- An occupational health referral provides independent, work-focused advice on how health affects someone's job. It is not a diagnosis or a disciplinary step.
- Discuss the referral with your employee and obtain their consent before submitting it.
- The usefulness of the report depends on the referral: give context and ask specific, role-related questions.
- Act on the advice: meet the employee, agree the adjustments, and set a review date.
If you manage people, you will at some point be asked to refer someone to occupational health, often with little explanation of what that involves or what it will produce. This guide sets out the process in practical terms, from deciding when to refer through to acting on the report.
What an occupational health referral is, and what it is not
An occupational health referral is a request for independent, expert advice on how an employee's health affects their work, and how their work may be affecting their health. It produces written recommendations tailored to that person's role. It is not a disciplinary measure, and it is not a request for a diagnosis: the clinician assesses function and fitness for work rather than sharing confidential clinical detail. Nor is it a second opinion on treatment, which remains a matter for the employee and their GP or specialist. Approached in this way, a referral demonstrates to the employee that their situation is being taken seriously and handled fairly.
A referral built around specific, role-related questions produces advice a manager can act on.
When to refer
There is no single trigger for a referral, but the common circumstances are straightforward to recognise:
- An employee has been absent for an extended or uncertain period and you need advice on a likely return and how to support it.
- A pattern of frequent short-term absence may have an underlying cause.
- An employee has told you about a health condition or disability that affects their work.
- Someone is struggling with attendance, performance or wellbeing, and health may be a factor.
- You are considering adjustments and need to know which would be effective.
- An employee is returning after surgery, serious illness or a period of poor mental health.
Referrals commonly involve mental health or musculoskeletal problems, where work and health interact closely. As a general rule, refer early: advice is easier to act on before a situation has become entrenched.
Discuss the referral and obtain consent
This step is the one managers most often overlook, and it is the most important. ACAS advises that you discuss the referral with the employee and obtain their consent before making it. Explain why you are referring them and what you hope it will achieve, and let them see the referral so that nothing comes as a surprise.
Consent continues throughout the process. The employee has the right to see the report before it is released to you, and may withhold consent for it to be shared. Where a doctor carries out the assessment, the employee also has rights under the Access to Medical Reports Act 1988, and any health information you receive must be handled in line with UK GDPR: stored securely, with access limited to those who need it.
Medwyn tip
Give the clinician the employee's role and main duties, a brief factual summary of the situation, and a small number of specific questions: Is the employee fit for their current role? If not now, when might they be? Which adjustments would help, and for how long? Are they likely to be considered disabled under the Equality Act 2010? Around six focused, role-related questions produce the most useful report.
What happens at the assessment
The clinician meets the employee, usually by telephone, video or in person, and considers how their health affects their work and daily activities. With the employee's separate consent, the clinician may seek further information from their GP or specialist, and then sets out practical, work-focused recommendations for you.
Reading the report
A well-written report answers your questions in plain language: fitness for the current role, recommended adjustments and how long they may be needed, a realistic view on return or a phased return, and, where relevant, an opinion on whether the person is likely to meet the Equality Act definition of disability. It will not contain confidential clinical detail the employee has not agreed to share.
Good practice
The clinician advises; the employer decides. The report is expert guidance, not an instruction, and the employment decision remains yours. That advice carries weight: employers who set aside clear occupational health advice without good reason have been found at fault at tribunal. Whether someone meets the Equality Act definition of disability is ultimately for an employment tribunal to determine.
Acting on the advice
Once you have the report, meet the employee, discuss the recommendations, and agree a plan: which adjustments you will make, who is responsible for each, and when you will review progress. If a particular recommendation cannot be implemented, record the reason and consider alternatives rather than setting it aside. Following reasonable occupational health advice supports the employee's return and gives you a defensible basis for your decisions.
To make a referral, or to talk through whether one is the right step, contact our team.
This article is general guidance for employers and is not individual medical or legal advice. If you are unsure how it applies to your organisation, contact our team.