I'm hoping for some useful feedback on this subject. My wife has been diagnosed with tennis elbow by an occupational therapist and is signed off work. It is painful and debilitating. The diagnosis is based on the volume of work that my wife was expected to get through while preparing lunch for around 70 children, many of whom have mild to severe food intolerances, which necessitates the preparation of separate meals. She has four hours to clean the kitchen, prepare the food, serve it up, wash dishes, and plan for the following day. She is not permitted to come in early or stay late. There is no assistance, no food processor, no pre-prepared foods, and only a small domestic dishwasher. She is regularly expected to peel large amounts of root vegetables, mash potatoes by hand, make large volumes of sauces, and lift/drain heavy pots. The kitchen is small, cramped, and not set up for professional catering, i.e. not only is it lacking professional equipment, but there is no risk assessment in place or training available from a competent person. Whilst my wife has catering experience as a volunteer cook in a local charity (where she took some online training courses), and has previously worked as a waitress, she has never worked as a professional cook before. She has now been asked to attend a meeting, at which (she has been advised) her employer may choose to end her employment on the grounds of capability. Should this happen, not only will my wife be out of work with a chronic injury that could affect her for years, but the cycle seems likely to continue with the next cook they place in this situation. Can anyone advise what should have been put in place for this role?

Hi StovieJoe

Your question is possibly problematic in terms of a reply due to Rule 9 of these Forums:

9. Discussion of potential or actual legal proceedings is prohibited on the public discussion forums. 9.1. Public inquiries, including where IOSH is a party to the inquiry, may be discussed on the Members’ Forum. 9.2. Information that has been intentionally released, for example to alert others to a particular hazard or fact, can also be discussed in the IOSH Members’ Forum.

9.1 and 9.2 don't really seem to apply to the scenario you describe.

It appears from your posting that your wife is an employee, in which case the first question should possibly be whether her condition is a reportable disease under Regulation 8 of the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (legislation.gov.uk) where her employer would be the "responsible person" as defined in RIDDOR.

Occupational diseases

8.  Where, in relation to a person at work, the responsible person receives a diagnosis of—

(a) Carpal Tunnel Syndrome, where the person’s work involves regular use of percussive or vibrating tools;

(b) cramp in the hand or forearm, where the person’s work involves prolonged periods of repetitive movement of the fingers, hand or arm;

(c)..........;

(d) .........;

(e)........... or

(f) tendonitis or tenosynovitis in the hand or forearm, where the person’s work is physically demanding and involves frequent, repetitive movements,

the responsible person must follow the reporting procedure, subject to regulations 14 and 15.

On the basis of your description it sounds like (f) would apply assuming the condition in the elbow(s) extends into the forearm(s) and is clearly linked in the diagnosis to the nature of your wife's work. (b) is less likely and (a) more unlikely.

But "diagnosis" is a defined term in RIDDOR:

"diagnosis” means a registered medical practitioner's identification (in writing, where it pertains to an employee) of—

(a) new symptoms; or

(b) symptoms which have significantly worsened;

....so you would need to check whether the occupational therapist is a "registered medical practitioner".

You have worked out for yourself that this work should have been subject to "suitable and sufficient" risk assessment, which should in turn have pointed to some measures to mitigate the risks.

When my mother was cook and caterer for similar numbers in the 1970s one of the simple things she had at her disposal was a rumbling machine which did most of the peeling of the potatoes, so the technology is not rocket science.

If this is reported under RIDDOR there is quite a good chance that the regulator would investigate for the simple reason that not many reportable diseases are reported - a mixture of the limits of what is reportable unde RIDDOR and high levels of underreporting of incidents that ARE reportable.

So, perhaps the first Q is whether the condition has been reported and if not, why not?

Feel free to private message me if you wish.

Good luck with this.  

When an occupational health professional gives advice to an employer about an employee's condition, in my experience this is always in writing.  So there may well be a written record of the professional advice that your wife shouldn't work, and she may be able to get a copy of it as it is personal information.  It's probably worth trying directly with the occupational health provider first.

Hi Kate,

There is a written copy of the report, which makes the behaviour of the employer stranger still. They are pressuring my wife to attend an interview (actually a second interview) to discuss her situation whilst there is written evidence declaring my wife to be medically unfit to return to work, and two weeks before the review date mentioned in the report. My wife is demoralised, and may decide to hand in her notice rather then return to the same work environment. However, it seems likely that her employment will be terminated, and the health & safety issues will be transfer to the next incumbent. This isn't acceptable either.

That is blatant dishonesty on the employer's part. 

I can understand why your wife may feel like resigning, but that may not be in her best interest.

Has she been in touch with ACAS to understand her employment rights in this situation and her best course of action?

Hi StovieJoe

Didn't take me very long to establish that this is a risk that a competent nursery might reasonably be expected to be aware of.

v055p00172.pdf (nih.gov) - study way back in 1998 - no, I wasn't looking for a study done in Japan. Just typed in a few words in google and up it came, referring to previous studies - not really surprising - any competent ergonomist looking at any job involving repetitive operations is going to be looking at potential issues and risk of what used to be given the generic term RSI (Repetitive Strain Injury) it's just that the nature of the injury and part(s) of the body will vary depending on the job.

Clearly whatever happens in terms of your wife's own employment that risk won't go away. So then it is about a risk assessment to work out what to do about it. However small the kitchen it would be difficult to argue that e.g. a food processor to mash potatoes would not be reasonably practicable. 

Good luck to both of you, Peter