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Why do occupational health put restrictions on the activities an employee can undertake following a medical?

Occupational health (OH) clinicians undertake medicals in line with nationally recognised guidance to ensure that employees are fit to undertake all aspects of their contracted role. For those undergoing a safety critical medical this assessment will include a detailed past medical history questionnaire and questions about current health conditions, symptoms and/or treatments.


Most staff who undergo safety critical medicals will be deemed fit for work without the need for any modification to the role they undertake or the need for any follow up by a nurse (OHA) or doctor (OHP). However, some staff may have health conditions which will require them to seek guidance from their GP or other health professional. It is vital that employers are made aware if employees have conditions which may cause sudden loss of consciousness or incapacity, reduced awareness, or concentration, affect their balance, coordination and/or mobility such that it may impact upon their own or others safety in the workplace, however GDPR limits the amount of information which we can share with an employer without the consent of the individual.


Following a safety critical medical the certificate will advise of any necessary action to be taken, if required, namely that your employee is:


Fit - No action required


Fit with recommendations - Staff may need to ensure that they comply with the workplace risk assessment and method statement (RAMS) to prevent potential harm i.e. Audio - To protect hearing, strict use of appropriate, well-fitting hearing protection recommended.


Fit with recall to OH - In some cases, OH need to repeat an aspect of the medical assessment i.e. repeat blood pressure, audiometry, or spirometry, where results are borderline to establish whether any further action needs to be taken, employees may be able to obtain the necessary information from their GP or optician and share this with OH to reduce the need for further follow up where the results meet the required criteria.


Fit with adjustments - This is used where an individual has previously been seen by an OHA or OHP and adjustments have previously been recommended by OH which need to remain in place i.e. HAVS - Recommend the daily exposure to vibration is kept below 100 points.


Fit with restrictions - In some cases where employees require restrictions to be put in place to remain in work (see above) this is normally in relation to one of the following:


  • High blood pressure

  • Distance vision (relating to visual acuity not meeting the required standards for the driving of Group 1 or Group 2 vehicles)

  • Blood sugar (in the case of insulin dependent diabetic staff, where their blood sugar does not appear to be managed effectively)

  • Undertaking safety critical work (where there is an underlying health condition of which the employer is not aware, and which may impact upon their fitness for role)


***In most cases any restrictions will need to remain in place until the individual has sought further support from either their GP (or specialist consultant), optician, or diabetic clinic (nurse specialist) and/or until they have been assessed by an OHA or OHP.


Fit with adjustments – Referred to OHA - An individual may have adjustments in place from a previous OH consultation however a follow up consultation may be required periodically to ensure that the employer is made aware of any relevant changes to their circumstances.


Fit with adjustments – Referred to OHP - An individual may have adjustments in place from a previous OH consultation however a follow up consultation may be required periodically to ensure that the employer is made aware of any relevant changes to their circumstances.


Unfit - In some circumstances, it may not be feasible for our clinician to make any recommendations or restriction to enable your employee to remain in work, in these circumstances it is likely that a management referral may be required.


If you require any further guidance on the role of occupational health in supporting your staff to return to or to remain in work and being able to undertake all aspects of their work please get in touch.

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