The problems with getting reports from a GP
With consent, an employer can write directly to an employee’s GP or Consultant, if they are receiving specialist care. However, many employers find the process of obtaining GP reports cumbersome, slow and often alarmingly expensive. More often than not, the reports that come back provide no insight or advice about the implications for managing a health condition in the workplace.
That’s one of the main reasons that occupational health exists as a professional service. It bridges the gap between GP, specialist, employee and employer. Although the employer is the one paying for professional advice, every occupational health provider has a duty to be fair, impartial and independent. As in any area of healthcare, the occupational health practitioner could be struck off if they breached the expected professional standards associated with delivering medical care and advice.
Going straight to a GP or specialist
Although many employers do write to an employee’s GP or specialist, it’s usually because they aren’t aware of the implications of the Access to Medical Reports Act 1988. While it may seem an arcane piece of legislation, it exists for found sound reasons and the principles it sets out are very clear and well understood in healthcare.
Essentially, with informed consent from the employee, anyone can get in touch with their GP and ask about the treatment they’ve been receiving, or for clarification about how a condition may develop in the coming months. Insurers often write to people’s GPs as part of a claim or underwriting process.
The key fact about the Act for employers to be aware of is that any report can only be released from the GP or specialist with the full consent of the employee. The employee can object to any of the reports’ content, they can ask for changes and even ask for parts to be taken out before it is released to the employer. That means the report, if it is provided, will only ever reflect the employee’s view of the situation.
Any employee also has at least 20 working days following a request in which to view, alter or amend the report, before it is released. That often places a minimum delay of at least 4 weeks in the way of getting answers for the business. Also, because most GP surgeries are set up to treat patients, not support employers, you can often find yourself repeatedly chasing a GP, just to get hold of the report.
How much do GP reports cost?
There is very little guidance from governing or guiding bodies (such as the GMC and the BMA) about what constitutes a good medical report. Although the BMA does provide a guide to fee levels, there is no formally agreed scale. This means that sometimes a report can cost £200 and arrive with three sentences of content. On other occasions you may receive ‘War and Peace’ for £50.
Sadly, sometimes when we chase to request a GP releases a report, there can come a time where the amount of chasing we are required to do becomes detrimental to the final quality of report when it is finally produced.
Some reports do transpire to be extremely helpful, however, others may require further investigation with the author before we are able to include the recommendations in our guidance to the employer.
Because of the sometimes arbitrary fees, which have to be passed back to the employer, as well as the frequent difficulty in obtaining reports in anything like a meaningful timescale, we generally only request third-party reports where they are explicitly essential – in about 5% of all the cases we receive.
If you’re currently working with an occupational health partner and find that you’re being asked to pay for GP or specialist reports in more than a handful of cases, it’s worth questioning why they are being requested. Although they may be needed, it’s also often a sign of defensive practice and sometimes it’s easy for an occupational health clinician to defer to a GP’s views, rather than form their own opinions.
GP or Occupational Health? What’s the difference?
Whilst a GP report will only ever reflect the views of the employee, occupational health is entirely independent and exists to provide professional advice to the employer. That does not mean the employer will always be told what they want to hear, far from it, because the occupational health clinician still has a clear duty of care to the employee too.
However, it does mean that if an employee objects to the content of a report about their health, it does not mean that the opinions in the report must be changed. Although the employee can insist that factual errors are rectified, simply not liking the opinions provided in a report are not sufficient grounds for changing the report.
So, whilst a GP report is always more likely than not to reflect what the employee would like to say in a report, the same is not true of occupational health. Reports from occupational health are always impartial, independent and transparent, although at heart are designed to provide advice to employers.
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