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Competency 4 – Maintaining relationship with patients: Understand the role of health professionals in relation to the employee/patient

Objective: to ensure the appreciation of the professional position of the OH advisor, employer and employees

INTERACTION WITH OTHER HEALTH PROFESSIONALS

1. Ethics Guidance for Occupational Health Practice  2012 (Faculty of Occupational Medicine).

KNOWLEDGE

UNDERSTAND THE ROLE OF HEALTH PROFESSIONALS IN RELATION TO THE EMPLOYEE/PATIENT AND EMPLOYER.

Health professionals have an ethical duty to put the interests of individual employees/patients first. So, learning of a health risk to an employee, it is the responsibility of the health professional to protect the health of the employee even if this is to the detriment of the employer. However, the health professional also has obligations to the employer, the workforce in general and to the general public.

KNOW WHEN AND HOW TO INVOLVE OTHER PROFESSIONALS

All consultations between an occupational health advisor (either a nurse or a doctor) and an employee are principally confidential. In most cases the occupational health advisor will not need to notify other health professions of their consultations with employees. In some circumstances the occupational health advisor might wish to involve or communicate with the employee’s treating doctor. This is usually the general practitioner (GP) but could involve a hospital specialist and is normally done with the consent of the employee. Such circumstances would include:

  • Informing the treating doctor of work related facts which may have a bearing on the health of the employee.
  • Referring employees/patients with matters of general medical care. This might occur following a regular review or statutory medical. The duty of care of an OHP is to ensure that any medical issue that might affect the health and welfare of the employee is addressed appropriately.
  • Obtaining a medical report about an employee/patient from the treating doctor. This needs to be done in accordance with Access to Medical Reports Act 1988.

It is unusual for an occupational health advisor to refer an employee/patient to hospital/secondary care. Where such a referral occurs, vital relevant information about the employee’s history and current condition, including details of the working environment, occupational exposures and work requirements must be passed onto the referring doctor. This is in addition to notifying the employee’s/patient’s GP. It is not only as a matter of professional courtesy, but the GPs are principally responsible for clinical care of employees/patients and therefore must be informed.

The circumstances in which an OHP may refer to a hospital physician include the following:

  • Emergency, for example and employee suffering from acute chest pain whilst in work.
  • Independent opinion for employment purposes. 
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