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The company I am working for has an employee who has said that he has three ruptured discs in his back and is taking painkillers whilst at work. I want to see what we can do to make his life less painful and safer until he has his operation. I believe that under the general duty of care in HASAWA we should help him as far as is resonably possible. I also think it is wise to request access to medical records and work with an OH provider and, as far as we can, his doctor to make sure we don't make his condition worse and that we help him aafter his operation. HR are fighting me on it saying "If he says he's ok to work we are covered." I don't believe that. Have I gone mad? Am I going too far? any opinions are welcome.
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David
I am with you with this one and I think HR could be a lot more helpful. That said, the general DoC on the employer - Wilsons and Clyde Coal Co Ltd v English (1938) - really only extends to workplace processes and equipment, until challenged that is. Nothwitstanding the latter, times have moved and the notion of a caring employer will extend to looking after the wellbeing of an employee to include a serious pre-existing condition I believe.
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 1 user thanked RayRapp for this useful post.
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In this case I would take medical advice from a qualified OH doctor. The patient might not know the full medical details of what is wrong with them and they might lie for various reasons. If their condition was to worsen they could claim that they were pressurised into returning to work. You really need an impartial judgement as to how their condition should be managed.
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You can and should do numerous things when you are aware of a potential occ health issue. Firstly, if they use a workstation – when was it last assessed given the individuals back issue? I was at my last IOSH Branch meeting and the presentation was about this subject, I’m not sure if you are aware of this but the majority of DSE chairs are never adjusted height wise (not seat height or incline, before loads of you reply) I mean the actual back frame never gets adjusted from the manufactures position. You also need to consider meds that are being taken, particularly NSAID for pain. Drugs like tramadol can cause periodic light-headedness – think driving and operating machinery etc. What if the individual gets worse, are sufficient first-aiders available and are they close by? I can think of many questions to ask and reasons to assist this individual. I also think they are owed that duty of care by an employer when informed they have a condition like this…. Speak to HR again and your senior management. Best of luck, PM me if you need any assistance.
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They need to be sent to Occupation Health Therapist for assessment, there is usually an independant one in every city centre these days. We send our staff when dealing with physical issues an a report foolows up with reccommendations for the comapmny to follow.
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What action would you take if he went to his GP who gave hime a fit for work note that made no recommendations and said he was fit to work ?
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Originally Posted by: Invictus  What action would you take if he went to his GP who gave hime a fit for work note that made no recommendations and said he was fit to work ?
GP's are not OH specialists. A ruptured disc is something that has to be looked at by a specialist. From a legal point of view if a GP says that the person is fit to return to work then we can accept this but I have had experience of GPs getting it wrong both ways- allowing people back to work when they shouldn’t and imposing excessive restrictions( which is more common) for people who could go back to work.
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As has been said, instant referral to an occupational health specialist and your HR department need a kick up the back side. They need to be involved as he may not be fit to work in that role, but fit to work. Oc health will also help with any adjustments needed to help him complete his role safely. As far as i am concerned i would treat him pretty much the same way as you would with a disability. Does he need a PEEP for example? He sounds like he is a person that currently has additional needs, maybe it needs to be explained better to HR. If you provide a little more context to your situation it may be of help. Edited by user 26 May 2017 13:44:30(UTC)
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Originally Posted by: DavidGault The company I am working for has an employee who has said that he has three ruptured discs in his back and is taking painkillers whilst at work. I want to see what we can do to make his life less painful and safer until he has his operation. I believe that under the general duty of care in HASAWA we should help him as far as is resonably possible. I also think it is wise to request access to medical records and work with an OH provider and, as far as we can, his doctor to make sure we don't make his condition worse and that we help him aafter his operation.HR are fighting me on it saying "If he says he's ok to work we are covered." I don't believe that. Have I gone mad? Am I going too far? any opinions are welcome.
I like the assumption of an operation.
Disc herniation is only likely to be operated upon in the current NHS if the person has other serious problems associated with the problem: such as poor bowel or bladder control.
A more likely scenario is that a after several lengthy examinations/MRI scan, he will be referred to "pain management" specialists (inevitably a private offshoot who give excellent, and lengthy, advice on how to take Aspirin etc)
And before you queue up to say I'm wrong....I'm not.
Been there.
Done that.
Still got L3/L4 and L4/L5 herniated discs.
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David From the limited information you present, at least three regulations apply: the DSE, MHO and PUWER. You need to carry out a reasonably careful task analysis to pinpoint work activities likely to aggravate the spinal problem of the employee, and to adapt his/her job accordingly. Show the HR people the specific paragraphs of relevant DSE, MHO and/or PUWER regulations and ask them to specify in appropriate detail how they recommend to control risks to the employee and to indemnify the employer in the case of any claim.
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Originally Posted by: johnmurray Originally Posted by: DavidGault The company I am working for has an employee who has said that he has three ruptured discs in his back and is taking painkillers whilst at work. I want to see what we can do to make his life less painful and safer until he has his operation. I believe that under the general duty of care in HASAWA we should help him as far as is resonably possible. I also think it is wise to request access to medical records and work with an OH provider and, as far as we can, his doctor to make sure we don't make his condition worse and that we help him aafter his operation.HR are fighting me on it saying "If he says he's ok to work we are covered." I don't believe that. Have I gone mad? Am I going too far? any opinions are welcome.
I like the assumption of an operation.
Disc herniation is only likely to be operated upon in the current NHS if the person has other serious problems associated with the problem: such as poor bowel or bladder control.
A more likely scenario is that a after several lengthy examinations/MRI scan, he will be referred to "pain management" specialists (inevitably a private offshoot who give excellent, and lengthy, advice on how to take Aspirin etc)
And before you queue up to say I'm wrong....I'm not.
Been there.
Done that.
Still got L3/L4 and L4/L5 herniated discs.
The operation is not an assumption, he has been told he will have it done.
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Thanks for the replies. It is good to know I haven't lost the plot. The replies, by and large, are how I have been approaching this one.
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get oh to speak to doctor/specialist for him and ask for signed release form of medical records,so they, and your team) can be advised on how to best assist him. perhaps a chat with him and whoever he is dealing with for his back, excercises and times off so he can do them when at work too have you looked further into why he has got the problem - rugby/other work/ former employment and are any activities happening outside of work which may contribute as well? does chiropractor/massage etc or placing heat/cold on back help? - availability of microwave/freezer for own pads or supports chair thoughts from chiropractor, oh and desk/activities done? talking to others who have already had operation, plan for return after operation, building up muscle prior and after operation, - physio requirements and who does it - perhaps prior appointment to know whats coming and how can get through it best - will it get fused? - expect 6-8weeks off activity then 1 year to feel right from anecdotal reports from peers. someone else said of their operation that they would rather of not had it done - so best to ask lots of questions as the patient - perhaps assist with questioning techniques through oh system to make best of process for all
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Paris vs Stepney Borough Council I believe, regarding the duty of care in such a situation.
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Originally Posted by: DavidGault Originally Posted by: johnmurray Originally Posted by: DavidGault <img src="/Themes/iosh2/icon_latest_reply.gif" title="Go to Quoted Post" alt="Go to Quoted Post">The company I am working for has an employee who has said that he has three ruptured discs in his back and is taking painkillers whilst at work. I want to see what we can do to make his life less painful and safer until he has his operation. I believe that under the general duty of care in HASAWA we should help him as far as is resonably possible. I also think it is wise to request access to medical records and work with an OH provider and, as far as we can, his doctor to make sure we don't make his condition worse and that we help him aafter his operation.HR are fighting me on it saying "If he says he's ok to work we are covered." I don't believe that. Have I gone mad? Am I going too far? any opinions are welcome.
I like the assumption of an operation.
Disc herniation is only likely to be operated upon in the current NHS if the person has other serious problems associated with the problem: such as poor bowel or bladder control.
A more likely scenario is that a after several lengthy examinations/MRI scan, he will be referred to "pain management" specialists (inevitably a private offshoot who give excellent, and lengthy, advice on how to take Aspirin etc)
And before you queue up to say I'm wrong....I'm not.
Been there.
Done that.
Still got L3/L4 and L4/L5 herniated discs.
The operation is not an assumption, he has been told he will have it done.
So did I.
It wasn't.
And won't.
It is available however, at the same hospital for £7500 +-, by the same team.
That is not an isolated story.
NHS2017 is cash-strapped, and fighting for more. Many NHS hospitals now source large percentages of their money by charging.
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