We have just completed an initial OH assessment to give us a base line of our employee's general state of health and our OH provider has identified a number of employee's with HAVs type symptoms. My initial concern is that by documenting these concerns, the OH provider has escalated an issue which whilst I accept requires further investigation, if undertaken by there own OH practitioner is charged at £320 per person. The cynic in me looks at this as just a potential money making exercise by the provider. Is it acceptable to refer said employee's to there own GP or should we take further steps, getting said employee's tested, further assessed, or do we go down the OH provider route?

I am not quite sure if I am fully understanding the situation. It looks like you have started the ball rolling by seeking to find a ‘baseline’ for general health (!) and almost inevitably this has thrown up a number of issues. If the employees work exposes them to vibration over the level where health surveillance is required, then you need to do that; which it appears that you have done. I don’t understand why you then need to pay extra to ‘document’ this, surely it is ‘part and parcel’ of the report you already have. If they are not being exposed to vibration at work, then arguably you need do nothing more. There are pros and cons of using a GP but I would suggest that most GPs are not as geared up for HAVS surveillance as most OH providers.

Go for an occupational health 'nurse' lead service as its much much much cheaper than an occupational health 'doctor' lead service for the same outcome and is as good in most if not all areas - There may be then a situation thereafter to use a occie health doctor but usually in only a few individual cases In my extensive experience in these areas I have found that this is not usually a GP area it is an occupational health specialist area and best lead initially by appropriate nurses

Baseline measurement involves the employee filling in a questionnaire - nothing more. The employee ticks boxes in good faith (or otherwise). To take surveillance forward to Tier 3 without confirmation from the client that the employees are actually an at risk group would seem on the face of it to be incorrect and unprofessional. HAVS health surveillance, even at Tier 3, is by no means an exact science. There are those who have progressed all the way to the more objective assessment at Tier 5 who have been found to exhibit NO symptoms at all. Get back to your Risk Assessment. If you're confident the employees aren't at risk from work activity and you can demonstrate that fact, then it's end of story - and I wouldn't be paying any bills for unrequested Tier 3 assessments either!