What can an employer ask occupational health?

What can an employer ask occupational health?

Legitimate questions all share one shape: they're about work. If the answer would change something you'd do to the job, the rota, the equipment or the timescale, it's a fair question.

• Fitness for specific duties. Not “are they fit for work” but “can they lift 15kg repeatedly, drive for four hours, work nights?”
• Which duties are affected, and how. This is what lets you reallocate intelligently rather than guessing.
• Adjustments, with a duration. An adjustment without an end date or a review point isn't advice, it's a shrug.
• Prognosis and likely return. Including whether a return to the substantive role is realistic at all.
• Health and safety restrictions. Driving, heights, lone working, machinery, night shifts.
• Whether work is contributing. Particularly for stress - and if so, which factors.
• Facts relevant to disability. Whether the impairment has a substantial and long-term adverse effect on day-to-day activities.
• When to review. The question employers forget, and the one that saves a second referral.

On the disability question, ask for facts rather than a verdict. In Gallop v Newport City Council [2013] EWCA Civ 1583 the Court of Appeal held that “the employer must not forget that it is still he, the employer, who has to make the factual judgment as to whether the employee is or is not disabled: he cannot simply rubber stamp the adviser's opinion that he is not.” A one-line “not disabled” from OH protects nobody.

What will occupational health not tell an employer?

Four things, reliably:

1. The diagnosis and clinical detail - test results, medication, treatment history, anything disclosed in the consultation without consent to share it.
2. Whether the absence is “genuine”. That's an employment judgement dressed as a medical one.
3. The decision. Whether to dismiss, discipline, redeploy or extend sick pay is yours.
4. A revised opinion because you disagree with it. Faculty of Occupational Medicine guidance is explicit that an occupational physician will not change a professional opinion “on the basis of lobbying by the patient, their employer or any other party” - though genuine factual errors will be taken into account.

The reasoning is practical, not procedural. As the FOM guidance puts it, the value of an OH assessment “comes from the individual disclosing confidential information that they are less likely to share with a non medical person”, and that relationship “has to be based on trust in the impartiality of the occupational physician… and trust relies on openness”. Strip out the confidentiality and you don't get more information - you get less.

Can you ask occupational health for a diagnosis?

You can ask. You should rarely need to, and you generally shouldn't get it without the employee's specific consent.

The reason it doesn't matter as much as employers think: two people with the same diagnosis can have completely different working capacities, and two people with different diagnoses can need the same adjustment. The diagnosis doesn't tell you what to do. The functional advice does.

There are narrow exceptions where a condition itself carries a statutory or safety consequence - certain safety-critical roles and driver licensing, for example. Those are role-specific; if that applies to you, ask about the restriction rather than the condition.

Good and poor referral questions compared

The full letter, with all nine questions in place, is in the occupational health referral letter template.

Where is the confidentiality line drawn?

At consent. The long-standing professional position, set out in GMC confidentiality guidance and reflected in Faculty of Occupational Medicine guidance for practitioners, is that a doctor should offer to show the person any report written about them for employment purposes before it is sent - unless they have said they do not want to see it, or disclosure would be likely to cause serious harm, or would reveal information about someone else who has not consented. It is an offer rather than an obligation to hand it over in every case, and plenty of people decline. Check the current GMC standards for the wording as it stands today.

The line holds after the report arrives, too. If a manager rings OH to talk it through, the FOM guidance is that clarification “should be restricted to the explanation of what has already been disclosed and not be used to introduce new information obtained in confidence”. A phone call is not a way round the report.

Where you're seeking a report from the employee's own GP or specialist rather than an independent OH adviser, a statutory regime applies instead - the Access to Medical Reports Act 1988, with notice, pre-access and amendment rights. The distinction is set out in can an employee refuse an occupational health referral.

What can you do with the report afterwards?

Act on it, or explain why you haven't. The gov.uk fit note guidance for employers is clear that “it is your decision whether to act on this advice” - but a documented departure is defensible and an undocumented one isn't.

Then treat the report as what it is. Health information is special category data under Article 9 of the UK GDPR; processing it for “the assessment of the working capacity of the employee” is contemplated by Article 9(2)(h), subject to the professional secrecy safeguard in Article 9(3). Where you rely on the employment condition in Schedule 1 to the Data Protection Act 2018, you must have an appropriate policy document in place. In practice: named roles only, a defined retention period, and not the shared drive.

From there, the next steps are usually a sickness absence review meeting to agree what happens, and a written phased return plan if a return is in sight. Check the advice against the fit note employer guide, and if you're still deciding whether a referral is warranted at all, start with when to refer to occupational health. For frequent short absences see sickness trigger points and the Bradford Factor; for mental health, the mental health absence guide.