OCCUPATIONAL HEALTH PROCEDURE

OCCUPATIONAL HEALTH PROCEDURE Occupational Health Procedure Page: Page 1 of 21

Recommended by Approved by Director of OD EMT Approval Date 2 July 2012 Version Number 2.0 Review Date July 2015 Responsible Executive Director Responsible Manager For use by Director of OD HR Manager All Trust Employees This policy is available in alternative formats on request. Please contact the Human Resources department on 01204 498400 Occupational Health Procedure Page: Page 2 of 21

CHANGE RECORD FORM Version Date of change Date of release Changed by Reason for change 0.1 16 October 2009 E Schofield Document creation 1.0 19 October 2009 26 October 2009 E Schofield Amended following comments received 1.1 15 February 2012 15 February 2012 J Hetherington Amendments to procedure as part of review cycle 1.2 4 May 2012 4 May 2012 N Lister Comments from Policy Group 2.0 2 July 2012 6 July 2012 E Forsyth Approval by EMT Occupational Health Procedure Page: Page 3 of 21

Occupational Health Procedure Contents 1. Legal Obligation 5 2. Purpose of Occupational Health Function 5 3. Structure of Occupational Health Service 5 4. Workplace Health Assessment 6 5. Management of Sickness Absence 8 6. Private Medical Appointment 10 7. Night Worker Assessments 10 8. Display Screen Equipment Regulations 10 9. Counselling and Support 11 10. Physiotherapy Services 12 11. Health Surveillance 13 12. Health and Safety 13 13. Infection Control 14 14. Immunisation Programme 14 15. Health and Wellbeing Promotion 14 16. Confidentiality 15 17. Roles and Responsibilities 15 18. Urgent and Routine Appointments 16 19. Related Documentation 16 Appendix 1: Pre-appointment Assessment Process Operational Recruitment 17 Appendix 2: Pre-appointment Assessment Process Non-operational 18 Appendix 3: Management Referral Process 19 Appendix 4: Physiotherapy Referral Process 20 Appendix 5: Counselling Referral Process 21 Occupational Health Procedure Page: Page 4 of 21

1. Legal Obligation 1.1 Under the Health and Safety at Work Act 1974 there is a general obligation for the Trust to ensure so far as reasonably practicable the heath, safety and wellbeing of all members of staff. 2. Purpose of the Occupational Health Function 2.1 The Trust has a commitment to the health and wellbeing of its staff. The aim is to employ people who are suitable for the job they are employed to do and promote health and wellbeing during the course of employment. The purpose of an Occupational Health (OH) Service is to: Implement agreed OH Policy and Procedure Ensure compliance with Health and Safety regulations Offer work health assessments to help ensure that employees are suitable to carry out their identified role To provide expert advice on OH issues and advise managers and HR in the event of illness or injury and its impact on the suitableness to return to work and/or the rehabilitation needs of individuals. Assist those individuals when they return to work to enable them to settle into their work pattern with minimum stress and disruption. Offer a variety of health education and health promotion programmes to encourage the health and wellbeing of all staff To provide a cost effective service to the Trust Offer counselling and physiotherapy services to staff within the agreed parameters To interpret current and future legislation and guidance and perform services in line with this legislation/guidance. To provide a vaccination programme to ensure that all staff are offered the necessary vaccinations. 2.2 The OH Service employs qualified Occupational Nurse Advisors, OH Physicians and Consultants; under the direction of the Director of OH. 3. Structure of the Occupational Health Service 3.1 Stockport NHS Foundation Trust provides an OH Service to the North West Ambulance Service. They act as a central unit and contract the services of other NHS Trusts in the North West area. Therefore all contact is made with the Stockport OH service in the first instance using: Email: snt-tr.oh@nhs.net Tel 0161 419 5677 Fax 0161 419 4953 www.stockportoccupationalhealth.nhs.uk (username: employee, password: NWAS. Managers log ins are allocated separately) Occupational Health Procedure Page: Page 5 of 21

3.2 The following OH Departments form part of the contract: Stockport Preston Aintree Carlisle Wigan Chester Lancaster Barrow Kendal 3.3 Appointments will generally be allocated on the basis of the most convenient location to home or work but staff may be expected to travel any reasonable distance to attend an appointment. 3.4 The Opening Hours for the OH departments will be 8.30am until 5.00pm. Managers and Supervisors will ensure that staff who work weekends and nights have access to professional OH advice as soon as possible. 3.5 The service is consultant-led and Dr Donald Menzies, Consultant in OH Medicine has the overall lead. The team consists of Doctors, OH Nurse Advisers, and a team of administrative staff. 3.6 Stockport OH has tendered the services of both Physio Met and Metro Physio for Physiotherapy services and therefore there are multiple locations across the North West. This service is accessible via your manager. They are also utilising the services of several counsellors, again to ensure equal service provision across the region. RANGE OF SERVICES PROVIDED 4. Work Health Assessment 4.1 The OH service will carry out work health assessments for all employees. The aim is to: To advise the Trust on prospective employees suitableness to work; To assess individual suitableness in relation to job requirements; To advise, where necessary, on any reasonable adjustments to the work environment or structure; To advise the Trust on the needs of individuals with functional impairment in accordance with Disability Discrimination Legislation; To check immunity and provide appropriate vaccinations and monitoring; To assess the OH requirements of individual employees; To reduce the risk to staff and patients of infection; To collect relevant baseline health data. 4.2 Process for Non-Operational Staff Occupational Health Procedure Page: Page 6 of 21

4.2.1 Once an applicant has been offered a conditional appointment they will be advised by the Central Recruitment Service (CRS) to complete the on line pre-employment medical questionnaire within a given time period. The OH Nurse Advisor will screen all questionnaires and in the majority of cases this will be sufficient to advise if the applicant is suitable for the job. Where there is doubt regarding suitableness, or responses indicate the need for further information, CRS will be informed and the OH Service will organise directly with the individual an appointment. CRS will notify the applicant of the website address and password. 4.2.2 If the OH service require further assessment of an individual an appointment will take place within five working days of receipt of the Health Questionnaire. The OH service will confirm the date of the appointment to the CRS and the individual. 4.2.3 Advice regarding suitableness for work or the need for further assessment will be emailed to the CRS within one working day of receipt of the completed Health Questionnaire. 4.3 Process for Operational Staff 4.3.1 The CRS will contact the OH service to obtain date for block bookings for large scale recruitment and a minimum of 1 month s notice will be given by the CRS. Cancellation of block bookings will be made within five working days of the date booked. The CRS will allocate appointments and provide a list to the OH service no later than 24 hours before the appointments. The CRS will advise applicants to complete the pre-employment medical questionnaire (enclosed with letter) and take it to the appointment. 4.3.2 If the OH service requires a further assessment of an individual an appointment will take place within five working days of the initial assessment. Again the OH service will confirm the date of the appointment to the CRS and the individual. 4.3.3 Advice regarding suitableness for work or the need for further assessment will be emailed to the CRS on the day of the appointment. 4.4 Format of Work Medical Assessment 4.4.1 The assessment will consist of a baseline health interview and immunisation assessment based on the job and risk assessment. 4.4.2 Final health clearance will only be given when control of infection has been satisfied and where appropriate, adequate information pertaining to the physical and psychological health of the individual has been obtained and assessed. 4.4.3 The OH service will submit a work assessment form to the CRS to outline the applicant s status and whether they are suitable for the job under one of 3 headings: Suitable for employment (unconditional); Suitable for employment (with conditions) such conditions to be specified; Unsuitable for employment. Occupational Health Procedure Page: Page 7 of 21

4.4.4 Where an individual has declared sickness absence of greater than one month in the last two years or four episodes in any twelve month period the CRS will be informed. If an identified underlying problem is now resolved and no further absence is anticipated from this problem, this must also be recorded. The Trust will also be informed if there will be any implications in relation to employment, for example, reasonable adjustments and potential future absence. 4.4.5 Where additional information is required from General Practitioners or treating Specialists the OH service will send a written request for a report within one working day of receipt of a signed consent for disclosure. Where an applicant attends the OH service for a work medical, consent will be obtained on the day. The advice, following the receipt of all necessary information, will be provided within two working days to the Central Recruitment Service. 4.5 Non Attendance 4.5.1 If an applicant does not attend their work medical assessment then the CRS will be notified on the same day as the appointment. The CRS will then contact the applicant to establish why they did not attend. If another appointment is necessary then they will be asked to contact OH direct, however only one further appointment can be made before the offer is withdrawn. 4.5.2 Should a member of staff be asked to attend an OH appointment it is a condition of their contract of employment to attend and therefore they are unable to opt out. 5. Management of Sickness Absence 5.1 Although the prime responsibility for managing absence rests with the manager, they may refer staff to the OH service for assistance in managing the case. The aim is for the OH service to: To provide advice to Managers in order to assist with the management and improvement of attendance. To provide guidance on information that managers should include in referrals; To advise on the rehabilitation and resettlement of employees on their return to work. To advise on suitability for ill health retirement. To advise on the suitability of redeployment options and any necessary adjustments to the workplace. To work in partnership with the Trust in reducing sickness absence levels. To provide advice to Managers and assist employees with health problems that are affecting their performance at work. To assist Managers with identifying problems with ill health related absence or performance, which affect the running of their services. Occupational Health Procedure Page: Page 8 of 21

5.2 In all cases the referral will be made by the manager to the OH Service on line via the website with the full knowledge of the employee concerned. Staff can also self refer by contacting the OH service or emailing them in line with the contact details in section 3.1. 5.3 If the manager or member of the HR team wishes to contact the OH clinician/advisor prior to the employee s appointment to discuss any specific issues then this should be highlighted on the referral. The OH service may also choose to contact the manager prior to the appointment should there be any issues for clarification. 5.4 Referrals will be made to the OH Department via the OH website; the central unit will then allocate the referral to the appropriate satellite unit who will then triage the referral. The satellite unit will then identify whether it s appropriate for the appointment to be made with an OH consultant/physician or Nurse Advisor. The satellite unit will then issue an appointment letter to the member of staff, copied to the manager and HR. 5.5 The OH service will provide advice on the issues raised in the referral. The advice will be restricted to the employee s suitableness for employment and the report will be emailed to the Manager and copied to the HR OH inbox where the relevant HR advisor can pick this up. Confidential medical information will only be divulged with the specific, informed consent of the employee concerned. 5.6 The initial report to the Manager may be preliminary; the OH service may provide more detailed advice dependent upon information subsequently obtained from the employee s own GP/Specialist in keeping with the Access to Medical Reports Act 1998. The OH service will actively chase GP/Specialist reports to ensure that a full report is provided as soon as possible. 5.7 The OH service will organise an urgent appointment so the employee is seen within three working days of receiving the referral and routine appointments so the employee is seen within ten working days. 5.8 An employee will not be able to cancel an appointment direct with the OH Department and therefore if they are unable to attend they should notify their manager, who will email the OH Department to request the appointment is re-scheduled, if this is necessary. It is expected that an appointment would only be cancelled in exceptional circumstances. 5.9 If an employee fails to attend (DNA) their appointment the manager (and HR) will be notified on the same day. A further appointment should be organised for those who DNA or cancel (via the manager) so the employee is seen within five working days of their original appointment. 5.10 The OH service will email a written report to the Manager and the relevant HR contact within three working days of the appointment by e-mail. On the day of the appointment the OH service will email the Manager and HR contact to confirm whether the employee is suitable to return to work. The content of the report will be discussed with the member of staff, however a copy will only be issued on request if a self addressed envelop is provided. Occupational Health Procedure Page: Page 9 of 21

5.11 Where an employee is back in work and requires a follow up appointment, the OH service will issue an appointment letter to the member of staff, copied to the manager and HR. 6. Private Medical Appointments 6.1 A representative from HR may request information in relation to a private appointment where this will expedite diagnosis or recovery. Any requests will be made direct with Stockport NHSFT who will liaise with the relevant unit to obtain costs for approval by NWAS. 7. Night worker Assessments 7.1 The aim of the OH service is to: To advise managers on the employee s suitableness to undertake night duty in accordance with the Night Workers Directive; To assess individual suitableness in relation to job requirements; To advise when necessary on any reasonable adjustments to the work environment or structure. 7.2 A night worker questionnaire will be available on the OH website for employees/new applicants to complete where necessary which will be forwarded to the OH service for assessment. In most cases, the information provided on the questionnaire will be sufficient to advise whether the applicant is suitable for night work. These requests are rare but are a requirement of the Working Time Regulations 1998. 7.3 If the questionnaire responses indicate the need for further information, the OH Service will inform the appropriate HR team/central Recruitment Service within 24 hours of the receipt of the form. 7.4 Confirmation of suitableness to work at night will be provided by the OH Service within 24 hours of the receipt of the completed questionnaire. The OH Service will provide any appropriate advice/action in relation to the assessment. 8. Display Screen Equipment Regulations 8.1 The aim of the OH Service is to: To advise managers on the employee s suitableness to undertake regular work using Display Screen Equipment (DSE); To assess individual suitableness in relation to job requirements; To support managers, in conjunction with Health and Safety, in developing skills to undertake a work station assessment; To advise when necessary on any reasonable adjustments to the work environment or structure. Occupational Health Procedure Page: Page 10 of 21

8.2 The Central Recruitment Service will highlight those staff who need to be offered a Keystone vision screening test under the regulations. All vision screening tests are done by Specsavers and therefore eligible staff will be provided with a form to complete (at the point of their contract of employment being issued) and return to Stockport OH Department should they wish to obtain a voucher, which they can take to any Specsavers store to purchase an eye test and standard pair of DSE use glasses. When the voucher is used the tear off slip must be completed by the member of staff and returned to the OH Department. 8.3 Staff that are subject to these regulations and who have completed a risk assessment can be referred by their manager or by self-referral if they develop visual or musculoskeletal symptoms which require specialist OH advice. The OH service will offer a further vision test or musculoskeletal assessment to these staff if necessary. The OH Service will advise on the outcome of these assessments and were further action is required for DSE use. 8.4 There are only a small number of staff within the Trust who will actually meet the requirements of DSE user under the regulations (please refer to the H&S tool kit and DSE guidance) and only these staff would qualify for the Specsavers voucher. DSE users who qualify under the regulations will be eligible to have an eye test every 2 years. This is a service which will be offered under the regulations however is not mandatory for the member of staff to have the test. 8.5 Information on how to receive an eye test (including all relevant forms and flowcharts) is available on the HR Portal. 9. Counselling and Support 9.1 The aim of the OH Service is to: To provide staff with access to independent and confidential counselling and support, to help them deal with work related and personal issues. On occasion, source appropriate support for specific issues. 9.2 Referral will primarily be by self referral. If a referral is made by the manager they should speak to the member of staff about the option of counselling and how to access the service. However in all cases the member of staff will need to contact one of the counsellors directly. All contact details and locations are listed on the website. Staff will be asked to leave a message with their name, contact number and the fact that they work for NWAS and they will be contacted by a counsellor within 24 hours. 9.3 The first face to face appointment will take place within 5 working days. 9.4 The counsellor will make an initial assessment and, should they feel that the maximum number of sessions the Trust are able to offer will not be sufficient, the member of staff will be asked to access the counselling service offered by their GP as well. A maximum of 5 sessions in any one year period (although in exceptional circumstances this may be Occupational Health Procedure Page: Page 11 of 21

reviewed by the Head of HR) will be provided and following the last session the member of staff will continue treatment with their GP should this be required. It is expected that in some cases only a few sessions will be required before the member of staff is discharged. 9.5 Further sessions may be considered in exceptional cases but authorisation must be provided by the Head of Human Resources prior to commencement of additional sessions. Counsellors will report individual cases to OH if there are risks of the employee being at work. 9.6 If the employee requires further treatment and wishes to purchase further sessions directly from the provider they can do so on a private basis. 9.7 The OH service will report monthly on the number of session used to date in order to ensure this does not exceed the total number specified in the contract. 9.8 Staff will be expected to attend counselling appointments in their own time and only in exceptional circumstances will they have approval to attend during work time. 10. Physiotherapy Services 10.1 The aim of the OH service is: To provide staff with early access to physiotherapy services to avoid periods of sickness absence or expedite a return to work. 10.2 Referral to physiotherapy services will be done by the manager via the website. All cases will be initially triaged by the Physiotherapy providers in line with the agreed criteria, in order to ensure the service is being used appropriately. If Physiotherapy is appropriate the member of staff will be contacted directly by the provider with an appointment within 24 hours of the referral being made. The first appointment will take place within two working days of the referral being received. 10.3 Each employee may receive up to a maximum of 5 sessions in any one year period for work related injuries (where an IRF has been completed) and a maximum of 3 for non-work related injuries. There may be however, occasions where the Trust provide additional sessions however, this will be assessed on a case by case basis. After the first appointment an assessment and prognosis report will be provided for OH. If the staff member reaches the fourth appointment then a further report detailing the current situation and progress will be provided. A final report will be provided at the sixth and last appointment providing a final position statement. All reports will be emailed to the line manager and the central unit at Stockport. If the employee requires further treatment and wishes to purchase further sessions directly from the provider they can do so on a private basis. 10.4 The OH service will report monthly on the number of session used to date in order to ensure this does not exceed the total number specified in the contract. Occupational Health Procedure Page: Page 12 of 21

10.5 Staff will be expected to attend physiotherapy appointments in their own time and only in exception circumstances will they have approval to attend during work time. 11. Health Surveillance 11.1 The aim of the OH service is: To comply with the requirements of Health and Safety Legislation; To reduce work-related morbidity; To identify work-related health problems at an early stage; To reduce the risk from workplace hazards by assisting with improvements in control of exposure; To monitor equality and diversity data in order to identify health inequalities that may exist. 11.2 The OH service will maintain a database recording information on absence management issues across the Trust. This information will be analysed and trends identified for discussion with the Head of Human Resources at the contract review meeting. 11.3 The OH service will notify the Trust within 24 hours of any issues which would require reporting to regulatory bodies if they are alerted to an issue. For example, notifiable cases of disease to the Health and Safety Executive in compliance with the Reporting of Injuries Diseases and Dangerous Occurrences Regulations 1995. 11.4 If there is a management referral following an issue described above then the OH service will provide long term surveillance on the employees concerned. This surveillance will be a proactive programme managed by the OH service and will include staff with long term health conditions. 11.5 If managers identify a problem with sickness absence, performance or morale affecting their staff then they should contact the OH service to discuss further. The Service can assist Managers in carrying out assessments of the working environment and determining action to be taken. Any advice requested will be within the areas that are relevant to OH. If the OH service identifies trends in absence then they should inform the relevant manager and HR lead. 12. Health and Safety 12.1 The aim of the OH service is: To assist the Trust in meeting their responsibilities under Health and Safety Legislation. 12.2 The OH service will advise on specific issues and on policy development as requested by the Trust s Head of Risk and Safety. Advice on specific issues will be provided within one week of request. A response is required within 24 hours for acute problems. Occupational Health Procedure Page: Page 13 of 21

13. Infection Control 13.1 The aim of the OH service is: To assist with the prevention of infection/cross infection by working closely with the Trust in developing and implementing relevant policies and procedures. 14. Immunisation Programme 14.1 The OH Service will provide a full vaccination programme that reflects the occupational needs of individual staff members. A database will be maintained and staff will be recalled at appropriate intervals. Relevant immunity will be tested and immunisations offered at the Pre-Employment Health Assessment and to existing employees, as necessary. 14.2 The OH Service will determine the Hepatitis B, C and HIV status of exposure-prone workers (Paramedics and Assistant Ambulance Practitioners) as part of the pre-employment medical process. This will assist the Trust to comply with the HIV Infected Healthcare Workers: Guidance on management and Patient Notification 2005 and the Department of Health Guidelines on Health Clearance for tuberculosis, hepatitis B, hepatitis C and HIV March 2007. 14.3 In line with the NWAS Management of Sharps procedure the OH Service will liaise with relevant Accident and Emergency departments to obtain results of testing following exposure to blood or other bodily fluids or undertake testing as required. The OH service will notify the Trust H&S lead of any reported needlestick injuries where it would appear that either the donor or member of staffs bloods have not been taken in order for them to investigate further. The OH Service will also provide counselling and follow up support to staff affected. 14.4 The OH Service will also publicise and carry out an annual influenza vaccination programme within the Trust. 15. Health and Well-being Promotion 15.1 The aim of the OH is: To raise awareness about occupational and lifestyle health issues and, where appropriate, facilitate change. 15.2 The OH Service will carry out two health promotion programmes each year and will be required to analyse the success/impact of each programme. Occupational Health Procedure Page: Page 14 of 21

15.3 The OH Service will support individuals who wish to make changes to their lifestyle by sign posting them to the relevant services or by providing the appropriate support, for example, smoking cessation courses, stress management, weight loss and general healthy living. 15.4 The OH Service will ensure that thee is a range of useful and current information available on the website to assist and advise staff. 16. Confidentiality 16.1 Confidential clinical records will be kept on all members of staff seen by the OH service and stored securely in the OH department in accordance with the Data Protection Act 1998. Clinical information regarding staff members will not be disclosed without the consent of the individual. 16.2 Management referrals will be submitted on line via a secure web based facility and all management reports will be submitted via NHS Net or the Trust email in which case they will be password protected. 17. Roles and Responsibilities 17.1 The general roles and responsibilities of managers, HR, staff and the staff side are: 17.2 Managers will: Familiarise themselves with this procedure and utilise OH when appropriate and in line with the Sickness Absence Policy. Discuss the content of any referral with the member of staff before submitting it to OH Ensure that any referrals made are completed on line and in full, providing all of the necessary information. Refer staff for counselling and physiotherapy when appropriate Promote a culture of good health and wellbeing. Discuss potential cancellations with staff that have been referred to OH to establish whether there is a legitimate reason. Interpret and utilise the advice provided by OH where appropriate. 17.3 Human Resources: The Corporate HR team are responsible for managing the OH contract The CRS is responsible for adhering the timescales for the pre-employment process. Provide advice on how to get the most out of the OH service. Advise managers when making referrals to OH Work with OH to agree a twice yearly health and well being agenda Work with OH to analysis trends and take action as necessary. 17.4 Employees: Occupational Health Procedure Page: Page 15 of 21

Employees have a contractual responsibility to attend all Occupational Health appointments and advise their line manager (or the manager who booked the appointment) when they cannot, so that this can be rearranged. 18. Urgent and Routine Appointments 18.1 An urgent appointment will take place within 3 days, if: Following a major incident the member of staff requires support or the manager requires advice. A member of staff informs the manager that they are due to return to work and the manager has concerns about whether they are recovered/able to return and carry out their role. Where there are concerns about a member of staff relating to drugs or alcohol. In summary where the impact can be immediate. 18.2 A routine appointment will take place within 10 days for all other cases, including: Stress and depressions cases. Needlestick injuries. Management referrals not related to the points above. In summary where the OH service are unable to make an immediate impact. 19. Related Documentation NWAS Sickness Absence Management Policy Employee guidance Manager guidance Stress Management Policy Management of Sharps Procedure Drug and Alcohol and Substance Misuse Policy and Procedure Occupational Health Procedure Page: Page 16 of 21

APPENDIX 1: PRE-EMPLOYMENT ASSESSMENT PROCESS - OPERATIONAL RECRUITMENT Pre-employment screening should be carried out prior to the individual commencing employment or taking up their new role. Central Recruitment Service (CRS) will submit the block booking form to Stockport OH at the time an advert is placed to provisionally book medical slots, 1 month in advance of the appointments required. Stockport OH will then return the block booking form, confirming the dates and times which have been allocated via email to the CRS. CRS will issue conditional offer letters to the successful candidates which will include confirmation of their occupational health appointment. An Occupational Health Questionnaire will also be enclosed. At this point, CRS will forward the successful candidate s names to Stockport OH via the block booking form. The OHA will advise CRS of the outcome on a preemployment assessment form, within 1 working day this will include: the individual s suitability for the role whether the Equality Act may apply whether the individual is suitable for the role with adjustments to the workplace or with suitable restrictions on work practices any identified implications of likely future poor attendance summary of episodes of absence over the last 2 years OHA will inform CRS on the day of appointment if an applicant does not attend their appointment. Occupational Health Procedure Page: Page 17 of 21

APPENDIX 2: PRE-EMPLOYMENT ASSESSMENT PROCESS NON-OPERATIONAL Pre-employment screening should be carried out prior to the individual commencing employment or taking up their new role. Central Recruitment Service (CRS) will advise prospective non operational NWAS employee to access Stockport OH web site and complete the on line pre-employment questionnaire (PHQ) and submit within a given deadline. E-mail is received by Stockport OH. Administrator will download PHQ, code and pass to Occupational Health Nurse (OHN) for processing. OHN reviews PHQ. If paper based assessment insufficient a telephone call to the individual may be required to seek further details or clarify unclear or missing information. Having conducted the paper review the OHN may need to undertake one or more of the below. A report will be sent to CRS of the action required: Obtain further reports from the individual s GP/Specialist (complying with the Access to Medical Reports Act 1988) A face to face appointment with an OHN is required and at which location and on which date this will take place. Paperwork will be processed to relevant satellite unit The OHA will advise CRS of the outcome on a preemployment assessment form, to include: the individual s suitability for the role whether the DDA may apply whether the individual is suitable for the role with adjustments to the workplace or with suitable restrictions on work practices any identified implications of likely future poor attendance summary of episodes of absence over the last 2 years Occupational Health Procedure Page: Page 18 of 21

APPENDIX 3: MANAGEMENT REFERRAL PROCESS NWAS HR/Manager will advise employee they will be referring them to the OH service and the purpose of the referral must be fully explained NWAS HR/Manager completes on line management referral request form and submits. E-mail is received by Stockport OH. Administrator will download referral, code, scan documents and pass through for triaging to the relevant OH provider. The OH service will provide a report to the contact entered on the referral form. This will answer any specific questions asked wherever possible and may include the following: Whether there is an underlying medical condition Where possible, whether any sickness absence is likely to improve When the employee is likely to be fit to return to work if currently absent Whether there are any health & safety issues arising Any recommended restrictions or adjustments and their duration Whether review is recommended, when and by whom Whether the employee s case is likely to be within the scope of the Disability Discrimination Act (DDA) If the DDA applies then what adjustments are recommended and what is their likely duration. Whether the case is reportable under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) Type of appointment is identified either to see OHP/OHN or other. Location for appointment to take place is established from referral. Documents are forwarded to relevant OH department for appointment allocation. Appointment letter sent to individual and copy e-mailed to referring Manager, HR and Stockport OH. Following appointment it may be necessary to undertake the following. The contact entered on the referral form will be advised of the required action(s) Obtain further reports from the individual s GP/Specialist (complying with Access to Medical Reports Act 1988) During the ongoing management of a case it may be necessary to undertake one or more of the following. The contact on the referral form will be provided with frequent status updates. Recommend and help co-ordinate referral to Specialist. Recommend and arrange a case conference where the OHP, employee, manager, HR may all (or some) be involved in a meeting to progress the case. Absence/Attendance Management Standard Appointments will be provided within 10 working days of referral or 3 days if valid urgent appointment required. A written report on the outcome will be provided within 3 working days. Where a GP/Specialist report is required reports will be requested within 2 working days of the appointment The referring Manager and Stockport OH will be informed within 24hrs should an employee fail to attend their appointment. Occupational Health Procedure Page: Page 19 of 21

APPENDIX 4: PHYSIOTHERAPY REFERRAL PROCESS Employee will speak with their manager regarding referral to physiotherapist or manager will suggest referral following reported incident and subsequent discussion with the member of staff. Manager will access physiotherapy section on occupational health web site www.stockportoccupationalhealth.co.uk. The manager and employee will review the criteria for referral and if they are met this will check the sites available for physiotherapy and then complete and submit the request form. If the individual does not meet criteria they will be advised to access their GP services. An OH professional can refer to physiotherapy provider in the same way. The Manager, individual, HR and Stockport OH will be included in e-mail confirming appointment to individual. Physiotherapy provider at the initial consultation, will where possible, advise the employee whether they feel that the 3/5 sessions will resolve their problem completely. If this is not the case the individual will be advised to contact their GP so they can access the service once they have used their 3/5 sessions. Once an appointment has been arranged, referring Manager, HR Manager and Stockport OH will be send initial report and then mid and final report to snt-tr.oh@nhs.net. These reports will be sent to the manager and HR. Occupational Health Procedure Page: Page 20 of 21

APPENDIX 5: COUNSELLING REFERRAL PROCESS Employee will access the counselling section on the Stockport occupational health web site www.stockportoccupationalhealth.co.uk. A list of the locations and contact numbers will be available from which the individual can make a choice The employee will contact the counsellor of their choice and in many cases will be asked to leave a message, giving their name, contact number and which organisation they work for. The counselling service will get in touch within 24 hours. If no contact has been made, the employee is asked to contact 0161 419 5677 or e-mail snt-tr.oh@nhs.net at Stockport. The individual s query will be looked into and the OH Administrator will make contact with the employee to resolve the issue. At the initial telephone contact the counsellor will want to record some basic information in order to identify the appropriate type of appointment A mutually convenient appointment will be arranged between the employee and counsellor. The counsellor will e-mail the initial contact details form to snt-tr.oh@nhs.net at the Stockport HUB. Stockport will send a unique code that the counsellor will use in all future communications with the Stockport HUB. At the initial face to face appointment, the Counsellor if possible will advise the employee as to whether they feel the 5 sessions available will be sufficient to deal with their issues. Where the Counsellor believes that additional sessions will be required, they will advise the employee to request referral via their GP so that they can access this service at the end of their sessions. Employees are able to self fund if they wish. Occupational Health Procedure Page: Page 21 of 21