These consist of face to face meetings between Occupational Health and HR and/or managers about one or more employees who have been seen by Occupational Health.

What is a Case Review Meeting?

These consist of face to face meetings between Occupational Health and HR and/or managers about one or more employees who have been seen by Occupational Health.

The Occupational Health professional consults the case records of all the employees listed for discussion by the manager/HR and if necessary consult with any other relevant clinician, e.g. Occupational Health Adviser consult with Occupational Health Physician.

The Occupational Health professional will advise the manager of the way forward on each case and will ensure feedback to the clinician dealing with the case, if any actions are agreed. These should be within the framework listed below.

The advantage of Case Review Meetings over Case Conferences is that a good working relationship can be built up between Occupational Health and the manager/HR and lead to consistency of approach. It can save time. Also there is the opportunity to receive advice on how to handle a situation in advance of appointments with the clinician.

How should Case Review Meetings take place?

Case Review Meetings are arranged at the request of the manager or HR representative though they may be suggested by Occupational Health. They are normally arranged with at least 7 days' notice.

In all situations the name(s) of those employees to be discussed will be required to allow for preparation.

Like a case conference, new questions requiring an Occupational Health opinion cannot be addressed. If new questions do arise which are important to understanding and progressing a case, Occupational Health should be notified in writing in order that these questions can be appropriately addressed by the relevant Occupational Health professional involved and discussed and consented with the individual prior to the meeting.

What can be discussed are issues with reference to the management referral and Occupational Health advice already consented with the individual. This may include for example: current status of health; prognosis; likely timescales; workplace adjustments. It also may include discussing and agreeing appropriate actions moving forward, eg planning a review appointment, writing to a GP or specialist for a medical report or referral to an external specialist for a medical opinion. It may also involve situations where there has been no referral to Occupational Health, for example where there are routine Health Screening concerns before an employee commences their post.

Depending on participants, HR or the manager will take the lead in setting up the Case Review Meeting. Meetings are likely to have a less formal structure than Case Conferences; however they can be chaired by HR if necessary.

When should a Case Review Meeting take place?

When to call a Case Review Meeting will vary in similar ways as Case Conferences as outlined above. In addition a Case Review Meeting may assist managers with forward planning and resolution when a number of difficult cases occur in a Department simultaneously.

Who should be present at a Case Review Meeting?

The following people should normally be present at the Case Review Meeting:

The Line Manager and/or one or more HR representatives

An occupational health advisor/physician

The Roles of Participants

Individual roles will vary depending on circumstances; however common roles may include the following:

Manager: To clarify and discuss expectations, requirements, possible adjustments and options available including timescales and limitations. To discuss and if possible agree actions moving forwards. HR Advisor: To gain a full understanding of the situation; offer advice within the context of the current legislation and University employment policy together with promoting possible solutions. To discuss and if possible agree actions moving forwards.

Occupational Health: To clarify regarding health implications for role, possible and solutions, including adjustments and outcomes, to assist the meeting with reference to advice already provided in report form and with reference to guidelines outlined below. To ensure issues of consent are dealt with appropriately. To discuss and if possible agree actions moving forwards. As with Case Conferences, the outcomes of the meeting need not be pre-determined and may depend on any objectives and the expectations of the manager and HR representative(s). Further discussion and later decisions may be required, however, it should be hoped that one outcome should be the development towards the resolution of a case.

Occupational Health Procedure in relation to consent, confidentiality and GMC guidelines:

With reference to GMC Guidance individuals must be offered the chance to see any information disclosed about them before it is sent to/by the Occupational Health professional.

The general principle is that there should be no surprises.

Applying this to case conferences and case review meetings:

Occupational Health can:

• Receive more information about an employee's job
• Receive information about relevant business issues and demands, but not personal things specific to the employee that are completely unknown to the employee themselves
• Clarify any points in the correspondence, in line with the employee's prior understanding
• Suggest other clinical services that might be helpful
• Suggest timing for review appointments or alternative methods of review
• Talk in general terms, e.g. 'typically for a case of this kind'
• The agreed management referral report should be used as well as any agreed points recorded in the notes.

Occupational Health cannot:

• Give an opinion on new questions which have not been discussed with the individual
• Give a second opinion without the individual having been seen
• Change the Occupational Health opinion without the individual having been seen or contacted again and given the chance to have a copy of their report before it is sent
• Use the meeting to circumvent consent and disclosure procedures
• Draft documents should not be used as the basis of a case conference

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• Approved on: 30 June 2013