10 STEPS TO MAKING A GOOD Occupational Health REFERRAL
Context
Occupational Health (OH) assesses the physical and mental health of an individual in relation to the impact of
health upon work and vice versa. The role differs from that of a GP in that the OH role is not about diagnosis
but about establishing ‘functionability’ in the workplace. OH offers a solution-focused approach to problems
providing advice and recommendations to assist managers to maximise attendance and the productivity of
their employees.
All reports will:
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Advise on the employees current health status
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Outline the prognosis for the condition. Where this is not possible, the report should indicate the
reason and when OH can expect to be able to advise on this.
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State the likely return to work date and return to full duties. Where this is not possible, the report
should indicate the reason and when OH can expect to be able to advise on this.
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Advise on the current functional ability of the employee - if work duties are affected, advise on the
timescales of the impairment
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Detail a specific rehabilitation plan, advise on adjustments (if appropriate) and outline clear
timescales
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Advise on disability in accordance with the relevant UK legislation (including an opinion of the
whether the individual is likely to be covered by the Equality Act or not. Note only a court of law can
determine this).
Managers should focus on the problem and typically, no additional questions should be required. Focus on the
problem and desired outcome is important and additional questions can confuse and distract from the issues.
Reports will seek to answer all relevant OH questions raised on the referral that will support case progression.
When Might Additional Questions Be Useful?
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Whilst it’s not necessary for managers to know what medication an employee is taking, an individual
may report side effects that affect them at work. It may, therefore be appropriate to explain what you
have been told and ask for advice around what this might mean in respect of work.
It may be useful to ask OH to advise when the individual is going to be able to return on full duties and
if this is not possible, why not, before considering dismissal for attendance reasons.
In cases where an Ill Health Retirement may be considered, you should ask OH if it would be
appropriate to request the pensions provider to consider Ill Health Retirement.
Assessments
Telephone assessments are appropriate in the majority of OH cases. The assessment is not about diagnosis
or checking the veracity of what someone has told their manager but about establishing ‘functionability’ in
respect of work. OH Advisers are experienced clinicians and do ask probing questions. As such, it is very
rare for there to be a medical reason to need a face-to-face consultation in all but a few situations (e.g. where
there are communication difficulties, etc). In general terms, the report should reflect the circumstances that
the individual has told their manager together with OH advice as set out above.
Requests for Medical Reports
OHassist OH Advisers will only request a medical report if it will add value and clarity. Examples of when they
might be requested are:
 If an individual doesn’t understand their condition
 If the information an individual provides is confused, clarity will be sought
 In cases of unusual tumours
 Rare diseases with no standard treatment process, or
 New therapies
Five Do’s
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Do ensure that the employee knows why the referral is being made and how the OH advice is likely to be
used.
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Do prepare the employee for their health consultation. Find out when their appointment is (normally within
a week of referral) and ensure they have time away from work and access to a private telephone where
they can talk in confidence.
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Do focus your referral on the positive – i.e. what functions the employee can carry out now or might be
able to carry out with help – and not on the limiting effects of their illness.

Do explain what physical functions the employee’s normal job entails to help the OH Service identify
potential strains – e.g. how long the employee is required to type, talk on the phone, walk, stand, etc. and
how many breaks they can normally take.
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Do explain what adjustments, if any, you have tried to resolve the health problem and whether there are
adjustments / alternative role or moves you could / could not reasonably consider.
Five Don’ts
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Don’t add detailed medical background information and list multiple issues and questions: focus on the
problem and desired outcome. OH advice is more effective when it is clearly focussed on a single issue.
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Don’t ask about things that are not directly related to what your employee can or cannot do at work or
what can be done to improve performance or attendance. For example, you do not need to know what
medication an employee is taking
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Don’t ask what further adjustments can be suggested to support the individual without (a) ensuring all
previous recommendations have been implemented, tried for a reasonable period of time or fully
considered and if not possible, the reasons why are clearly recorded (b) being sure that further
recommendations are reasonable i.e. be clear when you feel all reasonable attempts to support the
employee have been considered and set out what adjustments have been made or, if not possible, why.
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Don’t accept an outcome report if you don’t understand it or it hasn’t addressed all the issues. Telephone
the author of the report to voice your concerns.
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Don’t expect OH to tell you how to manage the case. Advice given, including suggestions on adjustments
you might consider, are just that – advice.
Further Help
OHassist has a number of training modules available at a small cost, if you would like any further information
please contact your contract team or the Helpdesk.