An occupational health referral for employers can provide useful evidence where an employee’s health affects their attendance, performance or ability to carry out their role.
Occupational health advisers focus on the relationship between work and health. They can help an employer understand likely timescales, workplace limitations and possible adjustments.
However, the report does not make decisions for the employer. Managers must still consider the evidence, discuss the findings with the employee and decide what action is reasonable.
What is an occupational health referral?
An occupational health referral asks a qualified health professional to assess how an employee’s condition affects their work.
The assessment may take place by telephone, video or in person. Afterwards, the adviser will normally prepare a report answering the employer’s agreed questions.
The report should focus on relevant workplace matters rather than provide the employee’s full medical history. For example, it may address whether the employee can return, carry out particular duties or benefit from changes at work.
Occupational health advice can support absence management, capability procedures and decisions about reasonable adjustments. It may also help an employer plan a safe and sustainable return to work.
When is an occupational health referral for employers appropriate?
An occupational health referral for employers may be appropriate where ordinary discussions and fit notes do not provide enough information.
Common situations include:
- long-term or repeated sickness absence;
- a health condition affecting performance or conduct;
- uncertainty about when the employee may return;
- a possible disability under the Equality Act 2010;
- concerns about whether particular duties remain safe; or
- the need to identify reasonable workplace adjustments.
Employers should not wait until dismissal appears likely. An earlier referral may identify practical changes that help the employee remain at work or return sooner.
Our employee sickness management page explains how medical evidence fits within the wider absence-management process.
Discussing the referral with the employee
The employer should speak to the employee before making a referral. It should explain why medical advice may help and what questions it intends to ask.
This discussion should remain supportive and factual. The employer should avoid suggesting that the assessment will automatically lead to disciplinary action or dismissal.
The employee should understand who will carry out the assessment, who may receive the report and how the employer intends to use it.
Employers should also give the employee an opportunity to comment on the proposed questions. This can improve trust and help ensure that the referral addresses the real workplace difficulties.
Does the employer need consent?
An employer should obtain the employee’s informed consent before arranging an occupational health assessment and receiving the resulting report.
Separate legal requirements apply when an employer requests a report from a doctor who has treated the employee. In that situation, the employer must explain the employee’s rights under the Access to Medical Reports Act 1988.
Health information also requires careful handling because it is sensitive personal data. Access should remain limited to people who genuinely need the information for employment decisions.
The employer should explain how it will store the report, how long it will retain it and whether it will share relevant recommendations with managers.
Questions for an occupational health referral
The quality of the report often depends on the questions the employer asks. Broad requests for “a medical opinion” may produce limited practical information.
The referral should include an accurate description of the employee’s role, duties, hours and relevant workplace concerns. It should also provide appropriate absence information and explain any formal process already underway.
Useful questions may include:
- Is the employee currently fit to perform their normal duties?
- When might they be able to return to work?
- Could a phased return or temporary change of duties help?
- Is the condition likely to meet the legal definition of disability?
- What workplace adjustments should the employer consider?
- Is the employee likely to provide reliable attendance in the foreseeable future?
The adviser may not be able to provide firm answers to every question. Nevertheless, a focused referral should produce more useful information than a general request.
Using an occupational health report fairly
The employer should review the report with an open mind and discuss its recommendations with the employee.
Occupational health advice is important, but it is not binding. The employer may accept a recommendation, seek clarification or consider another reasonable solution.
Equally, the employer should not reject advice merely because an adjustment causes some inconvenience. It should assess whether the proposal is effective, practical and reasonable in the circumstances.
Where the report refers to stress, anxiety or another mental health concern, the employer should also consider whether working conditions have contributed to the problem. Our article on stress-related absence considers this issue further.
Occupational health referral for employers and reasonable adjustments
An occupational health referral for employers can help identify adjustments for an employee who may be disabled.
Possible recommendations might include altered hours, additional breaks, home working, specialist equipment or temporary changes to duties.
However, the legal duty belongs to the employer rather than the occupational health adviser. The employer must decide whether adjustments are reasonable after considering the employee’s needs and the organisation’s circumstances.
If one recommendation is not workable, the employer should explore alternatives. It should also record the adjustments considered and explain its decision to the employee.
What if the employee refuses the referral?
An employee may decline an occupational health assessment or refuse permission for the report to reach the employer.
The employer should ask why and address any concerns about confidentiality, the referral questions or the chosen provider. It should explain that a lack of medical evidence may limit its ability to identify support.
If the employee continues to refuse, the employer may eventually need to make decisions using the information available. However, it should not treat refusal as automatic proof that the employee is fit for work or acting improperly.
The employment contract and sickness policy may require reasonable cooperation with medical assessments. Even so, employers should respond proportionately and consider the employee’s explanation.
Can occupational health evidence support dismissal?
Medical evidence may become relevant where an employee remains unable to work and no reasonable adjustment or suitable alternative role is available.
However, an occupational health report does not make dismissal automatically fair. Before ending employment, the employer should consult the employee, consider updated evidence and examine the likely prospects of a return.
It should also consider adjustments, redeployment and the effect of any disability. Our article on dismissal for repeated absence explains the wider factors employers should assess.
Common occupational health referral mistakes
Employers can weaken their position when they:
- delay the referral until dismissal appears inevitable;
- send inaccurate or one-sided background information;
- ask vague questions that produce an unhelpful report;
- fail to discuss the report with the employee;
- treat recommendations as either compulsory or irrelevant;
- share health information too widely; or
- make a final decision using an outdated assessment.
A clear referral, proper consent and meaningful consultation can make the evidence far more useful.
Advice on occupational health referrals
An occupational health referral for employers can support fair and informed decisions about absence, capability and workplace adjustments.
Employers Law helps businesses prepare referral questions, consider medical recommendations and manage the employment procedures that may follow.