How much is an employer entitled to know about medical appointments?

[Cooldryplace]

In work time?

I am line manager to a woman with multiple health issues, although it's not clear what they are. Most of the time she's a model employee, but she does have a lot of time off for appointments.

She's also very clear that her health is her business and won't share any details. So for example, when she provides an appointment letter (our standard policy) she will black out all the detail of what the appointment is actually for.

I've taken this at face value - her health her business and allowed the time off based on these redacted letters. My boss is now saying I should be insisting on knowing what they're for.

Model employee except for her disability"

Want to give a bit more thought to the implications of what you're saying?

Op or her boss doesn't actually know if it's a disability.

Our local private hospital offers reiki. I could get a letter from there with an appointment on and black out the details, so it looked like a hospital appointment.

An employer can manage someone out if they can not support (in the case) the 10% off per month.

While the employee doesn't have to give details, the employer doesn't have to just accept it if its becoming unmanageable

@Cooldryplace

Don't have a go at me I've been complying with all her requests. Boss has started to question whether it's reasonable.

Ok, well if you don't want to get dragged into an unlawful discrimination case, you should probably rethink how you're talking about her and her circumstances yourself.

As well as whether this employee and your boss would recognise themselves, and therefore you, from the details you've published.

@donquixotedelamancha do you want to read my full comment rather than just picking a half quote to suit your agenda?

She didn't declare anything to OH either.

We can't take annual leave because we only get school holidays. No flexible days, so recognising how hard that is appointments are usually granted.

The original query did in fact come from a position of concern. It looks like she might be spending a lot of money seeking alternative or possibly trial treatments. So boss is concerned whether this is actually good for her or whether a vulnerable person is being exploited, but also thinking WTF about the number of absences.

Your boss is not a Dr so knowing what the medical issues are won't be of any use to them- the medical professionals (booking her in for appointments) and occ health ARE medical professionals and have given their advice- reasonable adjustments and the requirement to attend appointments. And that is all yr boss needs to know.

Is your boss really going to overrule these medical professionals eg by saying 'actually you don't need to go to that appointment'. Boss would be very stupid if they are considering this. What are they trying to achieve here?

However you would be ok to have a conversation based on what yr company policy is on time off and pay for appointments and any policy on supporting disabled colleagues. In my company the policy says appointments should be arranged outside odd work hours if possible and if not possible, the time should be made up - can she make up the time? Tricky if you work full time I know!

You, or OH, or some other responsible person, need to know if it is a condition which may have repercussions in the workplace. Not just potential adjustments for her, but also to ensure that she does not is entirely a risk to colleagues.

It may be best to do this with OH or HR rather than directly within her own team, as she clearly does not want close colleagues knowing her personal health info (which is also entirely reasonable)

My last place I refused to give any details of my health and would black out departments etc because colleagues were gossiping twunts and nothing was private as I had previously found out the hard way.
I went to the occupation health appointment along with the letters showing the full details. We had a nice chat about my health and based on all this reasonable adjustments were put into place. Omg the speculation was hysterical about where I was disappearing to. At times I didn't want to take a chance that I had radiation in my system and I really didn't want it talked about especially around our service users.

Keep telling the manager on repeat they need to either drop it as occ health know what they are doing or ask the employee, preferably in an email 😁

@Cooldryplace

We can't take annual leave because we only get school holidays. No flexible days, so recognising how hard that is appointments are usually granted.

The original query did in fact come from a position of concern. It looks like she might be spending a lot of money seeking alternative or possibly trial treatments. So boss is concerned whether this is actually good for her or whether a vulnerable person is being exploited, but also thinking WTF about the number of absences.

Ask OH to review if there are concerns about her health deteriorating or the level of absences increasing. Presumably there is an absence policy that includes the provisions for disabled staff which can be followed?

If they didn't already, ask them to confirm if she is disabled under the EA so you can ensure you are compliant with the EA.

It sounded like they already had from what you posted, but if not then it should be asked now.

It's usually one of the key points in an OH report though, along with the reasonable adjustments that follow.

As for meddling in the decision-making of a woman with capacity to make those decisions, that's nobody's business. We all have the right to make decisions others consider unwise.

Keep that separate from employment matters. As her employer, you definitely don't have the right to delve into her medical info just because you disagree with her treatment decisions. If an employee with cancer declined chemo you wouldn't have any right to meddle there either, no matter how much you cared about them on a human level.

Is your boss really going to overrule these medical professionals eg by saying 'actually you don't need to go to that appointment'. Boss would be very stupid if they are considering this.

Exactly.

do you want to read my full comment rather than just picking a half quote to suit your agenda?

Eh, I quoted the bit I was replying to, why would I make people reread the whole thing, it's right above that post? Making an argument is not an agenda.

She didn't declare anything to OH either.

OH reports don't give unnecessary private medical details to the employer, that's why it didn't contain details. How could they have suggested reasonable adjustments (presumably under the EA2010) without knowing her condition?

I can see this from a different view. I have a rare complex illness and have also had cancer in the last year. Its not unusual for me to have up to 6 hospital apps a month( or more). I try to take as little time off as possible, and as my workplace is open 7-9 its very easy for me to attend apps and then work before/after, swap non working days etc. My work knows everything, im a totally open book. As far as im concerned its very unreasonable to expect your workplace to accomodate you when you refuse to tell them whats going on.

Ask HR or check your handbook/company policy first. You don’t want to wing it and get this wrong - she’s already been to occupational health after all

It depends on how far you want to take this if she otherwise doesn’t cause a problem. We’re recovering from the pandemic and many medical services have only just begun seeing routine patients again, which could explain the recent influx of appointments that she had. It could be 3 separate, minor things that are being investigated which have been in the pipeline but delayed due to lockdown.

You can take her to aside and ask her if she needs any support, if these appointments will be a regular occurrence (you can assess whether her time off affects business needs or not, or whether she needs to adjust her hours). Contrary to popular belief, you can sack a disabled person if their time off means they simply can’t fulfil their role - this is after reasonable adjustments have been considered & implemented and policy has been impeccably followed of course. This is a nuclear option that isn’t relevant at this stage.

@Redannie118 she’s already been to occupational health though, so presumably her health issue has already been discussed and verified with them

What does OH actually do in other organisations? Ours doesn't seem to check or verify anything, just tells us what the staff member tells them and makes suggestions on ways to support based on that.

Your boss is trying to get you to do their dirty work for them. If they want to take this up with this employee, tell them to do it themselves. Don’t be manipulated into being piggy in the middle.

OH reports don't give unnecessary private medical details to the employer, that's why it didn't contain details. How could they have suggested reasonable adjustments (presumably under the EA2010) without knowing her condition?

Of course she cab, because really all she is getting is time off.

You don't actually have to be diagnosed with anything to have reasonable adjustments made.

Op we would use OH for several reasons. Usually where an employee may need accommodations made.

Essentially, they are there to support the business really. But like HR. They should be trying to support the employee to be in work as much as possible within the constraints of the business. But really they are there so q employer can say 'oh recommended X, we implemented here and absence/ performance did not improve.

As part of a long list of other evidence they would bring.

In most cases, I have seen (but I work in the private sector) the outcome eventually would be that the employee has a certain amount they can take paid, the rest unpaid. Or overall reduction of salary (in this case by 10%), not sure how reasonable this is in schools.

Or if the business can not support 10% absence, eventually the person would be managed out. But there's a lot of steps to ensure it's done correctly and fairly to both employee and business.

Your line manager clearly wants you to be the subject of a formal grievance and not her. And to be able to blame you if the employee then files a discrimination claim - which will be funded by her Union, as there is clearly a more than 50% prospect of success - on account of her verified (by Occy Health) Protected Characteristic.

Seriously, step away from this - if your LM wants to bring this on your school, then she should be the one to order her to release information or refuse her appointments - and you will benefit from the protection of your union if you contact them and say you're being told to do something which is potentially breaching EA.

Mine was a chat about health and what was going on. We spoke about ways that I could carry on working as a result of health and the appointments. I'm the weeks leading up to me being signed off I was having weekly appointments and some weeks more than one depending on what consultant pa 's could kindly organise for ne.
I also told them that because colleagues were a bunch of nosy gobshites who clearly knew better than anyone else I would prefer to keep the details private and we discussed between us what the official line would be.

Some recommendations were talked about that day, others came about a week later after they had looked further into one of .g conditions. No one else was privvy to this info either.

My fit notes were also incredibly vague about the on going issues.

When I returned to work again I met with OT who once again made recommendations based on the info provided.

As far as HR was concerned they were happy with what they were privvy to. Those that needed to know the full details had that info. Everyone else could go and find a life elsewhere.

And for the hard-core who wouldn't let up if we were on the same lunch I would harass them about their dietary intake, take concern about their bladders/bowel when coming back from the loo, if they coughed/sneezed demanded to know other symptoms etc to see how they liked the constant health related questions as they tried to diagnose me.

@Cooldryplace

What does OH actually do in other organisations? Ours doesn't seem to check or verify anything, just tells us what the staff member tells them and makes suggestions on ways to support based on that.

Occupational health reports are only as good/ helpful as the questions the employer asks the Dr to respond to. So ask the questions you want the answers to!

They may also write to the GP for information too. Employee doesn't have to give permission but they'd be silly not to if they want to get the best support.

Your boss sounds really nosy.

If the employee is adhering to company policy around paid appointments and has engaged with OH, then your boss has to suck it up I'm afraid.

If that is ongoing and at that level of absence is her condition covered by the Equality Act? What is the absence policy for medical appointments? OH can agree what her manager is told about her medical history and any adjustments.

Much as I love mumsnet, don't get advice like this from the internet. You'll get people saying crap like "it's illegal to sack someone who is sick". Get a proper HR adviser or employment lawyer to advise you.
I will say this though (but do get this verified), as an employer you have a duty of care to your employees. How can you fulfil that if you don't know what the ailment is?
And OH can be good or rubbish depending on the practitioner. Some take at face value whatever they are told without any challenge.

Ok, well if you don’t want to get dragged into an unlawful discrimination case..

If there were to be a disability discrimination case, because say, the employer starts to insist that the time off is unpaid or even if the employment was terminated because of repeated absence, that the person in question has refused to reveal their “disability” (if it is one) is very relevant.

If the employer has not been provided with the medical information they feel is necessary, they cannot be expected to have made reasonable adjustments for it. If the employee wants the employer to work with them or accommodate them on this, then they need to cooperate. An employee cannot expect to just say I need two to three days off every month but I am not telling you why and consider that is enough. It is right that a manager has put their head above the parapet and said “hang on a minute” here, many would be too scared to.

If the employer has not been provided with the medical information they feel is necessary, they cannot be expected to have made reasonable adjustments for it

But the employer has been provided with the 'medical information' that they are entitled to receive. By occ health. The employee has engaged with occ health as requested to by their employer.
No employer has the 'right' to decide what level of 'medical information' they'd like to know

All employees have a right to medical privacy, which cannot be 'overridden' simply because a boss wants/ would like to know what's medically wrong with them !

They only have a right to know whether they can be classified as 'disabled', and are therefore eligible for a level of protection under law.

The definition is set out in section 6 of the Equality Act 2010. It says you're disabled if: you have a physical or mental impairment. that impairment has a substantial and long-term adverse effect on your ability to carry out normal day-to-day activities.