Occupational health: what can my employer ask?
Occupational health advises on how work affects your health and what needs to change. It cannot order you back to work, and a referral does not give HR access to your medical history.
Occupational health services give medical advice about how your job affects your health and how your health affects your work. If lifting, night shifts or returning after illness is a problem, an occupational health assessment can identify changes that could help. Before agreeing to a referral, ask what questions your employer wants answered and who will see the report.
What do occupational health services do?
Occupational health, often shortened to OH, is a medical advisory service focused on work. A nurse, doctor or other qualified professional might assess how a warehouse worker’s back injury affects lifting, whether a phased return would help after illness, or which changes would let someone with migraines work comfortably. Your employer may have an in-house service or use an external provider. Acas explains how occupational health works.
- Fitness for work: whether your health affects particular tasks, hours or a return after sickness absence.
- Workplace adjustments: whether different duties, equipment, shifts or a phased return could help you work.
- Health risks at work: how the job could cause or worsen a health problem, and what needs assessing or changing.
If you need occupational health advice, ask your manager or HR whether a service is available and how to request a referral. Describe the task that is causing difficulty and the support you need. If there is no service, your employer’s duties to address safety risks and make reasonable adjustments still apply.
Occupational health and wellbeing at work
Ask about changes to the job itself: shorter shifts after surgery, less lifting with a back injury or equipment that lets you work without worsening a condition. A report does not change a care rota or a warehouse task. Ask your employer which recommendations it will put in place and when it will review them with you.
What power does occupational health have?
An OH clinician cannot make you attend an appointment, accept treatment or return to work on a particular date. It gives a medical opinion, not an order. Your employer decides what happens at work and remains responsible for making that decision lawfully.
A “fit for work” opinion does not mean you need no adjustments. Nor does a recommendation automatically bind your employer. It must still consider reasonable adjustments where the disability duty applies, and act on workplace safety risks. Refusing OH does not stop it making a decision on the other evidence it has.
Is it a legal requirement to provide occupational health services?
There is no general legal duty to run an OH scheme. There are duties to manage workplace risks. In Great Britain, section 2 of the Health and Safety at Work etc Act 1974 requires employers, so far as reasonably practicable, to protect employees’ health, safety and welfare. Risk assessments and competent safety assistance are required under the Management of Health and Safety at Work Regulations 1999.
Occupational health and safety: your employer’s duty of care
Do not confuse an individual OH referral with health surveillance. Under regulation 6, an employer must provide appropriate health surveillance where its risk assessment identifies a need. Specific rules also apply to hazards such as certain chemicals, noise and vibration. For example, regular checks for a worker exposed to a respiratory sensitiser are different from referring someone with a long sickness absence for advice on returning. HSE sets out when surveillance is needed.
No general statute requires you to disclose every change in your health. You do have duties to take reasonable care, cooperate with workplace safety measures and report serious shortcomings in protections. Concealing a condition that makes a safety-critical task unsafe may also have contractual or disciplinary consequences. Ask what information your employer needs to make the task safe. Do not assume it needs your whole medical history.
What can my employer ask occupational health about me?
During employment, questions should be proportionate to the work decision: can you safely lift or drive, would shorter shifts help, and what support would make a return possible? A referral is not permission to ask for your entire medical history. Ask HR or your manager to explain what each question has to do with your job.
Timing and purpose matter. In Great Britain, Equality Act 2010, section 60 generally bans health questions before a job offer or before placing someone in a selection pool. Exceptions include asking about adjustments to an interview, whether someone can perform a function intrinsic to the job, diversity monitoring and certain positive-action or occupational-requirement questions. The intrinsic-function exception is not permission to demand a full medical history.
| Stage | Permitted approach in Great Britain |
|---|---|
| Before an offer | Health questions only within the section 60 exceptions; ask about interview adjustments where needed. |
| After an offer | Role-related health checks may be possible; equality and data-protection duties still apply. |
| During employment | Ask proportionate questions about absence, work capability, risks and support. A treating doctor’s report requires separate consent. |
The Equality and Human Rights Commission alone enforces the section 60 prohibition itself. An applicant cannot claim compensation merely because the question was asked. But if a rejection follows an answer about health, the question can affect the burden of proof in a disability discrimination case. Treat a blanket pre-offer questionnaire as a serious warning sign, not a harmless formality.
Referred to occupational health: what happens next?
An employer may suggest OH after repeated absences, a request for adjusted duties or a safety concern. Ask for the referral questions in advance. They should describe your actual work, including lifting, standing or shift patterns that affect your health. If a question or description is inaccurate, ask for it to be corrected before the appointment.
- Read the referral. Ask why it is proposed, what OH will assess and who is intended to receive the findings.
- Decide whether to attend. Acas says you do not have to agree. If timing, accessibility or the choice of clinician is the problem, suggest an alternative.
- Discuss work and health. The clinician may ask about symptoms, treatment and your work. A request for a report from your treating doctor is a further consent decision.
- Decide whether the OH report can be shared. The adviser must ask your permission before sending it to the employer.
- Discuss next steps. Ask how the employer will handle adjustments, review dates and any disagreement with the advice.
Can I refuse an occupational health referral?
Refusal does not make the case disappear. Your employer can still act on fit notes, attendance records, information you have volunteered and the demands of the role. It should not assume refusal proves you are fit or hiding something. It need not wait indefinitely for evidence you decline to provide, either. If the referral feels intrusive, explain why in writing and offer a narrower set of questions or evidence from your own clinician. See disciplinary issues during sick leave.
Can occupational health or my employer ask my GP for a report?
In Great Britain, the Access to Medical Reports Act 1988 applies to an employment report prepared by a doctor responsible for your clinical care, such as your GP or treating specialist. It does not normally cover a one-off assessment by an OH doctor who has not been responsible for your care. Acas nevertheless advises employers to inform workers of their rights when a doctor carries out the OH assessment. A report is not permission to inspect your complete GP record.
Before applying, the employer must tell you about your rights and obtain your consent. You can ask to see the report before it is supplied. The employer must tell the doctor that you want prior access and notify you when it applies. You then have 21 days beginning with the application date to contact the doctor to arrange access. If you make no contact in that period, the doctor may supply the report once it has elapsed. You need to contact the surgery within 21 days, not necessarily attend and read the report within that time. Section 4 sets out the time limit.
After you see the report, it cannot be sent unless you consent to its release. You may first ask in writing for anything incorrect or misleading to be amended. The doctor can decline, but must attach your statement of disagreement if you request it. You can instead withhold permission for release under section 5. You can also ask to see the report for up to six months after it was supplied; Acas explains the practical process.
Example: when to call the surgery
Your employer applies on 2 October and tells your GP you want to see the report first. The GP completes it on 10 October. Contact the surgery by 22 October. The application day counts as day one, so 22 October is day 21. If you contact them in time, access can be arranged later without the doctor sending the report merely because 21 days have passed. Once you have seen it, you decide whether it can go to the employer.
In Northern Ireland the 1988 Act does not apply. The equivalent consent and prior-access provisions are in Part III of the Access to Personal Files and Medical Reports (Northern Ireland) Order 1991, including a 21-day contact window in article 9. The 1993 Access to Health Records Order concerns access to health records generally; it is not the source of this employment-report procedure.
Occupational health report: your rights to confidentiality and access
Health information is special-category data under UK GDPR. To use it, your employer needs an Article 6 lawful basis and a separate Article 9 condition. Consent to release an OH or GP report is not automatically the employer’s data-protection basis. The ICO warns that consent is often unsuitable as an employer’s lawful basis because the worker may not feel free to refuse. Employment-law obligations or occupational medicine may supply a condition where their requirements are met.
Your manager may need to know whether you can lift, drive or work particular hours, what adjustments are proposed and when to review them. That is not a licence to circulate consultation notes or your full medical history. The ICO advises that OH should keep the medical detail and give managers only what they need. Occasionally a specific clinical detail will be necessary. Sharing confidential information with non-medical staff generally requires explicit consent as well as a lawful data-protection route. Your employer should explain from the outset who can see what, and must respect confidential communications with the clinician.
If an external OH provider acts under its own professional responsibilities, it is likely a controller of the clinical file in its own right. Send a subject access request to that provider for what it holds, and separately to your employer for the report or health information HR holds. The ICO’s OH guidance is under review following the Data (Use and Access) Act 2025. See also your rights over employee data.
Does my employer have to follow occupational health advice?
Your employer is not automatically bound by every OH recommendation. It should discuss the report with you, consider what is workable and explain any departure from the advice. A phased return, different equipment, changes to shifts or another role may be options. If two medical opinions conflict, Acas recommends discussing them with you, rather than choosing whichever is more convenient for the employer.
In Great Britain, a person is disabled under the Equality Act if an impairment has a substantial and long-term adverse effect on normal day-to-day activities; long-term usually means at least 12 months. Cancer, HIV and multiple sclerosis are treated as disabilities from diagnosis. When an employer knows, or could reasonably be expected to know, of disability and the disadvantage, it must make reasonable adjustments. That duty can apply to employees and to people doing contract work, including agency workers in appropriate arrangements. Genuinely independent self-employed people do not acquire employee rights just because they have an OH appointment.
Example: the chair is not the whole answer
An OH adviser suggests an ergonomic chair for a worker with a disabling back condition. The employer provides it, but still schedules eight-hour standing shifts. The chair does not settle whether other reasonable changes are needed. The employer must assess the disadvantage in the real job, speak to the worker and consider options such as shorter standing periods or different duties. See reasonable adjustments for disabled workers.
A safety risk can require action even if OH proposes none. If a clinician flags solvent exposure aggravating dermatitis, the employer should assess and control that risk. Where health surveillance is required, an OH referral cannot replace it.
Ask for the changes in writing
Write down the task, how it affects your health and the change that could help. Ask your employer to confirm which recommendations it accepts, when changes will start, when they will be reviewed and the reason for any refusal. Keep the report, your request and the reply. If medical opinions conflict, ask for a discussion rather than letting the employer pick the answer it prefers.
Ask your union for support before a referral meeting if you have one; Unite, UNISON and GMB represent workers across care, retail and warehouse work. Acas can explain workplace options, and Citizens Advice or a local law centre can help you understand a dispute. Raise an immediate workplace safety concern with the HSE. For a pre-offer health question in Great Britain, the Equality and Human Rights Commission enforces section 60.
Occupational health for healthcare and care workers
If you work in care or healthcare, an OH assessment can address whether adjusted duties or shorter shifts would help you return safely after illness. It must take account of what you actually do. Describe the lifting, hours and other tasks that affect your health, rather than relying on your job title.
Potential exposure to biological agents and work involving sharps may bring extra safety requirements. Required health surveillance is different from an individual referral for return-to-work advice. Your assessment and report permissions do not vanish because you work in healthcare. Vaccination questions require their own risk assessment, not an assumption that all care workers must agree to a jab. See biological hazards and vaccination at work.
Can occupational health affect sick pay or dismissal?
OH does not replace a fit note or decide sick pay. You can self-certify for the first seven calendar days of sickness; after that your employer can ask for a fit note. Doctors, nurses, occupational therapists, pharmacists and physiotherapists can issue them. Employees who qualify for Statutory Sick Pay (SSP) may receive it for up to 28 weeks; many contracts provide more generous sick pay. Ordinary unfair dismissal protection depends on employee status and qualifying service, whereas disability discrimination does not require two years’ service.
Since 6 April 2026, SSP has no lower earnings limit or three waiting days. The 2026-27 weekly rate is the lower of £123.25 and 80% of average weekly earnings. For an absence shorter than a full week, pay is based on sick qualifying days divided by qualifying days in that week, not calendar days divided by seven. The HMRC calculation guide gives the method.
Example: sick pay follows qualifying days
Maya earns £400 a week and normally works Monday to Friday. Her 80% earnings figure is £320, so the lower weekly SSP rate is £123.25. If she is sick Monday to Wednesday, the calculation is 3 ÷ 5 × £123.25 = £73.95, assuming she qualifies. It is not three calendar days divided by seven. Use the SSP calculator for your work pattern.
Ill-health dismissal can be lawful, but an employer should consult, assess the evidence available, consider a likely return and possible adjustments or alternative work, and follow a fair process. Dismissal because of something arising from disability may also need justification under section 15 of the Equality Act. See dismissal because of illness and the SSP guide.
Do not wait for an OH follow-up or a grievance to protect a tribunal deadline. Notify Acas within the applicable limit if you are considering a GB claim; timely early conciliation pauses the clock. The 2026 tribunal and 2027 unfair-dismissal changes described here are GB employment-law changes, not a statement of Northern Ireland tribunal deadlines. See how to bring a tribunal claim.
Occupational health: employee rights questions
Can I refuse an occupational health referral?
Yes. You can also attend but decline permission to share the OH report. Explain any objection and suggest a narrower or more accessible assessment. Your employer may still decide on the evidence it has; a refusal does not end its safety or disability duties.
Is occupational health the same as HR?
No. Occupational health gives medical advice about work and health. HR handles the employer’s workplace process. The employer decides what action to take, but paying for the assessment does not entitle HR to your complete medical file. It should receive only the information needed for the work decision.
Will my line manager see my diagnosis?
Not routinely. They should receive what they need to manage work and adjustments. Some clinical detail may be necessary in a particular case. OH consultation notes and the full medical record are not automatically shared.
Do I get paid for an occupational health appointment?
Check your contract and OH policy. There is no general stand-alone right to paid appointment time. But an unpaid, inaccessible or badly timed appointment that disadvantages a disabled worker can raise a reasonable-adjustments issue, as Acas explains. Ask whether you can attend during work time and whether travel costs are covered; neither is automatically guaranteed.
Can I be dismissed if I refuse OH?
Refusal alone does not settle whether a dismissal is fair. The employer must consider the information available, consult where appropriate and address safety and disability obligations. Ordinary unfair dismissal protection also depends on employee status and qualifying service.
Can I ask for my OH file?
Yes. Make a subject access request to the provider holding the clinical record, and to your employer for what it holds. If the provider is an independent controller, it must deal with requests for its own file.
Sources
- Occupational health assessments, Acas
- Getting a doctor’s report, Acas
- Access to Medical Reports Act 1988, legislation.gov.uk
- Access to Personal Files and Medical Reports (NI) Order 1991, Part III, legislation.gov.uk
- Equality Act 2010, section 60, legislation.gov.uk
- What if we use occupational health schemes?, ICO
- Health surveillance overview, HSE
- Work out Statutory Sick Pay manually, HMRC
- Employment tribunal time limits, Acas
- Employment Rights Act timeline update, GOV.UK
- Employee research Phase 1: Sickness absence, reasonable adjustments and Occupational Health, Department for Work and Pensions (published March 2023; fieldwork September to October 2020)