As an experienced Occupational Health Nurse, I have always wondered why it is that some HR professionals and managers write to GPs rather than ask an Occupational Health specialist for a report to help them to manage absence. Occupational Health is the speciality of medicine which has the knowledge skills and training to provide advice on fitness for work in any industry setting and also has specialist knowledge of the diseases of occupations
Asking a GP, who has never had any occupational health training or even visited a workplace, for an opinion on fitness to work, rarely provides any useful advice on capability. It generally lengthens the management of the absence as GPs are very busy and can take weeks before a response is received and the report can be expensive.
Maybe it’s time to review your approach?
1. In my experience, non-medical people writing for a GP report are mostly wasting their time. I know that seeking further medical evidence is advised in many management of absence procedures, but I do not believe writing to a GP will give you anything other than a report which states the employee’s perspective on their medical condition. Once that is written in a report, it can sometimes ‘stranglehold’ the employer into a corner it is difficult to get out of without being seen to be unreasonable.
‘If Mrs Jones could be given a job nearer to home with light duties, reduced hours and a different Manager, I am sure she would be able to return to work’
2. The GP report may advise you of an employee’s diagnosis, but can you really make a judgement on what work capability an employee has from a medical diagnosis? If for example they are diagnosed with bi polar disorder, endometriosis or sciatica where does this leave you? Can you be absolutely sure that you are aware of all reasonable adjustments possible for these conditions? Fitness for work is about capability and not disability and the majority of GPs do not have enough knowledge of the workplace, diseases of occupations or risk assessments to provide a report which can be used by employers to manage a case forward with confidence in the workplace.
3. Reasonable adjustments are required if a condition may be likely to fall under the provision of the Equality Act 2010. This is however ultimately a legal and not a medical decision, but identifying what your obligations are in terms of disability legislation, can be complex and the tribunals are busy with cases where employers have not considered what the employee can do, rather than what they can’t. GP reports do not generally offer much helpful advice in this area and employers can easily fail to make simple adjustments just because they have not been given enough guidance on what can be done in the workplace to increase the capability, or ‘workability’ of employees with a medical condition. The GP will confirm that a medical condition is present, but how does that translate into capability? Occupational Health can advise on these areas and you can usually bring employees back to work early knowing that work will not be detrimental to their condition.
4. Have you considered your obligations in terms of storing medical information? Data protection legislation places additional obligations on an employer to protect sensitive personal information. This includes information about employee’s physical and mental health and therefore sickness records and sick notes count as sensitive personal information. This information should be stored separately from personnel records and access restricted. It should also be password protected if stored electronically. Writing for GP reports and storing them poses an additional responsibility under this legislation and employers must ensure robust policies are in place which can be an administrative burden.
Any medical condition which may be due to an occupational factor such as occupational asthma, hand arm vibration syndrome or dermatitis requires that records are kept for 40 years under HSE regulations.
5. Have you made plans for the forthcoming changes to sick note provision? What will your strategy be when you can no longer write to GPs? As GPs will no longer be issuing sick notes, the advice on whether an employee is fit for work will rest solely with Occupational Health clinicians. It’s worth bearing in mind that a sick note is actually provided so that an individual can access sick pay, it is nothing to do with fitness for work.
Even now, if you have Occupational Health support in your organisation, you do not have to take account of the advice in a sick note or indeed a Fit Note unless you want to, which means that you can manage the case according to the needs of your business by taking Occupational Health advice. If you seek the opinion of an Occupational Health professional, you are entitled to take that opinion over that of the GP, which can still reflect the wishes of the employee. This has been confirmed in law.
Many employers worry about what they think of as the high cost of occupational health services, but services can be accessed free of charge. Also, many health screening and health at work service costs can be offset against tax. Many insurers are now encouraging employers to put an occupational health service in place as premiums can be reduced if workplace risks are managed more appropriately and claims are reduced.
Time to take another look?