How occupational health is different

Occupational health is a specialist area of medicine

We work with HR professionals every day and quite often find ourselves guiding HR Business Partners or referring managers through some of the nuances of occupational health. Although most HR professionals have a commitment to lifelong learning and often have specialist qualifications themselves (like CIPD Certificates or Diplomas), most experience working with occupational health is picked up ‘at the coalface’, rather than in a structured format.

How to get the most out of occupational health

The lack of formal training for HR professionals is the main reason we provide free coaching sessions for all our clients, to help them get the most out of their occupational health service. With sessions covering the best questions to ask, what can and can’t be done via occupational health and how to support employees through the process, we always start at the very beginning – how occupational health differs from other medical care.

It’s all about advice

When you visit your doctor, you’re seen as an individual, confidentially. Your doctor will never share your medical information with anyone else, unless because they’re ordered to by a Court, because of a Safeguarding issue, or in case you’re a danger to yourself or others. These events are incredibly rare and generally speaking, you have a totally confidential relationship with your GP.

Your doctor acts in the capacity of “your normal treating physician” and is bound by standards of care and principles set down by the General Medical Council (GMC). If a doctor accidentally (or otherwise) breaches GMC standards, they can be ‘struck off’ the Register and prevented from practising as a doctor. That’s why just about every doctor in the country is very, very careful about how they provide medical care, because they could lose their livelihoods if something goes wrong.

That means your doctor doesn’t generally have an employer’s interests or concerns at the forefront of their mind, although they do (very rightly) care greatly about the patient they are treating. So if they consider that an extending period away from work may be a positive step for their patient, the possible impact on your business isn’t necessarily going to factor too highly in their decision making.

Judge and jury?

Although many doctors are very happy to provide fit notes, they don’t receive a huge amount of training in how to manage the effects of work on health and health on work – the core purpose of occupational health.

The use of fit notes is generally improving over time, however, we still commonly find comments like “reduce stress” being provided to an employer on fit notes. What that guidance may mean in practice is anyone’s guess – without specialist advice from an occupational health doctor.

Because an occupational health doctor doesn’t act as ‘the normal treating physician’ and isn’t taking responsibility for the care that’s being provided to an employee, they can provide independent advice to an employer based upon their concerns or questions.

That doesn’t mean the occupational health doctor is there to do the employer’s bidding. They have to maintain independence and impartiality at all times, or they too can fall foul of GMC standards specifically related to sharing information with employers. It’s a very tight ethical line to follow, because although they’re instructed by the employer, they still have a duty of care to the employee, even though they’re assessing a situation, rather than providing treatment or care themselves.

A good example of the implications of the duty of care to the patient during an occupational health assessment is that even if the doctor suspects the employee isn’t being entirely truthful, they will never accuse them of lying. Advising and informing does not mean being judge and jury.

Advise and inform

Occupational health doctors are acting purely in an advisory capacity and have to maintain independence at all times. They’re not acting for the employee and they’re not there to take decisions for the employer – they inform and advise the employer, based upon the questions the employer asks of them at the start of an assessment process. What an employer chooses to do with the advice that’s given is entirely at their discretion.

Naturally, the quality of advice that’s provided can vary, just as the quality or strength of some legal opinions can vary. That’s why, if you are considering getting occupational health advice, it’s important to make sure you are working with an appropriately qualified and experienced clinician. We view five years’ post graduate practice as the minimum level of experience required to join our team.

Occupational health assessment

If you’re referring an employee for an occupational health assessment, it’s worth being mindful of the three main differences between occupational health and other areas or medicine:

• The clinician isn’t taking responsibility for the care being provided to an employee, they’re advising the employer on an independent basis
• Even though they’re commissioned (paid) by the employer, they still have a duty of care to the employee and will cannot take sides
• They won’t ever take decisions for an employer, the provide advice, which is used by the employer as they see fit

Because occupational health reports are essentially a medical opinion committed to paper, that means the questions asked at the start of the assessment process are inextricably linked with the content of the final report.

We’re very pleased to provide support for referring managers, to guide them through the best questions to consider for the circumstances they find themselves managing, as a core part of our services. Making sure the right questions are asked is usually the biggest steps towards getting positive outcomes in the shortest possible time.

If you have an employee that needs an occupational health assessment, or would like to learn more about the guidance and support we provide for managers, please contact us at any time.