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referrals to occupational health



Referrals To Occupational Health
Guidance for NUT members and local officers – posted 17/5/06

The Union is regularly contacted by members concerned about requests from employers that they meet with their occupational health services. Members often feel vulnerable and threatened by such requests. This leaflet explains the background to the referral system and offers advice about meeting with the Medical Adviser of the employer and how a return to work, where appropriate, should be managed. Further information or clarification on any points of doubt should be sought from the members’ NUT caseworker for from the South West Regional Office. In 1998 the Government recommended that all public sector organisations introduce progressively earlier or wider referrals to occupational health services to address cases of workplace injury or sickness. The NUT did not accept that any widespread abuse of sick leave arrangements had been taking place in schools and did not consider that there were good reasons for the introduction of absence monitoring procedures in schools. The Union was (and remains) concerned that it was the teaching environment that was a significant factor in teachers having to make use of sick leave and argued that these procedures were unlikely to address the issues of constant change, workload, pupil behaviour, bullying at work etc. which were common reasons for absence from work. All LEAs, however, now have in place policies relating to the management of sickness absence which, in the view of the Government, are intended to ensure:   Lost working time is minimised Return to work of teachers following illness or injury can be facilitated and supported in a way that will optimise the likelihood of rehabilitation back to full teaching duties Following illness or injury the teacher is fit to resume teaching duties and that any reasonable adjustments can be considered that will facilitate the return to work of teachers with a disability Work related causes of illness or injury can be identified, investigated and addressed in order that other employees are not similarly affected.



The LEA absence monitoring policy document should clarify the circumstances when a teacher may be expected to be referred to the

Authority’s Medical Adviser. Referral is normally triggered by a particular number of days of sickness absence, “frequent” short-term absences or, specific causes of absence. If a teacher is to be referred to the Medical Adviser it is essential that the employer has fully advised her/him of the reason for the referral, in line with the policy. Members should request a written explanation for the reason for referral plus a copy of the policy document if they have not been made available. In most cases the teacher will be asked to provide written consent to allow the Medical Adviser access to medical information from the teacher’s GP and, where relevant, consultant(s). The employer does not have sight of this material and we would advise members to co-operate with such requests which are made under the provisions of the Access to Medical Reports Act 1998. (N.B. This procedure should not be confused with requests from schools asking members to provide medical details to insurance companies who are seeking information to determine whether payment can be made to the school for supply cover purposes. There is no contractual requirement for a teacher to provide such confidential information to a third party if the teacher does not wish so to do). You have the right to view any information before it is sent to the Medical Adviser and you should therefore discuss this matter with your GP/consultants(s) at the earliest opportunity. When meeting the Medical Adviser you are able to be accompanied by a friend or representative. You have the right to have you GP present, if you so wish. Having met with you and considered any written information from your doctors, the Medical Adviser will send a report to the Human Resources department of the LEA which should normally incorporate the following points:   When you are likely to be fit to return to work or the minimum period for which you will continue to remain absent. When you are able to return to work, whether you will be fit for your full teaching duties, or whether there will be some limitations, what those limitations will be and whether they will be temporary or permanent. Whether you are covered by the Disability Discrimination Act (see below) Whether your employer can do anything to facilitate recovery and return to work.

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Whether redeployment or other adjustments should be considered. Whether the cause of absence is work-related or not. Requirement for further review.

Where relevant, the meeting should be viewed as an opportunity for you to indicate to your employer’s medical adviser any steps that your employer should be taking to assist you at this time to ensure that when you do return to work it will be on a permanent basis. The guidance from the Medical Adviser’s report will be used by your employer to determine how your eventual return to work will be managed. Prepare for your meeting. Discuss your situation with your doctors, NUT Representative, Division Secretary or, Regional Office. Make notes of the points you wish to raise and be included in the Medical Adviser’s report .Take your notes to the meeting.

Examples of adjustments requested by members in this situation include:         A phased return to work. Moving to part-time work. Special equipment such as a chair. Making adjustments to premises. Changing room allocation(s). A more reasonable timetable/workload. An extension of paid sick leave. Redeployment

You should ensure that you receive a copy of the Medical Adviser’s report. If there are any errors in the report you should write to the Medical Adviser, explaining any inaccuracies and request a copy of the revised report. If the Medical Adviser suggests a course of action that you are unhappy with e.g. a return to work earlier than you believe is appropriate, you should discuss this with your GP and ask your GP to write to the Medical Adviser on your behalf, recommending a more suitable arrangement. Prior to a return to work it is essential that any recommendations made in the Medical Adviser’s report have been discussed with your employer and written agreement has been produced clearly explaining how your return to work is to

be managed, taking into account the recommendations. You can take a Union representative with you to the meeting with your employer to discuss the detail of your return to work. Remember, the purpose of the meeting is to arrange the best terms that will ensure that when you do return to work it will be a permanent return. If a phased return to work has been recommended you are advised to clarify with your NUT Division Secretary the appropriate salary arrangements that will apply during this period as well as the reasonable duties that you will be undertaking until you resume your normal workload. The Disability Discrimination Act The Disability Discrimination Act (DDA) places a legal duty on employers not to discriminate against employees and to make reasonable adjustments appropriate to the individual and her/his disability. The adjustments listed earlier in this leaflet would be considered to be “reasonable adjustments” under the terms of the Act. The DDA defines a disabled person as someone who has “a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities”. An impairment has a long-term effect if it has lasted or is expected to last for at least 12 months. The definition covers physical, sensory, or mental impairments; progressive conditions such a cancer, MS, muscular dystrophy and HIV infection; severe disfigurements and people who have had a disability in the past. The DDA requires employers to consider how working conditions must be made suitable to the employee, rather than the other way round. Failure to make reasonable adjustments, victimisation or discrimination on the grounds of disability can be challenged and members should contact the Union if they have concerns about how their employer is failing to accommodate their disability. Regional Office can provide further assistance/documents about these and other matters such as sick leave, state benefits and pension/salary issues. Further Information Fitness to Teach: Occupational Health Guidance for the Training and Employment of Teachers Obtaining Occupational Medicine Health Advice on Fitness to Teach (These documents are produced by the Faculty of Occupational Medicine “to promote good, consistent practice among those who provide occupational health services for teaching staff” and can be viewed at

DfES Circular 4/99 – Physical and Mental Fitness to Teach of Teachers and of Entrants to Initial Teacher Training DfES Circular 20/99 – What the Disability Discrimination Act Means for Schools and Local Education Authorities (These documents may be viewed at

Access to Work (This Government scheme providesfinancial assistance and practical support to disabled employees and their employers to help overcome work related obstacles resulting from a disbility. Further details can be viewed at

Teacher Support Line 0800 0562 561 (A confidential telephone counselling service for teachers run by the Teacher Support Network charity) which also operates an on-line service which can be accessed at their website

NUT Regional Office, 1 Lower Avenue, Heavitree, Exeter, Devon, EX1 2PR Telephone 01392 258028 Fax 01392 412801 E-Mail

NUT Website: This document was last updated on 25th April, 2006

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