Chapter 4 - Occupational health

Appendices

1. List of notifiable diseases
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2. OHCSS Referral Form
3. OHCSS Consent Form
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4. Contact details
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5. CPS location codes
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6. Health Questionnaire: Night Workers

Introduction

1. The Department retains the services of two occupational health advisers (OHAs) - Capita (formerly know as BMI) and Atos Origin.

Capita provides advice on:

• Retirement on medical grounds
• Industrial injury claims
• Eligibility for the Civil Service Pension Scheme
• The extension of Sick Pay at Pension Rate beyond 12 months

Atos Origin became our main OHA in February 2006 and they provide medical advice and expert professional opinion on:

• the health and fitness of staff;
• workplace conditions, health hazards to staff and all other aspects of health and safety at work including reasonable adjustments to maximise attendance and demonstrate a duty of care;
• medical examinations and health promotion;
• first aid.
2. HR may make use of all these services although it is likely that greatest use will be made of the case referral service - i.e. seeking advice on the health and fitness of individual members of staff and potential members of staff. The main contact with OHA will be through the HR Advisors or the HR Recruitment team if it involves a referral during the recruitment process.
3. Details of the OHAs' charges are held by the Human Resources Directorate.

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Referral procedures

Reasons for referral

4. Referral action must be taken in the following cases: information on:
• where there is a health concern in respect of a candidate who is successful at a recruitment interview (see Volume 1 Chapter 1);
• employees recruited to undertake driving duties or night duties, prior to commencing employment (see paragraph 17);
• where an employee informs line management that they are unable to carry out the full functions of the post/level because of a medical condition;
• where an employee's health seems incompatible with the requirements of the job - e.g. cardiac conditions in drivers - especially where this may represent a danger to the employee or others;
• where an employee has been in receipt of sick pay at pension rate for a period approaching 12 months (whether in continuous or broken periods) and is unable to resume duty;
• where sickness absence results from a medical condition which might make retirement on medical grounds appropriate they should be referred to Capita (formerly BMI); or
• if a request for medical retirement is received it should be referred to Capita (formerly BMI)
5. Referral action should also be considered in the following cases:
• when an employee has been on a continuous period of sickness absence for 20 calendar days or has been absent because of illness intermittently for a cumulative period of 20 calendar days (both certificated and un-certificated) within a rolling one year period;
• when an employee has repeated short spells of absence attributed to a single cause or related causes;
• where the outcome of injury or illness is uncertain, or the duration of the absence seems excessive for the cause;
• in all cases of a notifiable disease (see Appendix 1) if there is any doubt whether, or for how long, absence is necessary because of the danger of infection or contagion. Staff who have been in contact with infectious diseases (other than normal childhood diseases) may return to duty if given clearance by their medical practitioner or the public health doctor of the NHS Health Authority or Board;
• where there are requests for resumption of duty on a part-time recuperative basis. If such a request is supported in writing by the GP/Consultant, it should be accommodated wherever possible. Cases of doubt or those which present difficulty should be referred to the OHA. The employee on resumption of duty, receives full pay for the days/hours worked. Any balance of the working week/day is covered by sickness absence and attracts pay at the appropriate sickness absence rate. If, after returning to work on such a basis, the employee has not returned to their conditioned hours after 12 weeks, the case should be referred back to the OHA;
• if management suspects abuse of the sickness absence provisions;
• when sickness absence results, or may result, in an oral or written warning (see Volume 2 Chapter 4);
• where work performance has declined, or an inappropriate change of behaviour has led to falling efficiency, and illness or alcohol/drug abuse is suspected. Such referrals should include full details of the deficiencies/changes noted;
• If dismissal is contemplated in a case involving poor attendance.

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Referral procedures: Existing staff

General referrals of existing staff should be made to Atos Origin. Although there are a limited category of cases where existing staff should be referred to Capita (formerly BMI) these are:

• Early medical retirement (compulsory or voluntary)
• Industrial injury claims
• Extension of Sick Pay at Pension Rate beyond 12 months.
6. Submission to Atos Origin, or in specified particular circumstances to Capita (formerly BMI) should include the following documents:
• an up to date sickness absence record;
• fully completed referral form;
• informed consent form;
• line management report, including individual's job description/role and impact on the business;
• any other relevant information to facilitate 'fit for purpose' advice.
7. An occupational health consent form is valid for 6 months from its date of signature. Where there are difficulties in trying to obtain an updated consent form from staff on sickness absence the file should be referred to the OHA with the most recent form available; the OHA will then determine whether, in each particular case, an updated form is necessary. The employee should always be invited to complete the consent form but they are not obliged to do so. However, the employee should be made aware that if the OHA cannot contact the employee's own GP or specialist for information, they could be asked by the OHA to consent to an independent medical examination. Employees have a right to see the medical reports provided by their GP or specialist, and to withhold their consent for the reports to be sent to the OHA.
8. Questions should be asked of the medical adviser when forwarding a submission. These may include:
• the expected duration of the medical condition and prospects of an early return to work;
• whether the impact of the medical condition is likely to have an effect on work performance now or in the future;
• whether any aspect of the working environment or tasks performed are causing or aggravating the medical condition;
• whether any managerial action is needed to facilitate an early return to work and/or continued good attendance;
• the prospects of the employee giving regular and effective service in the future;
• whether it is appropriate to continue paid sickness absence or to seek retirement on medical grounds. (Authorisation for retirement on medical grounds can only be approved by Capita (formerly BMI)).
9. If management action is being contemplated, the OHA should be informed and invited to comment.
10. Submissions should be sent in a grey file marked with the employee's name and 'Restricted - Staff' written on the front cover.
11. Each time a case is re-referred to the OHA, it must be accompanied by an updated sick print. If the individual's signature on the consent form is more than or approaching 6 months old, a new consent form should be signed by the individual. Generally consent forms are only valid for 6 months from signature.
12. A client code and a location code (Appendix 5) must be entered on the referral form. This also applies to recruitment cases.
13. All cases for Atos Origin should be sent to their office in Glasgow. (see Appendix 4). All cases for Capita should be sent to their office in Coventry. (See Appendix 4)

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Referral procedures: Recruitment cases with health doubts

14. Recruitment health concern referrals should be submitted in case files. A reason should be given for the referral, together with copies of the completed Occupational Health Referral Forms, Data Protection Notice and Medical Consent Forms, a detailed job description (with particular reference to the physical/mental requirements of the post) and the Recruitment/PCSPS Health Declaration forms ensuring that:
• all questions are answered;
• the full name/address/telephone number of the doctor is stated;
• the candidate has consented to their doctor/specialist being approached and the consent form has been completed fully;
• the Recruitment/PCSPS Health Declaration forms have been completed or updated within the previous 6 months (see paragraph 2 if this is not the case).
15. Where available the following documents should also be sent:
• references from previous employers/schools/colleges;
• records of previous Government employment including sickness absence record.
16. If a candidate is to be recruited to a permanent position after a fixed term appointment, the following should also be included:
• an up-to-date sickness absence record which indicates the reasons for absence;
• the manager's appraisal/recommendation which should include details of the candidate's work performance and management's comments regarding the suitability of the candidate.

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Referral procedures: Medical examination of drivers

17. The Civil Service definition of a driver is any employee who is frequently or regularly engaged on driving duties, either full or part-time, whatever the vehicle. This includes those who undertake the duties of an absent driver as well as those who have regular or part-time employment as a driver. It does not include CPS staff whose duties are of a peripatetic nature.
18. All newly appointed drivers must be referred to the OHA for a medical examination before taking up duty. This applies also to staff who are:
• to be transferred from non-driving to driving duties;
• to take on part-time duties as a driver in addition to their other employment;
• to provide cover for absent drivers.
19. Those specified above should be asked to complete an Atos Origin consent form (Appendix 3). Existing staff should be referred to the OHA in accordance with paragraph 6. Recruits should be referred in accordance with paragraph 14.
20. Drivers employed by the CPS do not need to be re-examined as a matter of course, although they may need to have more frequent or regular examinations in special circumstances: for example, where an individual has a medical disorder which is mild or in its early stages (i.e. a prospective disability) which justifies reviews.
21. Referral to the OHA for possible re-examination should also be made:
• if a driver suffers any serious illness or injury which may affect their fitness to drive - e.g. heart disorder, vertigo, visual impairment, epilepsy, diabetes;
• following any single sickness absence of 28 days or more;
• in any case where there is doubt about the individual's medical fitness to drive.
22. When drivers are re-employed on driving duties after a break in service, their sickness absence records should be checked and the case referred to the OHA if there have been any health problems or there is any doubt about fitness to drive.
23. All staff employed as drivers should be told by management that if at any time they become aware that they have a health problem which may affect their fitness to drive, they must inform their line manager.
24. Attendance for a medical examination should be regarded as official duty and travel and subsistence allowance under the normal rules should be paid.

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Action on return of submission files

25. HR staff are responsible for assessing the advice/recommendation(s) received from the OHA and for advising line management on any appropriate action.

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Medical retirement

26. If medical retirement is recommended, or the OHA suggests that it be broached with the employee concerned, managers should inform the individual of the services offered by Care First and encourage them to make contact. In certain cases it may be appropriate to ask Care First to make the initial approach and broach the subject of medical retirement with the individual.

Written confirmation should be obtained from the employee that they are willing to accept medical retirement and placed on the submission file which should be sent to Capita (formerly BMI).

27. The file should be sent to Capita (formerly BMI) and a Medical Retirement Certificate requested.
28. The Pay & Benefits Business Centre should be informed at the earliest opportunity that the employee is willing to accept medical retirement. The Pay & Benefits Business Centre will send the employee the appropriate which has to be completed and processed before pension can be paid.
29. On receipt of the Medical Retirement Certificate, the employee should be informed in writing of the date of retirement. This must not be earlier than the date of the Medical Retirement Certificate.
30. Medical Retirement Certificates are valid for 4 months 10 days.
31. Copies of the Medical Retirement Certificate and the minute to the employee informing them of the date of retirement must be sent to the Pay & Benefits Business Centre - Nottingham.

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Access to health records

32. The Access to Medical Reports Act 1988 provides individuals with a measure of control over medical records provided by their doctors for employment, or insurance, purposes. This is achieved by giving individuals a right to see, comment on and consent to the provision of such reports and by establishing a procedure for ensuring this.
33. The Access to Health Records Act 1990, which came into effect on 1 November 1999 and only applies to health records made after that date, provides a right of access to health records by the individuals to whom them relate and other persons, particularly employers and prospective employers. It also gives individuals the right of access to health information held about themselves, allows for inaccurate information to be challenged and, in some cases, corrected and for a limited amount of relevant information to be released after the death of a patient if it is needed to settle a claim. In some specific instances it allows access to be granted to another person on behalf of the individual.
34. Information recorded before 1 November 1991 is not subject to the Act unless later information which is covered by the Act is, in the opinion of the OHA, unintelligible without earlier details.
35. Medical records are held on the OHA file in a sealed envelope marked 'Medical Information - to be opened only by the Medical Adviser'. Atos Origin hold this file securely at their offices. In the case of Capita (formerly BMI) the medical records are kept in a sealed envelope attached to the individual's personal file which is held securely by the CPS Human Resources Directorate.
36. If a medical examination has been carried out in order to prepare the advice, the record of this examination is covered by the Act. A medical examination carried out by a consultant, an OHA doctor or a Local Medical Officer nominated by the OHA would be covered by the Act.
37. There is no right of access to records where the advice has been prepared solely on the basis of papers submitted by the Department and/or by the employee's GP. It may be necessary to consult the OHA to see whether an examination has been carried out.
38. Where an application to see a health record concerns notes made in the 40 day period immediately before the date of application, the Department has 21 days in which to give access to the record. If the Department has to seek further information to verify the identity or entitlement of the applicant to see the record, the 21 day period begins on the date that information is provided.
39. Where the application concerns information recorded after 1 November 1991 but more than 40 days before the date of application, the record holder has 40 days in which to give access. As above, the time limit for giving access begins at the date of verification of the applicant's entitlement.
40. Access to medical records can only be granted by the OHA. However, reports, correspondence and other data including general medical advice can be accessed by the individual concerned through the Department's Open Access policy.
41. An employee must make a written request for access to the medical records which should, on receipt, be clearly date stamped. Assuming the individual is entitled to see the medical records, the request and the OHA file (including sealed medical notes) should be returned to the OHA.
42. Capita (formerly BMI) will arrange for access to the appropriate health records and will return the papers in a sealed envelope to the Department for retention. In the case of Atos Origin access to the appropriate records will be arranged and they will be returned to Atos to be held securely at their premises.

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