Human Resources Policy No. HR65 Occupational Health Service Additionally refer to: HS01 Health & Safety Policy HR06 Maintaining High Standards of Performance HR07 Disciplinary Policy for Doctors and Dentists HR09 Alcohol & Substance Misuse HR29 Special Leave HR31 Managing Sickness Absence HR36 Disciplinary Procedure HR48 Managing Staff with MRSA HR63 Managing Poor Performance HR66 Staff Counselling Service Sponsor: Head of Human Resources in conjunction with Director of Corporate Affairs Date agreed by TNCC: November 2009, reviewed November 2010 Date agreed by Board: January 2010 Date of next review: October 2015 Version: 2 The original expiry date of this policy has been extended in agreement with staff side as we transition into a new policy consultation process. Page 1 of 16
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Contents Page Number Section 1 Introduction 3 Section 2 Scope 3 Section 3 General Principles 3 Section 4 Responsibilities 4 Section 5 Process 5 Section 6 Confidentiality 5 Section 7 Infection Control 6 Section 8 Needlestick/Percutaneous and Mucousal Splash Incidents 6 Section 9 Pre-Employment Health Checks 6 Section 10 Monitoring and Review 7 Appendix A Occupational Health Referral Form 8 Appendix B Work Health Assessment 9 Appendix C Work Health Assessment Process Flow-Chart 15 Page 3 of 16
1. Introduction 1.1 The primary purpose of this policy is to outline the role of the Occupational Health Service and the process by which employees are referred to their services. 1.2 All employers have a legal obligation to protect the health and safety of their employees. The Trust believes that all staff should have the opportunity to access support through a high quality Occupational Health service for any health issues which are a result of, or which affect, their employment with the Trust. 1.3 Occupational Health is a distinct branch of medicine concerned with how a worker s health can affect his/her ability to do the job and how work and the work environment can affect an employee s health. The Occupational Health service provides specialist advice to employees and management on all matters relating to the health, safety and wellbeing of employees of the Trust and recognises the rights of individual employees under human rights legislation. 2. Scope 2.1 This policy applies to all staff who are directly employed by the Trust, whether full time or part time, permanent or temporary including those employed by the Trust via the Temporary Staffing Department. 2.2 The policy does not apply to individuals employed by agencies or other contractors. Issues relating to occupational health services for these individuals should be referred to the appropriate employer. 2.3 In implementing this policy, managers must ensure that all staff are treated fairly and within the provisions and spirit of the Trust s Equality & Diversity Policy. Special attention should be paid to ensuring the policy is understood when using it for staff new to the NHS or Trust, by staff whose literacy or use of English is weak or for persons with little experience of working life. 3. General Principles 3.1 An employee may be referred by management to the Occupational Health Service at any time during their employment. Cases where referral to the Occupational Health Service may be appropriate include: where an employee moves to a new role within the Trust (see section 9.5) where an individual s performance at work is impaired by ill health where, due to an underlying health condition, an individual returns to work under different working arrangements such as a new post or with adjustments to the workplace (to confirm the suitability of the changes) where, in accordance with the Trust s Managing Sickness Absence Policy (HR31), an employee has breached a short-term or long-term trigger point or a pattern of absence becomes apparent during a period of long-term absence to determine when and under what conditions and employee is able to return to work if a manager has specific concerns over the employee s health and wellbeing. employees suffering from work-related stress employees suffering from manual handling or musculo-skeletal injuries where the employee or manager has identified a work related problem that requires support from the Staff Counselling Service where an employee is involved in sharps injuries with exposure to body fluids Page 4 of 16
4. Responsibilities 4.1 The Occupational Health Service has a responsibility to support and advise the Trust and its employees to maintain employee health in the workplace. In undertaking its duties in this respect, a personal health record (a medical record) is created about each employee referred to this service. Occupational Health work in collaboration with Human Resources, the Staff Counselling Service and the Health and Safety team for the improvement of the working environment for staff. 4.2 The role of the Occupational Health Service is to: work within Department of Health guidelines for screening staff assess risk against individual job profiles, personal risk and organisational needs work within legal requirements such as the Management of Health and Safety at Work Regulations 1999 identify hazards at an early stage and advise staff accordingly provide valid methods of immunisation, screening, testing and surveillance provide professional support and advice to any employee suffering work-related health problems provide an independent medical opinion to managers regarding the health condition of individuals advise managers of any work-related factors that may affect an individual s ability to attend work regularly advise managers of the anticipated date of return to work and/or likely duration of the illness advise managers of the potential for recurrence of illness advise managers of the suitability of employees to carry out night work advise managers of any short or long term workplace adjustments which may be made to enable an individual to remain in employment correspond with any other medical professional involved in individual cases in order to ascertain the information required provide psychological support and advice including referral where appropriate to the independent Staff Counselling service provide advice and support on the resettlement and training for persons with disabilities monitor employees returning to work following sickness absence and provide management guidance provide a limited health treatment service provide advice on the compliance with health, safety and disability legislation. Page 5 of 16
4.3 The role of the manager is: to refer employees to the Occupational Health Service when appropriate, providing adequate information for the Occupational Health team to make a valid assessment of employees wellbeing to allow staff time to attend appointments in relation to health and safety and infection control (please refer to HR29 Special Leave) to implement any recommendations made by the Occupational Health Service wherever possible. Managers or employees who disagree with recommendations or advice should discuss the matter with a member of the Occupational Health team. If this fails to resolve the issue the manager or employee should contact the Human Resources Service for further advice to monitor temporary arrangements that have been put in place following recommendations from Occupational Health, ensuring they remain fit for purpose 4.4 The role of the employee is: to attend occupational health appointments as requested by management to provide accurate and honest information to Occupational Health clinicians to adhere to any restrictions recommended by Occupational Health. 5. Process 5.1 Before referring an employee to the Occupational Health service a manager should seek to meet with the individual to discuss the content of the referral form, confirm the reason for the referral and obtain the employee s consent. Where consent is not given, the employee should be reminded that the Trust may require them to attend for a medical opinion and if they fail to do so the Trust will make decisions regarding their future employment under the relevant Trust policy based on the limited information available to date. 5.2 Referral to the Occupational Health Service by a manager should be made using the standard referral form (Appendix A). It is important that managers provide sufficient information on this form to enable Occupational Health to give a fully informed and considered opinion. 5.3 Follow up appointments may be made directly between the Occupational Health Service and employees where appropriate. 5.4 In emergency circumstances, e.g. those relating to needlestick injuries or infection control, employees can self-refer or can be referred by their line manager 6. Confidentiality 6.1 The confidentiality of patient s privacy, wellbeing and dignity is guaranteed, except as set out below. All Occupational Health records will be maintained securely in the Occupational Health Service in accordance with data protection requirements. 6.2 In certain circumstances, in order to provide accurate reports, the Occupational Health Service may obtain relevant information from other clinical sources (e.g. G.P. reports, Consultant reports). This will only be done with the consent of the employee. Page 6 of 16
6.3 Confidentiality is not an absolute obligation. Disclosure may be required by law or it may be in the public interest to do so. Additionally, situations may arise where the harm in maintaining confidentiality is greater than that in disclosing the information. For example: when confidential information is needed to protect someone s health and safety concern for public welfare concern for the safety of other specific persons police requests for client information with statutory authority or court order clients with reportable communicable diseases when necessary in order for the Trust to comply with its statutory duties under health and safety law, in particular the Reporting of Injuries, Diseases and Dangerous Occurrence Regulations 1995. 7. Infection Control 7.1 When an employee is suspected of contracting or carrying an infection it is the responsibility of the Occupational Health team to: carry out screening and treatment programmes under the direction of the Director of Infection Prevention and Control and in accordance with appropriate protocols liaise with the Infection Control team on the results of screening tests and appropriate action to be taken notify the appropriate Line Manager if any management action is required. 7.2 Please refer to the relevant Infection Control policy for more information. 8. Needlestick/Percutaneous and Mucousal Splash Incidents/Bloodborne Viruses 8.1 Infection from blood or bodily fluids may occur following incidents such as an injury from a used needle or sharp, splashing onto mucous membranes or a bite or scratch from an infected patient when the skin is broken. Employees involved in such an incident should immediately follow the relevant Trust Health & Safety guidelines available on the Trust Intranet and ensure their manager is informed and the incident is reported via the Datix system. 8.2 If the incident occurs outside Occupational Health working hours (08.30 to 4.30pm Monday to Friday) employees should attend Accident and Emergency for initial assessment and inform Occupational Health via answer phone providing their name, phone number and details of injury. Employees will then be contacted by Occupational Health as soon as possible for follow up assessment, immunisation and counselling. If the incident occurs during working hours Occupational Health should be informed immediately. 9. Health Checks Work Health Assessments 9.1 Employees have a duty and responsibility under health and safety legislation and a professional responsibility not to endanger, by their acts or omissions, the health of other employees, patients, visitors or any other persons within the Trust. Page 7 of 16
9.2 All Trust employees are required to complete a Work Health Assessment form (Appendix B). This must be done after the conditional offer has been made but before the employee commences employment and any conditional offer of employment must be subject to this screening. Please see the Work Health Assessment Process Flow-Chart (Appendix C) for more information. 9.3 No questions relating to health or sickness absence can be asked prior to offering employment to an employee and can only be asked if relevant, to enable an employee to carry out their duties. 9.4 The Occupational Health Service will review any completed Work Health Assessments and then determine if any action is required prior to the employee commencing employment and inform the individual or manager as to the applicant s fitness for work in the position stated on the form. If it is found an employee has provided false or inaccurate information to occupational health in order to gain employment, disciplinary action may be taken in line with the Trust s Disciplinary Procedure. 9.5 If a prospective employee is assessed as not suitable for the role during the conditional offer stage, reasonable efforts should be made to make adjustments to the post where possible or suitable alternative employment should be sought for the individual. Where adjustments cannot be made or suitable alternative employment is not available, then the conditional offer should be withdrawn at this stage. Managers should refer to Human Resources Service for guidance. 9.6 Employees moving to a new role within the Trust may be required to complete a Work Health Assessment check where there is a break in service or their new role is substantially different in terms of clinical duties, patient contact or physical demand. 10. Monitoring and Review 10.1 This policy will be reviewed and monitored by the Human Resources Department. This will include regular review meetings with the Occupational Health Service, the annual business planning meeting and through consultation with managers, staff and staff representatives. Any queries relating to the application of this policy should be referred to the HR Department. 10.2 The joint TNCC will be responsible for the periodic review of the policy to ensure it remains appropriate and effective. Page 8 of 16
APPENDIX A For the latest version of the Occupational Health Referral Form please visit the Trust Intranet: http://intranet/hr/occupational_health_page.asp Page 9 of 16
APPENDIX B!!"#!" $ %% "& &!' #' " "(")"$ Yes No *+*,+-+*-.*,*--*#*$! "#$% &' () * +! &' * + *! &' ) &') &'),) ' *-!.*/((0! () " ' &')+ &'+! &'+ 1-23.#4+'0 */ -") 2) + & *+/! + )) ))"" * 7 (5. 066 Page 10 of 16
SECTION B HEALTH DECLARATION -*+ *+*0, 8 9: + +) ' " +:"; < 9:" +) +'+) => +' +'; /) / 66666666666-,,,,.(066666666666 -?.0 6666666666666666666666.,066666666666 " 6666666666666666666666 6666666666666666, -? 666666666666 6666 666666666666666666 *6666666666666666666!-+*+ 8 :"+1 : ( *&'. )0 ' ),): ( *&'+ + < :"+2 (." 2@0 -(3+*+44,*-!*-+*+5+,3 #*+*+-0+5$0-0++-0* *+-#4+')$ Page 11 of 16
SECTION C FURTHER HEALTH INFORMATION *+,--4*3+2*+ 0-*6*++*/ = + ( - " ' +" + + ) ' ' +'* A)(:1A' +' A A= '! " '" ' =) B" )(?A( * (:1 " +)" ( - )"+ ( ) -.8CC$0:+ " : = ++)+ = 66666666666 66 Yes No +,-0,*+56*+70+,**+0-*0+**+8 ++ 1. Do you have any illness/impairment/disability (physical or psychological) which may affect your work? < Have you ever had any illness/impairment/disability which may have been caused or made worse by your work? D Are you having, or waiting for treatment (including medication) or investigations at present? E Do you think you may need any adjustments or assistance to help you to do the job? 5. Do you have any of the following: a) A Cough which has lasted more than 3 weeks b) Unexplained Weight Loss c) Unexplained Fever Page 12 of 16
+*+!-+0*+ Yes No Page 13 of 16
SECTION D - IMMMUNISATIONS *+ 4**0*7 ("" (?A(*(:1 "F (" " "" )'! (?A(*(:1F ("""+'F :A++)F6666666666666666666666 66666666666666666666666 ' "" ("" +)" F +*+/+,6*+ " / 0 *+44 +,*- *+8 0 0 ** &"&*+* 4*74*+*+-00-0+4**+-- & 7---*07-3 @+?'.(AA,!0?*G.?" 0 : F.G0",, ' *'!" (""'!)F ( " " - " **4*+*+ 8 :> -766666666666< :> -766666666666D :> -7666666666?.0? - -76666666 6 66 (" ' 8< F :A = +F - 6666666666 666 66 Page 14 of 16
*+*+,--4*+ ) + + " A " 2@ " 8 : + "= : : ' < : "+! " 2@ D : ) " 2@+" +' 5 A*" /) 666666666666666666666666 -.066666666666 66!*+4+') H" = ) + > 6 6666666666 -H+ ) " ) -H+ )G 2 ( 66666666666666666666666666666666666 6666666666 /) 666666666666666666666666 -.066666666666 66 Page 15 of 16
APPENDIX C Page 16 of 16