The sickness absence occupational health report is one of the key interfaces between the occupational health practitioner and human resources.
Needless to say the report should be clear, focused and appropriate to the context of the employer, the employee and their workplace.
A brief website survey revealed little comprehensive guidance available on the theme of how to compile an occupational health report. The following attempts to identify some of the main points that may be useful to those compiling such a report on the assessment of those absent from work due to illness or injury.
It was generally agreed the employee must be made aware of the reason for the referral to the occupational health practitioner and it is good practice to obtain written consent prior to an assessment being carried out and a report being prepared.
In addition, reports must be delivered to the employer in a timely manner. The employer should also pay attention to the format of their request for a report – by providing sufficient background information on their employee and their job and questions that are relevant to obtaining information that will be appropriate to ongoing case management.
The top 10 tips for preparing an occupational health report are:
1 It must be in writing, using language that can be easily understood by a non-medical audience and be of practical value to personnel/management and the employee.
2 It should be focused and deal with matters of employment and fitness for work.
3 With the employee’s consent, it should contain relevant and appropriate medical information, including any interventions being planned to allow HR/management to achieve a full understanding of the employee’s situation.
4 It should include details of any functional limitations or relevant disabilities that may temporarily or permanently affect the employee’s ability to carry out their job.
5 If the employee is absent, guidance in relation to the timescale for a return to full or restricted duties should be provided, expected duration of any limitations and whether a review is necessary.
6 It should indicate if further information needs to be obtained from the employee’s general practitioner or hospital doctor to enable a better understanding of the underlying medical condition to be attained.
7 It should advise whether the condition is likely to be covered by disability discrimination legislation and if adjustments to the job would be appropriate, and if these are likely to be temporary or permanent.
8 It should indicate if it appears that the employee’s medical condition is related to their work, including any allegations of internal disputes that may require management assessment.
9 It should provide an opinion on the impact of the employee’s health condition on future attendance or performance and whether retirement on health grounds may be appropriate.
10 It should indicate if a case conference with HR or management would be helpful, or if a workplace visit would provide further information that would assist in providing advice.
The above may be helpful in structuring an OH report. More debate is needed on this issue – namely what should a good report contain?
From the employer’s perspective, the benchmark is whether or not the report assists them in their ongoing management of the case. This may include dealing with issues of disability, managing a return to work or ongoing absence, or preparing for termination of employment on health grounds.
The OH practitioner should be assisting the employer by providing timely, relevant and appropriate reports. That being said, the practitioner may feel constrained by issues of confidentiality which may lead to a report that contains little or insufficient information.
The key here is to ensure that the employee understands the process in which they are engaged and that written informed consent for a report to be prepared has been obtained.
It would also be good practice to inform the employee at the conclusion of a consultation what the report is likely to contain.
Others go further and suggest the employee should be given a copy of the report for their agreement or otherwise in advance of it being sent to the employer – this would be difficult to operate in practice and if the consent process is adequate, unnecessary.
In conclusion, the key stakeholders in this important interface, occupational health advisers and HR managers, need to continue to engage in the debate and to come together to share each others’ experience and identify their needs. Practical guidance on standards of reporting from the relevant professional bodies would also be of considerable assistance.
Ken Addley is director of Northern Ireland Civil Service Occupational Health Service, Belfast; Isobel Hannah, occupational health nurse; and Patricia McQuillan, assistant director nursing.
1 The University of Warwick Sickness Absence Management Workshop. October (2006).
2 Staff Guide to Occupational Health Advice and Referrals from Northumbria University Occupational Health Service (2008).
3 Association of NHS Occupational Physicians Society Guidelines (ANHOPS 1999): The Role of Occupational Health in the Process of Sickness Absence.
4 The Highland Council. Guidelines for Referral to the Council’s Occupational Health Adviser or Medical Adviser (2008).
5 Collaboration Working Together. Denize Bainbridge. Occupational Health Journal January (2009).
6 Employment Law and Occupational Health- A Practical Handbook J Lewis and G Thornbory (2006) Blackwell Publishing.
7 Referring sickness absence cases to OHS – A best practice guide for Departments and Agencies. NI Civil Service OHS.
8 Effective Medical Reports. Managing sickness absence. A toolkit for changing work culture and improving business performance. EEF, London (2007).