Consent to an Occupational Health Report

Occupational Health & Safety Service

CONTROLLED DOCUMENT – DO NOT COPY

CONSENT TO AN OCCUPATIONAL HEALTH REPORT

CONSENT TO AN OCCUPATIONAL HEALTH REPORT

Referral to Occupational Health

Your Manager has referred you to the Occupational Health Service for an assessment of your health in relation to your employment at Newcastle University. Your Manager will have discussed the reason for your referral with you. If you are not clear about the reason for the referral you should discuss the matter with your Manager or Human Resources (HR) before your appointment date.

The Occupational Health Assessment

The purpose of an occupational health assessment is:

1. to offer you advice and support
2. to assess your fitness to work
3. to ensure your health and safety at work.

You will be seen by an Occupational Health Physician/Nurse who will make an assessment, which may include a physical examination. They may require further information from your GP or specialist. If this is the case your rights under the Access to Medical Reports Act 1988 will be discussed with you. If you agree to Occupational Health approaching your doctor for a report you will be asked to sign a separate consent form.

The Report by the Occupational Health

Once all the necessary information is gathered a written report is sent electronically to your named manager and to the relevant HR mailbox, unless you specify that you want the report to be sent to a named HR contact.

HR will upload this report to your personal file. Access to all data held on the University’s Human Resources system (SAP) is securely controlled. Access to the relevant HR mailbox and any sensitive personal data within the report is restricted to named members within the HR team for processing or monitoring purposes.

Medical information will only be disclosed to HR and your Manager with your consent and if it is relevant to your health and safety at work.

The report will:

1. advise on your work capacity
2. respond to specific questions as detailed on the referral form by your Manager/HR
3. makerecommendations on workplace adjustments if necessary.
4. indicate if you have a disability that is covered by the Equality Act (2010), in which case this will be recorded on your HR personal record. This will enable the University to meet its obligations to monitor its workforce accurately, and help it to meet the needs of disabled employees.

If you have significant health problems you may be restricted from undertaking some or all of the duties required of your post. If this is the case a statement will be made of suitable alternative tasks you could undertake.

You may request a copy of the report. If you wish to comment on the report or point out any factual inaccuracies, please forward your comments to

I have read the above information and have discussed it with

…………………………………..………………………………..

(Occupational Physician / Occupational Health Practitioner/ Occupational Health Adviser)

Please tick relevant boxes

I refuse to give my consent

I consent to an OH report to be made available to:

The referring manager ………………………….…………………………..

Named HR Officer ………………………………………………………

 HR Generic mail box ………………………………………………………

I wish to see a copy of this report before it is released

 I wish to see a copy of this report at the same time as it is released

I do not wish to see a copy of this report

Email address

Postal address if different from Registration Form

Assessment Report:

Signature:……………………………...... Date:…………………….……………………......

Interim Report:

Signature: ……………………………………………. Date: ………………………………………………………

Discharge Report:

Signature: ……………………………………………. Date: ………………………………………………………