BACKGROUND & PRESENT CASE
A healthcare organisation refereed an employee in a clinical role to Occupational Health following several periods of short-term sickness absence and ongoing stress related primarily to personal circumstances.
Although the employee remained able to carry out their normal duties, periods of increased stress had affected sleep, energy levels, wellbeing and at times, concentration. The employer sought Occupational Health advice on fitness for work and whether any additional support was required.
OUR ASSESSMENT
Following a clinical consultation, review of medical information and assessment of the functional and safety implications of the employee’s symptoms, we identified the following:
- The employee remained able to undertake their normal clinical duties safely and effectively.
- The difficulties were predominantly related to personal circumstances rather than workplace factors.
- Periods of increased stress were affecting sleep, energy levels and overall wellbeing.
- Concentration could be temporarily affected during more difficult periods but improved with appropriate rest.
- There was no evidence at the time of assessment that symptoms were preventing safe clinical practice.
- Some fluctuation in symptoms and further short-term absence remained possible while the underlying circumstances continued.
OUR RECOMMENDATIONS
We recommended a supportive approach focused on maintaining wellbeing while enabling the employee to remain safely at work:
- Continue accessing appropriate wellbeing support, including talking therapy where helpful.
- Seek further support from their GP if symptoms persist or worsen.
- Prioritise measures that support resilience and wellbeing, including rest, physical activity and stress-management strategies.
- Maintain regular, supportive communication and welfare discussions with management.
- Signpost to appropriate workplace wellbeing or counselling services.
- Arrange a further Occupational Health review to reassess wellbeing and continued fitness for the safety-critical role.
OUTCOME / RESULTS
- The employee was assessed as medically fit to continue their normal clinical duties.
- No specific workplace restrictions or adjustments were considered medically necessary at the time of assessment.
- Workplace factors were not identified as the primary cause of the employee’s difficulties.
- Further short-term sickness absence remained possible while the underlying personal circumstances continued.
- A follow-up Occupational Health assessment was recommended to review wellbeing and continued fitness for work.
KEY LEARNING POINTS
- Fitness for work should be based on an employee’s current functional capacity and occupational risk, rather than stress symptoms or sickness absence alone.
- Understanding whether difficulties are primarily work-related or linked to circumstances outside work helps employers provide appropriate and proportionate support.
- Employees in safety-critical roles may remain fit for work while experiencing personal stress, with appropriate support and Occupational Health follow-up providing additional reassurance.
CLINICIAN COMMENTS
“Ongoing personal stress does not necessarily mean an employee is unfit for work; assessing functional capacity and occupational risk allows support to be put in place while enabling them to remain safely in work.”
CONFIDENTIALITY NOTICE
All personal and organisational details in this case study have been anonymised to protect confidentiality.
