Employees are often suspicious when occupational health ask for medical reports from their own Doctors – thinking that they are being checked up or worse, not telling the truth about their health.
This article takes you through reasons why occupational health might ask for a report from your GP and Specialist in the first place, the process, what happens when the report is returned, and things that happen along the way. See also my earlier article aimed at Occupational Health Practitioners
Requesting GP and Specialist Reports
Occupational health can ask for a GP or Specialist report for a variety of reasons, such as:
- To confirm a medical condition
- Where there is doubt about progress of your illness
- Informing the GP about a work situation relating to your health and asking advice
- For ill-health retirement reasons
- Prior to starting work especially in jobs such as working with children or vulnerable adults
- A procedural requirement prior to a business taking action e.g. dismissal
But GPs and Specialists will not release any information unless you, their patient, has given permission for the information to be shared. This is called giving ‘Consent’
Consent process for GP or Specialist Report
The consent process is covered by law (Access to Medical Reports Act) and steeped in medico legal tradition and practice. The Act states:
Right of access.
It shall be the right of an individual to have access, in accordance with the provisions of this Act, to any medical report relating to the individual which is to be, or has been, supplied by a medical practitioner for employment purposes or insurance purposes.
All health professionals value and uphold the consent process. It is a fundamental part of the special relationship between you and your own doctors and nurses. It is especially important when working outside of the NHS and seen, with confidentiality, as one of the cornerstones of good health practice.
Is the law that controls how personal information is used by organisations, businesses or the government. Everyone who is responsible for using data has to follow strict rules called ‘data protection principles’.
They must make sure the information is:
- used fairly and lawfully
- time limited and for a stated purpose
- used in a way that is adequate, relevant and not excessive
- kept for no longer than is necessary
- handled according to people’s data protection rights
- kept safe and secure
- not transferred outside the UK without adequate protection
There is stronger legal protection for more sensitive information, such as:
- ethnic background
- political opinions
- religious beliefs
- sexual health
- criminal records
In my experience though, the facts of the DPA are barely understood by most. So occupational health professionals go to great lengths to make sure that the consent process is legally sound and that you, as the subject of the report, have the chance to say yes or no to the request.
For more information about the consent process, and see a typical form and GP letter
There is usually a time delay from the day we request a GP or Specialist report, to the day it comes back. Some GP and Specialist reports I’ve requested have taken over six months to arrive. Meanwhile, everyone waits; with me phoning the surgery/clinic every couple of days to hurry it along.
Difference between GP and Specialists Reports
Your family doctor (GP) keeps full records of your health from cradle to grave. If you move house/area then your records will move with you to a new GP. The GP gives you individual advice.If you need more investigations or help then you are sent to see a Specialist. Specialists deal with a particular type of health issue, such as heart, lung, kidney, skin, mental health and dementia and usually, are hospital based.
Specialists keep the GP informed about how the treatment is going, what treatment you need and the long-term plan for you. The GP and Specialist work together providing a team approach to your health. You can have many Specialists but you will only have one GP – these are in charge of your referrals and treatments, keep all your health records together and coordinate treatment. In my experience, when providing reports, GP’s are quicker returning the report than Specialists, but Specialists tend to be more factual.
Questions to Ask:
Typical questions asked in a GP or Specialist report:
- When is the person expected to return to work?
- What can we do to help improve attendance?
- If you have any long-term health conditions that could be covered by the Equality Act
- Can we have a copy of your health file?
- Checking some detail that is under dispute that could result in serious action e.g. confirm medication side-effects, compliance with addiction therapy
One way of hurrying up the report would be for you to contact your GP and Specialist and asking them to answer as soon as possible, telling them why it is important to you. If you have signed to say you want to see the report, the GP or Specialist will hold the report until you’ve done that. What many don’t realise is that the terms of the consent say that you have 21 days to see the report and then it’s sent even if you haven’t seen it after the 21 days. My advice is to ask for a copy of any report they send, then everyone is clear on what has been said.
Although you have the right to change the report, rarely have I seen anyone do this.
Receiving the Medical Report
Hopefully, the Doctors answer all the questions asked, but in 50% of cases, questions are missed. The occupational health professional will read the report and, based on the report contents, take the following action:
- Let management know that the report has arrived
- Send your Doctors invoice to management for payment
- Decide on the likely course of action
In most cases, you will have the opportunity to see/discuss the contents of the report and the next steps with the occupational health professional. One thing to remember is that GP and Specialist reports are not binding on the employer, it is a suggestion only. Managers are allowed to override what the GP or Specialist suggests and often do.
Guidance from the Department of Health gives this advice to employers:
The assessment about whether your employee is not fit for work or may be fit for work (and any other advice in the fit note) is classed as advice, and it is for employers to determine whether or not to accept it. Occasionally, you may believe that your employee is not fit for work when they have been assessed as fit for work by their doctor, or you may think that your employee could do some work when they have been assessed as ‘not fit for work’ by their doctor….. In situations like this, you as the employer are within your rights to gather other evidence about your employee’s fitness for work from other doctors or healthcare professionals. You can choose to give this other evidence precedence over the advice in the fit note.
Why not send Medical Reports to HR/Management
Managers and HR do not have medical training. They are unlikely to fully understand how health impacts on work or vice versa. Some even ‘Google’ health conditions and read extraordinary tales of horror and treatment failures, without considering if it is all true or not.
This approach has no place when deciding a person’s livelihood and for helping sick or injured workers. Health issues should be dealt with on an individual basis, using tried and tested methods. Occupational health professionals know the workplace, the management, and you. They can look at the situation and have a good idea of what is achievable. Then starts the process of trying things out. Finding a way through the maze of options, for the benefit of both you and the workplace.
The GP’s and Specialists tend to give full health details when they know they are writing to fellow health professionals; whereas if an untrained person requests it, they probably won’t. This is why the report is not sent directly to HR or management.
Occupational Health Extracts the Relevant Information
The occupational professional shares relevant facts from the report that helps manage your case.
For example, your manager will not need to know that your blood pressure is 180/120 (very high). Or you have started on 5 mg long blood pressure tablet name in the morning. But will need to know that you cannot drive a fork lift truck or work nights yet.
Some health problems (like blood pressure) are so common that the occupational health professionals recommend it would be better to share this with the manager, especially if everybody already knows. After all, some people love to talk about their health – warts and all!
The other problem is if the employee thinks that the GP’s advice is binding on the employer. And although it isn’t – it really doesn’t help a situation. Especially if your poor health is work-related or there are claims of bullying or harassment. A medical report has been known to make matters a lot worse. Most GP and Specialist reports clarify a situation but some can make matters more confusing, prolonged and create problems.
The occupational health professional is best placed to advise you and your manager on whether a report will be helpful. They will balance the request against time taken (the main problem with reports arriving) and the seriousness of the situation. GP and Specialist reports are useful. But it is just as frustrating when the report hinders rather than helps; by being ambiguous or late in returning. This is why GP and Specialist reports are not always the best way forward. They should only be used when absolutely necessary, taking into account the problems which can occur.