A Manager’s Guide to the Occupational Health Referral Process

Phoenix Occupational Health can improve the current and future health and success of its staff by developing a healthy culture and adopting a systematic pro-active approach to occupational health.

The role of Occupational Health in the management of health related absence

Management of health related absence is the responsibility of managers. However Occupational Health involvement can be an effective way of supporting managers in the management of long and short term health related absence. The role of the Occupational Health service in relation to the management of health related absence is to:

  • Provide clear, actionable, advice to managers on fitness for work issues;
  • Provide support and advice to employees regarding their specific health issues as well as the promotion of wellbeing and a healthy lifestyle;
  • Advise both employee and management on appropriate rehabilitation programmes/return to work strategies.

Purpose of Management Referrals

Effective management of health related absence within an organisation can:

  • Improve employee attendance and performance;
  • Reduce both direct and indirect costs of health related absence;
  • Increase productivity;
  • Improve morale.

Referral of staff to the Occupational Health Service can provide you with the clear and objective advice to enable you to manage health related absence effectively.

The most effective way to ensure you get the most out of your Occupational Health service, in relation to absence management is to refer employees as soon as you have any concerns about their health, attendance or fitness to work.


The Occupational Health (OH) assessment will enable the Occupational Health Nurse (OHN) to provide a clear opinion on:

  • Fitness for work: whether or not the person has a health problem that may affect fitness for work;
  • Return to work: if the person is currently absent, when they are likely to return;
  • Rehabilitation advice;
  • Temporary or permanent workplace restrictions/adjustments that need to be considered (may be in line with the measures that may enable the person to return to work before full recovery;
  • The implications of the Equality Act 2010 ;
  • Future attendance: how much absence is likely in future due to health problems

This advice should enable you to deal with any problems in a fair, consistent manner, balancing the needs of the employee with business priorities and requirements.

The above recommendations on adjustments are advisory only. It is for you to decide whether or not to implement them.

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

When to Refer

A member of staff should be referred for an OH assessment:-

  • Where they have had several episodes of short-term absences in line with your company’s health related absence policy.
  • Where there is concern that they may have work related health problems or that existing health problems are being aggravated by work duties.
  • Where they may have difficulties coping on return after being absent e.g. following a serious illness or disability.
  • Where there may be an underlying health factor contributing to performance issues.
  • Where there is long term or continuous health related absence i.e. longer than 3 weeks.
  • If you are uncertain whether or not a referral is appropriate you should contact Phoenix Occupational Health for further advice.

How to make a referral

The reasons for the referral MUST first be discussed with the employee. They must be fully informed as to why they are being referred to OH and what information you require from the OH assessment. We would encourage that a copy of the completed management referral form is given to the employee or its contents discussed prior to forwarding it Phoenix Occupational Health

Once OH has received the referral form the appointment details are sent to the member of staff.

What to expect at the appointment

The employee is assessed by an OHN, taking into account a range of issues. A detailed history will be taken, including details on relevant and past health issues, treatment, day to day restrictions, work issues etc. Where appropriate, the OHN  may undertake a clinical examination to determine functional capability.

In some instances it may be necessary to request medical information from the person’s GP. In this case, this will be discussed with the employee and informed consent gained by the OHN. In such cases, only the OHN will have access to the GP/Consultant report and an interpretation of the report, together with further advice and recommendations will be sent to the referring manager/Human Resources Department.

Many employees do not need to be routinely reviewed by the OHN. However, where recovery or response to treatment needs to be determined, the OHN may advise a review of the employee. This will be detailed in the OH report.

Occupational Health Reports

The contents of the OH report will depend upon the nature of the problem and the questions that have been asked in the referral. OH Reports focus on the effects of the health problems on work. Medical information is not usually disclosed and is not usually necessary to effectively manage an employee. Where medical information is required in the report to assist you supporting the employee, the written consent of the employee will be obtained. In this case, you must ensure you retain the report and the sensitive data contained in the report according to the principles of the Data Protection Act.

A copy of the report is routinely provided to the employee by OH.

Rehabilitation Plan

The OH practitioner may advise a rehabilitation plan to allow the member of staff to gradually build up to full duties. A rehabilitation plan can support an employee back to work before they are fully fit, as control measures are in place to protect their health and safety. Recommendations for a rehabilitation plan may include:

  • temporary redeployment, and/or
  • working reduced hours, and/or
  • assistance with some tasks especially if physically demanding, and/or
  • temporary restrictions on tasks undertaken.

This information should be regarded as advisory, implementation of adjusted duties should be considered reasonable to the department. If further information is required, or you wish to discuss the suggested adjustments then please contact Phoenix Occupational Health

What next?

Once you have received the report, you should arrange to discuss the report with the employee.

Please note that the opinions expressed in the report are based on clinical knowledge and experience and are not subject to negotiation or amendment. However, if you have questions about the report, or it does not provide you with the information you need, you should contact the OH Practitioner to discuss your queries.