suitable.

{{org_field_name}} will, so far as applicable to the assignment:

• obtain sufficient information about the role and its requirements to enable the suitability of the worker to be assessed;
• take reasonably practicable steps to ensure that the worker and the client organisation are aware of any requirements imposed by law or by a relevant professional body that must be satisfied before the worker undertakes the assignment;
• make reasonably practicable enquiries to ensure that the proposed placement would not be detrimental to the interests of the worker or the client organisation;
• obtain and consider relevant information concerning workplace risks, requirements and control measures that may affect the worker’s fitness or ability to undertake the assignment safely;
• ensure that any occupational-health or fitness requirement applied to a worker is relevant and proportionate to the particular role;
• work with the worker and client organisation to identify and implement reasonable adjustments where required;
• provide the client organisation with relevant information about functional restrictions or adjustments where disclosure is necessary and lawful, while limiting disclosure to the minimum information required;
• avoid disclosing a worker’s diagnosis or detailed medical information where the relevant risk can adequately be managed by communicating a functional restriction, adjustment or fitness outcome;
• respond promptly where information is received indicating that a worker may no longer be suitable or medically fit for a particular assignment; and
• cooperate with the client organisation in relation to legitimate health and safety matters affecting temporary workers.

Where {{org_field_name}} receives information giving it reasonable grounds to believe that a worker is unsuitable for an assignment for which the worker is being supplied, {{org_field_name}} will act without delay in accordance with the Conduct of Employment Agencies and Employment Businesses Regulations 2003, including informing the hirer and ending the supply where the Regulations require this.

Where information indicates that a worker may be unsuitable but does not yet provide reasonable grounds to conclude that the worker is unsuitable, {{org_field_name}} will make the further enquiries required by the Conduct of Employment Agencies and Employment Businesses Regulations 2003 and will take any further action required by those Regulations.

Nothing in this section permits unnecessary or disproportionate disclosure of a worker’s medical or health information to a client organisation.

15. Safeguarding and Fitness to Work

If a temporary worker’s fitness to work creates a safeguarding risk:

• The director will take immediate action to remove the worker from assignments pending assessment
• The issue will be managed in line with the Safeguarding Adults and Children Policy and the Disciplinary Policy if necessary
• Referrals will be made to relevant authorities, including the NMC (for nurses) and the Disclosure and Barring Service, if appropriate

16. Continuous Improvement

The director will:

• Review this policy annually or sooner if required by changes to legislation, best practice guidance, or service needs
• Audit recruitment, supervision, and incident data to identify areas for improvement
• Use learning from incidents and feedback to strengthen fitness to work and occupational health processes
• Promote a culture where health, safety, and wellbeing are prioritised and valued

17. Policy Review

This policy will be reviewed annually by the director of {{org_field_name}} or sooner where indicated by changes in law, regulatory guidance, or organisational learning.

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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.