assessing fitness for work and return to work Flashcards
when do we need to assess fitness for work?
- patient condition may limit/prevent them from carrying out their job
- patient condition may be made worse by job
- patient condition makes them personally unsafe in the working environment e.g. fall unconscious whilst operating machinery
- patient condition makes it unsafe for themselves and others e.g. bus driver
- patient condition may pose a risk to community e.g. food handler
in what circumstances do we actually assess fitness for work? (6)
- post-offer of job
- after sickness absence
- job change (role/working demand)
- periodic review
- return to work after injury or illness
- possible retirement on grounds of health
is a GPs role more to assess fitness to work when patient starts working or is returning to work?
returning to work, ask questions:
- does patient want to return to work?
- does patient need to be symptom free before returning to work?
- is some work feasible?
employer usually assesses fitness to work when starting work
What is the equality act 2010?
unlawful for an employer to discriminate against workers, including job applicants, on the ground of medical disability; it requires that all reasonable steps be taken to accommodate their health problems.
what is the general structure of a FTW consultation with GP?
- patient details
- reason for referral
- sickness absence record
- current job info
- occupational history
- presenting complaint
- history of presenting complaint
- drug history
- past medical/surgical history
- past social history
- hobbies
- physical examination (if required)
whose job is it to tell the DVLA when there is an issue with fitness to drive?
the driver/patient must inform the DVLA
*the doctor can only advise individual on impact of medical condition on safe driving, tell patient to inform DVLA and notify DVLA that the patient needs to notify them of medical condition.
what aspects of a person’s health condition may affect their working ability?
- stamina - full-time work, physical demands
- mobility - walking, bending, stooping
- agility - dexterity, posture, coordination
- rationality - mental state, mood
- treatment - side effects, duration
- intellectual - cognitive abilities
- essential for job - food handlers, driving
- sensory aspects - safety, self and others
what aspects of a person’s occupation may affect their health condition?
- demands of job - physical, intellectual
- environment - dust, chemicals, noise etc.
- temporal - shift work, early starts
- travel - commute between sites, travel abroad
- organisational - lone-working, customers, management
- layout - ergonomics aspects, workstation, work equipment
how can the workplace be modified to reduce risk of disease and support less-fit individuals?
- encourage patient to keep in touch with work
- reduced hours (half days, phased return)
- change pattern of work/shifts
- change tasks or work content
- adapt the workplace - alter layout
- reduce pace of work - frequent or longer breaks
- adapt equipment
- provide training
- provide for mobility and transport
- redeployment - temp. or permanent
after how long an absence must you complete a sick-certificate (SC2)?
4 days
after how long an absence may an employer ask for a medical certificate?
7 days
return to work should be one of the key clinical outcomes by which the success of treatment is measured. what are the benefits of re-employment? (Waddell and Burton 2006)
- improved general and mental health
- reduced psychological stress and minor psychiatric morbidity
- minimises the harmful physical, mental an social effects of long-term sickness absence
- reduced risk of long-term incapacity
- improves quality of life and well-being
