- An occupational health assessment is an independent, work-focused conversation about how your health affects your job and what would help. It is not a test, a disciplinary step or a form of treatment.
- You should see the referral before it is sent, and the clinician will offer to show you the report before your employer receives it. Your employer gets advice on fitness and adjustments, not your medical history.
- You do not have to agree to an assessment or to the report being released, but without it your employer has to make decisions on the information it already holds.
- Most assessments take place by video, telephone or in person and usually last 45 to 60 minutes. At Medwyn the written report follows within 72 hours.
Your manager has mentioned occupational health. Perhaps you have been off sick for a while, or a health condition is making parts of your job harder, or you are due back after an operation and nobody is quite sure what you can safely do. Whatever the reason, most people arrive at their first occupational health appointment with the same two worries. What are they going to ask me, and what happens to what I say? This guide answers both, and the practical questions in between.
What an occupational health assessment is
An occupational health (OH) assessment is a review of how your health affects your ability to do your job, and how your job might be affecting your health. It is carried out by a qualified occupational health clinician, usually an occupational health nurse or physician, who considers you, your role and the demands of the work, then advises your employer on your fitness for work and any adjustments that would help.
The distinction that matters most is that an OH assessment is about function, not diagnosis. Acas describes it as a useful addition to a fit note or a doctor's report, because it is more focused on how someone does their job and how the job might affect their health. Your GP treats you. The OH clinician gives an impartial opinion, to you and to your employer, about work. The Faculty of Occupational Medicine's standards for occupational physicians are explicit that employers are entitled to advice about an individual's fitness for work, but not to diagnoses or specific clinical details without the employee's informed consent and a genuine need to know.
It is also worth saying what an assessment is not. It is not a disciplinary step, it is not a medical you pass or fail, and the clinician does not decide whether you keep your job. Occupational health provides advice. Decisions remain with your employer.
The clinician is not there to catch you out or to decide whether you keep your job. They are there to work out what would help you do your work safely and well.
Why employers refer people to occupational health
The usual trigger is that health and work have started to overlap. Common reasons include absence that has become long-term or keeps recurring, a return to work after significant illness, injury or surgery, a condition that is affecting performance or attendance, a request for adjustments that a manager is unsure how to meet, and roles where fitness has to be confirmed for safety reasons. Employers also refer people who are struggling with stress or their mental health, who often benefit from an early referral.
Not every employer offers this. Government research published in 2023, drawing on a 2020 survey, found that only 45% of workers in Great Britain had access to occupational health through their job. A referral is an investment in getting your situation right, not a mark against you.
Before the appointment
Your manager should explain why they are referring you and what they want to know, and you should see the referral form before it goes to the provider. Read it. If it contains factual errors, say so before it is sent. Your consent to the referral is needed, and a good referral sets out the reason, the questions your employer wants answered and any relevant background such as absence dates and fit notes.
A little preparation makes the appointment more useful. Think about which parts of your job are difficult at the moment and why, what a typical day looks like, what has already been tried, and what you think would help. Have to hand a list of your current medication, any recent fit notes, and letters from your GP or specialist if you have them. You will not be asked to hand over your medical records, but the clinician can only advise on what they know.
Medwyn tip
A short note of what you can and cannot manage at work, in your own words, is worth more than any medical letter. "I can sit for about 20 minutes before I need to move" gives the clinician something concrete to work with.
What happens during an occupational health assessment
For most people the assessment is a structured conversation, held by video or telephone or in person. The clinician will introduce themselves, explain the purpose of the assessment and confirm what your employer has asked. They will take a history of the health issue, ask about treatment and how it is going, and then spend most of the time on function. What can you do comfortably, what is difficult, what makes it worse and what helps, both at work and day to day.
They will also ask about the job itself. The tasks, the hours, the physical and mental demands, any hazards, and anything at work that you feel is affecting your health. A physical examination is not always needed. If one is, the clinician will explain why and ask your permission first. Where more information from your GP or specialist would help, the clinician will ask you to sign a separate consent form, and Acas confirms you have the right to see that doctor's report before it is sent to occupational health.
Before the conversation ends, the clinician will tell you what they intend to advise. There should be no surprises in the report.
What questions are asked at an occupational health assessment
Expect questions along these lines. How is your health at the moment and what treatment are you having? How does the condition affect you day to day, and which parts of your job does it affect? What has helped and what has made things worse? Is anything at work contributing? What are your own thoughts about returning to or continuing at work, and what would need to change? Where it is relevant you may also be asked about sleep, mood and energy, because they affect capacity for work.
You will not be asked to justify your absence or defend your performance. That is not the clinician's role, and a report that strays into it would not be doing its job.
Can you refuse an occupational health assessment?
Yes. Acas is clear that a worker does not have to agree to an occupational health assessment, and that after an assessment the clinician must ask for the worker's permission before sharing it with their employer. You can decline the referral, and you can decline to have the report released after you have seen it.
It is worth thinking carefully before you do. Acas lists the benefits of agreeing, which include getting the support you need, returning to work safely and more quickly, and avoiding your employer making big decisions without important information. If there is no report, your employer will still have to make decisions about your absence, your role or your return, and it will make them on what it already has, which is usually a fit note and what you have told your manager. A report written by an independent clinician who has listened to you is normally your best protection in that process.
If your concern is about a particular question or piece of information, say so. The clinician can advise on what is relevant and what is not, and only relevant information belongs in the report.
Good practice
If you are unsure about the referral, ask your manager or HR to talk you through the questions they are asking and why. In our experience most worries about occupational health come from not knowing what has been asked, and seeing the form resolves many of them.
The report, and who sees it
The report is the product of the assessment. It is written for your manager or HR in plain language, and it covers whether you are fit for your role with or without adjustments, what adjustments would help and for how long, likely timescales for a return or for improvement, whether the Equality Act 2010 may apply, and answers to the specific questions your employer asked.
What it does not contain is your medical history. Medical detail stays with the clinician. The Information Commissioner's Office says that, as far as possible, an occupational health adviser should hold the medical information about a worker and only tell the worker's manager the results of the health assessment, and that workers are entitled to assume that what they tell a doctor, nurse or other health professional will be treated in confidence unless told otherwise.
Under General Medical Council guidance, a doctor writing a report for employment purposes should offer to show the patient the report, or give them a copy, before it is sent. If you point out an error of fact, the doctor should correct it. If you disagree with an opinion, the doctor need not change it unless it rests on an error of fact, and at Medwyn the report can record that your view differs. If you withdraw your consent, the doctor must abide by your wishes, other than in the rare cases where disclosure is required by law or can be justified in the public interest. They may tell your employer that consent was withdrawn, but nothing more. Medwyn applies the same approach whether the assessment is carried out by a physician or an occupational health nurse.
Once you are content, the report goes to the person who referred you. Medwyn issues reports within 72 hours of the appointment.
How long does an occupational health assessment take?
At Medwyn a new appointment usually lasts 45 to 60 minutes and a follow-up 30 to 45 minutes. Employers are offered an appointment within five working days of the referral, and the written report follows within 72 hours. Where the clinician wants to check progress, for example partway through a phased return, a review is arranged rather than a fresh referral.
What happens after the assessment
The report is advice. Your employer decides what to do with it. Acas encourages employers to consider the recommendations of both the occupational health assessment and any doctor's report, and, where advice conflicts, to talk with the worker and agree the best course of action. Expect a conversation with your manager about the recommendations, what can be put in place and when, and a date to review how things are going.
If adjustments are recommended and you are likely to be disabled under the Equality Act, your employer has a legal duty to consider them. Our guide to workplace adjustments under the Equality Act explains how that duty works. If a phased return is recommended, it should be written down with review dates, and our manager's guide to phased returns sets out what a good plan contains.
If you feel the report has not been acted on, raise it with your manager or HR first. If you disagree with the report itself, use the review stage to say so. And if the situation is part of a wider dispute at work, your employer's grievance procedure, not the assessment, is the place to deal with it.
If you are the manager making the referral
Everything above is easier when the referral is done well. Explain the purpose, share the form with the employee before it is sent, keep the questions to six and make them about function rather than diagnosis. Our occupational health referrals page sets out the six steps, our article on management referrals that get you a useful answer shows how to frame the questions, and the full referral guide is free to HR teams on request.
Used well, an occupational health assessment turns an uncertain situation into a clear set of next steps, for the person being assessed as much as for the employer. If you have been referred to Medwyn and something here has not answered your question, our team is happy to talk it through before your appointment.
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.
