Intended for healthcare professionals

Education And Debate


BMJ 1996; 313 doi: (Published 19 October 1996) Cite this as: BMJ 1996;313:999
  1. Anil Adisesh,
  2. Gordon Parker

    One in 14 consultations with a family doctor by patients of working age is for a condition that is due to work or that affects ability to work. General practitioners are often in the best position to make an early diagnosis of occupational illness, to prevent further problems by taking appropriate action, and to facilitate a return to work after illness or injury. Hospital specialists also need to consider the possibility of work related causes for an illness and the effects of the illness and treatment on future fitness for work. Therefore, doctors in both primary and secondary health care should be aware of the role and responsibilities of occupational health services and work with them for patients' benefit.

    Aims of an occupational health service

    The promotion and maintenance of the highest degree of physical, mental, and social wellbeing of workers in all occupations

    World Health Organisation 1950

    Occupational health services are not distributed uniformly among the 24 million people employed in the United Kingdom; their provision is influenced by the size of the company and the nature of the industry. In the public sector (NHS, civil service, etc) 72% of employees have access to a doctor at the workplace compared with only 20% of workers in the private sector. There is no statutory responsibility in Britain—in contrast to other European countries—for employers to provide an occupational health service or even access to an occupational physician.

    Many large employers in the private sector (and increasing numbers of NHS trusts) have occupational health services headed by a specialist occupational physician and supported by occupational health nurses and ancillary staff. Smaller firms may have services headed by an occupational health nurse. Medical communication may therefore be with a specialist occupational physician, a local general practitioner or other doctor providing advice on a part time basis, or a nurse. …

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