Occupational Health Referrals (UK): What to Expect, How to Prepare, and How to Use the Report

Done well, an occupational health (OH) referral is a practical, confidential way to understand someone’s work capacity and agree proportionate adjustments. Done badly, it’s a vague letter and a trust problem. Here’s a plain-English guide—employee and manager views—grounded in current UK guidance.

What an OH referral is (and isn’t)

• Purpose: to give the employer expert advice on function and workplace adjustments, not a diagnosis deep-dive. OH is a medical service used to help decisions about supporting someone to do their job, return to work, or avoid further harm.

• Consent matters: the OH clinician must check you agree to share their report with your employer. No consent, no report (except rare legal/public-interest exceptions).

• Quality marker: look for SEQOHS-accredited providers—the UK benchmark for safe, effective OH services.

When to refer (manager checklist)

Refer when you need clinical-occupational advice that you cannot get from line management alone, for example:

• repeated or long sickness absence;

• uncertainty about fitness for specific duties or shifts;

• questions about reasonable adjustments (hours, environment, assistive tech);

• planning a staged return;

• safety-critical roles where medication or symptoms might affect risk.

ACAS’s guide is clear: OH helps managers make decisions by translating health information into work-focused advice. Acas

How to write a good referral (manager view)

Keep it short, factual, and anchored to the job. Include:

1. Role profile and essential tasks (attach it).

2. Specific questions (e.g., “What adjustments would reduce sensory overload in open-plan?” “Is a graduated return over 4–6 weeks appropriate?”).

3. Context (patterns of absence; trigger events; existing adjustments tried).

4. Worker’s contact details and preferred format/location for assessment.

SOM’s report-writing guidance to clinicians mirrors this: clear questions in, clear answers out. The Society of Occupational Medicine

What happens in the assessment (employee view)

Expect a structured conversation about your job demands, symptoms or triggers (e.g., noise, ambiguity, task-switching), and what helps. You can bring a one-page “barriers and supports” note. Afterward, OH produces a report to management that answers the referral questions in work terms: likely prognosis, fit for work (with/without adjustments), suggested adjustments, and review points. You choose whether the report is released.

Consent, confidentiality, and who sees what

• Clinician’s duty: OH doctors and nurses follow professional ethics (GMC/FOM) and need your informed consent to disclose confidential information. They should not surprise you—good practice is to discuss the gist before sending.

• Employer’s duty: your employer must handle any health information lawfully under UK GDPR/DPA 2018—limit access to those who need to know, store securely, and record a lawful basis and special-category condition (often Art. 9(2)(h) “occupational health”).

What a useful OH report looks like

According to SOM, a good report: states who it goes to; answers the manager’s questions; focuses on function (what the person can do); recommends specific adjustments; and reminds employers to share the report on a need-to-know basis only. 

Examples of proportionate, work-focused advice:

• predictable meeting windows; protected focus blocks; written briefs and same-day decision notes;

• environmental tweaks (quiet zone, glare control, noise-reducing headset);

• assistive tech and short training;

• graded return (hours/meetings phased over weeks) with review dates.

Using the report well (manager playbook)

1. Act quickly. Low-cost, reversible adjustments should start now; set a review date.

2. Record decisions in a short adjustments record (“passport”) owned by the employee; revisit at triggers (new manager, role, site).

3. Keep clinical detail out of line files. Route documents to HR/OH; store minimally and securely

4. Close the loop with the employee: confirm what you’ll implement, who’s doing what, and how you’ll judge success.

Common pitfalls (and better patterns)

• Vague referrals → vague reports. Ask concrete questions tied to the role.

• Fishing expeditions. OH is not a backdoor capability process; keep to work need and consent.

• “Diagnose before we help.” Adjustments can start on need; OH can refine them, but don’t gatekeep support behind paperwork.

• Privacy leaks. Don’t forward reports widely or store health data in team drives.

• Buying any OH service. Prefer SEQOHS-accredited providers; it’s the recognised UK quality standard.

Templates you can copy

Manager referral (short):

Reason for referral: X months’ absence related to [condition/impact] and uncertainty about work capacity for [duties]. Questions: (1) Fitness for role now/over next 3 months? (2) Recommended reasonable adjustments (hours, environment, assistive tech, supervision)? (3) Is a graded return appropriate—if so, proposed pace and review points? (4) Any safety considerations? Attachments: Role profile; attendance record; current adjustments tried. Employee informed and consents to referral: Yes/No (if yes, date).

Employee consent note (for clinic):

I consent to an OH assessment and to a report being sent to [manager/HR] that answers the referral questions about my work capacity and suggested adjustments. I understand I can see the report before it’s shared and can ask for factual corrections.

Frequently asked (fast)

• Can my manager see my full medical records? No—only the OH report with your consent; medical records stay with OH/GP unless separate lawful grounds apply. (GMC/ICO)

• Can I refuse consent? Yes, but then the employer decides based on limited information; sometimes that delays adjustments or a return-to-work plan.

• What quality should we expect from OH? Look for SEQOHS accreditation and reports that are work-focused, specific, and actionable.

References 

• Advisory, Conciliation and Arbitration Service. (2025, Feb 17). Using occupational health at work; Occupational health assessments. https://www.acas.org.uk/using-occupational-health-at-work

• Faculty of Occupational Medicine. (2017, updated 2024). Confidentiality: disclosing information for employment, insurance and similar purposes (GMC guidance relevant to OH doctors). https://www.gmc-uk.org/

• Society of Occupational Medicine. (2020). Guidance as to an Occupational Health report to management. https://www.som.org.uk/

• Information Commissioner’s Office. (2024–2025). Data protection and workers’ health information. https://ico.org.uk/

• SEQOHS (FOM). (n.d.). Safe Effective Quality Occupational Health Service – accreditation. https://www.seqohs.org/

• Society of Occupational Medicine. (2021). Guidance for OH report writing (NEC). https://www.som.org.uk/