Occupational health focuses on the relationship between work and health, helping employers maintain a healthy, productive workforce. This can involve supporting employees with long-term health conditions by recommending adjustments that promote productivity sustainably, ideally from the outset of their employment. Occupational health clinicians can help assess an employee’s health in relation to their role and provide recommendations to their employer. At Insight Workplace Health, we frequently encounter questions about "reasonable adjustments" and whether these recommendations must be strictly followed by employers, or whether there is any flexibility around implementing them.
Here are 10 key elements of practical guidance for understanding and managing “reasonable adjustments” in occupational health.
1. What is the relevant legislation?
While there are limited direct guidelines on supporting workforce health in the UK, some key laws are crucial to understand. One is the Equality Act 2010, which protects against discrimination based on characteristics like disability, sex, and age. This Act outlines employer responsibilities in making reasonable adjustments to support employees with disabilities.
2. How does the Equality Act define disability?
Other than a few exceptions, the Equality Act 2010 doesn’t categorise disability by specific diagnoses. Instead, it considers the functional impact of a condition on daily life. An impairment with a “substantial” and “long-term” negative effect on day-to-day activities qualifies as a disability under this Act. Importantly, health and function are considered without taking into account treatments that might alleviate symptoms.
3. Can occupational health confirm if someone is covered by the Equality Act?
Understanding if an employee’s condition is likely to qualify as a disability is important, as it triggers specific legal responsibilities for employers. Unless an employee has a health condition that is automatically covered by the Act, occupational health can offer an opinion on whether an employee is likely covered, based on health assessments, but a definitive answer can only be determined by a legal ruling, such as via an employment tribunal.
4. What is an employment tribunal?
Employment tribunals handle workplace disputes when organisations and employees can’t reach an agreement, usually after attempting resolution through Acas. In tribunal cases, a judge applies legal principles to decide the outcome. These processes can be resource-intensive and stressful, so it’s best to address health and work issues early—something occupational health can assist with to prevent escalation.
5. Is what happens at an employment tribunal made public?
Employment tribunal decisions are published online and contribute to case law. While no two cases are identical, this helps stakeholders get insights into how legal principles are interpreted in specific workplace scenarios.
6. What does the Equality Act 2010 say about reasonable adjustments?
The Act mandates employers to “take such steps as it is reasonable to have to take” to avoid putting disabled people at “a substantial disadvantage”. The law does not define specifics, rather that the steps an organisation is expected to take depends on what is reasonable for its context. So what is ‘reasonable’ for a large organisation with significant operational support may be more compared to a small employer with one or two staff. Employers must assess what they can reasonably offer based on their specific context and capabilities.
7. Can occupational health define what’s “reasonable”?
"The employer, not occupational health, decides what they think is reasonable for their business in terms of cost and practicality, but the eventual decision on reasonableness is for the employment tribunal. Occupational health’s function is to make recommendations to the employer of possible adjustments to the physical workplace, or terms and conditions of employment (provisions, criteria and practices), or the provision of aids, which may assist the worker to join, return to or remain in the job. The basic provisions are in the Equality Act and there is more detailed guidance in the EHRC Employment Code of Practice. There is a huge amount of case law, but each case depends on its facts. Employment tribunal decisions are often interesting but they are not binding legal precedents. EAT decisions are binding precedents."
Diana Kloss, expert in employment law and occupational health law
8. What if an employer can’t implement occupational health recommendations?
If implementing occupational health recommendations proves challenging, communication is essential. Employers can discuss alternative options with occupational health, who may be able to offer further recommendations based on operational feasibility. At Insight Workplace Health, we often suggest three-way meetings between the organisation, employee, and clinician to collaboratively explore solutions and streamline decision-making
9. Is redeployment to a different role within the organisation an option?
In some cases, redeployment—moving an employee to a different role—can be considered. This can be temporary or permanent. Redeployment is rarely a first line option, as it comes with its own challenges, given change is a known trigger for work-related stress. However, when carefully managed, it can be a viable adjustment strategy.
10. How do changes to an employee’s role, or even redeployment affect their pay?
If an employee’s role changes significantly to meet their health needs, pay protection may be considered as part of reasonable adjustments. As with all measures, how much an organisation can reasonably be expected to do depends on the context including the resources available.
By understanding these core principles, employers can more effectively navigate reasonable adjustments, support their workforce, and build a healthier, more inclusive workplace. Insight Workplace Health is here to assist with tailored advice and collaborative solutions, helping your organisation take the lead on work and health, contact us here or call us on 01792 321010 to get the ball rolling today.
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