Management Referral Policy

Management Referrals to the Staff Occupational Health Service

The SOHS provide line managers with guidance on issues of health regarding short and long term absences and where there is an underlying health concern or disability. For this reason staff with existing or potential medical concerns should be encouraged to attend appointments with the SOHS, to ensure that managers receive relevant information about their ability to undertake their duties. Where staff decline to attend the SOHS, managers may need to take decisions on the information available to them at the time.

The University of Sheffield undertakes to treat equally, disabled and non-disabled employees in employment matters and make reasonable adjustments to meet the needs of disabled employees in accordance with the Equality Act 2010.

1. Who should be referred to SOHS?

A manager should consider referring a member of staff to SOHS for a health assessment where:

• The employee has had several episodes of short-term absence or exceeded the short-term sickness absence trigger level (see Section 7 of the Sickness Absence Policy)
• There is a long term or continuous sickness absence (see Section 9 of the Sickness Absence Policy)
• There may be an underlying health factor contributing to performance issues
• There is a concern that there may be work related medical problems or that an existing health problem is being aggravated by work duties
• There may be difficulties coping on return after being absent
• The employee has developed a disability and advice is required regarding any workplace modification / safe systems of work.

N.B. This is not an exhaustive list.

Where a manager is unsure whether a referral would be appropriate, advice can be sought from the relevant HR Adviser and/or Staff Occupational Health Adviser.

It is recommended that the manager meets with their staff member prior to the initial referral to SOHS. Subject to the nature of absence and the medical issue involved, the Return to Work interview may be an appropriate opportunity to discuss a referral to the SOHS. It is recognised that in some instances it may not be possible for the manager and staff member to meet, e.g. when the staff member is off long term sick. However, the manager must still communicate their decision to refer the employee to SOHS even when a meeting is not possible. After this meeting the manager should identify what information they require from the SOHS to help them manage the staff member in light of the University´s Sickness Absence Management Procedure.

The manager should explain to the staff member the reasons that they consider it would be beneficial for a referral to be made to SOHS. It is important that managers explain that the referral is not a sanction, but is to assist the manager in dealing with a health concern by ensuring that they have medical advice on the most appropriate course of action. A referral from a manager will not be accepted unless a consent form has been received stating that the referral has been discussed with the individual.

Guidance on individual cases can be sought through your customary HR Adviser who will discuss whether a referral is appropriate.

2. How to make a referral

As outlined in Section 1, the manager should discuss/communicate the reason for the referral with the staff member. Additionally the manager should obtain the staff member´s signed consent, on a Medical Consent Form, prior to attending the appointment. A medical consent form should be completed by the manager and individual being referred; this enables the manager to receive a report from the SOHS with the full consent of the individual. This report will be confidential.

If the staff member is absent from work due to ill health the manager should write to them explaining the reasons for the referral and enclosing a copy of the consent form to sign.

Once the consent form has been returned to the manager the original document should be sent to the SOHS, in addition to a completed Occupational Health Assessment – Management Referral Form.

Upon receipt of the Management Referral Form and Medical Consent Form the SOHS will schedule an initial assessment visit and confirm the appointment details both to the employee and manager within 3 working days.

The SOHS aims to see all management referrals within 2-4 weeks. However, where the manager believes that a referral is urgently required, they should contact the SOHS who will endeavour to arrange an earlier appointment; the SOHS will prioritise accordingly.

Managers should ensure that they inform staff that, if they are unable to attend the appointment on the date/time proposed, they should immediately contact the SOHS to arrange an alternative appointment.

It is the managers´ responsibility to provide the SOHS with all relevant additional documentation.

3. The appointment

The staff member will either be seen by one of the Staff Occupational Health Advisers, who are nurses with a professional specialism in occupational health, or by the Staff Occupational Physician, who is a clinician again with a specialism in occupational health.

During the appointment the Adviser/Physician will discuss the health issues with the staff member and how they impact upon the individual in the work context. The staff member will have the opportunity to discuss any health concerns in confidence and will receive advice on steps they can take to improve their health and attendance at work. The individual may also be asked to sign a further consent form in order that the OHA/Physician can request additional medical information from their GP/ Hospital Consultant. This report will be confidential and not disclosed to a third party without the consent of the individual.

Where illness is long term in nature, and there is little likelihood of a return to work in the foreseeable future, the issue of retirement on medical grounds may be discussed.

Where an employee has a high level of short term absence the Adviser/Physician will discuss the reasons for this and what steps the staff member can take to improve their attendance.

4. Report from the SOHS

Following the consultation, the SOHS will produce a written report which will be sent to the manager, with a copy to the relevant HR Adviser. A copy of the report will also be provided to the staff member upon request. The report will be sent to the manager within 5 working days of the appointment. Where further information is required prior to the provision of a full report, managers will be advised of the estimated timescale within which the full report will be available.

The content of a report will vary according to the nature of the medical issue and questions asked in the referral. The information provided may include:

• an assessment of fitness to work
• in the case of short term absences, clarification of whether there is/there is not an underlying medical reason preventing improved attendance
• likely timescale for a return to work
• recommendations on how to assist successful return, e.g. phased return (see below) or modifications required, reasonable adjustments, reduction in hours or change in working patterns
• if not fit to return to previous work, advice with regards to retirement on medical grounds, if applicable.

N.B. This is not an exhaustive list.

The report will concentrate on the effects of the health problems in the work place. Medical details are not normally disclosed, however in many instances it may be beneficial to the employee to agree to the Adviser/Physician disclosing the nature of the health problem to ensure that the manager is able to make reasonable adjustments.

Should the manager have any questions, upon receipt of the report, they should contact either the SOHS Adviser/Physician to discuss or their customary HR Adviser.

On some occasions the SOHS Adviser/Physician may recommend that the employee attends a follow up appointment. Where this is deemed necessary the SOHS Adviser/Physician will inform both the staff member and manager of their recommendation. In most cases an appointment will be arranged at the conclusion of the initial visit.

5. Action upon receipt of SOHS report

It is the manager´s responsibility to ensure that appropriate action is taken following receipt of the SOHS report. The HR Advisers role is to give guidance and work in close conjunction with managers to ensure that any necessary steps are taken within a reasonable time frame.

Upon receipt of the SOHS report the manager and HR Adviser should discuss the content of the report and what steps may be appropriate in that particular circumstance. The manager, and where appropriate the HR Adviser, should then arrange to meet with the employee to discuss the SOHS report and the steps that will be put in place.

Depending on the advice recommended by the SOHS, action required may include liaison with other agencies e.g. Access to Work, referral to the Staff Counselling Service. Formal meetings with Trade Union involvement may be required and where a range of complex issues are involved it may, in some instances, be appropriate to hold a case conference to discuss all the issues and to seek an appropriate resolution. A case conference allows all individuals that have an involvement in a particular issue, e.g., the staff member, their manager, the SOHS Adviser/Physician to discuss practicable ways of resolving outstanding issues and agreeing a way forward.

If retirement on ill-health grounds has been recommended the HR advisor will discuss the process and the options available to the individual.

6. Phased Returns

Following a period of long term sickness absence it is often beneficial for individuals to return to work gradually; empowering an individual to influence their return to work can help boost well-being and confidence. This is known as a phased return to work, programmes are normally of between four – six weeks duration, in some circumstances these may be longer.

Phased returns can be recommended by SOHS following a management referral. The Adviser/Physician will assess the individual´s fitness to work and will recommend a phased return programme. The SOHS Adviser/Physician will discuss their proposal with the manager and, where applicable, with the HR Adviser, to ensure the phased return programme is operationally viable. Details of the proposed phased return programme will be provided to the manager and HR Adviser in the SOHS report.

SOHS will generally review an individual toward the end of their phased return to work in order to assess their progress.

This information should be read in conjunction with the Sickness Absence Management Policy (currently under review) available on the web at www.shef.ac.uk/hr/info/policy/sick_policy.html. (Hard copies are available from your customary HR Adviser)

April 2007