Occupational health is health care that specialises in the effects of health on work and the effects of work on health. We are trained to advise on:
We also advise management about work exposures that might cause harm and how to avoid harm to employees.
Occupational health practitioners work with management to develop policies to improve and protect health in the workplace, and carry out clinical assessments of individuals. Most clinical assessments involve an interview with a doctor or nurse, either face to face or by telephone. Occasionally this will involve a clinical examination or some tests.
Our main role is to help individuals start work, and stay in work, rather than trying to stop individuals from working. We are all governed by strict ethical guidelines and are expected to be impartial throughout the process. We cannot 'take sides' either of the employer or employee.
Some patients are used to being fully supported by their GP when they ask, but occupational health clinicians can only recommend support if there is a clear objective reason to do so. Patients are sometimes given inappropriate advice by GPs or specialists who do not normally have any training in occupational health, and they may find that the occupational health clinician will disagree with this advice. If you are concerned by this, you should ask the clinician for an explanation.
Occupational physicians are sometimes asked to provide an independent opinion on eligibility for pensions or income protection insurance. The assessment is usually based on the medical records and reports but occasionally a clinical examination is requested, sometimes as a home visit. This is an objective assessment and has to be based on the rules or regulations of the pension scheme, or the insurance contract. Treating clinicians may not be aware of these rules, regulations or contractual terms, so they may advise that their patient should be retired on ill health grounds, or that they are permanently unfit for their job, when in fact they do not meet the terms of the scheme. There is usually a mechanism to appeal any opinion or decision internally, and through the relevant Ombudsman.
Intimate medical examinations are not normally undertaken in occupational health clinics, so chaperones are not usually available. Employees are welcome to bring a relative or friend with them. If you do want a chaperone, you may request one but this needs to be made clear when the appointment is booked. If you make the request at the start of the consultation, the appointment may need to be re-booked for a future date and alternative location.
If you are allowed to self-refer you will have been given an appointment to see the clinician. If you have been referred by management, you will have been told why you are being referred and in most cases you will sign a consent form agreeing to the assessment. You can withdraw consent at any time.
Most appointments last between 40 and 60 minutes but some can take longer. The clinician will undertake most of the assessment by asking questions about your health and treatment. They may examine you clinically if necessary, however if they already have reports from treating clinicians they may not need to physically examine you.
The clinician will then write a report. Dr Williams usually types the report while you are present so you can read it and ask questions about it. You will then be asked if you consent to the report being sent to the employer. You can have a copy of the report sent to you if you wish. If Dr Williams has to spend more time preparing the report, for example for a complex insurance assessment or ill health retirement, you can ask to see a copy of the report before it is sent. An encrypted link to a copy will be emailed to the address you provide and you will have 48 hours to comment on it before it is sent.
You can withdraw consent at any time. If you do so, no report will be sent, so the employer will have to come to their own conclusions without the benefit of a medical report. This may not be in your best interests.