Keeping the workforce happy, healthy & safe
Knowing when to refer an employee to occupational health (OH) can feel like a grey area.
Refer too soon, and the employee may feel singled out. Wait too long, and valuable time is lost in supporting their health and helping them stay at work.
This guide outlines the key situations where a management referral is appropriate and provides practical steps to help you decide with confidence.
1. Understand the purpose of an OH referral
An occupational health referral is not about disciplinary action. It is about getting independent, clinical advice on how an employee’s health affects their ability to do their job, and what adjustments may help.
Referrals provide:
- Guidance on fitness for work
- Recommendations for adjustments
- Advice on return-to-work timelines
- Support for employers in meeting legal duties (e.g. Equality Act)
2. Common triggers for a management referral
Consider a referral when you see one or more of the following:
- Repeated short-term absences (e.g. three or more in six months)
- Long-term sickness absence (usually four weeks or more)
- Concerns about fitness for specific duties (e.g. safety-critical tasks)
- Ongoing health issues impacting attendance or performance
- Return-to-work planning after significant illness, surgery, or injury
- Mental health concerns where independent advice would support both employer and employee
- Workplace adjustments are needed but it’s unclear what is appropriate.
3. Questions to ask yourself before referring
A quick self-check can help you decide:
- Has the employee’s health issue lasted longer than expected?
- Are performance or safety concerns linked to health?
- Am I unsure what reasonable adjustments might help?
- Would independent advice give me and the employee more clarity?
If the answer is “yes” to any of these, a referral is usually the right step.
4. Talk to the employee first
Always involve the employee in the decision. Be clear that:
- The referral is about support, not discipline.
- They will have a say in the process and must give consent.
- The report focuses on work-related recommendations, not personal medical history.
5. Make the referral clear and specific
The more focused your referral questions, the more useful the report will be.
- You need directly ask the questions you need answered.
- Be open and transparent.
- Give the background to the reason for the referral.
- Outline the physical and mental demands of the job.
- Include any adjustments you have made so far.
- Consider outlining the impact that the absence or performance has on the business and/or the team.
6. Act on the advice
Once the occupational health referral is complete and you have the report:
- Review the recommendations carefully.
- Discuss them with HR and the employee.
- Agree on reasonable adjustments or a return-to-work plan.
- Keep communication open with the employee – especially if the condition is ongoing.
Quick checklist: When to refer to Occupational Health
- Repeated or long-term absence
- Health concerns affecting performance or safety
- Unclear on appropriate workplace adjustments
- Return-to-work after serious illness or injury
- Mental health concerns that need independent support
If you’re unsure whether to make a referral, it’s usually better to act sooner rather than later. Early involvement of occupational health can prevent long-term absence, protect employee wellbeing, and give you clear guidance as an employer.
Want to know more?
For a full overview, see our Management Referrals page.
Make a Management Referral
Download or complete the Management Referral form below.
If you would like help with completing one of our forms please go to our How to Complete a Management Referral page for guidance.
If you would like advice on how best to complete the referral please call us on 01225 809099 to discuss your case with us. We believe this will ensure you can get the support you require and can achieve a clear and transparent process for all involved.
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