Whether it is about yourself or an employee we only need hear about a health matter if it has an adverse effect on someone’s ability to do their job safely and effectively. Many people living with a health condition are able to practise safely and effectively with or without adjustments. If a health condition is being managed appropriately then we don’t need to hear about it.
When might health be an impairment?
A health condition (which includes an addiction to drugs or alcohol) could have an adverse effect on a person’s ability to do their job safely and effectively. For example, where the worker’s reasoned decision making, thinking and/or behaviour are affected or where there is a physical symptom that means they cannot carry out their role safely and effectively.
Managing a health condition
We would expect workers to manage health conditions by:
- being open and honest with their employer about their condition and any limitations they may have
- complying with any recommended steps to manage the condition.
This might include where the worker:
- has shown good insight into the extent and effect of their condition
- is taking appropriate steps to access treatment and following advice from their treating health professionals
- is receiving support from occupational health through the employer
- is managing his or her practice appropriately, for example by taking sick leave.
Employers are still responsible for meeting their duty of care to their worker and people who use services. You should not refer to us until you have concluded your normal employment procedures unless you believe the worker presents an immediate risk, including to themselves.
Here are some examples of certain health conditions that might mean fitness to practise is impaired (this is not a complete list):
- periods of unconsciousness or blackouts
- serious memory loss
- inability to control anger or other emotions
- reduced ability to make decisions
- inability to carry out certain physical tasks
- lack of self-awareness and impact of behaviour on others
- lack of concentration
- alcohol and substance addiction
- a serious communicable disease.
Long term untreated (or unsuccessfully treated) or unacknowledged physical and mental health conditions will be of particular concern if they suggest a risk to public protection.
Short term illnesses and conditions related to pregnancy should be managed by the employer and should not usually be referred to us.
Here are some examples of when to refer a health matter to us or not
Example: Health (alcohol dependency)
A registered residential child care worker has told you that she suffers from alcohol dependency but her addiction is under control and she is attending counselling sessions.
The worker is managing her health condition and you are satisfied that she has insight and an understanding of the impact that her alcohol dependency could have on colleagues and people who use services. You and the worker discuss the worker’s progress and the stability of her condition at regular supervision sessions. The worker has never attended work under the influence of alcohol and you have no concerns regarding the worker’s practice.
You do not need to tell us about it as the health condition is being managed.
However, due to personal circumstances the worker starts to consume alcohol again, attends work and attempts to provide care to people using the service while she is under the influence of alcohol. On realising that the worker is under the influence of alcohol you ask the worker to go home. The worker is suspended.
You should now tell us about the worker’s impaired fitness to practise.
Example: Health (severe back pain)
A registered support worker in a care at home service for adults tells you that she has been experiencing back pain for some time. She now finds it very painful to undertake moving and handling of people who use services or to carry out the majority of the personal care tasks which her role requires.
An occupational health assessment confirms the worker’s back pain is severe. Continuing to carry out some tasks presents a high risk of damaging the worker’s back further. You consider any adjustments that can be made to allow the worker to continue to carry out her role, including whether a colleague can assist with moving and handling and personal care. However, the care service is quite a small service and anyone assisting would be carrying out the majority of the worker’s role. As you cannot make adjustments to allow the worker to continue carrying out her role safely and effectively, the worker is dismissed on the grounds of capability due to health.
You should tell us about this at dismissal.