Occupational health: What can I expect?Watch
The vast majority of healthcare workers and students will, at some time, require input from occupational health.
An occupational health (OH) review is a requirement of all universities for healthcare courses. Employers will also require you to undergo a review prior to starting your role. The purpose of OH is to assess your health and to determine whether you require any adjustments to enable you to get the most out of the course. The role of OH continues whilst you are on the course, as they exist to provide ongoing support, and also support in case of injury, sickness absence or pregnancy.
This article will focus on university OH procedures, however those from employers are very similar. Employers tend to request vaccination history and require either an online or paper form to be completed. Employers may conduct quick telephone appointments to clarify medications etc. and can then arrange a full assessment if they deem it necessary.
How do I arrange my appointment?
Your university will contact you with arrangements for your occupational health review. Sometimes, universities will send a form for you to fill in and will only call you in if you have a medical condition or are taking medication. Other universities will schedule appointments for every student regardless.
Often, appointments take place in the summer prior to you commencing on the course, however some universities conduct their appointments in the first few weeks of the course. This just depends on the individual policy of the university.
Once you are enrolled at the university, if you require further OH input (e.g. due to pregnancy, injury, extended sickness absence) you can be referred back to OH by your tutor, or you may be able to contact them directly, depending on your university policy.
I have a serious health condition – can I be seen more quickly?
If you have a condition which you think may seriously impact your ability to participate in the requirements of the course (e.g. epilepsy, severe visual impairment, significant physical disability), it is wise to contact the university as early as possible, even prior to applying or receiving an offer.
Some universities may be willing to advise you whether the course is suitable for you or not, or schedule an earlier appointment, however others may require you to go through the normal process. This is very much dependant on the resources available at the university.
What happens at the appointment?
Generally you will already have provided your medical history and any current medications. Bear in mind that the OH department do not have any access to your medical history, other than the information you have provided, so may require lots of details from you. The nurse or doctor will discuss these with you. There are several things that the OH staff are looking to find out. These are:
- Whether you have any medical conditions or conditions under investigation
- Whether you are seeing a medical profession with regards to these (e.g. are you attending for regular follow ups or reviews?)
- Whether your condition is stable or fluctuating
- How it impacts on your daily life and whether it could cause you difficulty in participating fully in the requirements of the course
- Whether there is any possible risk to yourself, other students, staff and patients
- Whether you normally have any adjustments in place (e.g. extra time in exams at school or the ability to take breaks when you need to).
The general goal of an OH appointment is to gather information about your health, to determine whether there are any significant health issues, and to ascertain whether your condition is well-controlled. ’Well-controlled’ can be hard to define, but often a condition would be considered well-controlled if you are having regular reviews with a healthcare professional, are currently undergoing medication or treatment, or are no longer requiring treatment.
Many (but not all) universities follow the HEOPS guidance. This is the governing body for occupational health practitioners working in higher education settings. This guidance covers the general principles of OH however should not be solely relied upon as different universities may be able to make different adjustments. All cases will still be reviewed on an individual basis, however the website can give you some idea as to the level of fitness required for your course. You can see the criteria here: http://www.heops.org.uk/guide.php
What do I need to bring?
You will likely be asked to provide a history of your childhood vaccinations. You, or your parents, may already have a copy of this, however if you don't, you will need to request a copy from your GP. This should list all of the individual vaccinations and date given. Some universities require a medical certificate - a letter from your GP stating that you are fit and able to meet the demands of the course. For both of these services, there is often a charge. Previously, students have paid anything from £10 to £60 for this letter. There may be an additional smaller fee for your vaccination history. How much exactly this will cost is determined by your GP. There may be an extra fee for a quick turnaround, but bear in mind that it may take up to a month for this to be processed. It is advisable to wait until these are requested by the OH department before making any requests to your GP, in case they are not required.
If you are on any regular medications, a repeat prescription or a list of these (including the name, dosage and how often you take it) is advised as this can simply be reviewed and photocopied by the OH nurse or doctor.
What if I don’t disclose something?
You can’t be forced to disclose your medical history, however it is strongly recommended that you do so. Failure to disclose something which then causes harm to patients could have very serious consequences. If this did occur, and you were sent to a Fitness to Practice hearing, questions would certainly be asked about your rationale for not disclosing.
Occupational health is a confidential service, and you should be provided with information about how your data will be handled, and who it will be shared with.
‘But what if I fail?’
Many people are anxious about attending occupational health appointments, with a fear that they will ‘fail’. OH is not a ‘pass or fail’ assessment, but is a service which exists to assess any medical conditions you may have and to put adjustments in place to assist you.
Most healthcare courses do require a certain level of fitness and physical ability. You will be expected to fulfil your role, so would need to manage spending 12 hour shifts on your feet, participate in moving and handling and carry out all the duties associated with your role.
But people do fail, right?
Occasionally, someone may have a condition which prevents them from meeting the requirements of the course, or has a condition where there is a significant risk to the general public. This applies to only a very small number of applicants. Wherever possible, the university will implement a management plan to make adjustments which will enable you to continue with the course.
Occupational health departments do not have the power to remove you from a course or to prevent you from continuing on your course. They may make a recommendation of this nature to your course leader or line manager that they review your capability to continue. This would only ever be done if there was deemed to be a significant risk to yourself or others.
As discussed, this is a very rare occurrence. However, if it were to happen, your next steps would be to contact the OH department in writing and inform them that you do not agree with their recommendations, and that you would like a second opinion and to appeal the decision. If you have also been contacted by the course lead, you should inform them of the same. At this point, it would also be appropriate to seek a letter from your GP in support of your appeal, although you should be aware that there is often a charge for this service.
You should be assured that no employer wishes to decline an applicant on the basis of health grounds, and that all employers and universities have a responsibility to comply with the Equality Act 2010. Wherever possible, all reasonable adjustments should be exhausted before declining the applicant. The types of adjustments that can be made may very by university/employer, so rejection from one does not necessarily mean that you would be rejected by all.
I have a question - how do I prove vaccinations if I grew up in a different country and may not have access to my medical records anymore?