Occupational health referral at work: what happens and what you are entitled to know

Your employer can ask you to see occupational health, but you do not have to agree. If you do, the assessment is a confidential medical conversation, and the occupational health adviser must ask your permission before the report goes to your employer. Where the law gives you rights over a medical report, mainly one written by your GP or specialist, you can see it before your employer does and ask for errors to be corrected.

When employers make a referral

Occupational health is a medical service that an employer can use for decisions about your health and work. It may be the employer’s own team (common in NHS trusts) or an outside provider (common in councils and schools). Acas lists the usual reasons for a referral:

• you have been off sick for a long time, or are about to return after sickness absence
• you are struggling with your physical or mental health at work
• your employer needs advice on reasonable adjustments for a disability
• repeated short absences, or concerns about whether you can carry out your work
• health and safety concerns about the job
• a decision on company sick pay, ill-health early retirement or a similar scheme

Check whether your employer has an occupational health policy, which Acas says would set out when referrals happen and what follows, and ask HR for a copy. If you are disabled, the referral is often how the employer finds out which reasonable adjustments would help.

What you should be told first

NHS Employers advises managers to explain the reason for the referral, give you a copy of the referral letter and keep the focus on how your health affects your ability to do the role, not on medical detail. Ask for the letter if you are not offered it.

Acas says whether you are paid for the appointment should be set out in the organisation’s policy, so check this before you go.

What the appointment involves

The adviser may ask about your health, any treatment you are having and any worries about returning to work. They are looking at how you do your job and how the job might affect your health, which adds to what a fit note or doctor’s report says.

Sometimes the adviser needs more information from your GP or specialist. If so, you should be told why and asked to sign a consent form. You can refuse, though that can leave the adviser with less to go on.

Consent and confidentiality

The adviser must ask for your permission before sharing the outcome with your employer. You should be told how to withdraw consent later.

Acas says the employer should only share the report with people who genuinely need it, such as your line manager or HR, and should keep you informed about how it is stored and used. NHS Employers says sickness absence information is confidential and should not go to the wider team unless you have clearly agreed. If you would rather colleagues did not know the details, say so. Agreeing a short neutral message for the team is acceptable.

What the report says

Acas describes a report that focuses on how you do your job and how the job might affect your health. It may recommend more time off, a referral for therapy, changes to your workspace, or a phased return to work.

Occupational health advises and the employer decides. If you are disabled, the employer has a duty to make reasonable adjustments when it knows, or could reasonably be expected to know, about your disability, so a recommendation for adjustments carries weight. Acas says the employer decides whether to put recommendations in place, based on its own needs and its obligations to you.

Your right to see a medical report

The Access to Medical Reports Act 1988 covers reports for employment purposes written by a medical practitioner who is or has been responsible for your clinical care. That points to a report from your GP or a hospital specialist. A report by an occupational health clinician who has not treated you does not obviously fit that definition, so there the consent rules above are what protect you.

Under the Act, and according to Acas:

• your employer must get your consent before asking for the report
• it must tell you in writing about your rights under the Act
• you can refuse consent
• you can ask to see the report before it goes to your employer
• you can ask the doctor to correct anything inaccurate or misleading
• you can refuse to let your employer have the report
• you can ask for a copy within six months of it being completed

If you want to see the report first, contact your doctor within 21 days of your employer’s application. Your employer must tell the doctor in its application that you have asked, and tell you the application has been made. If you refuse consent altogether, your employer has to decide using what you have told it, your fit note if you have been off sick for more than seven days, and any occupational health report that exists.

If you disagree

Start by saying so, to occupational health and to your manager. If the advice conflicts with your own doctor’s, Acas says the employer should talk with you and agree the best way forward.

If you are unhappy with how the referral, the adjustments or your information was handled, Acas says to raise it with your employer, usually informally first. If that does not work, you can use the grievance procedure. Acas, a trade union rep, HR or Citizens Advice can explain your options. This is general information, not advice on your own case.

If the referral relates to a new job offer rather than your current one, see the guide to pre-employment occupational health checks.