GP vs OH.  Know what you're getting.
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GP report vs OH report

So you have an employee who is absent with a long term ill health condition. As the manager you wonder what the future looks like for the employee. What is their prognosis? When are they likely to be able to return to work? Will they be able to do their job in full when they return? Will adjustments be needed at the workplace? Basically, you need medical advice.

As an employer, there are generally two avenues to go down in order to get a doctor’s advice when an employee is absent or suffers from ill health at work. Either you write to the employee’s GP or NHS specialist or you send them to see an Occupational Health Physician (OHP) or Nurse. Which option should you choose? It helps to understand what you can expect from the GP versus the OHP.

Writing to the GP

Anyone can write to the GP for clarification on the employee’s medical situation but the employee must first give their consent for you to do so. As part of the consent, the employee can ask to see the GPs report before it is sent to the employer. At this point, the employee has the right to withdraw their consent to share the medical information.

1-3 months wait time

Once you have the employee’s permission to contact the GP, you outline what it is you require clarification on. This could be, for example, “How long is recovery likely to take?” Once the GP clinic receives your letter, they will usually take anywhere from 1 to 3 months to write their reply. If the employee has asked to see the report first, there will be added delay whilst this is arranged.

The GP will charge a fee for writing a report and the amount will depend on the doctor’s surgery. Usually this is somewhere around £100. The report you receive should explain the nature of the illness, the current treatment and the prognosis. The details may vary depending on what questions you’ve asked the doctor to answer.

Getting an OH professional to write to the GP

Many OH providers recommend writing to the GP in cases of long term illness, where medical information from the treating doctor is useful. In that case the OH clinician will obtain consent from the employee to write to the GP and the resulting GP report will be sent to the OH clinician, not to the employer. The OH provider will then interpret the medical information and provide a management report that should provide specific advice about the employee’s fitness to work in light of the new information.

The pros…

The benefit of this approach is that the medical professionals can share medical information that may not mean much to a layperson. The OH professional will also be able to give more definitive advice on work related questions since their expertise lies in occupational medicine.

And the cons…

The downside is that it takes even longer – although the added wait is usually just a few days rather than weeks – and there is an added fee. You also will not be able to see the GPs report, which is addressed to the OH clinician only.

Ditching the GP

Usually the advice an employer gets from a GP is too little, too late. Of course, if you want confirmation about the treatment and timescales that the employee is reporting back to you, it can be useful to get this in writing from the doctor. However, the amount of time it takes to get a response means your opportunity for proactive early intervention is gone. What you could consider instead, is sending the employee to a private doctor or nurse who specialises in Occupational medicine to find out what work they can and can’t do.

The OH report will only answer the questions you ask

The first thing to bear in mind about OH referrals is that you will get answers to the questions you ask so if you haven’t asked the clinician to assess what adjusted duties the employee can undertake, don’t expect the report to tell you that. Also, if there are any differences in opinion between the employee and the employer, it is best that these are out in the open since the OH clinician can’t become your behind-the-scenes undercover spy. However, providing as much information about the medical history, job description, available adjustments and modifications will help you get better and more tailored advice about the case in your OH report.

The employee has the right to see the referral documents

Make sure that your employee knows why you are sending them to the OH clinic. They have the right to see any documents you share with the Physician so anything that is sent to the clinic should be clear to the employee from the outset. The employee must give their consent for the OH report to be released and they can choose to review the report before it is sent to the employer.

OH advice trumps the fit/sick note

The OH report may give different recommendation to what is on the employee’s fit / sick note. In that case, the OH advice trumps the fit note since it is based on a specialist medical opinion. If a GP has signed someone off work completely but the OH report suggests they are fit for modified duties, it is fine for the employer to bring that employee back to work. You should make sure appropriate risk assessment has been carried out before the employee returns to make sure it is safe to do so.

Consider the OH advice in light of your business

The recommendations or adjustments that the OH report gives are not always feasible to put in place. Each employer must consider the recommendations in light of each individual situation and make a decision on whether to implement them or not. Simply following the OH advice does not protect the employer from liability in terms of health & safety regulation or other legal obligations.

The bottom line

On the whole, OH reports are much easier to obtain than GP reports. It takes around 1-2 weeks to arrange an OH appointment and it usually takes 1-2 weeks after that to get the report back. These days, more and more of the consultations are held over the phone and then you can have a report within a week of referral. This is pretty awesome in terms of actually helping the employee recover as quickly as possible and supporting them back to work.

The cost of an OH report varies from about £150 to £400 or even more. If at the end, you’ve managed to help the employee return to work sooner, these costs are quickly absorbed and well worth it. On the whole, spending a little more money to have work specific advice much sooner seems like a no-brainer. Of course, in some cases the OH report will be inconclusive and may recommend writing to the GP for further information, too. Most likely, those are the cases that would end up becoming long term whatever action you took.

A third way: fit for work service

In the UK, employees and employers now have a third option: Fit for Work service. Employees can be referred to this service after they’ve been absent for 4 weeks or longer. They will have an OH assessment to produce a Return to Work plan. This service is free of charge. It is still new so the success of these interventions in reducing length of long term absence is being reviewed.


If you’d like more advice on Occupational Health or access to ad hoc OH services, get in touch.