BACKGROUND & PRESENT CASE

A professional services organisation asked Occupational Health for advice on supporting an administrative employee who was returning to work while still receiving treatment for a cancer-related condition. The employee had restarted work from home and was managing ongoing therapy, but the employer needed guidance on managing fluctuating fatigue, changes in concentration, and the increased risk of infection.

OUR ASSESSMENT

After a clinical consultation, review of medical information, and a workplace risk assessment, we identified the following:
• The employee remained clinically vulnerable to infection, making office attendance unsafe at this stage.
• Remote working was effective, and the employee was meeting expected performance levels.
• Fatigue and occasional dips in concentration were expected around treatment cycles or during particularly busy tasks.
• Ongoing therapy and further medical procedures were planned.
• The employee demonstrated good self-management strategies and had a solid support system outside of work.

OUR RECOMMENDATIONS

We recommended practical, evidence-based adjustments to help the employee work safely and sustainably:
• Continued remote working as a medically appropriate adjustment.
• Flexible absence management, in line with the Equality Act 2010.
• Flexibility for medical appointments and days when symptoms are more noticeable.
• Regular, supportive check-ins with management.
• Task adjustments during periods of increased fatigue – for example, during busy billing cycles or high-concentration work.
• Task rotation to help balance workload and manage symptoms.
• Access to emotional wellbeing support, either through the GP or the employer’s Employee Assistance Programme (EAP).
• Office attendance to be reviewed only when medically appropriate, based on advice from the treating specialist.

OUTCOME / RESULTS

• The employee has continued to work full-time from home with satisfactory performance.
• Workplace attendance remained medically unsuitable due to the ongoing infection risk.
• Further treatment is anticipated, with a short period of recovery time expected.
• The case demonstrates effective long-term disability management in line with the Equality Act 2010.

KEY LEARNING POINTS

• Remote working can be a safe and effective adjustment during long-term medical treatment.
• Flexibility around symptoms and appointments supports productivity and reduces sickness absence.
• Following advice from Occupational Health enables employers to make safe, consistent and legally defensible decisions.

CLINICIAN INSIGHT

“Remote working was essential in protecting the employee’s health while enabling them to continue contributing effectively during ongoing treatment.”

CONFIDENTIALITY NOTICE

All personal and organisational details in this case study have been anonymised to protect confidentiality.

Here at Fleet Street Clinic, we have had many stool samples come through our laboratory. One recent clinical case using our in-house Full Gastrointestinal PCR Panel, presented unprecedented results.

Patient overview:

• 51-year-old patient
• Travelled to and from Pakistan for a trekking trip
• The patient presented with a history of severe diarrhoea
• Symptoms recorded: erratic bowel movement and weight loss.

Test results:

The PCR result came back quicky as positive for four pathogens:

• Cyclospora cayetanensis,
• Enteroaggregative E. coli (EAEC),
• Enteroinvasive E. coli (EIEC)/Shigella,
• and Enteropathogenic E. coli (EPEC)

This is highly unusual and it is little wonder why our patient was feeling so unwell with severe symptoms.

Our Biomedical Scientist, Jenny Reyes commented; “This is my first time in all of my time as a Biomedical Scientist to encounter such a result with four pathogens presenting all at once.”

Without our GI PCR test, this patient may have undergone many tests to identify the cause and may not have identified that the symptoms were the result of four simultaneous pathogens causing a mixed infection.

The advantage of a panel PCR test is its ability to identify the exact cause, enabling targeted treatment.

In this case, the clinician overseeing this patient’s care was able to tailor treatment to address all four identified pathogens simultaneously with precision.

Without this technology, diagnosing a mixed infection could have taken significantly longer, requiring multiple different tests to pinpoint each cause.

This would have increased the risk that only one pathogen would have been identified, leaving the symptoms caused by the others untreated even after addressing the diagnosed cause.

We encourage all patients with unexplainable gastrointestinal symptoms to consider the GI PCR Panel. It really does offer faster, more targeted care and can identify mixed infection with ease!

More information on our GI Panel:

Our Gastrointestinal Panel Test delivers accurate and reliable results quickly, often within a matter of hours.

It is capable of detecting any of the 23 commonest pathogens that cause diarrhoea – such as E. coli, campylobacter, norovirus salmonella, shigella and giardia, from a single stool sample – all that’s needed is a simple swab.

This supports our rapid diagnostic process, clinical management and educated treatment decisions which improve overall patient outcomes.

Learn more and book today

Throughout the pandemic we have supported many industries trying to navigate business-as-usual alongside managing the potential risk of coronavirus in the workplace.

Identifying covid-positive individuals as well as outbreaks is essential, but it is also important not to underestimate the peace of mind testing brings to employees who may be anxious about catching covid-19 in the work environment, especially those who have been in close contact with someone at work who has subsequently tested positive.

The creative arts industry has been particularly impacted by closures, and given  the close-contact nature of the theatre and performing arts sector, outbreaks do occur. The speed at which those infected can be identified can make all the difference between a show going ahead or being cancelled.

We have supported Kenny Wax Productions for the last 2 years with crisis management and routine testing using our ultra-rapid covid-19 rt-PCR testing service.

Here’s how we supported the production of MAGIC GOES WRONG during their Christmas crisis:

At 15:18 on New Year’s Day (a Saturday), we received a text to say that the entire cast of MAGIC GOES WRONG was heading straight to Fleet Street, following a positive result from one of their actresses. The only way the evening performance could go ahead was to determine whether covid-19 had spread throughout their cast, or not.

We understood the urgency of this situation and quickly and calmly took samples from a cast of 21 against the clock. We ran them through our lab at the same time, which can be quite a challenge. Since we knew that there would not be enough time to re-run samples, this needed to be done with special care. For us to be able to give Kenny the “thumbs up” to go ahead with the evening show, it was imperative we got things right the first time.

One of the best things about our NeuMoDx lab equipment is that we can load each sample as soon as it is taken, rather than waiting for the complete batch. We started running samples immediately, the last of them had finished running by 18:10, when we were able to assure Kenny that it was safe for the cast to go on with the show.

We were able to go from initial text enquiry to sample-taking and final, confirmed results for the entire cast in just over 3 hours.

Kenny Wax, the Producer of MAGIC GOES WRONG explains:

“Our West End hit MAGIC GOES WRONG had managed to avoid shutdown. However, an actress who had been feeling a little unwell leading up to New Year and continuously tested negative on lateral flows, finally came through with a positive test on Saturday morning 31st December. Hearing this news, the rest of the cast became very anxious about continuing performances until they were confident that covid had not spread throughout the company.

As Producer of the show, I was made aware of this information at 1.45pm. There was due to be a matinee at 2.30pm and an evening show at 7:30pm. We had no other option than to cancel the matinee but in an attempt to save the evening performance (a Saturday Night), at very short notice we attempted to get the whole company of 21 people PCR tested in the afternoon. To achieve almost the impossible everyone set off for the Fleet Street Clinic and by 6.10pm, we received the good news that the rest of the company had tested negative on the PCR and we were able to continue with the evening performance and the following two
shows on the Sunday. This not only saved us another financial blow due to cancellations at the box office, but we were able to provide entertainment to 1,500 customers across those three performances.

Dr Dawood’s staff at the Fleet Street Clinic are always polite, friendly and efficient. They fully understood the nuances of working with a West End theatre production company on a very tight deadline. I am very grateful for their continuing support and cannot recommend them highly enough.”

For more information on our corporate coronavirus testing services and other covid-19 support services.