HR Connect

• Urgent referrals for cases such as terminal illness or other serious illness.
• Long-term absence: when the employee has been absent for 29 days or more and advice is needed on likely return, rehabilitation, or adjustments. Not all absences of 29 days or longer require an automatic referral. Managers should consider whether Occupational Health input is necessary, for example where there is a clear recovery period or return-to-work timescale and no additional advice is required.
• Frequent short-term absence: where there are patterns of absence or an underlying health condition is adversely affecting work or health. Not all short-term absence cases require referral. Please see the section When a management referral may not be appropriate
• Patterns of work-related absence that are directly attributable to the workplace.
• Consideration of ill-health retirement or redeployment: this should be discussed with HR and the employee before referral. Ill-health retirement applies only if the employee has been in the pension scheme for at least two years, is permanently unable to work, and all reasonable adjustments have been considered. Occupational Health cannot advise on health-related termination but can provide guidance on long-term fitness for work to support management and HR decision-making in line with the attendance management policy.
• Significant underlying health issues affecting workplace performance or attendance.
• Mental health problems, such as severe anxiety, depression, or similar concerns affecting work.
• Significant psychological distress linked to traumatic events in the workplace or formal workforce processes, such as witnessing a traumatic incident at work, experiencing harassment, or being involved in an investigatory process, where there are concerns about the impact on health, wellbeing, attendance, or work performance.
• Changes in workplace behaviour: such as altered appearance, inconsistent attendance, or concerns about possible alcohol or substance misuse. This should first be addressed by the manager through discussion with the employee. If the employee is unable to provide a reasonable explanation, referral to Occupational Health may be appropriate.
• Neurodivergent conditions, including dyslexia, ADHD, and autism. Reasonable adjustments may include changes to the working environment, flexible working arrangements, and tailored support strategies. These can often be agreed jointly with the individual and line manager at a local level. Support is available through Access to Work. Further guidance is available via Supporting and Working with our Neurodivergent Colleagues – NHSGGC diverse workspace. Complex cases may require Occupational Health support.
• Menopause and women’s health: reasonable adjustments can be agreed jointly at a local level in line with the Menopause and Menstrual Health Policy | NHS Scotland. Additional supporting information and guidance for managers is available via Women’s Health – NHSGGC and The Menopause – National Wellbeing Hub. If significant concerns remain following the implementation of adjustments, a referral to Occupational Health can be submitted for further advice.
• Work-related stress where local measures to reduce or resolve the stressors have already been explored and the stress is affecting health or exacerbating a pre-existing condition. Please see When a management referral may not be appropriate for more information.
• Musculoskeletal conditions where the employee is absent, or at risk of absence, due to a work-related musculoskeletal problem, or where the employee has sustained a musculoskeletal injury following an accident or injury at work. Please see When a management referral may not be appropriate for details of the self-referral process to physiotherapy.
• Formal workforce policy support where the employee is at Stage 3 of the Attendance Policy or requires support through formal NHS Scotland Workforce Policies.

Managers are responsible for considering and exploring reasonable adjustments with the employee in line with the Equality Act 2010 and NHSGGC Reasonable Adjustment Guidance. Employers have a legal duty under the Equality Act 2010 to consider and make reasonable adjustments where a disabled employee would otherwise be placed at a substantial disadvantage. Adjustments should be discussed at the earliest opportunity and tailored to the individual to remove or reduce disadvantage at work.

In many cases, managers can identify and implement adjustments locally, for example to duties, hours, work patterns, the working environment, or support arrangements. Please refer to the NHSGGC Reasonable Adjustment Guidance, Reasonable Adjustments for staff with disabilities or long-term conditions – NHSGGC, for detailed information on what may be appropriate, how decisions should be recorded, and the wider support available.

Referral to Occupational Health should be made where further assessment or specialist advice is required, for example where the impact of a health condition on work is unclear, where complex restrictions or adjustments may be needed, or where advice is required on fitness for work. Occupational Health provides independent advice to support management decision-making but does not replace the manager’s responsibility to explore and implement reasonable adjustments where appropriate.

If you are only seeking to refer a staff member for talking therapy or counselling, please advise the staff member to self-refer via email or telephone 0141 277 7623.  If you have the staff member’s consent to refer them for talking therapy or counselling, please make the referral on their behalf using email.

If, as the manager, you also require advice regarding fitness for work, adjustments, or other health and work concerns, please submit a management referral and note this within the background to the referral. During the assessment, the clinician will make any necessary arrangements for assessment with the Occupational Health Psychology and Wellbeing Service

In all cases, a talking therapy element will remain confidential and no feedback via a report will be available to the manager. Further information and additional mental health and wellbeing resources can be accessed via Mental Health and Wellbeing – NHSGGC.

Employees can self-refer to the Occupational Health Physiotherapy Service for treatment and advice using the self-referral form. If, as a manager, you also require advice regarding fitness for work, adjustments, or other concerns, please submit a management referral. Further information is available for the occupational health physiotherapy service.

Work-related skin problems should be referred via the Skin Health Surveillance process. Please do not submit a management referral.

Instead email the completed skin health surveillance questionnaire directly to our the service.

If urgent advice is required regarding a skin problem please direct the employee to contact Occupational Health by phoning 0141 201 0594 or by email.

Managers should first follow the Stress in the Workplace guidance. Further advice can also be sought from Health and Safety, HR, and Occupational Health. Where an employee reports a health condition caused or worsened by stress, a referral to Occupational Health may be appropriate.

If a referral is required, managers should detail the steps taken locally to address the reported work issues, outline any considered or agreed actions, and include a copy of the agreed risk assessment actions.

Frequent short-term absence does not automatically require a referral to Occupational Health unless there are patterns of absence or an underlying health condition is adversely affecting work or health. If no clear link is identified, managers should discuss the absence pattern with the employee and ask whether there is an underlying health condition contributing to the absence.

If the employee does not identify a specific health condition, this should be documented and managed in line with the current attendance management policy. Self-referral or management referral to Occupational Health can be considered if the employee wishes to discuss a health issue that they do not want to raise with their manager.

If an employee is experiencing non-work-related stress or bereavement, the details of the Occupational Health Psychology and Wellbeing Service can be given to the employee with advice to contact the service if additional support is required.

Managers should also consider temporary adjustments that may support the employee. Long-term absences of more than 2 months may be referred to Occupational Health if further advice is needed.

If an employee is pregnant and does not have any current health concerns, managers must first carry out a workplace risk assessment, as required by law. This assessment should specifically consider any risks to new and expectant mothers and must be regularly monitored and reviewed throughout the pregnancy.

Managers should ensure the risk assessment process is completed and maintained as the primary step. Detailed guidance on this process can be found via Maternity Policy Guide for Employees | NHS Scotland

Referral to Occupational Health may be appropriate if there are significant health concerns related to the employee’s work or if there are changes in health that may affect their ability to work safely.

If an employee is preparing to return to work soon, managers can first discuss the situation with them directly. If there are concerns about residual symptoms that may affect their ability to perform their usual duties, managers should consider whether temporary modifications or restrictions to the role are possible.

A phased return can help support a smoother transition back to work. The Once for Scotland policy allows for a four-week phased return on full pay without requiring the use of accrued leave. It may also be helpful to break up the working week, for example by scheduling non-consecutive working days, and gradually increase the employee’s hours until they return to their contracted hours.

In some situations, extending the phased return may better support the employee, and accrued annual leave could be used to prolong reduced hours after the initial four-week period. Any phased return plan should be discussed with the employee before they return, taking account of any necessary adjustments to duties.

Discuss this with the employee before submitting the referral.

Consider and document relevant local measures before referral or contact Occupational Health if unsure.

Consider and document relevant local measures before referral or contact Occupational Health if unsure.

Clarify the concern through discussion and local review or contact Occupational Health to discuss before referral.

If you are unsure whether referral is needed, contact Occupational Health to discuss before submitting.

Manage locally and keep the situation under review. Contact Occupational Health if circumstances change or advice is required.