Fit for Work & Referral to OHS

University managers sometimes need medical advice to assist in the management of an employee. Common areas of advice include: fitness for work, workplace hazards and risks, fitness to return to work after illness or injury, consideration of ill-health retirement, advice on sickness absence including planning the return to work, whether an illness may be caused or made worse by work, or whether a decline in work performance could be caused, in whole or in part, by ill-health. Managers and employees have the option to send referrals to Occupational Health Services to get solution-focused, evidence-based advice to these questions. For information on how to refer to Occupational Health Services, see the Referral to Occupational Health Services section below.

Occupational Health referrals are often complex and this guide provides advice on making an effective referral. In all cases, the reasons for referral must be work attributable.

The OHS team obtain factual medical information and provide a report containing the necessary facts, interpretation, specialist professional opinion, and recommendations to support you in taking management decisions. The report will, with the consent of the employee, be shared with management, Human Resources and the employee, and often the employee’s GP.

New Starter Health Assessments & Clearance

As part of the recruitment process of the University, all new starters (including those changing roles) must complete a New Starter Health Declaration prior to starting in their new role. This declaration gives new starters the opportunity to disclose any health condition or disability and seek advice on how to best manage them in the workplace. It is also an opportunity to receive support and advice on reasonable workplace adjustments or accommodations to help them manage their health at work.

New starters undertaking roles identified to involve work with hazards or safety critical activities will also be asked to complete a New Starter Health Questionnaire. This questionnaire is designed to ask relevant health quesitons related to those hazards and activities being undertaken in the role. OHS will assess the responses to these questions and provide departments with a Fit for Work Assessment detailing whether the new starter is medically capable to perform the role.

For guidance on completing the New Starter Health Questionnaire please consult the New Starter Health Questionnaire Guidance (50kb).

For more information on the New Starter Health Assessments & Clearance and the recruitment process in general, please visit Personnel Services' website.

Monitoring the Health of your Employees

We recommend all departments should have a system for monitoring sickness absence and maintain regular contact with employees that are at home with an illness or injury.

If you do not foresee the necessity for any management decisions, you should advise the employee to make arrangements to see their general practitioner. If the health problem is made worse by or interferes with work, the OHS will, upon referral, provide a health assessment and appropriate advice to the employee informing you if there is a need for you to consider modifications, either temporary or permanent, to a work task and/or work environment.

Referral to Occupational Health Services

For health-related support to be effective and sustainable it requires input from all the stakeholders in the process; this includes involvement of local HR contacts and management. The referral process facilitates this open form of communication between all parties whilst maintaining the employee's medical confidentiality. Before making a referral to OHS, the intended reasons for referral should be discussed between the employee and either their manager or the local HR contact. The employee must have seen the referral, together with any enclosures, such as sickness absence records, and be aware of the reasons for referral. If the Occupational Health specialist deems that the employee does not understand the purpose for which the report may be used, they are ethically obliged to terminate the consultation.

In cases where an employee does not feel able to discuss their concerns with their manager, it is advised employees seek advice and support from their local HR contact. This may then result in a referral to Occupational Health Services. Employees may also directly contact Occupational Health Services for advice.

In all cases, please use the Occupational Health Services Referral Form (28kb) to make your referral. Please provide all requested information in your referral and all questions and issues you want explored.

There is no obligation for an employee to consent to a referral. In such cases, you should consult your personnel advisor and inform the employee that refusal to engage with the referral may result in a management decision being made without the benefit of a medical report. The Occupational Health specialist must be satisfied that the employee consents to the assessment and understands the purpose of the medical report before carrying out a consultation. Upon receipt of a referral meeting the above criteria, the employee will be contacted within 5 working days to arrange an appointment.

Following the consultation and the consent of the employee, you will receive a written report within 5 working days. It aims to give you unbiased professional advice, providing the necessary facts, interpretation, specialist opinion, and recommendations to support you in taking management decisions.

We may request additional medical information from the employee’s GP or treating medical professional which may not be available for some weeks or months. Where a health problem is part of a performance or conduct concern or grievance, you should also consult your personnel advisor.

We will arrange a follow-up if we consider this to be value adding to  the case, for example to see if an employee’s sickness absence has improved following surgery or completion of a course of treatment.

Reproductive Health

University safety policy requires departments to make a risk assessment for the work of new and expectant mothers. It is recommended that health and safety queries from Departments are addressed in the first instance either to their Departmental Safety Officer, or to the Area Safety Officer or to the Safety Office.

The Occupational Health Service can assist with health queries about pregnancy and work, and breast-feeding and work. We accept queries from individual employees, or from those with Departmental responsibilities for new and expectant mothers. Providing answers may require a consultation. Please use the Occupational Health Services Referral Form (28kb) to make your referral.

Disability in the Workplace

The Occupational Health Service works with the University Staff Disability Adviser and managers to advise on reasonable adjustments to ensure that the workplace is inclusive for employees with a disability. This may require adjustments to the processes of work or the work environment to overcome barriers to successful work. Please use the Occupational Health Services Referral Form (28kb) to make your referral. The Occupational Health Service will provide:

  • Advice to departments on broad reasonable adjustments
  • Information regarding the provision and purchase of adaptive and ergonomic equipment.
  • Identification of training needs
  • Information on local services for assistance and funding of specialist equipment


How do I know if an employee is at risk of becoming absent at work?

Establishing an open and trusting management style and being approachable all helps employees to communicate if they are experiencing difficulties and at risk of being absent. Monitoring employees’ health and performance should be undertaken using the existing personnel tools and resources

If I make modifications or adjustments to the work arrangements of one of my team, will the rest of the team become disgruntled?

How colleagues view reasonable adjustments made for an employee requiring a rehabilitation programme will depend very much on the culture that you as a manager create and promote in the workplace. Some people may think that equal opportunities should mean everyone is treated the same. In fact in order to treat people fairly you may need to treat them differently according to their individual needs. Your attitude and commitment will be vital in ensuring the culture of the organisation is inclusive and accommodating.

What are the key points I should remember as a manager when contacting absent employees?

The key points are:

  • Make contact early, agree the contact strategy immediately. Be consistent for all your team.
  • Create a supportive atmosphere right at the start.
  • Tell the employee that they are missed
  • Don’t assume that your employee’s treatment and recovery will be the same as someone you may know who had the same condition. Often there are circumstances unique to your employee that will influence the length of absence and course of treatment. Maintain confidentiality. Don’t talk to others about the employees circumstances without their consent
  • Realise that everyone deals with work place pressures differently and treat all employees as individuals.
  • Actively listen to the concerns of the employee and enquire about their welfare.
  • Remember that advice and support regarding the management of workplace pressures can be provided via your personnel adviser
  • Help the employee stay updated about what is happening at work. Keep them up to date with news of team events and the workplace. Invite them to team meetings.
  • Let the employee know how alternative work could be arranged for them if advised by OHS
  • Talk about the progress they’re making towards their return to work and express confidence on the employees ability to attend work in the future.

Can I provide extra information to OHS in private that I have not included on the referral?

All information that you provide to OHS, must be disclosed in the referral and a copy provided to the employee prior to the consultation. All conversations are documented in the employee’s medical record.

Is a return to work interview necessary in all cases?

It is important that a return to work interview be conducted on every occasion, without exception. Return to work interviews:

  • Enable managers to become involved in monitoring sickness absence on a day to day basis
  • It makes certain that the employee is fit and able to work
  • It sends a positive, supportive message to the employee as well as to the rest of the team
  • It reinforces the Universities commitment to maintaining employee wellbeing in the workplace
  • It gives the employee an opportunity to voice any concerns or problems they may have that are affecting their attendance at work.
  • It is the appropriate forum to discuss an employee’s sickness record.
  • It creates the opportunity to recognise when an employee is making an effort to return sooner than they had originally expected.
  • It is a reminder of University policy and good management practice - the interview is part of the Attendance Management process.

 Do I send Doctor’s Sick Notes to Occupational Health?

All Doctor’s Sick Notes go to your local personnel adviser