As the effectiveness of fit notes is called into question again, I also ask how we are doing at making OH referrals effective.

A family member was referred to OH and an appointment was made at a location over 30 miles from their home address, at 9am on a Monday morning, meaning a 2 hour drive on the M25 in rush hour traffic. Unfortunately, the person making the referral had neglected to inform OH that the individual could only drive for a maximum of 30 minutes.
I attended an OH appointment after I broke my hip and was disappointed with the outcome. The author specified dates by which I would be able to weight bear, drive and return to full duties, which surprised me as my Consultant was unable to make such predictions. The timescales in the report were hugely inaccurate and it did not advise on topics such as workplace adjustments (I needed different chairs, support cushions, desk locations etc.) and how best to facilitate my return to work. The report also stated that there were no sinister underlying causes for the break, which was surprising as at the time I was awaiting a number of tests and scans to determine the cause. Had I not had such a positive relationship with my manager, the OH report would have made things very difficult indeed; there was a date, written in black and white which I apparently should have been back to full duties by. It appears that the OH professional wrote their opinion as fact and was not aligned to what my manager needed to know.
The topic of OH referrals is a pertinent one and leads me to question why such a key provision in employee well-being is not being utilised effectively. I suggest that as HR professionals we must improve the way in which we (and managers in the business) work with our OH colleagues in order to achieve the business benefits from our OH services.
Mismatch in expectations?
HR/managers appear to think that OH has all the answers and they expect to receive specific direction in order to progress with absolute clarity and certainty. I suggest that HR/managers can be guilty of putting the responsibility on OH and of referencing OH reports as if they were gospel. I wonder whether we have lost sight of the fact that a) the report is dealing with people and medical issues which are individual, changeable and difficult to predict and b) that the report is there to provide a basis for future decisions, not to dictate what to do next or provide definitive medical diagnoses. With OH being asked questions so specific such as "what date exactly will the broken bone heal? Exactly how far can the person drive?"  it is no wonder HR/managers can be left feeling disappointed. I believe that we need to be more effective in asking the right questions, knowing what answers we need and providing the right information to OH in order to facilitate an effective return to work. There is also scope for both parties to address any misunderstandings about what the service is there to provide.
Are we getting the right information?
I once received a report which advised a change in start time of 1 ½ hours, with no explanation as to why. Upon meeting with the employee they explained that it was due to medication which needed to be taken at a certain time, with specific guidelines around food and driving, but the report had made no reference to medication whatsoever. As an HR Advisor, it is not dictation that I need in order to take the OH report and make an informed decision, but an understanding of the reasoning behind the advice provided.
Is the report a true reflection?
In addition to my own experience, take the example of an employee with a rare condition whose report came back with a number of actions (without any rationale), written in an instructive manner. The employee was upset with the report, and informed me that the OH professional had told them that they had to compromise on what adjustments could be made and so the report was OH’s opinion on what adjustments to make. The employee, however, did not feel that they were appropriate or achievable, and were not in line with their specialist’s advice, but mistakenly thought that everything in the report had to be followed. It also did not provide the company with a true reflection of the work-related effects of the condition. An appropriate conclusion was eventually reached, but until it was we had an employee off sick, feeling under pressure to meet unrealistic expectations and a management team frustrated with HR’s advice to complete an OH referral (what good has it done?).
Sadly, these examples are not unique and, in my humble opinion, I think that this could be a result of the mismatch in expectations from HR/managers and possibly with OH professionals not fully understanding what companies really need.