What's occurin'?..........In an occupational health assessment (management referrals)
Employees being referred by their line manager and/or HR to occupational health are usually very unfamiliar with OH.
It is a speciality of health that is rarely encountered. Often health specialities are according to a part of the body; cardiology – heart, respiratory – mainly lower respiratory system, psychiatry – mental health, OH like general practice (GP) cover all aspects of health and wellbeing. A whole system framework, mental & physical and contextual, work, society & societal is active during the assessment.
Being referred can bring with it some worry. Having a little bit of insight into the likely topics, focus and questions asked will alleviate some of the worry.
Firstly of course the clinician will introduce themselves; detailing name and professional title – Dr, physio or Nurse as common examples.
Following this, is the need for x2 data checks of identity to match with the information on the referral form. Typically, I use date of birth and first line of address.
Explaining why the individual has been referred and questions being asked from the referral form allows for a clear purpose from the outset and so is essential.
The clinician broad assessment content:
Work; role content, hours, pattern, location, commute & other travel demands, equipment, physical environment, psychological environment, attitude, pressures, adjustments, relationships, sense of meaning and accomplishment.
Health; diagnosed ill health conditions, symptoms, establish variability of symptoms, treatments past, current, future.
Functional abilities relating to day to day living activities and work activities. This will cover physical, concentration, memory and emotion management domains.
Mental health assessment which may include suicide risk assessment, if referred due to mental ill or has long-term ill health symptoms such as pain or poor sleep. Discerning a sense of beliefs about their health status, abilities and limitations is attempted.
Social circumstances; friends, family support, lifestyle; eating, alcohol consumption, smoking, hobbies, exercise, dependents and out of work responsibilities.
Assessment of health may include using robust tools to assess symptoms from a particular ill health condition such as the fibromyalgia impact assessment questionnaire. If a face to face assessment observation of movement could be appropriate. If telephone based asking the individual to perform certain movements may also occur.
The clinician will always take an understanding, listening and empathetic approach, wanting the employee to find the experience supportive. Questioning is exploratory, enquiring to understand employee perception and fact. Clinical skill is used to respect employee boundaries, to know what requires further questioning and avoid distressing the employee.
The final stages of the assessment are to give an overview of the report content and offer advice to the employee. The guiding rule with the report content is “there should be no surprises” when the employee receives it. OH, will give the employee the opportunity to see the report before it is sent to the referring people/person and always a copy will be sent at the same time. On occasions I will actively encourage the employee to have sight of the report before it is sent. An explanation is given to the employee that factual errors can be considered for correction but clinical opinion and judgements cannot.
After the assessment the clinician may need to do research to explore the medical and health evidence base which directs opinion.
OH clinicians are always appreciative of the employee time and effort to engage in the OH assessment process.