What is the role of occupational health review?

[Bangersndmash]

I have been really, really unwell this past year. Breast cancer, chemo, radiotherapy, my latest stint has been 3 weeks as in in patient and a very serious rare disease has now popped up.

long story short, I obviously took this is sick leave and now have to have an OC health review to be able to return to work. I work from home, and want to be able to return to work due to simply NEEDING to. Who does the occupational health person support? Is it there for my interest or for the companies interest? Should I tell them everything or err on the side of caution?

i can do my job otherwise I wouldn’t suggest it, and I am suggesting amendments, but i do want and need to return to work.

ive never had to do this before, I have worked pretty much all year so im absolutely clueless.

TIA

The role of OH is an independent one. In my organisation and I think this is standard, they will take the referral made by your employers and have the consultation with you. In that consultation they will ask questions about your condition and treatment, day to day living etc and obviously you can tell them information as well as responding to their questions. A report is issued to your employer with their findings and recommendations which may be around reasonable adjustments regarding hours, location, duties etc and it is for the employer to consider these recommendations.

Well it should be in the interest of both parties to have a review of needs and accommodations. I imagine it’s more useful to them if you provide all information but I can also understand why you might be concerned.

What are your specific concerns about the process?

There’s probably an element of covering their back from your employer’s side but that doesn’t mean it won’t benefit you. They will want to be able to show they’ve checked you’re able to return to work, and what adjustments you may need - as you’ve had cancer you’re covered by the equality act so they have a duty there regarding reasonable adjustments.

Ime, working in the Public Sector, OH reports work well to support the employee. My advice would be to be honest about any limitations caused by the illness/treatment and suggest any adjustments that you think would help. Part of the report is likely to be around a phased return to full duties, maybe over a month, or a shorter period if you feel able.
In general if the employer doesn't feel able to grant the adjustments they should be able to make a business case that would stand up in an Employment Tribunal.

As you wfh, I doubt there will be any problem, as any issues are usually around start/finish times, breaks and sometimes car parking arrangements/work space.
Please don't worry about the process, your employer may also want to complete a Risk Assessment, depending on the industry you work in.

I have been so unwell I have been unable to walk from the bed to the toilet (5 ft away) in hospital. Whilst I am discharged I am recovering and doing really well, I am scared to tell them how bad it’s been and the full extent because I don’t want it to now sound like I am unable to work, when the reality is I can and am, i just need adjustments. Should I be honest and tell them how bad it’s been? Or would that hinder me in the sense that they don’t want me to do “too much”
and they don’t think I can cope and won’t let me return? I know my own capabilities and wouldn’t do something I can’t but I feel if I admit how scary it has been they won’t allow me to come back or something. Which is why i asked in whose interest do they serve.

Tell them how bad it has been, and remind them when they forget about it.

Mine <sighs> couldn't understand why I couldn't go straight back to work once the pain in my head had passed (severe migraines). I can't walk or drive. She didn't see how this would impair me at work, a role which she didn't seem to have any understanding of whatsoever. I spent most of the call having to explain my job to her.

It seemed like it was very much the company covering its back. It made very little difference to my actual job or accommodations made.

I'm sending best wishes for your recovery, @Bangersndmash!

In my experience from talking to OH where I work (outsourced to an independent company) they very much listened to what I said. So they wouldn’t have written that I couldn’t do anything if I told them I felt I could.

Also where I work, they had the option to recommend a follow up in X number of weeks, so they gave a recommendation, with the suggestion that I speak to them again to see how that was going and whether I need further adjustments, to stay the same, or actually to reduce some of it as things improved.

Your employer won't expect you to be fighting fit after such a serious hospitalisation. But they will need a clear picture of when you want to return and what limitations you might have. Don't dwell on telling them how bad it had been. Concentrate on where you are now. Just say you envisage returning to work but that you will need their help with adaptations to do so.
Take someone with you to the meeting if you find it intimidating - a trusted friend, colleague is all you need. They are not there to speak for you, but they can take notes of what was discussed and agreed, which is useful for reference.
As an ex union rep, I have attended loads of these- more for moral support and ideas than anything else. These meetings are meant to be supportive not punitive.
I would imagine they will ask for some kind of a GP note to say you are fit to work before they will allow you back on site and some sort of indication of any ongoing hospital appointments. Don't underestimate how tiring going back to work will be. Lots of employers welcome a phased return to work to give you chance to adjust and give them a chance to review any adjustments.
This can be a very supportive process. For example, you could negotiate extra breaks, hybrid working, a later start to the working day, parking near main entrance, a downstairs office to avoid stairs, extra toilet breaks, a work area near a toilet and loads more.
Whilst the above are suggestions, not all may be possible depending on where/ how you work. Think about adjustments that might be appropriate in your situation and take a written list with you. Be prepared to explain why you need to these adjustments.
The employer has to be seen to be making reasonable adjustments and should give reasons if they say they cannot accommodate your suggestions.
You should be leaving that meeting with written notes of possible adaptations, clear expectations of what they want from you as an employee, and a review date for a further meeting to discuss progress.

I've had oh a few times and they've honestly been great. I tell them everything but I do have a bit off an oversharing problem 🤣 but nothing bad has ever happened or gone against me.

I have secondary breast cancer and currently on long term sick. My biggest issues are fatigue and concentration etc. I had a review after 3 months, I explained what treatment I've had and any issues with it. They then did a fatigue assessment. Once completed she said as I thought. I don't think you are fit enough to go back so I will recommend another three months to your employer. She said they'd review it in 3 months again and then we'd talk any adaptations or concessions I might need if ready to return. She was extremely neutral and I thought actually quite understanding. I made the process in my head much worse than it actually was.

I'm a way they need to know how bad it got. They can then be really hot on their recommendations to ease you back in more gently. I don't think they are there to catch you out. If you go in with exactly what you want, possibly even more than you think you need. For example an extra day WFH initially or more rest breaks.

In terms of the purpose of the OH Assessment, has the employer provided you with a copy of the referral they sent to the OH Provider? That should have clear directions as to what you are being assessed on. Ask for it if you don’t already have it.

Most probably it will ask

Is employee able to return to work?

Is a phased return advisable? On what terms?

Does employee have likelihood of returning to full capacity to fulfill their role?

What reasonable adjustments should be put in place?

You are automatically covered by the 2010 Equality Act because you have had cancer. This means your employer should make reasonable adjustments to enable you to return to work.

You say you wfh so that’s already sorted. Do you want to continue working the same number of hours as before? Would you prefer to have a midweek day off to recuperate and work longer hours the other days? Or cut your hours so you work fewer days, or fewer hours each day?

Are there any aspects of your role that you will find particularly difficult because of your illness?

Finally, are you a trade union member? They will help you through your return.

When I’ve had an OH review, OH then send a written report to my employer with their summary and any recommendations they propose. My HR department has always agreed with anything they’ve recommended and basically treat OH as the gospel.

Make sure you ask to see the draft OH report first (i.e. before they send it to your employer) rather than agreeing they can send it to you and your employer at the same time. Occasionally they can and do make mistakes but more importantly, if there is anything you tell OH that you don’t want your employer to know (example, something personal re your mental health), this is your opportunity to make sure it is not included in their report.

This is very good advice. Particularly the emphasis about focusing the conversation on where you are now and what needs you have now. After all, people return to work from having been in a coma or otherwise at death’s door; where you are coming from is not the point and arguably not your employer’s concern.

Will your GP be helpful?

I would not want to give unnecessary ammunition to a present or future manager, either. You need to answer the questions posed and you need to ask for the accommodations you think you will need, with justification (that OH should help with) but you don’t owe your employer unnecessary information. Preserving a boundary around your personal information shows you to be professional.

I haven’t RTFT yet so I apologise if someone has already said this.

Best wishes, OP.

You don't need to tell them how bad it's been. You need to tell them what it is right now and what they can do to make sure you are supported in work. They don't need to know your full medical history.

Thanks for the advice all. Silly question but if I asked for reduced hours, or longer breaks, would this mean I would be paid less?

If it’s during a six week phased return, no, you get paid as normal.

If it’s a permanent change then they might alter pay, especially around hours worked.

This will depend on the employer and contractual terms and/or goodwill,

For example, my former employer classed a phased return as sick leave for the days/hours that weren’t worked as per your usual contracted hours. So depending on how much paid sick leave you had left, you might receive full pay for the duration of the phased return or you may only be paid for the hours/days worked.

Christ @HundredMilesAnHour that’s very unusual and really shitty of them. I am glad to see it’s an ex employer.

It depends. If you are asking for a permanent change in hours, this would be a change in contract and pay. If you are asking for phased return to work where you build up hours over a period of time, they may be open to paying you in full. Additional breaks will depend on goodwill of the company. They may wish to adjust your start/end time or to let you have short breaks whenever you want. If you are working from home, I assume you can take a 5 minute break whenever you like without having to log it anyway.

In my experience, a box ticking exercise that resulted in nothing useful for me.

I was out sick with a combination of burnout and a bowel condition similar to IBD for about 4 months. This was roughly 2022.

When I had my OH review before my phased return, 80% of the conversation was the nurse trying to explain to me (over the phone, we’d never met, she’d never examined me) how my condition was almost certainly long COVID. I was like, nope, it’s a damaged pancreas. She was like, but you’re fatigued, I’ll just put down long COVID. 🤷🏻‍♀️

Useless.

No it would not be permanent, it would be over a handful of weeks just to ease me back into it. How sure are you that I’d get paid, is there a law or something which states this? I’ve used all my company sick pay. Thank you

I had an OT review by my employer a few years ago. I was really suffering with chest infections in the winter due to my asthma, I had lost my dm months before. I spoke with the OT and asked was it ok to share the findings, I said yes. The OT said that the HR manager needs to back off and leave me alone. I got left alone. The HR manager left 6 months later, she’s been replaced with someone more sympathetic and staff friendly.

It will be in your company policy somewhere. I don't believe there is a blanket rule/law. Your manager/HR will be able to let you know.
I really don't think there is any point in worrying about it and trying to predict what the outcome will be. I suggest making a list of what you think will be helpful and not worrying whether it is feasible or reasonable. This is all up for negotiation with your employer and you wouldn't want not to ask for something just because you are worried you won't get it when your employer may be more than willing to accommodate.

They will ask about your condition and how it affects you and your ability to do your job, they will make reccomendations to your employer for reasonable adjustments to your role to help you work to the best of your ability.

@Skybluecoat they were absolute arseholes to me but are actually a very prestigious global name who publicly claim they go above and beyond for both clients and staff. Don’t even get me started! 😡

Edit: just to add, my sick leave and subsequent phased return was due to being forced to work in the office (pre-restriction relaxing for Covid) where my client’s team triggered a Covid outbreak (this was documented by senior mgt) and I ended up with long Covid (and still have it years later).