The purpose of this section is to describe the various roles carried out by doctors and dentists from a functional perspective and to aid decision making about work place adjustments. The aim is to help doctors and dentists continue to work and train, as far as is reasonably practicable, by mitigating the effects of illness or disability.
The table below provides an initial assessment of job requirements, describes how certain health conditions may affect work tasks and provides some generic suggestions about workplace adjustments or support that may assist work ability. The first column highlights functional requirements that apply to jobs. The second column gives some examples of health conditions that may affect ability to undertake the requirements of job roles. The examples are not exhaustive and there may be other conditions not listed that may affect the job role. The right hand column gives examples of the range of support or adjustments available for those with health conditions or what Trusts / practices can do to protect health and wellbeing particularly if there is a health condition or disability. Reasonable adjustments must be considered for staff with disabilities in compliance with the Equality Act 2010
If you are unsure about any of the information below, you should contact local occupational health services and ask to speak to one of the occupational health nurse advisers.
A more detailed analysis of the functional requirements of jobs has been undertaken by constructing job families. Functional requirements that are common to the families are listed, as well as exceptional functional requirements for specific tasks.
A general overview can be obtained from a consideration of in-patient or outpatient work. Thereafter, specific activities undertaken within job families are presented, with functional requirements and health and safety issues.
FUNCTIONAL REQUIREMENT – CHOOSE THE ROWS THAT APPLY TO THE ROLE
HEALTH PROBLEMS THAT MAY AFFECT WORK TASKS
ADJUSTMENTS/SUPPORT THAT MAY BE AVAILABLE
Direct regular contact with patients or handling specimens
These will include most medical roles
Low immunity due to conditions such as HIV infection, lupus or drug treatment such as chemotherapy or high dose steroids may cause vulnerability to some infections.
It is necessary to have either been vaccinated against or have immunity to hepatitis B, measles, mumps and rubella, chicken pox and tuberculosis. Annual seasonal flu vaccination should be encouraged.
Direct regular contact with high risk patients including immunosuppressed, pregnant women, neonates
High risk patients require a higher level of protection against infectious diseases. Staff working with this patient group must comply with immunity requirements or may need restrictions on work or redeployment.
Exposure prone procedures (EPP) such as work in delivery suites, operating theatres or trauma within A & E
All FY1 posts are classed as EPP.
All surgeons, dentists, medical staff in A&E, Urology, Obs and Gynae, require clearance to practice exposure prone procedures (EPP). Other roles may be EPP.
|The UK Department of Health states that healthcare workers performing EPP must not be infected with HIV or be infectious for hepatitis B or hepatitis C infection.
|At this time HIV infection is not compatible with EPP work. However in many cases, someone with HIV infection may be able to work with specific restrictions on their practice. EPP workers infected with hepatitis B or C may require additional tests of infectivity before a decision about EPP clearance can be given. Again, some restrictions on practice may be sufficient to allow the infected healthcare worker to work.
Ability to undertake general physically demanding work including regularly moving/handling patients, lifting or moving loads > 5kg, frequent walking (or running in an emergency) or prolonged standing
This job may require regular pushing, pulling, lifting and carrying of heavy loads such as patients, trolleys, equipment and materials or wearing lead apron, travelling across the hospital
Musculoskeletal problems (back, neck, arms, shoulders, joints etc). Conditions that cause fatigue.
If you have a problem that causes back pain particularly or have problems with your joints especially knees or feet you should contact the local occupational health for advice.
|Most musculoskeletal problems are minor and resolve with treatment. Some chronic problems may require adjustments if mobility, strength, grip or flexibility is impaired. Patient moving and handling equipment should be available in all clinical areas. Adjustments to the workplace, equipment and work practices are possible. Support is often available from the staff physiotherapist, the moving and handling advisors and the health and safety team.
Resilience to workplace pressures including working to deadlines or in stressful environments.
Working in the health service can be busy and pressurised at times and work in patient areas can be distressing due to patients with serious illness or death. Starting a new job can add additional pressures.
|Mental health problems including anxiety or panic disorders, depression, bipolar affective disorders, schizophrenia. Some medications used to treat these conditions may causes side effects such as sedation, tiredness or reduced concentration. Other conditions that may be affected by stress include epilepsy, bowel conditions and some cardiac conditions.
|Support is available from staff counselling and stress management services, occupational health and your manager. If there are significant current/ ongoing mental health problems (including work related stress). An occupational health adviser can have a confidential discussion about stressors and how to manage them. Trusts should have a robust stress management policy and process that can help minimise the effect of workplace stress.
|Regular night work including on-calls
|Diabetes, epilepsy, heart conditions, sleep disorders such as sleep apnoea, mental health conditions.
|For most people it takes a little time to get used to shift patterns i.e. change in dietary and sleep patterns. This may be made more difficult by some health conditions. Temporary or permanent adjustments may be required although most people with underlying health conditions can work a variety of shifts without adversely affecting their health.
Activities requiring good hand strength, or dexterity
These tasks may also include those requiring steady hand, fine motor movements or delicate manipulation
Musculoskeletal problems (back, neck, arms, shoulders, joints etc).
If you have problems with the hands or wrist such as repetitive strain type conditions you should contact local occupational health services.
|Most musculoskeletal problems are minor and resolve with treatment. Some chronic problems may require adjustments if mobility, strength, grip or flexibility is impaired.. Adjustments to the workplace, equipment and work practices are possible. Support may be available from the staff physiotherapist, the moving and handling advisors and the health and safety team.
|Regular computer-based work or desk-based work
|Musculoskeletal problems (back, neck, arms, shoulders, joints etc), eye conditions or conditions affecting the hands or wrists.
Most musculoskeletal problems are minor and resolve with treatment. Some chronic problems may require adjustments if mobility, strength, grip or flexibility is impaired. Adjustments to the workplace, equipment and work practices are possible. Support may be available from the staff physiotherapist, the moving and handling advisors and the health and safety team.
Free eye tests should be available for “VDU” users in line with H&S legislation.
Good hearing and vision including accurate colour vision.
Some aspects of the role may have safety critical features such as visual or audible alarms or colour coded components. Many roles include the necessity to accurately read patient written or electronic information quickly and in pressured situations.
Sensory problems i.e. hearing, sight (that are not corrected by spectacles, lenses or hearing aids) which may include colour blindness, detached retina, macular degeneration or profound hearing loss.
Dyslexia can pose additional problems for computing and reading or recording complex health information and additional specialist support may be required.
An assessment will be undertaken in regard to any sensory deficit that may impact on staff safety. Adjustments available may include hearing loops, adapted telephones, training for staff in understanding disability.
A specialist report on dyslexia may be necessary to put in place suitable adjustments that will protect both the healthcare worker and patients.
|Working with chemicals, substances or work processes that can affect the skin including wet work, use of latex gloves or skin irritants or sensitisers.
Skin conditions i.e. dermatitis, allergies, psoriasis
Working with broken skin on hands, wrists or forearms is an infection control risk in jobs with patients or unenclosed specimens.
Those with a pre existing skin problem require skin surveillance and may need adjustments. Alternatives to most products can be found to accommodate skin issues. Temporary adjustments may be made for those with short-lived broken skin on their hands, wrists or forearms.
Those with suspected work-related allergies may be referred for allergy testing.