Occupational Health Referrals: When and How to Refer UK Employees

Quick Answer: When Should You Refer to Occupational Health?

Refer an employee to occupational health when:

• They have been off sick for 4+ weeks with no clear return date
• They have recurring short-term absences for the same or related conditions
• They disclose a disability or long-term health condition
• You need advice on reasonable adjustments or fitness for work
• There are concerns about workplace factors contributing to ill health
• An employee is returning from a serious illness or injury

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What is Occupational Health?

Occupational health (OH) is a specialist medical service that advises employers on the relationship between work and health. OH professionals (typically doctors or nurses with specialist qualifications) provide independent medical opinions to help employers make informed decisions about:

• Fitness to work and any limitations
• Likely absence duration and prognosis
• Recommended workplace adjustments
• Whether a condition constitutes a disability under the Equality Act 2010
• Whether workplace factors are contributing to ill health

OH is not treatment -- it is advisory. The OH professional assesses the employee and provides a report to the employer with recommendations.

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The Referral Process

Step 1: Identify the Need

Common triggers for an OH referral:

• Absence exceeding your policy threshold (typically 4 weeks continuous)
• Repeated short-term absences suggesting an underlying condition
• Employee disclosure of a disability or health condition
• Manager concern about an employee's health or behaviour
• Pre-employment health screening for roles with specific requirements
• Post-incident assessment following a workplace accident

Step 2: Obtain Employee Consent

Under the Access to Medical Reports Act 1988 and UK GDPR, you must obtain the employee's informed consent before making an OH referral. The employee has the right to:

• Know why the referral is being made
• See the referral questions before the appointment
• Refuse the referral (though this may limit the employer's ability to support them)
• See the OH report before it is sent to the employer
• Request amendments to any factual inaccuracies

If the employee refuses consent, document this and make decisions based on the information available to you. You cannot force a referral.

Step 3: Draft the Referral

A good OH referral should include:

• Employee name, role, and department
• Reason for the referral
• Absence history (dates and durations)
• Any information the employee has shared about their condition
• Specific questions you need answered

Key Questions to Ask

1. Is the employee fit to return to their current role? If not, when is this likely?
2. Are there any workplace adjustments that would facilitate a return?
3. Is the condition likely to recur and cause further absence?
4. Does the condition meet the definition of disability under the Equality Act 2010?
5. Are there any workplace factors contributing to the condition?
6. Would a phased return be beneficial, and if so, what would you recommend?
7. Are there any duties the employee should avoid temporarily or permanently?

Step 4: Act on the Report

When you receive the OH report:

• Share it with the employee (they may have already seen it)
• Discuss the recommendations with the employee
• Implement reasonable adjustments where recommended
• Document agreed actions and review dates
• If recommendations cannot be followed, explain why and explore alternatives

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Common Types of OH Referral

Sickness Absence Referral

The most common type. Used when an employee is on long-term sick leave or has recurring short-term absences. Focus on prognosis, adjustments, and return-to-work planning.

Fitness for Work Referral

Used when there are concerns about whether an employee can safely perform their role. Common in roles with specific physical or mental requirements (drivers, machine operators, healthcare workers).

Disability Assessment

When an employee may have a condition that constitutes a disability under the Equality Act, an OH assessment helps determine whether reasonable adjustments are needed.

Pre-Employment Screening

Some roles require pre-employment health assessments (healthcare, food handling, safety-critical roles). These must be proportionate and non-discriminatory.

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Costs and Providers

Typical OH Costs

Choosing a Provider

Look for:

• SEQOHS (Safe, Effective, Quality Occupational Health Service) accreditation
• OH physicians registered with the Faculty of Occupational Medicine
• Experience with your industry and typical conditions
• Clear turnaround times for reports
• Availability for urgent referrals

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How Grove HR Supports OH Referrals

• Referral tracking with status updates and deadline reminders
• Report storage securely linked to employee records
• Action plan templates for implementing OH recommendations
• Follow-up scheduling for review meetings and progress checks
• Absence correlation linking OH recommendations to absence patterns

Streamline your OH process with Grove HR.