What is the aim of fitness for work?
To ensure that the individual is fit to perform the tasks required for their job effectively, without posing a risk to their own, or others health and safety.
In what situations is assessment needed?
1) If the patient condition limits or prevents them from performing a job effectively. (MSD)
2) If the patient condition may be made worse by the job. (Physical exertion with rest or CVD)
3) If the patient condition puts themselves and the community at risk. (Food handler and infectious transmission)
4) If the patient condition makes some jobs and the work environment unsafe to them personally. (unconscious episodes in a hazardous environment)
5) If the patient condition puts themselves and others at risk. (Train driver)
When is fitness for work assessed?
1) Return after sickness absence
2) RTW after injury or illness
3) Post-offer, pre-placement
4) Job change- role or work demands
5) Period review relating to specific guidelines
6) Possible retirement on grounds of health
Who assesses fitness to start work?
The employer, advised by their occupational health advisor
Who assesses RTW?
GP
- does the patient WANT to return to work
- does the patient need to be symptom free before RTW?
- is some work feasible?
What is the aim of medical assessment?
To look at
- the effects of health on work
- the effects of work on health
- workplace adaptations required for employee to work safely
- to communicate outcome and recommendations
- to follow the equality act
What is the equality act?
It is unlawful for an employer to discriminate against workers or applicants on the grounds of medical disability, steps should be taken to accommodate their health problems.
How can you be referred to FTW?
Self referral, management referral, HR
What might the employer ask when referring an employee to occ health?
1) what is the likely date of return to work?
2) Will the pt need continued treatment or medication after RTW?
3) Will there be residual disability?
4) Will it be permanent or temporary?
5) What duties can/not the patient do?
6) Will the employee be able to render regular and efficient service?
What is the role of drs in fitness to drive?
Advise the individual on the impact of their condition on safe driving.
Ensure they understand the legal requirements to notify the DVLA
Notify the DVLA if the patient can’t or won’t
What are the fitness factors for effects of health on work?
- stamina- full time, physical demands
- mobility- walking, bending, stooping
- agility- dexterity, posture, coordination
- rational- mental state, mood
- treatment- side effects, duration
- intellectual- cognitive abilities
- essential for job- food handlers, driving
- sensory aspects- safety, self and others
- demands of job- physical/ intellectual
- environment- shop floor/office
- temporal- shift work, early starts
- travel- commute/ abroad
- organisational- lone work or with customers
- layout- ergonomic aspects, work station, work equipment
What workplace modifications can be offered?
- Keep in touch with work
- Reduced hours
- Change pattern of work/ shifts
- Adapt the workplace, alter layout
- Reduce pace of work, frequent or longer breaks
- Adapt equipment
- Provide training
- Provide mobility and transport
- Redeployment
After how long an absence is certification needed?
4 days
What are the benefits of re employment?
Improved general and mental health
Reduced psychological distress and psychiatric morbidity
Minimises the harmful physical, mental and social effects of long term sickness absence
Reduces the risk of long term incapacity
Improves QOL and well being
