What is the Purpose of a Management Referral to Occupational Health

Occupational health (OH) providers can do many things for a business, one such service is to help workers who become ill and struggle at work. In cases where health is compromised, there is a process called ‘management referral’. But what is a management referral?

Why Ask for a Management Referral?

If managers have concerns about the health of an individual related to their job then a specialist health adviser may be needed to give your business some work advice; the most common type of assessment will be from an occupational health service. The individuals’ GP, whilst understanding the health issues and their patient, may not understand the work processes or the hazards present in the workplace. More importantly though is the patient/Doctor relationship which is primarily based on the GP being supportive of their patient, making decisions about employment difficult due to conflicting interests between the work and health.

An independent medical assessment from an OH service is a way of obtaining a work-focused, objective and medically competent opinion. This is particularly imported for high-risk work, and long-term capability is in question or the situation is overlaid with domestic issues and conflicts with management.

Reasons for referral:

  • Long and short-term repeated absences by workers
  • Advice on capability – is the person able to do the job even though they have a medical problem?
  • When a person might be returning from sick leave and advice on a suitable rehabilitation programme
  • Disciplinary issues related to illness
  • Many other instances – for example, one manager suspected a worker had changed the date on his fit note (true story); or whether drugs are involved in an accident or poor performance.

The problem is, that there are so many health issues, managers cannot be expected to know how everyone affects each individuals.

Common Practice

Management referrals though must follow the ethical practice and this includes knowing about:

  1. Relevant guidance and the law concerning data protection, confidentiality, and an individuals’ rights, such as giving consent
  2. Manager’s expectations – they will receive a report which is understandable, pragmatic, brief, helpful and usually negotiable
  3. The referee/worker/patient expectations from the appointment, for example, understanding, advice, discussion about the way forward, an opportunity to ask questions
  4. How the system works best in your company and requirements to do so, such as policy, communications, rules, co-operation, openness, honesty, trust, patience and the level of understanding of health principles

Questions asked by managers for a management referral:

  • Is he/she fit to undertake/return to their job?
  • Are there underlying medical conditions to account for this level of sickness absence?
  • Does the Equality Act 2010 apply?
  • When will he/she be fit to undertake full duties?
  • What sort of work adjustments are necessary to help this person stay at work?
  • Is this level of absence likely to continue?
  • Can we offer more help or support to help this person?
Management Referral
Management Referral

Impact of a Great Management Referral Process

  • Managers need to understand what a person can or can’t do when they have a health issue. If you hire an OH service, advice will be independent of the person and the work situation. Bear in mind that managers have the last word on whether to accept the recommendations from OH.  Managers have other issues, such as safety and practicalities of working to consider also and sometimes they are not compatible.
  • Managers/employers will discuss the need for referral to OH with each person before setting up an appointment with OH.
  • The management referral can be over the telephone or face to face; it depends on the nature of the health issue. For example, a broken ankle would need examination if walking or climbing is part of the job. However, many illnesses can be discussed over the telephone, especially if the worker is ready to return to work.
  • All discussions are medical ‘in confidence’, with the medical report having been discussed and agreed with the employee first.

Employees find the management referral a benefit, not only to talk to another health professional but also for the advice. This advice generally covers alternative methods of treatments or reassurance. The recommendations coming from the assessment helps employers too, who need guidance on how to deal with them.

If employees refuse to cooperate with the referral process (and they are quite within their rights to do so), then a manager can may their own decision based on what they know at the time.

Legal Situation

Under the Health and Safety at Work etc Act, 1974, (bit.ly/2F5EKBV) all business should make sure of the general health and safety of their staff and any affected by their work.  There are also numerous other laws which place the duty of care on the employer to care for workers. Bear in mind that personal health issues under the Data Protection Act are classed as ‘sensitive’ in nature so confidentiality in the workplace is important for maintaining employee’s trust.

Information Required for a Management Referral

  • Ensure OH is aware of all relevant facts about the situation so that the advice given is meaningful and useful; both to the manager and the employee.
  • The nature of the worker’s job is important. Different jobs require different capabilities. For example, think of the physical requirements needed to be a miner as opposed to a receptionist? To counter this, provide a current job description.
  • The report from OH will answer the questions asked and may contain recommendations for the employer to consider – especially if the Equality Act 2010 applies.

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