I as a first line would ask the employee to discuss my report with the GP as I find this a quicker option. Then review and find out what the GP said and then if I think he has not discussed it or the GP is not on board either send a copy to the GP or send a letter ( with consent0.
D
J Its Friday and the weekend weather loos fab hoorah…
Hi Carr. Specialist practitioners from what I can see are only being advised to get a report if their is a disagreement somewhere regarding return to work. For instance if OH opinion is different from GP or employee. I would do so in those circumstances just to make sure the employee has given me all the facts as sometimes they are not completely sure themselves or if the employee is a poor historian have not had to ask for many reports either and I don't see as though my practice would need to change. I am sure the majority of us do this already. I am not very confident on mental health issues and therefore would always get a report from the treating specialist in severe cases. Tracy
Sent from my BlackBerry® wireless device
Date: Fri, 31 May 2013 00:00:19 +0100
Subject: Re: [OCC-HEALTH] report requests from GPs
Having worked for an organisation where requests for FME were rigorously monitored for "clinical and business value" to the case I can count on 2 hands the amount of reports I have requested over the last 5 years +. I agree with the rationale to a large degree that you have to be sure the report you request is going to provide extra information than you can gain from OH assessment alone (rather than just re-iterating what the employee can tell you in more medical language) otherwise there is are substantial financial and time costs to having to defer an opinion pending FME. .
I was therefore concerned when I read that the tribunals want "That if the employee has been treated or is being treated by a hospital specialist, there is a current report on file from the specialist concerned" from the attached guidance. This indicates that report requests should be much more frequent even if you don't feel they will add value to the actual OH assessment? This would add huge costs?
What are other people's take on this.
On 30 May 2013 23:42, sharon naylor <[log in to unmask]> wrote:
Have to say - I rarely go for reports by choice. Not sure they add a huge amount unless you are aiming for IHR , in which case you are frontloading the case
Date: Thu, 30 May 2013 22:02:36 +0100
From: [log in to unmask]
Subject: Re: [OCC-HEALTH] report requests from GPs
To: [log in to unmask]
And the company are Willing to pay a fee of £x for a report if this nature!
Gp can then choose To write War and peace or single sentence...
I have a standard letter with allowances for a bit of free text. We have a form that details the type of letter by title/code, add in the free text and our admin lady prepares the letter for signing. To paraphrase (off the top of my head)...
Dear Dr, your patient is an established employee of ****** where he is required to (relevant tasks)
He is currently absent from work with a diagnosis of *******
In order to support him in the workplace, recommend any reasonable adjustments and provide his employers with comprehensive advice it would be invaluable to have from you a report detailing
- The course and duration of his current health problem necessitating absence from work
- An account of any treatments/medication prescribed and an estimation of their efficacy
- Any onward referrals /treatments being considered
- Copies of any relevant correspondence from specialists
- Any other information you feel relevant
(optional) I am aware that other employees with this condition have found **** to be of benefit, and have advised him to discuss with you at his next appointment
Consent to contact you has been sought etc etc
Date: Thu, 30 May 2013 21:18:04 +0100
From: [log in to unmask]
Subject: Re: [OCC-HEALTH] report requests from GPs
To: [log in to unmask]
Excuse me for asking, but having written a report request today to a GP and cutting and deleting for ages I wonder if you would share some wisdom as to what (taking your OH expertise out of the equation if you can) wording of the request is likely to acieve the most valuable report for an OHA.
I try to be succinct and not infer that I know what's best for the client but then feel I am really just confiming diagnosis and treatment plans. Any thoughts/words of wisdom would be gratefully received
Thelma you have received some good advice here in structuring a plan to move forward.
As a GP and OHP I am interested in how and what you requested of the GP. Have you been given a diagnosis? - there is a big difference between Gilbert's syndrome, Haemochromatosis, Alpha-1-anti-trypsin deficiency, thallasaemias, in terms of relevance , natural history, likely functional problems long term etc... You say there has been a lot of input by GP, OHP and OHN and the symptoms you report of 'continual vomiting' are unlikely not to have been investigated. Has a differential diagnosis been attempted by anyone? I'd be surprised if the GP hasn't.
I usually have a good success rate of getting relevant information from GPs and specialists so I would be interested in the text of your request letter to the GP, as it may need tweaking to improve the response rate and quality of response
cheers
On 28 May 2013 21:07, kate owen <[log in to unmask]> wrote:
The dynamics of why the symptoms have suddenly resolved is IMHO not relevant to you going forward, though please note that I understand how easy it is to get caught up in the red herrings, internal politics, and tangents of a case. I fall foul so often myself.
If you have medical confirmation of a possible liver problem then I think like Anne has already said in a different way then fitness for work is twofold i) are there any significant risks to them if their liver is compromised in returning to work (chemicals etc at work) and ii) will their level of symptoms impact on work (e.g.vomitting).
Surely if the risk assessments are done and you have reassured yourself as to i) then you are only able to give advice based on their description of their level of symptoms and IMHO you cannot be expected to justify beyond that unless you have evidence that suggests otherwise, hence the suggested trial return to work.
I would document '**** wants to RTW', ''**** says not vomiting' etc. just in case you should ever be required to justify your advice and then leave it to HR if they want to challenge authenticity of the reported symptoms or if the individual wants to make a claim that they were forced back to work to early.
N.B. I am conscious that you cannot give all info on Jisc and therefore please note, if you have reasonable suspicions/evidence that they are not fit for work due to alcohol intake then please disregard all of the above
Dear Thelma,
Thank you to Anne and Sue for unpicking the issues and making suggestions of ways to approach this case.
I agree that HR issues are not our concern.
The employee is due for a review and one of the options was to allow then to return on trial basis should they state they are fit to return to work. The last time when the employee attend the OH dept they stated they vomit on there travel but i do not think it was suggested to do a risk assessment as they believe at the time they where very ill and gave a 4 wks sicknote but 2 days later they was suddenly fit to return.
When they return to OH this time they will be assessed to ascertain fitness to return to that role. The concern for me is that we had very little information from their GP when last approached them. It is unlikely that if we request further info on the employees health that he will give us helpful info about the current health status of the employee. We do not have sufficient medical information about the employees illness apart from possible liver problem and impending investigation under the care of a consultant.
I do not want to think that we have allowed someone to return to work prematurely and they claim that they are forced to return to work because there job was threatened.
I cannot possibly understand all those symptoms this employee have reported to us have suddenly dissapeared in 2 days.
Many Thanks again
At first site this is quite complex. If I were dealing with this I would
unpick the issues as this makes it easier to "see the wood for the trees".
1. Whether she is to be dismissed or not is out of your hands - that is a
management problem - they own the problem so leave it to them to resolve.
Capability or otherwise is not an OH issue.
2.You have more info than you are able to include on JISC but you seem to
think she may now claim that she is well enough to return to work - that is
just a complicating factor. Despite investigations re her health being
ongoing this may be because she thinks that the employer may be about to
instigate disciplinary action in relation to her non-attendance. This may or
not be the case. Many people have serious health issues which are being
investigated and they are still able to attend work and give "effective
service". The only proviso being if she has a liver condition is there
anything in the workplace which she handles which could cause her additional
problems eg materials which are potentially hepatotoxic such as solvents.
3.If she is likely to vomit unexpectedly then there are issues associated
with working in a sterile area - so a "risk assessment" in relation to this
would be an appropriate next step.
3.Is it likely that her condition could be covered by the Equality Act 2010?
- if so then what modifications could assist her to remain at work. You can
make those recommendations - management are then responsible for acting on
them.
Does this help you to identify the central issues?
Anne
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