Does an Employer Have to Follow Occupational Health Advice?

An Occupational Health report might recommend reduced hours, a phased return, changes to duties, additional breaks or a different working arrangement.

Sometimes those recommendations are straightforward to put in place, but there will also be occasions when a manager looks at an Occupational Health recommendation and thinks it simply will not work for the business.

So, does an employer have to follow Occupational Health advice? Not automatically. Occupational Health provides medical advice to help an employer make an informed decision, but it does not make the decision for the employer. Acas confirms that it is for the employer to decide whether Occupational Health recommendations are put in place, taking account of both the needs of the organisation and its legal obligations.

That does not mean an employer should simply disregard advice it does not like. The report needs to be properly considered, particularly where the employee may be disabled and the recommendations could amount to reasonable adjustments.

Is Occupational Health Advice Legally Binding?

Occupational Health recommendations are not generally instructions that an employer is legally required to implement exactly as written.

The purpose of Occupational Health is to provide specialist advice about the relationship between an employee's health and their work. This might include whether they are fit to work, how their condition affects them at work, whether adjustments could help or what support may assist with a return following sickness absence.

The employer then needs to consider that information alongside the requirements of the employee's role and the circumstances of the organisation.

This distinction matters because Occupational Health may understand the employee's medical position but will not necessarily have the same detailed understanding of how a particular team, service or job operates.

Can an Employer Ignore Occupational Health Advice?

There is an important difference between deciding not to follow an Occupational Health recommendation and simply ignoring it.

An employer may properly consider a recommendation and conclude that it cannot reasonably be implemented. That decision should be based on the circumstances of the employee, their role and the organisation rather than simply because the recommendation is inconvenient.

Ignoring the report altogether is much harder to justify, particularly where it contains relevant information about a disability, possible reasonable adjustments or the employee's ability to carry out their role.

Employers should be able to show that the advice was considered, even if the eventual decision was to take a different approach.

Can an Employer Reject an Occupational Health Recommendation?

Yes, there may be circumstances where an employer decides that a particular recommendation cannot reasonably be accommodated. For example, Occupational Health might suggest changing someone's working hours, removing a particular duty or allowing them to work from home.

The manager may know that the role requires attendance at particular times, that a significant part of the job involves the duty Occupational Health has suggested removing or that the work genuinely cannot be carried out remotely.

That does not necessarily mean Occupational Health was wrong to suggest the adjustment. Its role is to identify something that may help the employee from a health perspective. The employer's role is to decide whether it can actually be implemented in the workplace.

Does an Employer Have to Follow Occupational Health Recommendations About Reasonable Adjustments?

This is where employers need to be particularly careful. If an employee is disabled for the purposes of the Equality Act 2010, the employer has a legal duty to make reasonable adjustments where the duty applies. What is reasonable will depend on the individual circumstances.

An Occupational Health recommendation may provide useful evidence about adjustments that could reduce the disadvantage experienced by the employee, but Occupational Health does not ultimately decide whether an adjustment is legally reasonable.

The employer needs to consider factors such as whether the adjustment would be effective, whether it is practical, its impact on the organisation and any health and safety implications.

An employer does not have to make an adjustment that is unreasonable. However, rejecting one suggested adjustment should not necessarily end the conversation. There may be another way of achieving the same objective.

Can Occupational Health Decide if Someone Is Disabled?

Occupational Health may give an opinion on whether an employee's condition is likely to meet the definition of disability under the Equality Act 2010. That opinion can be helpful, particularly because Occupational Health may have information about the nature, duration and impact of the employee's condition.

But whether somebody is legally disabled is ultimately a legal question rather than something an Occupational Health practitioner can conclusively determine. Employers should therefore be cautious about treating a sentence in an OH report as a definitive answer either way.

If the available information suggests that the employee may be disabled, it will usually be sensible to consider the employer's obligations on that basis rather than dismissing the issue simply because the report does not give a definite answer.

What If Occupational Health Recommends Reduced Hours?

Reduced hours are a common Occupational Health recommendation, particularly during a phased return to work. The employer should consider what Occupational Health is trying to achieve. A temporary reduction in hours may allow someone to rebuild their capacity following a period of sickness absence rather than immediately returning to their full working pattern.

The practical arrangements still need to be discussed. How long are the reduced hours recommended for? Will they gradually increase? Which duties will the employee complete during those hours? When will the arrangement be reviewed?

A recommendation for reduced hours does not mean an employer has to agree to an indefinite reduction without considering how the role will be covered. A clear review point can be particularly useful where an adjustment is intended to be temporary.

What If Occupational Health Recommends Working From Home?

Again, the recommendation needs to be considered rather than automatically accepted or rejected. The employer should understand why homeworking has been suggested and what problem it is intended to address.

If the employee can carry out their role effectively from home and the arrangement would remove or reduce a disability-related disadvantage, that may be relevant when considering whether it is a reasonable adjustment. For another role, regular physical attendance might genuinely be necessary.

Rather than simply saying that the organisation does not normally allow homeworking, the employer should look at the particular employee, their role and the reason the adjustment has been recommended.

What If an Occupational Health Recommendation Is Not Clear?

Ask for clarification. An OH report is much more useful when the employer understands what is being recommended, why and for how long. For example, a report might say that an employee would "benefit from reduced workload" without explaining what that means in practice.

Does that mean fewer hours? Fewer cases or customers? Removal of particular duties? Different targets? Is it temporary or expected to be long term?

Rather than trying to interpret a vague recommendation, it may be appropriate to go back to Occupational Health with further questions, subject to the appropriate consent and referral arrangements.

Good Occupational Health referrals also help prevent this problem. The questions asked should relate to the decisions the employer actually needs to make.

Should an Employer Discuss the Occupational Health Report With the Employee?

Yes, the report should normally form part of a conversation rather than being treated as a decision in itself. The employee may be able to explain which recommendations they think would help, how their condition affects particular parts of their job and whether there are other options that could work.

The manager can also explain any genuine operational concerns. That discussion may result in an alternative that works for both sides.

For example, the exact adjustment recommended by Occupational Health may not be workable, but a slightly different change might provide similar support without creating the same operational difficulty.

What If the Employer Disagrees With Occupational Health?

An employer does not need to pretend that a recommendation is workable when it genuinely is not. What matters is how the employer reaches that conclusion.

There is a significant difference between properly considering a recommendation and deciding, for clear reasons, that it cannot reasonably be implemented, and simply ignoring the report because the recommendation is inconvenient.

Managers should be able to explain what they considered, what discussions took place with the employee, why a recommendation was not adopted and whether alternatives were explored. This becomes particularly important where disability and reasonable adjustments are involved.

Can an Employer Choose a Different Adjustment?

Potentially, yes. The aim should be to understand the difficulty the employee is experiencing and consider what reasonable steps could remove or reduce that disadvantage.

Sometimes the exact recommendation made by Occupational Health will be the most sensible solution. In other cases, the employer and employee may identify a different adjustment that achieves a similar result and works better operationally.

Employers should avoid becoming so focused on whether one particular recommendation can be implemented that they stop looking at the underlying problem.

What If Occupational Health Says an Employee Is Fit to Return to Work?

A statement that someone is fit to return does not necessarily mean they should immediately return to every aspect of their role without support.

The report may say that the employee is fit to return subject to adjustments, a phased return or temporary restrictions. Employers should read the report as a whole rather than focusing on one sentence.

The employee's circumstances may also change, particularly if some time passes between the assessment and their actual return.

What If Occupational Health Says an Employee Is Not Fit for Their Role?

This does not automatically mean the employee should be dismissed. The employer will usually need to understand the prognosis, whether the situation is temporary or long term, what adjustments have been considered and whether there are other realistic options.

Depending on the circumstances, that might include further medical advice, reasonable adjustments, a phased return, changes to duties or consideration of suitable alternative work.

Where continued employment genuinely does not appear possible, an employer may eventually need to consider a capability process. That decision should be based on the wider circumstances and a fair process, rather than treating the Occupational Health report itself as the decision.

What Should Employers Do After Receiving an Occupational Health Report?

Start by reading what Occupational Health has actually said rather than jumping straight to whether you agree with the recommendations.

Consider the medical advice alongside what you know about the employee's role and discuss the report with them. If something is unclear, seek clarification rather than making assumptions.

Where adjustments have been recommended, consider whether they are workable and whether the employee may be disabled under the Equality Act. If a particular recommendation cannot reasonably be implemented, record why and consider whether there are other ways to provide support.

Occupational Health is there to help employers make better-informed decisions. It does not remove the employer's responsibility for making them.

Need HR Support?

Occupational Health reports can be extremely useful, but knowing what to do with the recommendations is not always straightforward.

BloomHR can support small businesses with sickness absence, reasonable adjustments, Occupational Health referrals and capability issues, helping managers understand the advice they have received and decide on appropriate next steps. Contact us for more information.