This factsheet from the CIPD outlines the kind of occupational health services an organisation might offer and the role of confidentiality and consent in discussing an employee’s health.
It is stressed that confidentiality and consent are central to the relationship between occupational health (OH) professionals and employees, and it's essential that employers uphold the legal and ethical guidelines surrounding that confidentiality. The factsheet concludes with a look at pre-employment health queries and what is legally permissible.
OH encompasses a range of professions from different disciplines. The two most visible are OH doctors and nurses, who should have specialist qualifications in either occupational medicine or OH nursing. Others include OH physiotherapists, occupational psychologists, occupational hygienists, ergonomists and OH technicians.
Many organisations, including some large employers in both the public and private sectors, outsource their entire OH function to one of the many commercial OH providers. Others will engage the services of a provider as and when needed. OH encompasses a range of professions from different disciplines. The two most visible are OH doctors and nurses, who should have specialist qualifications in either occupational medicine or OH nursing. Others include OH physiotherapists, occupational psychologists, occupational hygienists, ergonomists and OH technicians. Only large organisations are likely to employ their own in-house OH professionals. Some, particularly those working in hazardous or safety-critical areas, may have a team comprising full-time OH nurses, physicians, technicians and administrative staff, says the factsheet.
Types of OH services
The range of OH services an organisation decides to offer will depend on the nature of their business, but can include:
Assessing employees on long-term sick leave, advising on the likely timescale of the absence and promoting an effective return to work.
Using a ‘biopsychosocial’ approach to recovery from sickness to help recognise the psychological, social and work issues that can act as barriers or facilitators to returning to work.
Assessing fitness to work regarding ill-health capability dismissal or ill-health retirement.
Helping employers fulfil their duties under the Equality Act 2010 (including disability, pregnancy and age discrimination).
Advising on ergonomic issues and workplace design.
Introducing programmes to support the wider health and wellbeing of the workforce.
Performing statutory health surveillance where this is required by law, such as when workers may be exposed to hazardous substances, noise or vibration.
Managers should be aware that any conversations they have with OH might be noted in the OH records. It’s inappropriate for managers to have ‘off the record’ discussions about an employee’s health and it’s not the role of OH to find a spurious health reason for a dismissal when the issue should be dealt with by management, the factsheet notes.
It also stresses that there are both legal and ethical issues on maintaining the of employee health confidentiality information. Registered healthcare professionals OH physicians and nurses are required by their regulatory bodies to preserve medical confidentiality and only reveal health information to third parties with the individual’s informed consent. The exception to this is by court order or ‘disclosure in the public interest’ where the individual has refused consent to disclose information and there’s a genuine risk to the safety of others.
Within an organisation, OH professionals will liaise with HR and health and safety managers. Line managers must feel able to approach OH to discuss concerns and issues, although discussions about an individual employee’s health should be restricted to issues relevant to their fitness to work. Managers should be aware that any conversations they have with OH might be noted in the OH records. It’s inappropriate for managers to have ‘off the record’ discussions about an employee’s health and it’s not the role of OH to find a spurious health reason for a dismissal when the issue should be dealt with by management. Any formal referrals by a manager of an employee to OH should be made with the individual’s informed consent with open and full disclosure of the reason.
There are both legal and ethical issues on maintaining the of employee health confidentiality information. Registered healthcare professionals OH physicians and nurses are required by their regulatory bodies to preserve medical confidentiality and only reveal health information to third parties with the individual’s informed consent. The exception to this is by court order or ‘disclosure in the public interest’ where the individual has refused consent to disclose information and there’s a genuine risk to the safety of others. Examples could include where child abuse is suspected or where an individual ignores explicit medical advice that they are unfit to drive.
Employee health records must be kept separate from personnel records and should only be accessed by qualified health professionals (OH clerical staff should sign confidentiality agreements in the same way as administrative staff at a GP surgery).
An employer or manager will sometimes request OH to assess an employee’s fitness for work and produce a report. An employee must consent to the assessment and also to the sending of the report. However, if the employee refuses consent, then the employer or manager is entitled to make a management decision without it, which could, of course, be to the detriment of the individual.
The factsheet is available in full here.
CIPD June 2021