Occupational Health Consultancy Insurance

This profession's structural difficulty is that a single report serves an employer who is paying and an individual who is affected, and the two frequently want opposite conclusions.

An employer wants a clear answer: fit, not fit, fit with adjustments, likely return date, work related or not. An individual wants their condition understood, their job protected, and their clinical information kept private. A report that is useful to the employer can feel like a betrayal to the individual, and a report that protects the individual can feel evasive to the employer. Complaints come from both directions, and in a dismissal or a tribunal the report is read line by line by people looking for something.

So the discipline is scope and precision. Answer the question that was asked rather than the one that was implied, express opinions as opinions with the basis stated, distinguish clearly between what the individual reported, what was observed, and what is concluded, and avoid clinical detail the employer does not need in order to act. Record the consent position: what the individual agreed could be shared, and whether they saw the report first where that applies. A report that is precise about its own limits is defensible from both sides.

Most fitness for work opinions carry employment consequences. A few carry consequences for other people, and those deserve a different level of care.

Driving, working at height, operating plant, rail safety critical roles, confined space work, and roles requiring an emergency response all depend on an individual's fitness in a way an office role does not. An opinion that somebody is fit for a safety critical role, where a condition or a medication then contributes to an incident, is examined against what was asked, what was disclosed, what was tested and what guidance applied. The individual may have had a reason not to disclose something, and the employer may not have described the role accurately.

So the inputs matter as much as the opinion. A written description of the actual role and its demands rather than a job title, specific questions about the relevant functions, the applicable standard or guidance recorded, tests appropriate to the role rather than generic, and a clear statement of any limitation or review interval. Where information is incomplete, say so and qualify the opinion rather than giving an unqualified one. And where an individual declines to disclose or consent, record the position rather than assuming.

Health surveillance failures are advisory failures about design rather than about any individual appointment.

Surveillance exists to detect early signs of conditions caused by work: hearing loss, hand arm vibration syndrome, occupational asthma, dermatitis, and effects of silica, lead or solvents. Designing a programme means deciding which groups are in scope, what to monitor, at what frequency, and what to do with a result. A programme that excluded an exposed group, monitored the wrong thing, ran at too long an interval, or had no effective route for acting on an abnormal result will fail to catch a developing condition, and the person affected ends up worse off years later with a claim against their employer.

So the design reasoning needs recording and revisiting. Which exposure groups were identified and on what basis, the frequency chosen and why, what an abnormal result triggers and who acts on it, and a record that results were actually communicated and acted upon rather than filed. Where an employer declines to include a group, reduce a frequency or act on a recommendation, that refusal in writing is the defence. Restate outstanding recommendations at each cycle rather than carrying them silently, exactly as in compliance consultancy.

Occupational health providers hold health information about people who are not their clients, which makes the data exposure sharper than in most consultancies.

Files contain medical histories, GP and specialist correspondence, test results, medication, mental health information and disclosures made in confidence, about individuals who were sent by an employer. Health data is special category data. A breach does not expose commercial information; it exposes somebody's diagnosis to people who should never see it, including potentially their manager and colleagues, and the affected individuals have no relationship with you as a client.

So the controls need to match the sensitivity. Multi factor authentication without exception, strict separation between clinical records and the reports released to employers, care with distribution because a misdirected report is the classic failure, access limited to clinical staff rather than available across an organisation, retention periods applied and records destroyed when they expire, and particular care where surveillance records must be retained for decades. Then check the cyber wording on special category data and on the cost of notifying affected individuals, because those people are not the client who bought the policy.

Two parties can complain about one report. We are an FCA regulated broker and will not tell you we are the best choice. These are the questions that decide it.