Occupational Health
Process Explained
Referrals, Reports & Rights. A step-by-step guide to how medical fitness is assessed and what it means for your career.
Trust Notice: Based on Police Regulations 2003 & Home Office Guidance. Independent explanatory guidance.
Executive Summary
Occupational Health is a risk management tool, not a disciplinary body.
The Essentials
- Advisory Only: OH advises on fitness; they do not make the final command decision.
- Confidentiality: Clinical details stay with OH clinicians unless you consent; your force receives a report on fitness, adjustments and likely return.
- Outcomes: Can range from full fitness to restricted duties, or referral for ill-health retirement.
What Is Occupational Health?
Occupational Health (OH) is your force's occupational health service, run in-house or by a contracted provider. Home Office statutory guidance says it has a role both in giving advice to managers to help them take decisions and in supporting officers who ask for its help (para 19.36), and that managers make the decisions, informed by that advice (para 19.39). It sits between the medical world (your GP/Specialists) and the operational world (your Force), but it reports to the force, not to you alone.
It Does Not
- Discipline officers
- Dismiss officers
- Make misconduct decisions
It Does
- Assess fitness for role
- Advise on adjustments
- Risk manage health issues
The Referral Process
Referral Initiated
Referral is usually triggered by HR or Line Managers due to:
Appointment Scheduled
You will attend an assessment, either in person or virtually. This is with an OH Nurse or Physician. They will review your history and current condition.
Medical Assessment
A clinical evaluation of your capacity to work. They may ask for consent to write to your GP or specialist for more information.
Report & Recommendations
A report is issued to management. Ask whether you can see it before it is sent. It answers: "Is the officer fit?" "Are adjustments needed?" "Is this likely to be permanent?".
What Does The Report Say?
The report does not normally disclose private medical details (such as "the officer discussed childhood trauma"). The ICO says release of medical information to non-medical staff generally needs your explicit consent, with limited exceptions such as a legal duty or a serious risk to others. See what OH can share with your force.
Standard Report Sections:
Fitness Outcomes
Fit For Full Duties
Officer can deploy fully. No medical barriers to operational policing.
Recuperative / Adjusted Duties
Officer can work but with limitations (e.g. office hours, non-confrontational). The Home Office Annex EE determination calls a time-limited return after illness "recuperative duties" and longer-term duties with workplace adjustments "adjusted duties". The force decides, taking OH's advice into account.
Temporarily Unfit
Total inability to work for a defined period (sick leave). Review expected.
Permanently Unfit
OH's view that you are unlikely to regain fitness for ordinary duties. The force may then refer the medical questions to an SMP; retirement is not automatic (see below).
OH vs SMP
Occupational Health
Advisory
Day-to-day management of health. They suggest adjustments and support. They can advise the force that an SMP referral may be appropriate if permanence is suspected; the police pension authority makes the referral.
Selected Medical Practitioner
Statutory
The doctor who answers the medical questions for Ill-Health Retirement: whether you are unfit for the ordinary duties of a police officer and for any regular employment, and whether that is likely to be permanent (Police Pensions Regulations 2015, reg 81). The police pension authority then decides whether to require you to retire or to continue to serve (reg 82). SMP decisions can be appealed within 28 days.
Been referred to an SMP? The printable SMP appointment checklist lists the papers to gather and the questions to ask beforehand, and the SMP process guide explains what the report decides.
Retirement Forecast
If OH has mentioned "permanent unfitness", it helps to know what an ill-health pension would pay before any SMP decision.
Ill-Health Retirement Calculator →For your ordinary pension at normal pension age, see how much your police pension will be.
Mental Health
OH frequently handles cases of Stress, PTSD, Anxiety, and Depression.
If your condition followed trauma on duty, make sure the incident is recorded: it may matter later for an injury award, which is decided by an SMP if you leave. OH may recommend:
- Trauma Therapy (CBT/EMDR)
- Phased Return Plans
- Redeployment
- TRiM Referral
OH is one route to support, and it reports to your force. There are also confidential routes that are separate from your force, such as the Oscar Kilo crisis line, Samaritans and your GP: see the police mental health support services directory and officer suicide data and support resources.
Frequently Asked Questions
Can occupational health dismiss you?
No. Occupational Health advises; managers decide. Home Office statutory guidance says managers are responsible for decisions about the officer, informed by professional advice including OH (para 19.39). Dismissal for attendance can only follow the unsatisfactory attendance procedure under the Police (Performance) Regulations 2020, and ill-health retirement is decided by the police pension authority after a selected medical practitioner (SMP) has answered the medical questions.
What happens if OH says I’m permanently unfit?
OH's view is advice, not the decision. If permanent unfitness is in question, the police pension authority must refer the medical questions to a Selected Medical Practitioner (SMP) before considering retirement (Police Pensions Regulations 2015, regulation 81). If the SMP finds you permanently unfit, the authority, after considering all the circumstances including your input, may require you to retire or may require you to continue to serve (regulation 82). You can appeal the SMP's decision within 28 days of receiving the report.
Can I refuse occupational health?
You cannot be physically made to attend, but Home Office guidance says that where the force must carry out a risk assessment, officers can be required to cooperate with occupational health (para 19.37). If you do not attend, managers will make decisions on the limited information they have, which may not work in your favour. Whether declining could become a conduct matter depends on the circumstances, so speak to your Federation or staff association rep first.
Does OH affect misconduct?
OH can provide evidence of mitigation (e.g., if a medical condition contributed to behavior). However, a medical condition does not automatically stop misconduct proceedings. The two processes often run in parallel.
How confidential is the process?
OH clinicians owe you a duty of confidence, and the ICO says OH should, as far as possible, hold your medical information and tell managers only the results of the assessment; releasing medical details to non-medical staff generally needs your explicit consent. OH is not secret in the way a crisis line is, though: its job is to write a report to your force on fitness, adjustments and likely return. Ask what will go in it and whether you can see it first.