Occupational Health Service PROCEDURE FOR REFERRAL TO THE OCCUPATIONAL HEALTH SERVICE SELF REFERRALS Most referrals to Occupational Health usually come via management such as HR or line managers. However all members of staff are able to “self- refer” if they wish and are encouraged to seek advice before they become ill and absent. All employees who self-refer to the Occupational Health Service will be assured that any discussions will be treated confidentially and no reports are returned to management without explicit consent. However in relevant workrelated cases, where it would be beneficial to the employee to directly raise issues at management level, they will be encouraged to do so. Self-referral to the Occupational Health Service has limitations on how much assistance can be given for workplace matters unless management are involved. Most occupational health issues can only be addressed if the University/manager is aware of the circumstances. Without knowledge of a problem the manager cannot be expected to give appropriate support, so in instances of work related health matters, the management referral process is advised. If it is a safety concern with health implications, the Area or Departmental Safety Convener should be included in the process. 1. The Occupational Health Service does not diagnose or treat non-occupational conditions – these should be directed towards a General Practitioner. 2. Self-referral to the OHS will be assessed initially by an Occupational Health Adviser and confidential advice given and only in exceptional cases if the Occupational Health Advisor thinks it necessary, onward referral on to the Occupational Physician may occur. 3. Staff will be encouraged to consent to a report to management if there are work related issues to ensure appropriate action can be taken. Refusal to do means the consultation will be of little benefit so no further appointments will be offered unless there are exceptional circumstances or follow up is required to ensure any adjustments implemented are effective. 4. There may be instances where disclosure of certain information is considered necessary by the Occupational Health staff and they will seek guidance from a higher authority or a professional governing body if this is the case. Where information disclosed falls within the category of posing a danger to the health and safety of any person, a criminal offence, or fails to comply with any legal obligation, whether it is confidential or not is irrelevant. Self–referrals can be made directly with Occupational Health. MANAGEMENT/HUMAN RESOURCES REFERRALS Line Managers should consult with Human Resources when they wish to refer employees to the Occupational Health Service for medical assessment or examination. The manager should discuss the reasons for doing so and seek advice on completion of the referral form. The intention should then be discussed with the employee and the reasons for referral explained to them. A referral form is completed, signed and sent to Occupational Health by the referring manager or member of the Human Resources team. This form contains information outlining the circumstances for referral and relevant questions to be answered and should be made available to the employee if requested. The Occupational Health Service will advise on an appointment date and time and the manager will notify the employee. Follow up appointments will be made directly by the Occupational Health Service with the employee University of Strathclyde Occupational Health Service Procedures Following the consultation at the Occupational Health Service a report will be returned to management advising on relevant issues. The contents of this report will be discussed and agreed with the employee at the time of the Occupational Health Service appointment. The employee is entitled to a copy of this report if required. Medical details about individuals will only be made available to managers in so far as it is necessary to enable them to discharge their management responsibilities. Appendix 1 – Management/Human Resources Referral to Occupational Health DISCLOSURE Guidance documentation identifies seven situations where confidential information can be disclosed; 1. With the consent of the employee. 2. If disclosure is clearly in the patient’s interest but it is not possible or undesirable to seek consent. 3. If it is required by law. 4. If it is unequivocally in the public interest. 5. If it is necessary to safeguard national security or to prevent a serious crime. 6. If it will prevent a serious risk to public health. 7. In certain circumstances for the purposes of medical research. Where disclosure is considered necessary by the Occupational Health staff, they will first seek guidance from a higher authority or a professional governing body. If information disclosed falls within the category of posing a danger to the health and safety of any person, a criminal offence, or fails to comply with any legal obligation whether it is confidential or not is irrelevant. CONSENT The Access to Medical Reports Act 1988 applies when the Occupational Health Service seeks a medical report from an employee’s general practitioner or any other medical practitioner who is or who has been responsible for the clinical care of the employee. This may be requested when further information is required to assist Occupational Health staff in the case management of an employee. Occupational Health staff will; 1. Obtain the employee’s informed written consent for the application of the report. 2. Inform the employee of his or her right to Withhold consent to the application being made. Access the report before it is supplied. Where it has been indicated that the individual wishes to see the report he/she has 21 days from date of consent to make arrangements. If arrangements have not been made within that time the doctor may send the report regardless. Withhold consent once the employee has seen the report. Request amendments to the report or include a statement from the employee. Access the report for up to 6 months after it has been supplied. Failure to give consent will be notified to the referring manager and they may then have to base their decisions solely on the information that is available to them. Appendix 2 - Notice of Proposal to Apply for a Medical Report for Employment Purposes The University of Strathclyde is a charitable body, registered in Scotland, with registration number SC015263 Appendix 1 Occupational Health Service REFERRAL TO OCCUPATIONAL HEALTH SERVICE – HUMAN RESOURCES / MANAGEMENT Private and Confidential PERSONAL DETAILS Mr/Mrs/Miss/Ms/Prof/Dr/Other Male/Female Surname First Name Home Address Home Tel No Post Code Date of Birth Full Time/Part Time Post Held Place of Employment Date Appointed Total Service Expiry Date of: Half Pay OR Full Pay REASONS FOR REFERRAL (Past 2 years) or enclose copy of record DATE FROM DATE TO NO. OF DAYS REASONS FOR ABSENCES CODE REASONS FOR REFERRAL Please tick the following box or boxes to indicate the main reason (or reasons) for referring this employee and give further details in the section provided below. Long term sickness absence Frequent short term absence Possible effects of health on behaviour at work Possible effects of health on work performance or work capacity Possible effects of work on health Advice on rehabilitation after illness Advice on early retiral on health grounds Suspected alcohol or drug related problems Fitness for transfer to new duties Other reasons (please specify in section below) □ □ □ □ □ □ □ □ □ □ ADVICE FOR MAKING A REFERRAL Please complete this section giving the relevant background and the specific questions you wish the Occupational Health Service to address ADVICE FOR MAKING A REFERRAL Before signing the referring manager’s section below, please read the following general advice to managers: Before the referral, the employee should be informed of and understand the reason why they are being referred and their agreement to attend should be obtained. The referral from will be sent by the referring manager/HR to Occupational Health outlining the circumstances and highlighting the questions to be answered. The confidentiality of the employee’s clinical details is respected unless consent is given to disclosure. The report from the Occupational Health Service to the referring manager/HR will be discussed with the employee by the Occupational Health Physician or Nurse undertaking the assessment. Communications with General Practitioners or hospital doctors will only take place with the signed consent of the employee taking into account the Access to Medical Reports Act. Managers and employees should understand that all correspondence in the occupational health record, including the manager’s referral correspondence, can be seen by the employee under the Data Protection Act. All sections of the referral form must be completed and signed before sending by mail or, by arrangement, through a secure fax. Please do not e-mail this form. Name of person making referral (please print) Designation Location Tel no Full address for correspondence E-mail address for confirming appointments I have read the referral advice, communicated with the employee being referred and completed all sections of the form. Signature (Not pp) Date The University of Strathclyde is a charitable body, registered in Scotland, with registration number SC015263 Appendix 2 UNIVERSITY OF STRATHCLYDE OCCUPATIONAL HEALTH SERVICE To (Employee): ……………………………………. NOTICE OF PROPOSAL TO APPLY FOR A MEDICAL REPORT FOR EMPLOYMENT PURPOSES I intend to request the medical practitioner named overleaf to supply me with a medical report about you. You have certain rights under the Access to Medical Reports Act 1988, which are explained as follows. 1 You may refuse consent now, in which case I will not proceed any further with the application. 2. You have the right of access to the proposed report before it is supplied to me, and you will be asked to indicate (overleaf) your wish. If you state that you require access you should contact your doctor within 21 days (from the date of application) to arrange it. Provided that you do this he will then keep the report until you have seen it and agreed that he can then send it to me. However, if you do not contact him he may send the report to me at the end of this period without your further permission. If you do not request access now the waiting period will not apply. Nonetheless you may change your mind and write to your doctor to state that you do wish to see the report before he sends it to me. Unless it has already been sent he will then wait 21 days from the date of your letter for you to contact him to make arrangements for access as above. 3. Where you have been given access to the report, you have the right to request your doctor to amend any part of it which you consider to be incorrect or misleading. Your request to him to do this must be made in writing. 4. You also have the right of access to this report after it has been sent to me, and to any other medical report relating to you supplied for employment or insurance purposes by your doctor in the previous six months. This right only applies to a report prepared from 1 January 1989 onwards. 5. The Act describes certain circumstances that allow your doctor to deny you access to a report or part of one. He will notify you of this if it applies, and will not supply it to me without your consent. You will still have access to any part of a report which is not restricted by this exemption. 6. Your doctor is entitled to charge a reasonable fee to cover the cost of supplying you with a copy of a medical report Applicant …………………………………………… Position ………………………………….. Signed ……………………………………………… Date ……………………………………… The University of Strathclyde is a charitable body, registered in Scotland, with registration number SC015263 PART A CONSENT TO APPLY FOR A MEDICAL REPORT I have read and understood the summary of my rights under the Access to Medical Reports Act 1988 as stated overleaf. □ I give you my permission to apply to the medical practitioner named below for a medical report. OR □ I do not wish you to apply for a medical report PART B REQUEST FOR ACCESS TO A MEDICAL REPORT OR CONSENT TO SUPPLY WITHOUT PRIOR ACCESS If you have agreed in Part A to the application for a medical report, you should now indicate whether you wish to have access to the report before it is supplied. Tick one box to indicate your wish. ……………………………………………. (Name and address of GP/Consultant) To: Dr ……………………………………………. ……………………………………………. Tel No. □ ………………………………………………. I give you my permission to supply a medical report to the applicant named overleaf and I do not request access to it before it is sent. OR □ I wish to have access to the medical report before it is supplied to the applicant named overleaf. Signed(Employee)………………………………………… Date ………………………………………. This form is valid for 6 months from the date of signing. Processed in accordance with the Data Protection Act 1998 The University of Strathclyde is a charitable body, registered in Scotland, with registration number SC015263