What kind of information should I receive before I am referred to occupational health?

Before you are referred to occupational health your employer should provide you with a written explanation of the reason for your referral and a copy of the sickness management policy or other relevant document. You should also be informed of your right to be accompanied at the medical assessment by a friend, union representative or your GP. Furthermore, you should be asked to provide written consent to allow the employer’s medical adviser access to information from your GP and/or specialist consultant, where relevant. For further information, refer to the NEU document Medical Reports, available on the website at: neu.org.uk

When is it reasonable for my employer to refer me to occupational health?

Your employer’s sickness management or absence monitoring policy document should set clear guidelines for referrals to occupational health services. Speak to your NEU division or association if your employer’s policy does not address this. Referral is normally triggered by concerns about your ability to undertake your contractual duties safely and effectively, and may arise as a consequence of frequent short-term absences or prolonged sickness absence.

What criteria will be used by my employer to judge my ‘fitness to teach’?

Your employer will consider whether you:

  • have the health and wellbeing necessary to deal with the specific types of teaching and associated duties in which you are engaged
  • are able to communicate effectively with children, parents and colleagues
  • possess sound judgement and insight
  • remain alert while supervising pupils and/or working with hazardous materials
  • respond to pupils’ needs rapidly and effectively
  • manage classes
  • do not constitute a risk to the health, safety or wellbeing of the children who you teach, and
  • can, where disabilities exist, be enabled by reasonable adjustments to meet the above criteria.

If I take prescribed medication or over-the-counter medication which may have side effects, am I obliged to notify my employer?

Employers subject to the Education (Health Standards)(England) Regulations 2003 have a duty to ensure that existing and prospective teachers have the health and physical capacity to teach and will not put children and young people at risk. It is therefore common for schools/academies to adopt a sickness or drugs and alcohol policy which requires employees to notify a manager if they take prescribed medication or over-the-counter medicines that impair their ability to function safely at work.

If such a requirement applies to teachers and support staff at your workplace, provided the terms of disclosure are reasonable, you should comply. In the union’s view, an employer will be acting unreasonably if it imposes an obligation on all staff to inform managers of any prescription medication taken, even where the medication is unlikely to impair their ability to function safely at work.

If your employer operates such a policy, you are not obliged to disclose health information, and you should seek assistance from the union if you are threatened with disciplinary action for failing or refusing to disclose such information.

Can I ask to be medically assessed by my GP instead of my employer’s medical adviser?

Yes, but whether your employer agrees to your request will depend on the nature of your employer’s concerns and whether your GP or specialist consultant, where relevant, has the necessary expertise to address these concerns. Your employer’s medical adviser will normally be expected to be familiar with the duties and responsibilities of teachers and support staff, and have a sound general understanding of legislation and associated guidance relevant to the education workforce, including rules relevant to retirement on the grounds of ill health. In any event, nothing would prevent your employer from asking for reports from both your GP and occupational health.

I am a supply teacher. Can the employer at the school to which I am assigned refer me to their occupational health services?

If your state of health is genuinely a concern then, depending on whether you are employed by the school governing body, a multi-academy trust (MAT), local authority or supplied by an agency, you may be asked either to meet with the school/MAT/local authority’s medical adviser or with your agency’s medical adviser. In some cases, eg where you fall ill or are injured while on assignment, there may be an arrangement to refer you to the school/MAT/local authority’s occupational health services regardless of who your employer is. If you are unsure of the correct procedure to follow, speak to your agency or the school/MAT/local authority’s human resources (HR) services.

Can my employer dismiss me if I refuse to be medically assessed?

Although dismissal may result from your refusal to be medically assessed, the appropriate question is whether it would be fair to dismiss you. In most cases dismissal for refusing to attend a medical assessment is unlikely to be fair, but your employer may impose sanctions short of dismissal where your refusal is deemed unreasonable. Some sickness management policies state, for example, that a failure to attend a medical assessment without reasonable cause may result in the withholding of sick pay and/or disciplinary action. Indeed, if the Burgundy Book (the national agreement on teachers’ conditions of service in England and Wales) forms part of your employment contract, your employer may be entitled to suspend contractual sick pay if you refuse to undergo a medical assessment.

Can I self-refer to my employer’s occupational health services?

That would depend on your employer’s arrangements for occupational health advice. Your employer’s sickness management policy should tell you whether you can self-refer or not. If there are no arrangements for self-referral, you can seek support and advice from your GP instead.

What information will the medical adviser have about me before my assessment?

Your head teacher will normally be expected to provide the following information as part of the referral:

  • your personal details including your full name, date of birth, home address and contact telephone number
  • details of the location and specific nature of your teaching duties, together with details of any associated duties which the medical adviser should be aware of
  • the duration of sickness absence and the reason(s) given from medical certificates
  • sickness absence records for the preceding two years, with reasons
  • the basis on which the referral is being made and the questions that the head teacher is seeking to have answered
  • information regarding your performance in your duties and any recent changes
  • details of any outstanding disciplinary or grievance procedures
  • confirmation that the reason for referral has been fully explained to you and that you have consented to being seen.

What steps should I take before my meeting with the occupational health adviser?

Below are some suggested steps that you can take before you meet the medical adviser:

  • Ask for a copy of the referral letter to occupational health.
  • Make a note of any statements in the referral letter with which you disagree.
  • Make a list of any reasonable adjustments you think should be made to your working conditions or working environment.
  • Ask Access to Work (see below) whether they would be able to help fund the adjustments you think you might need.
  • Don’t forget to take your notes with you to the meeting.

What is Access to Work?

Access to Work is run by the Department for Work and Pensions (DWP) via the Jobcentre network and can provide assistance towards additional costs resulting from disability. Examples of assistance include:

  • additional fares to work
  • special equipment
  • adaptations to equipment and buildings.

Contact details for Access to Work are available at: gov.uk/access-to-work/overview

What sort of adjustments may I request?

You may request the following adjustments during your meeting with the employer’s medical adviser, although what follows is not an exhaustive list:

  • a phased return to work
  • a move to temporary or permanent part-time work
  • special equipment such as voice recognition software
  • changes to the school premises
  • room re-allocation
  • limited timetable/workload
  • treatment of certain periods of sick leave as ‘disability leave’
  • absences during working hours for rehabilitation, assessment and/or treatment
  • extension of paid sick leave (in limited circumstances)
  • transfer to a vacant post.

The medical adviser will be able to recommend adjustments which would enable you to continue in work, return to work or work in a different role or in a different location, but it is for your employer to determine whether it is reasonable for such adjustments to be made.

Can I ask for adjustments even if I am not disabled?

Yes, you may request adjustments even if you are not disabled. However, your employer will have a ‘duty’ to make reasonable adjustments only if you are disabled. The union will always seek to argue that any condition which necessitates a referral to occupational health amounts to a disability, unless expressly excluded by legislation, such as alcoholism or hay fever.

A disability is defined under the Equality Act 2010 as a physical or mental impairment which has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities.

An impairment has a long-term effect if it has lasted, or is expected to last, for at least 12 months, or has not lasted 12 months, but is likely to recur. Cancer, multiple sclerosis and HIV automatically qualify as disabilities. For more information about the law on disability discrimination and reasonable adjustments, see NEU guidance on Disability Discrimination.

What should I do if the medical adviser suggests a course of action I am unhappy with?

If the medical adviser suggests a course of action that you are unhappy with (eg a return to work earlier than you believe is appropriate), you should discuss this with your GP or specialist and ask them (assuming they agree with you) to write to the medical adviser on your behalf, recommending a more suitable arrangement.

Where your GP or specialist takes a different view to that put forward by the medical adviser and a compromise cannot be reached, your employer should arrange a second occupational health opinion from a different occupational health specialist. Your employer is not obliged to seek a second opinion, but you may wish to remind them at this point that they have a duty to protect your health and safety and/or the health and safety of others.

What should happen prior to my return to work?

Prior to a return to work it is essential that any recommendations made in the medical adviser’s report are discussed between you and your employer, and written agreement is produced, clearly explaining how your return to work is to be managed in the light of the recommendations. You can take a union representative with you to the meeting to discuss the detail of your return to work. Remember, the purpose of the meeting is to arrange the best terms that will ensure that when you do return to work it will be a permanent return.

If a phased return to work has been recommended, you are advised to clarify with your workplace rep or branch secretary the appropriate salary arrangements that will apply during this period, as well as the reasonable duties that you will be undertaking until you resume your normal workload.