Occupational Health Assessment UK: What to Expect, Questions & Your Rights

Updated: September 2026

An occupational health assessment is a work-focused health assessment that looks at how your health affects your job and how your job may affect your health. It can help an employer understand whether you are fit to work, whether temporary or ongoing adjustments may help, and what support could make a return to work safer and more sustainable.

If you have been referred to occupational health, it is normal to have questions. You may want to know what will happen, what the assessor will ask, whether your employer will see your medical information, or whether you can refuse the assessment.

This UK guide explains the process from both the employee and employer perspective, using current Acas, HSE, ICO, NHS and GOV.UK guidance.

Occupational Health Assessment: Quick Answers

What is it?	A work-focused assessment carried out by an occupational health professional or another suitably qualified healthcare professional.
Why might I be referred?	Common reasons include sickness absence, a health condition affecting work, return-to-work planning, concerns about workplace adjustments or questions about fitness for a particular role.
Can I refuse?	For an ordinary occupational health referral, a worker does not have to agree to the assessment. However, refusing may mean the employer has to make decisions using the information already available.
Will my employer see everything I say?	No. Occupational health information is confidential. The occupational health adviser must ask for your permission before sharing their assessment report with your employer.
Can occupational health contact my GP?	Sometimes, if more medical information is genuinely needed. You should be told why and asked for consent before a medical report is requested.
Is it the same as a fit note?	No. A fit note and an occupational health report are different documents. Occupational health focuses more specifically on your job, workplace and possible support.
Is it the same as health surveillance?	No. Health surveillance is a separate system of repeated health checks used where workers remain exposed to particular health risks at work.

In This Guide

What is an occupational health assessment?
Why have I been referred to occupational health?
What happens at an occupational health assessment?
What questions will occupational health ask?
How should I prepare?
Can I refuse an occupational health assessment?
Is occupational health confidential?
What will my employer be told?
Can occupational health contact my GP?
How do I get an occupational health assessment?
What is an NHS occupational health assessment?
What can the assessment recommend?
Reasonable adjustments
Occupational health assessment vs fit note
Assessment vs health surveillance
Guidance for employers and HR
Frequently asked questions

What Is an Occupational Health Assessment?

An occupational health assessment is a confidential, work-focused review of an employee’s health and ability to carry out their job.

Unlike a normal GP appointment, the main question is not simply: “What condition does this person have?”

Occupational health is more interested in questions such as:

How is the person’s health affecting their work?
Could the job be making the health problem worse?
Can the person carry out their role safely?
Would workplace adjustments help?
Would a phased return to work be appropriate?
Is further medical information or review needed?

The aim is usually to give the employee and employer practical information that helps them make sensible decisions about work.

Occupational health does not replace your GP, specialist or other treating healthcare professional. Instead, it looks specifically at the relationship between health and work.

Why Have I Been Referred to Occupational Health?

Being referred to occupational health does not automatically mean that your job is at risk or that your employer believes you are unable to work.

Employers use occupational health for many different reasons.

Long-term sickness absence

If you have been away from work for some time, an assessment may help identify what support could make a safe return possible.

Repeated short-term absence

An employer may want to understand whether an underlying health issue is contributing to repeated absences and whether workplace support could help.

A health condition affecting work

You may still be working but finding particular tasks, hours, environments or working arrangements difficult because of your health.

Return to work after illness, injury or surgery

Occupational health can consider whether you can return to normal duties immediately or whether a gradual return would be safer.

Mental health or work-related stress

Occupational health referrals are also used where stress, anxiety, depression or another mental health issue is affecting work or sickness absence.

Where work-related stress is part of the situation, employers should also consider the workplace factors contributing to the problem rather than relying only on individual support. Spark’s guide to employers’ duty of care for workplace stress in the UK explains this in more detail.

Questions about workplace adjustments

A manager or HR team may know that an employee needs support but require professional advice about what adjustments could be appropriate.

Safety-sensitive work

Where a role involves driving, operating machinery, working at height or another safety-critical activity, employers may need clearer information about whether a health problem could affect safe working.

What Happens at an Occupational Health Assessment?

The exact process depends on why you have been referred, your job and the occupational health provider. However, most assessments follow the same broad pattern.

Before the appointment

Your employer will normally send occupational health a referral explaining why advice is being requested.

A useful referral should describe:

your role and main duties;
the reason for the referral;
relevant absence or work concerns;
any known workplace risks; and
the questions your employer wants occupational health to address.

You may receive a questionnaire or information explaining the assessment and how your health information will be handled.

If anything about the referral is unclear, you can ask your employer or occupational health provider what the assessment is intended to cover.

During the appointment

The occupational health professional will usually discuss your health and how it relates to your job.

The assessment may be carried out face to face, by telephone or by video, depending on the reason for referral and the provider.

Acas guidance says an occupational health adviser may ask about your health, any treatment you are receiving and concerns you have about returning to work.

The discussion may also cover:

which parts of your job you can currently manage;
which tasks are difficult or make symptoms worse;
working hours, shifts or travel;
medication or treatment where relevant to work;
how long the problem has been affecting you;
whether you feel ready to return to work;
support you are already receiving; and
workplace changes that might help.

Some referrals may involve a physical or functional assessment, but an occupational health appointment is not automatically a general medical examination or a day of medical tests.

After the appointment

The occupational health professional will usually prepare a work-focused report or recommendation.

According to Acas, the occupational health adviser must ask for the worker’s permission before sharing the assessment report with the employer.

The report may help the employer and employee discuss what should happen next.

Occupational Health Assessment UK health review components — Occupational health assessments review multiple health and workplace factors, not just medical symptoms.

What Questions Are Asked at an Occupational Health Assessment?

There is no single list of questions used in every occupational health assessment. The questions should relate to the reason for your referral and your job.

You may be asked questions such as:

What health problem are you currently experiencing?
When did it begin?
How does it affect your daily life?
How does it affect your ability to work?
Which parts of your job are most difficult?
Are any workplace factors making the problem worse?
Are you receiving treatment or medical support?
Does any medication affect alertness, concentration or physical ability?
Do you feel able to return to work?
Would reduced hours or different duties help?
Are there any adjustments you think would make work easier?
Do you have concerns about returning to the same working environment?

You do not need to prepare a perfect answer to every question. The most useful approach is usually to be honest and explain how your health affects your ability to do your job.

If you are anxious about the conversation, Spark’s related guide on what to say — and what not to say — during an occupational health discussion may help you prepare.

How Should I Prepare for an Occupational Health Assessment?

You do not normally need extensive preparation, but spending a few minutes thinking about the impact of your health on work can make the appointment more useful.

Before the assessment, consider:

what has changed in your health;
which parts of your job you can still manage;
which tasks are difficult;
whether work affects your symptoms;
what support has already been tried;
what your GP or specialist has advised;
whether you have a fit note or other relevant documentation; and
what workplace changes you think could help.

You may find it useful to write down two or three points you particularly want to discuss.

Try not to minimise a problem because you are worried about appearing difficult. At the same time, there is no need to exaggerate. Clear, factual information usually gives the assessor the best chance of making useful recommendations.

Can I Refuse an Occupational Health Assessment?

Yes. For an ordinary occupational health referral, a worker does not have to agree to an occupational health assessment.

Acas specifically states that an employer can ask a worker to agree to an assessment, but the worker does not have to consent.

However, refusing the assessment does not necessarily stop the employer from needing to make decisions about absence, capability, return to work or workplace support.

Without occupational health advice, the employer may have to make those decisions using the information it already has.

This is why Acas notes that attending an assessment can help an employee:

get appropriate support;
return to work safely;
avoid further health problems; and
reduce the risk of important decisions being made without relevant health information.

Important: occupational health assessment is not the same as statutory health surveillance

Different rules may apply where health surveillance is required because of workplace exposure to specific health hazards.

HSE guidance explains that workers can have legal duties in relation to required health surveillance, and employers should explain what may happen if a worker refuses to attend.

Is an Occupational Health Assessment Confidential?

Yes. Information you give to an occupational health professional is treated as confidential medical information.

This does not mean that nothing can ever be reported to your employer. The purpose of the assessment is normally to provide the employer with useful work-related advice.

However, there is an important difference between:

your detailed medical information; and
the work-focused conclusions and recommendations provided to your employer.

The Information Commissioner’s Office says workers are generally entitled to assume that information they give to a doctor, nurse or other health professional will be treated in confidence.

ICO guidance also says access to workers’ medical information should be limited to people who genuinely need it.

What Will Occupational Health Tell My Employer?

An occupational health report should normally focus on information the employer needs to manage the person’s work safely and fairly.

Depending on the referral, the report may cover:

whether the employee is currently able to work;
how health affects particular work activities;
temporary restrictions;
possible workplace adjustments;
whether a phased return could help;
likely timescales, where they can reasonably be estimated;
whether further review would be useful; and
other work-focused recommendations.

Your employer does not need unrestricted access to your entire medical history simply because you have attended occupational health.

Acas states that the occupational health adviser must ask for the worker’s permission before sharing their assessment report with the employer.

Employers must also handle any health information they receive in line with data protection law. Health information is particularly sensitive personal data and access should be restricted to people who genuinely need it for their role.

Can Occupational Health Contact My GP?

Yes, but they cannot simply obtain your medical information without involving you.

An occupational health professional may sometimes decide that more information from your GP or another doctor involved in your care would help them give accurate advice.

Acas guidance says that where more information is needed from the worker’s doctor, the worker should be told why and asked to sign a consent form.

The worker also has rights relating to seeing the doctor’s report before it is sent under the relevant medical-report legislation.

ICO guidance advises employers not to request an employee’s entire medical record unless it is genuinely necessary. Usually, specific relevant information is more appropriate.

How Do I Get an Occupational Health Assessment?

Occupational health is usually accessed through your employer rather than booked in the same way as a normal NHS GP appointment.

If your organisation has an occupational health service, referrals may be made through:

your manager;
HR;
a health and safety team;
an internal occupational health department; or
an external occupational health provider used by the employer.

If you think an occupational health assessment could help, check your organisation’s occupational health or sickness-absence policy.

You can also ask your manager or HR whether a referral is available and explain why you think work-focused health advice would be useful.

Smaller organisations may not have a permanent occupational health department but can use an external provider when advice is needed.

Fitness for work assessment UK appointment with occupational health professional

What Is an NHS Occupational Health Assessment?

People searching for an NHS occupational health assessment may mean one of two different things.

An occupational health assessment for an NHS employee

NHS organisations have occupational health arrangements for their workforce, just like many other large employers.

An existing NHS employee may therefore be referred for work-focused advice about sickness absence, fitness for work, adjustments or return-to-work planning.

A work health assessment during NHS recruitment

NHS employers also carry out work health assessments as part of employment checking where appropriate.

NHS Employers describes a work health assessment as a process used to assess whether a candidate will be in a suitable role and working environment.

This is different from assuming that the NHS provides a general occupational health assessment service that anyone can simply request from their GP.

What Can an Occupational Health Assessment Recommend?

The outcome depends on your health, your job and the questions in the referral. There is no single result used for every assessment.

Common recommendations may include:

continuing normal duties;
temporary changes to particular duties;
reduced hours;
a phased return to work;
ergonomic equipment;
temporary changes to shift patterns;
additional breaks;
working from a different location where practical;
avoiding specific safety-sensitive duties temporarily;
further treatment or clinical input;
another occupational health review; or
additional time away from work where appropriate.

The occupational health professional provides advice. The employer then needs to consider that advice alongside the employee’s circumstances, operational needs and any legal duties.

Can Occupational Health Recommend Reasonable Adjustments?

Yes. Recommending practical workplace adjustments is one of the most useful functions of an occupational health assessment.

Examples might include:

Situation	Possible adjustment
Fatigue or treatment schedule	Adjusted start and finish times
Returning after long-term sickness	Phased return with gradually increasing hours or duties
Back or musculoskeletal problem	Ergonomic equipment, reduced lifting or temporary modified duties
Mental health difficulty	Temporary workload changes, structured check-ins or greater flexibility where appropriate
Difficulty working night shifts	Temporary rota adjustment where operationally possible
Sensory or physical disability	Equipment, workspace or communication changes

An occupational health recommendation does not itself decide what adjustment must be made. The employer considers the recommendation.

However, employers have legal duties to make reasonable adjustments where the Equality Act 2010 duty applies.

What is reasonable depends on the individual circumstances, including how effective the change would be and the practical circumstances of the employer.

What Happens When Occupational Health Recommends a Phased Return?

A phased return allows someone to come back to work gradually rather than moving immediately from full sickness absence to their normal workload.

A plan might change:

working hours;
number of working days;
duties;
workload;
shift pattern; or
level of responsibility.

A good phased return should normally have review points rather than continuing indefinitely without discussion.

For stress-related absence, Spark’s Wellness Action Plan guide gives employers and employees a practical way to agree support and review what is working.

You can also read how being signed off with stress works in the UK if sickness absence is part of the situation.

Occupational Health Assessment vs Fit Note: What Is the Difference?

A fit note and an occupational health assessment can both provide information about health and work, but they serve different purposes.

	Fit note	Occupational health assessment
Main purpose	Provides formal advice about fitness for work	Provides more job-specific advice about health, work and support
Focus	Functional effects of the health condition on work	The employee’s health in relation to their particular job and workplace
Possible recommendations	Not fit for work or may be fit for work, with advice where appropriate	Work restrictions, adjustments, phased return, review or other work-focused recommendations

Fit notes are not limited to GPs. In the UK, registered doctors, nurses, occupational therapists, pharmacists and physiotherapists can legally certify fit notes when they are appropriately acting within their professional scope.

An occupational health report is not automatically a statutory fit note. The two can be used together because occupational health often has more information about the employee’s actual role and workplace.

Is an Occupational Health Assessment the Same as Health Surveillance?

No. An ordinary occupational health assessment and health surveillance are different processes.

An occupational health assessment is usually requested to answer a specific question about an individual’s health and work.

HSE defines health surveillance as a system of repeated health checks used to identify ill health caused by work.

It can be legally required where employees remain exposed to particular health risks despite appropriate controls.

Examples can include exposure to:

noise;
hand-arm vibration;
certain hazardous substances; and
other specific occupational hazards where the legal criteria are met.

Health surveillance should not be confused with a general employee health check or optional workplace wellbeing screening.

For a fuller explanation, see Spark’s guide to health surveillance in UK workplaces .

What Is the Difference Between an Occupational Health Check and an Employee Health Check?

The terms are sometimes used loosely, but they can mean different things.

An occupational health assessment normally answers a work-related question, such as whether a health problem affects someone’s ability to perform their role or whether adjustments could help.

A general employee health check or wellbeing screening may instead look at broader health measures and may not be connected to sickness absence, fitness for work or a particular job.

Statutory health surveillance is different again and is linked to specific occupational exposure risks.

Occupational Health and Mental Health at Work

Occupational health can be particularly useful when mental health is affecting work but the practical next step is unclear.

For example, an assessment may help identify:

whether workload is affecting recovery;
whether temporary changes to duties could help;
whether a phased return is appropriate;
whether working hours need reviewing;
whether regular manager check-ins would be useful; and
whether professional mental health support should be considered separately.

Occupational health should not be used as a substitute for managing workplace stress risks. If workload, relationships, poor management or organisational change are contributing to difficulties, the employer may need to address those issues directly.

Employers looking at the wider support picture can also use Spark’s Employee Mental Health Resources UK guide to understand how occupational health, EAPs, counselling and manager support fit together.

For Employers: How to Make an Occupational Health Referral Useful

A vague referral often produces a vague report. Employers usually get more useful occupational health advice when they provide clear, relevant information and ask practical questions.

1. Explain why the referral is being made

Avoid sending only: “Please assess this employee.”

Explain the work-related issue the assessment should help clarify.

2. Describe the job accurately

Include relevant information about:

main duties;
physical demands;
working hours and shifts;
safety-sensitive responsibilities;
travel requirements;
work environment; and
known workplace hazards where relevant.

3. Ask specific questions

Useful referral questions may include:

Is the employee currently able to carry out their normal role?
Are there temporary restrictions we should consider?
Would any workplace adjustments help?
Would a phased return be appropriate?
Is further review recommended?
Could any aspect of the role worsen the health condition?

4. Do not ask occupational health to make management decisions

Occupational health provides professional health and work advice. Decisions about employment, capability, operational arrangements and whether recommendations are reasonable remain with the employer.

5. Protect confidential information

The employer should tell workers how occupational health information will be used and who may have access to it.

Only people who genuinely need health information for their role should have access.

6. Act on the relevant findings

A referral has little value if recommendations are filed away and never discussed.

Employers should review the report with the employee, consider appropriate adjustments and agree when progress should be reviewed.

Where work-related stress may be involved, a workplace stress risk assessment can help identify organisational issues that an individual occupational health referral alone cannot resolve.

Building Better Occupational Health and Employee Wellbeing Pathways

Occupational health works best when it sits within a clear employee support pathway rather than being used only after a problem has become serious.

UK employers may need to connect occupational health with manager support, stress prevention, employee wellbeing resources and clear referral processes so employees know where to go when they need help.

If your organisation is reviewing its wider wellbeing approach, explore Spark’s corporate wellbeing solutions for UK employers .

Occupational Health Assessment FAQs

What is an occupational health assessment?

An occupational health assessment is a work-focused health review that considers how an employee’s health affects their job and how the job may affect their health. It can provide advice about fitness for work, workplace adjustments and return-to-work support.

What happens at an occupational health assessment?

The assessor will normally discuss your health, treatment where relevant, job duties, how your condition affects work and any concerns about returning to work. They may then prepare a work-focused report or recommendations.

What questions are asked at an occupational health assessment?

Questions vary according to the referral. You may be asked about your health, treatment, symptoms, job duties, workplace difficulties, return-to-work concerns and adjustments that could help you work safely.

Can I refuse an occupational health assessment?

For an ordinary occupational health referral, yes. Acas states that a worker does not have to agree to an assessment. However, the employer may then need to make decisions using the information already available. Different considerations can apply to legally required health surveillance.

Will occupational health tell my employer everything?

No. Information shared with occupational health is confidential. The report to the employer should focus on relevant work-related conclusions and recommendations, and the occupational health adviser must ask for the worker’s permission before sharing their assessment report.

Can occupational health contact my GP?

They may request relevant medical information where it is genuinely needed. You should be told why, and consent is required before a medical report is obtained. Specific rights also apply to medical reports requested from doctors.

Can occupational health sign me off work?

An occupational health report and a statutory fit note are different things. Occupational health can advise on whether you appear able to work and what restrictions or adjustments may be appropriate. A statutory fit note must be certified by an eligible healthcare professional acting within their professional scope.

Who can issue a fit note in the UK?

Registered doctors, nurses, occupational therapists, pharmacists and physiotherapists can legally certify fit notes when they are appropriately acting within their professional scope.

Can occupational health recommend reasonable adjustments?

Yes. Occupational health may recommend adjustments such as altered hours, modified duties, ergonomic equipment, additional breaks or a phased return. The employer decides how to respond while also considering any legal duty to make reasonable adjustments.

How do I get an occupational health assessment?

Occupational health is usually accessed through your employer. Check your workplace policy or ask your manager or HR team whether an occupational health referral is available.

Is occupational health the same as health surveillance?

No. Occupational health assessments generally answer a specific health-and-work question. Health surveillance is a repeated system of checks used where workers remain exposed to particular occupational health risks and legal criteria are met.

Does my employer have to follow occupational health advice?

Occupational health recommendations are professional advice rather than management decisions. The employer considers the advice and remains responsible for the final workplace decision. However, it must also meet applicable health and safety, employment and Equality Act duties.

The Main Thing to Remember About Occupational Health

An occupational health assessment is not supposed to be a test that you either pass or fail.

Its purpose is to understand the practical relationship between your health and your work.

If you are an employee, the most useful approach is usually to explain honestly what you can do, what you are finding difficult and what might help.

If you are an employer, use occupational health to obtain focused professional advice — but remember that the report is only one part of good management.

The strongest outcome is usually a clear plan that protects the employee’s health while helping the organisation understand what safe and sustainable work looks like.

Important: This guide provides general information about occupational health and employment practices in the UK. It is not individual medical or legal advice. Employment and health circumstances vary, so employees and employers should seek appropriate professional advice where needed.

Official UK Sources and Further Reading

Last factual review: 12 September 2026.