Specialist advice in the following areas

  • Fitness for work
  • Return to work
  • Rehabilitation advice
  • Future attendance
  • Future performance
Staff referral form [Download file]

Purpose of fitness referrals

The purpose of an Occupational Health referral is to help individuals and their manager understand the impact of health problems on work. Current health and functional/cognitive ability are assessed and how these impact an individual’s capacity to undertake their role.

A report to management will contain an objective, specialist opinion on an employee’s ability to undertake responsibilities of their role, as well as recommendations on workplace adjustments (temporary or permanent) to assist them in doing so successfully despite an enduring health problem or disability.

The assessment also provides the person referred an opportunity to discuss any health concerns in confidence with an OH Advisor and receive advice on what they can do to improve their health and/or attendance at work. 

The assessment will usually provide a clear opinion on:

  • Impact of a health condition on attendance or performance - if the person has a health problem that may affect their reliable attendance or may affect their performance at work.
  • Return to work - if the person is currently absent, when they are likely to be ready to return
  • Rehabilitation advice - whether an employee will benefit from a structured period of rehabilitation following a significant illness. An incremental increase in hours, responsibilities/ deadlines is a supportive adjustment that may enable the person to cope with the transition along with additional demands of returning to work such as commuting before they feel “fully fit”
  • Future attendance an opinion on future absence due to the health problems assessed
  • Future performance an opinion on the person’s ability to undertake the responsibilities of their role
  • Permanent workplace adjustments to support a disability or health condition

This should enable you to address issues in a fair, consistent manner, balancing the needs of the person with work requirements and the College’s legal responsibilities under the Equality Act (2010).

Any recommendations on adjustments to duties etc. are advisory. It is management’s responsibility to ascertain if they are reasonable and to be able to justify that decision.

Care should be taken so decisions are in line with the College’s commitment to “parity of esteem” for physical and mental health problems along with being a Disability Confident Employer.

Managers guide

When to refer

A member of staff should be referred if any of the followinig apply:

  • Following any return to work meeting where an employee indicates they would like support to manage a health problem
  • Where they have had several episodes of short-­term absences which they attribute to an ongoing health problem
  • Where there is concern that they may have work­related health problems or that existing health problems are being aggravated by work duties (for example: allergy or musculoskeletal problems)
  • In anticipation of their return to work following a serious illness (for example: cancer, heart condition or surgery) mental health condition or other active health problem resulting in a disability
  • Where there may be an underlying health factor contributing to performance issues
  • Where there is long term or continuous sickness absence i.e. longer than four weeks
  • If an employee is receiving treatment for a progressive or life limiting illness and might benefit from retirement on the grounds of ill health
  • If you are uncertain if a referral is appropriate, you should contact Occupational Health or HR for advice

How to make a referral

Consultations cannot be arranged without a completed referral form.

To ensure an open and transparent process the reasons for referral must first be discussed with the member of staff and their consent obtained.

The referral form should be completed with factual information, if they are away from the workplace due to illness they should receive a written explanation along with the referral form. This must be completed prior to Occupational Health involvement.

An email from the individual can be accepted as evidence of their willingness to participate, this will confirmed by the OH Advisor when they attend.

How to get the most from a referral

The key to obtaining useful advice from OH is to make a detailed referral. Completion of the OH referral form provides the advisor with the most essential information. You should ensure you include:

  • Information on the problem and how it is affecting their work/duties and
  • The questions you would like answered
  • Details of support /adjustments which have already been put in place
  • Up to date information on attendance record

You should provide a clear description of the person’s job and the major tasks within this. The Job Demands Section of the referral form provides a template for this. A job description should also be supplied.

Arranging the consultation

The completed referral form should be emailed to the Occupational Health inbox as per the instructions on the form. It is then triaged and the individual will be contacted with an appointment. Consultations with Nurse Advisors are usually offered within 10 working days and Physician appointments within 15 working days.

All Clinical consultations are undertaken by Occupational Health on the South Kensington Campus.  If a member of staff is unable to attend it may be possible to undertake an assessment by Skype if clinically appropriate.

Occupational health consultation

The person is assessed by an Occupational Health Advisor (a specialist in workplace health) using a systematic approach. They will be asked questions about their health and the effects of any health problems on their work and home life. The advisor also asks about other issues that may affect their health and about any treatment they have received. Where appropriate, the OH Adviser carries out a functional assessment. If a clinical examination is necessary, the OH Physician will see the person. In some instances it may be necessary to request medical information from the person’s GP. It may also be necessary to review the person after a period of time sufficient to assess recovery or response to treatment, before a firm opinion can be given on when a person is ready to return to work or to full duties.


A report is always provided after the person’s first consultation and usually within 5 working days of attendance.

The contents of a report will depend upon the nature of the problem and the questions that have been asked in the referral. The information given will cover:

  • Whether the person has a health problem which may affect attendance or  performance at work
  • If so, the effects on future attendance/ performance
  • Time needed off for appointments, treatment etc.
  • The likely time it will take for the person to regain their fitness to return to work
  • Recommendations on workplace adjustments or a rehabilitation plan to assist successful return
  • If not fit to return to previous work, prospects for re­deployment/retirement on medical grounds

Reports concentrate on the effects of health problems affecting work. Medical diagnosis or specific details of treatment are not usually disclosed, unless necessary for managing the person in their work and only when they have given consent for disclosure

Application of the Equality Act 2010

Where an individual has a disability or long term health condition they may benefit from permanent adjustments to assist them in undertaking their work if applicable this will be covered in the report.


A number of ethical and legal frameworks cover how confidential medical information is managed in the OH context.   Medical information supplied in the course of an OH consultation is held in confidence and only divulged in exceptional circumstances as outlined by the medical and nursing professional bodies.

Reports should be treated as sensitive “special category data” (as defined by GDPR). The fitness assessment and recommendations on adjustments to accommodate health problems can be shared with others on a ‘need to know’ basis. - To facilitate effective decision-making and implement recommendations, it may be necessary to share the content of the report with those with managerial responsibility for the individual concerned, (HR /Senior Management).  Individuals with access to this information are accountable for how it is stored and shared.

An OH report does not usually include confidential medical information. Where it does it is only with the consent of the individual concerned and their specific consent should be sought before such information is divulged to others.

Rehabilitation Plans

The OH Advisor may propose a rehabilitation plan to assist the member of staff to gradually build up to the full duties of their role. This is often helpful to the person returning to work after a serious illness, following surgery, or while they are undergoing a course of treatment. It is also helpful to assist them to adapt to managing the effects of a longer term physical or mental health condition. A rehabilitation plan can also assist a person return to work earlier than first thought. Recommendations for a rehabilitation plan may include:

  • Adjustment to working hours -increasing on a phased basis
  • Adjustment to tasks
  • Assistance with some tasks especially if physically demanding and/or
  • Temporary restrictions on tasks undertaken
  • Temporary redeployment, and/or
  • Working from home - subject to operational feasibility

It is essential that feedback on the progress of a rehabilitation plan be shared with the OH Advisor so that it can be adjusted to better suit the needs of individual and their work environment. 

The Occupational Health Advisor may consider it helpful to signpost the individual to a number of sources to support their recovery or improve their well-being. This may include Equality Diversity and Inclusion Centre, Access to Work, physiotherapy, counselling, peer coaching, skills training, Sport Imperial or a smoking cessation service. 

Staff who cite workplace stress as an issue are encouraged to use the online resources on the Health and wellbeing pages and to use them to prepare to discuss their concerns with their manager. Complementary information is available for managers. 

It may also be necessary to conduct a workplace visit.

What next

Once you have received the report, you should arrange to discuss the report with the member of staff. If you have any questions about the report, or it does not provide you with the information you need, you can contact the OH advisor to discuss this first.

Follow-up consultations

When an Occupational Health Advisor considers an individual will benefit from further support or that it is necessary to monitor the outcome of treatment and/or further investigations, a review appointment will be arranged.

Further assistance

Managers can seek guidance from HR on management issues arising out of a fitness assessment. You can also contact Confidential Care’s Management Support line, to talk through how to discuss a management problem with a member of staff.