Occupational Health

Many medical conditions and virtually all minor health problems have minimal implications for work and should not be a bar from employment.

For most jobs no agreed advisory medical standards exist and for many jobs there need be no special health requirements. 

Where questions about health are included on job application forms this should be only to seek information that may be necessary to enable any modifications to the interview process.  

The reason for the employment health assessment should be confined to fitness for the proposed job and only medical questions relevant to the employment should be asked.

Criteria for conducting health surveillance includes when:

• an individual being exposed to a hazardous substance that is linked to an identifiable disease of adverse health effect
• there is reasonable chance that the disease or adverse health effect may occur under the conditions of work
• there are valid techniques of detecting the disease or adverse health effect

Health surveillance is likely to be necessary where there is exposure to:

• carcinogens—in practice valid tests and techniques do not exist but the a health record is needed
• dangerous pathogens, e.g., hepatitis B, HIV and TB
• certain sensitisers, such as  substances that may cause occupational asthma, e.g., laboratory animals, mineral oils, wood dust, solder fumes
• substances that may cause dermatitis, e.g., latex
• noise and vibration

Health surveillance is a system of ongoing health checks.

These health checks may be required by law for employees who are exposed to noise or vibration, ionising radiation, solvents, fumes, dusts, biological agents and other substances hazardous to health, or work in compressed air.

Health surveillance is important for:

• detecting ill-health effects at an early stage, and ensure better controls to prevent them getting worse
• providing data to help employers evaluate health risks
• enabling employees to raise concerns about how work affects their health
• highlighting lapses in workplace control measures, therefore providing invaluable feedback to the risk assessment
• providing an opportunity to reinforce training and education of employees (eg on the impact of health effects and the use of protective equipment)

Risk assessment should be used to identify any need for health surveillance. Health surveillance should not be used as a substitute for undertaking a risk assessment or using effective controls.

Health surveillance is needed to:

• protect workers who are at an increased risk
• identify work-related ill health at an early stage so that steps can be taken to treat the condition and prevent further damage
• give early warning that protective control measures are no longer effective

Health surveillance does not reduce the need to eliminate or manage health risks.

Health surveillance is a particular legal requirement and should not be confused with:

• activities to monitor health where the effects from work are strongly suspected but cannot be established
• workplace wellbeing checks, such as promoting healthy living
• fitness to work assessments such as fitness to drive forklift trucks or health assessments requested by night workers

Types of Health Surveillance:

• Animal Allergy - including laboratory animals
• Hand arm vibration (HAVS)
• Pathogens or biological agent work
• Respiratory sensitiser
• Skin irritants and sensitiser

Manager responsibilities

• After a carefully conducted, suitable and sufficient COSHH risk assessment inform OH of the potential need for health surveillance
• Ensure prompt referral to OH if a member of staff reports ill health symptoms that could be related to their working environment, e.g., respiratory/skin problems
• Ensure that where reasonably practicable any recommendations from OH are implemented

OH responsibilities

• Ensure that health surveillance is undertaken on staff identified as requiring it and at the appropriate level, e.g., one off registration for carcinogen work or initial face-to-face assessment and follow up assessment for laboratory animal workers. The level of health surveillance will depend on the assessed health risk of exposure and individual susceptibility.
• Report the results of all health surveillance carried out and maintain the COSHH Health Record
• Report any occupational diseases identified through health surveillance to the manager for Accident and incident reporting and investigation through for reporting to the Health and Safety Executive under the Reporting of Injuries, Disease and Dangerous Occurrences Regulations (RIDDOR)
• Maintain a recall system to ensure that the named contact person is advised when an individual's health surveillance is due as well as supplying information about non-attendees

Employee responsibilities

• Comply with the health surveillance programme
• Early reporting to management and OH any possible work related ill health symptoms

Learning and Development

You will be able to find details on learning and development opportunities across NSS within the HR Connect page - Learning and Development and Organisational Development.

For specific learning that's highlighted below, please log into Turas Learn

Modules within the Health & Safety tab:

• NSS Stress Management for Employees
• NSS Stress Management for Managers 

What needs to be included in a record of health surveillance?

Record:

• The persons name and National Insurance number
• The substance they are exposed to, and when (start date, frequency of use)
• The surveillance test that is done on them, and the tester
• The outcome e.g. passed / retest / failed (but not the test data).

Remember that a Health Surveillance record is different to a medical record.

Medical records are generated by a health professional, namely a Dr or Nurse, who is competent as regards the hazard, risks and likely health effects. The information contained in a Medical Record depends on the nature of the medical carried out. ALSO the Medical Record is medical-in-confidence material and it is the responsibility of the health professional that has created it to ensure that nobody else gets access without informed consent from the individual whose medical record it is.

Further information on health surveillance overview is available.

What is Cohort?

Cohort is an Occupational Health software package proven within both the corporate and NHS Market place. The Cohort system is used to manage the Occupational Health (OH) records for NHS National Services Scotland (NSS) and centrally manage a wider OH service for 4 other NHS Scotland Boards.

The flu virus mutates so you need to be vaccinated yearly for protection.

Yes. If you have a health problem that you think is affecting your ability to perform at work or is aggravated by or associated with your work, then please do contact us.

We will ask you to complete a self referral form and return this where possible prior to arranging the appointment, this is to ensure that you are given an appointment with the appropriate team member at the outset 

For NSS, PHS, NES, and HIS employees please submit via nss.occupationalhealth@nhs.scot

For SAS employees please submit via nss.sasoccupationalhealth@nhs.scot

No definitely not.

If the referral has been made by your manager information reported back to your manager is on a need to know basis only and only answers the specific questions that have been asked and that you will already be aware.

Information reported back to your manager is factual advice that is given with you informed consent and is focused on achieving the best way forward to manage your health problem at work.

If the referral is initiated by you but following assessment workplace changes are deemed to be necessary to accommodate your health condition, then we would fully discuss how this could be managed with you before talking to anyone else

NSS has to consult with all your employees on health and safety. This does not need to be complicated and can be done by listening and talking to them about:

• health and safety and the work they do
• how risks are controlled
• the best ways of providing information and training 

In a very small business, you might choose to consult your workers directly.  Alternatively, you might consult through a health and safety representative, chosen by your employees or selected by a trade union.  As an employer, you cannot decide who the representative will be.

Consultation is a two-way process, allowing staff to raise concerns and influence decisions on the management of health and safety.  Your employees are often the best people to understand risks in the workplace and involving them in making decisions shows them that you take their health and safety seriously.

Unless clearly stated in your contract or as part of the sickness absence policy then you don't have to attend.

However if you decline the offer of an assessment by and occupational health doctor or nurse then your manager will have to manage your case without the benefit of you both receiving appropriate occupational medical advice and support.

If your manager is suggesting that you are referred to OH for an assessment and advice as part of managing ill health or performance they are likely to be being proactive in seeking specific advice in how to manage any health condition that you may have in relation to your work.

It is however imperative that they first discuss this with you so that you are clear about the reason and benefits of the referral and any specific questions being asked. If this has not been explained to you by your manager then please ask him/her to do so. The Management Referral Form has been designed to assist with such a referral and should be completed by your manager and the consent form signed by you

For current answers to the questions below please see the FAQ section of the Maternity & Breastfeeding HR Connect Page

• I have a pregnancy related medical condition - how does this this affect my risk assessment?
• How do i conduct a risk assessment for a pregnant worker
• What facilities are available for pregnant and breastfeeding mothers across NSS
• Can I still breastfeed when I return
• Does the risk assessment process get repeated as my pregnancy progresses?
• DO I have to tell my employer that I am pregnant or a new mother?
• As a manager what specific risk should I be looking for if an employee is a new or expectant mother?
• Am I entitled to time off to attend antenatal appointments?
• What action needs to be taken if a risk is identified for a new or expectant mother?
• If an employee is breast feeding when they return to work, are there specific workplace risks to consider?
• Can a new or expectant mother still work nights?

To read more about the Winter Vaccines please click here to take you to the NHS Inform Website

Flu & COVID-19 Winter Vaccinations

You can receive the flu and/or COVID-19 vaccines this autumn/winter if you are in the groups below. At your appointment, staff will check that you are eligible. If you are not, you will not be offered a vaccine on the day.

Wherever possible, those eligible will receive both the flu vaccine and COVID-19 booster at the same appointment. This is a safe and effective way of protecting you this winter.

Appointments for winter vaccines will be available for booking from 22nd August for health and social care staff. All other groups should wait until they are contacted by NHS Scotland before trying to reschedule or book their appointment.

Groups eligible for Flu & Covid19

• aged 50 or over
• frontline health or social care worker
• aged 5 to 49 years with an eligible health condition, including those with poorly controlled asthma
• aged 5 to 49 years and are a household contact of someone with a weakened immune system
• an unpaid carer or a young carer (16 years or over)
• pregnant

For more information, please visit NHS Inform

Groups eligible for Flu Only

• adults aged 16 to 49 with well controlled asthma
• non-frontline health worker
• nursery, primary or secondary school teachers or pupil-facing staff
• support workers in local authority or independent settings
• prison officers or support workers who deliver direct front-facing detention services

For more information, please visit NHS Inform

When can I book an appointment online?

Over 65s and patient facing health care workers can book from Monday, 22^nd August 2022, for appointments starting from 5^th September 2022.  

Everyone else should wait until they are contacted by NHS Scotland.

Flu - Will the flu jab give me flu?

The flu jab cannot give you flu as it does not contain any live viruses.

No! Flu is a virus and can affect anyone, no matter how good your immune system is.

Who will be offered the flu vaccine

You'll be offered the flu vaccine this year if you're:

• aged 50 years or over (or will be by 31 March 2023)
• a resident or staff working in a care home for older adults
• a younger adult in long stay nursing and residential care settings
• a health or social care worker
• aged 6 months to 2 years with an eligible health condition
• aged 2 to 5 years not yet at school (children must be aged 2 years or above on 1 September 2022 to be eligible)
• a primary or secondary school pupil
• aged 5 to 49 years with an eligible health condition
• aged 5 to 49 years and are a household contact of someone with a weakened immune system
• an unpaid carer or a young carer
• pregnant
• nursery, primary or secondary school teacher or a pupil-facing support staff in local authority or independent setting
• part of the prison population, a prison officer, or support staff who delivers direct front-facing detention services

NHS Scotland recommends you get the vaccine as soon as it's offered to you.

If you have a confirmed coronavirus (COVID-19) infection, please don't attend your vaccination appointment. You can rearrange it online.

Which vaccines are used?

The following vaccines are routinely used in Scotland for people aged 18 years and over:

• cell based Quadrivalent Inactivated Vaccine (Seqirus)
• cell-based Adjuvanted Quadrivalent Influenza Vaccine (Seqirus)

This year, the Adjuvanted Quadrivalent Influenza Vaccine (aQIV) is being offered to people aged 65 or over. This vaccine contains a substance, known as an adjuvant, to help to stimulate the immune system and create a better response.

This vaccine has been widely used in many other countries and has been shown to offer better and longer-lasting protection in older people than flu vaccines without an adjuvant.

What happens if I don’t have a computer or a smart phone?

You can book via the national help line on 0800 030 8013.  They will find a date and time in the online portal for you. 

Vaccine side effects

Like all medicines, the flu vaccine can cause side effects. They're usually mild and normally last only a day or two. It’s normal to experience side effects after a vaccine. It shows the vaccine is teaching your body’s immune system how to protect itself from the disease. But not everyone gets side effects.

These potential side effects are much less serious than flu or complications associated with flu.

Common side effects

Very common side effects in the first day or two may include:

• having a painful, heavy feeling and tenderness in the arm where you
• had your injection
• feeling tired
• headache, aches and chills
• diarrhoea, nausea and vomiting
• mild flu-like symptoms.
• fever (temperature 37.8°C or above)
• feeling generally unwell

You can rest and take the normal dose of paracetamol (follow the advice in the packaging) to help make yourself feel better.

Phone 111 if you're concerned about yourself or anyone else in your household who is unwell following a vaccination.

Fever after the vaccine

It’s quite common to develop a fever (temperature of 37.8°C or above) after a vaccination. This normally happens within 48 hours of the vaccination and usually goes away within 48 hours.

If the fever starts more than 48 hours after the vaccination, or lasts longer than 48 hours, you should seek medical advice as you may have coronavirus or another infection.

More information about vaccine side effects

More information on the possible side effects of the flu vaccine is available in the patient information leaflets:

• cell-based Quadrivalent Inactivated Vaccine (QIVc) Flucelvax Tetra (Seqirus)
• cell-based Adjuvanted Quadrivalent Influenza Vaccine (aQIV) (Seqirus)
• egg-based Quadrivalent Inactivated Vaccine (QIVe)
• Fluenz Tetra nasal spray suspension Influenza vaccine (live attenuated, nasal)

What are my choices likely to be for the venue of my vaccination? 

You will be able to book to attend a community clinic of your choice. These facilities allow us to vaccinate as many people as possible, quickly, efficiently, and conveniently for most people.  However an appointment can be booked in another health board area if more convenient – for example if you live in one town or city but work in another.

We continue to explore available options to maximise capacity in the vaccination programme, for example providing additional clinics at evenings and weekends, or through targeted outreach to support specific communities.

Flu - I've never logged in before to book an appointment

Even if you have never logged in before, you can find your username on your appointment letter or by using the 'Get your user name' option.

You can then set up a password by selecting the new user option to register.

I’ve moved from one area of Scotland to another

You can use the portal or, if you don’t have online access, call the National Helpline on 0800 030 8013 to get an appointment. As long as you have a Scottish vaccination record it doesn’t matter if you have moved address, you can still book.

Flu - I've heard the vaccine does not work and that I will still get flu?

In the past 10 years the vaccine has provided good coverage against flu and it is still the best way to fight flu this winter.

Flu - Is the flu vaccine safe?

The vaccine is well tested and has an excellent safety record.

All medicines (including vaccines) are tested for safety and effectiveness before they're allowed to be used.

Once they're in use, the safety of vaccines continues to be monitored by the Medicines and Healthcare products Regulatory Agency (MHRA).

It's also safe to get the flu and coronavirus vaccines at the same time.

NHS Scotland recommends that all pregnant women should have the free flu vaccine every time you're pregnant. This is because the flu viruses circulating change each year.

Why should I get the vaccine?

Pregnant women are at a greater risk of serious flu-related complications so need extra protection. Complications may include as early labour, low birth weight and stillbirth.

Every year in Scotland, a number of pregnant women will get influenza (flu). Some will need hospital treatment or be admitted to intensive care. Those with a health condition such as diabetes or asthma are particularly vulnerable.

It only takes a few minutes to get vaccinated. The flu vaccine takes around 10 days to work, so the sooner you get it the better.

The flu vaccine:

• can help protect you and your developing baby against this year’s flu virus during pregnancy and for at least 3 months after birth
• contains no live viruses and cannot give you flu
• is safe for your baby and for you at any stage of your pregnancy
• can be given at the same time as other vaccines

How do I get the flu vaccine?

Speak to your midwife about getting your flu vaccine.

If you've had the flu vaccine before

Even if you’ve had a flu vaccine in the past, you need to get vaccinated again this year. This is because the virus changes constantly and your immunity reduces over time.

If you’ve been pregnant before, remember that a healthy flu-free pregnancy last time is no guarantee you won’t catch flu this time. To make sure you get the maximum protection, it's recommended that you get the vaccine.

Other vaccines during pregnancy

There are 2 other vaccines offered during pregnancy – coronavirus and whooping cough.

Find out more about the coronavirus and whooping cough vaccines in pregnancy

How do I cancel and /or rebook using the online portal?

We advise people to make every effort to attend a vaccination appointment when one is offered, but accept that this is not always possible which is why we offer an online rescheduling facility on NHS Inform for those who could not attend. 

However, if you were offered an appointment and didn’t attend or reschedule, you will not be able to book a new appointment on the online portal. 

In those specific circumstances you will need to phone the National Helpline on 0800 030 8013 for the Helpline to book a new appointment for you. 

If you have an egg allergy

Some flu vaccines are made using eggs.

Tell the person giving you your vaccine if you have an egg allergy or if you’ve ever had a serious allergic reaction to a flu vaccine.

If you're affected, please speak to your health professional for advice. An egg-free vaccine may be available.

I can't see an appointment online that suit's me, do the Helpline have access to additional appointments?

No, the helpline access the same system used by individuals and so do not have access to additional appointments.  If you cannot find an appointment that suits you please check back at a later time as new options will come up as other people reschedule their appointment.  Health Boards will sometimes add more capacity or new clinics dependent on staffing or other factors, so please check back regularly.

Flu - I can't remember my Username

If you have lost or forgotten your username, you can recover it by selecting the 'Get my user name' option.

Flu - I can't remember my password to the online Portal

If you have lost or forgotten your password, you can recover it by selecting the 'forgotten your password' option.

I cannot access the online portal but am eligible and want a jag – what do I do?

You can book an appointment via the NHS Helpline on 0800 030 8013.

Flu - Do I need the flu jab if I'm not in an at risk group?

Anyone can get flu and pass it on to vulnerable groups, even with no symptoms, therefore it's important to get the flu jab to stop the spread of the virus.

Click MyCohort to access the system

Via the Quick System Links on the HR Connect homepage on HR Connect

The site is accessed via a web link and is compatible with mobile devices, laptops, PCs and tablets.

MyCohort performs best on Edge or Chrome and is also compatible with IE but does face issues when launched on Firefox.

NSS and PHS employees - If your personal details have changed please let Occupational Health know via Contact Us on HR Connect. 

NES, SAS and HIS employees - If your personal details have changed please let Occupational Health know by emailing nss.occupationalhealth@nhs.scot.

If you didn’t receive a registration email as part of the process then return to the login page, select Resent verification link and enter your email address.

If you have completed the registration process and are using the correct email address, then select Forgot password?  You will need to enter your logon (email address) and follow the instructions on the email you receive.

NSS and PHS employees - If this doesn’t work then contact the Occupational Health team via Contact Us on HR Connect.

NES, SAS and HIS employees - If this doesn’t work then contact the Occupational Health team at nss.occupationalhealth@nhs.scot

Please ensure that you are using your correct email address and your date of birth is entered as DD/MM/YYYY

NHS Board                                                    Email address ending

• National Services Scotland:              xxx@nhs.scot
• National Education Scotland:            xxx@nhs.net (for some staff this maybe your Turas email account
• Public Health Scotland:                    xxx@nhs.net or xxx@phs.scot
• Healthcare Improvement Scotland:   xxx@nhs.net
• Scottish Ambulance Service:            xxx@nhs.scot

If this doesn’t work then contact the Occupational Health team by emailing nss.occupationalhealth@nhs.scot

NSS and PHS employees - Contact the Occupational Health team via Contact Us on HR Connect who can add your details to the system or confirm your login email address

NES, SAS and HIS employees - Contact the Occupational Health team via nss.occupationalhealth@nhs.scot who can add your details to the system or confirm your login email address

This issue is caused by entering your password incorrectly multiple times.  Please wait 10minutes and retry.  We would recommend resetting your password if you are unsure of your password, again please wait 10minutes after the error message on the screen before resetting your password.

For NSS and PHS employees - If this doesn’t work then contact the Occupational Health team via Contact Us on HR Connect.

For NES, SAS and HIS employees - If this doesn’t work then contact the Occupational Health team via nss.occupationalhealth@nhs.scot

If you don’t receive a registration email when you tried to self-register with your email and date of birth then return to the MyCohort login page and select Resent verification link and enter your email address and a link will be sent to you within 10- 15seconds.

For NSS and PHS employees - If this doesn’t work then contact the Occupational Health team via Contact Us on HR Connect.

For NES, SAS and HIS employees - if this doesn't work then contact the Occupational Health team at nss.occupationalhealth@nhs.scot

Please Note - as we use National Health Boards to deliver services this option may not be available at this time

You will need to have completed your self-registration to get access to the system, refer to the How do I get access to MyCohort FAQ.

Once you have successfully registered please watch this short video on how to view, book and manage your appointments.

Please Note - as we use National Health Boards to deliver services this option may not be available at this time

If you are new to MyCohort then you will need to complete self-registration.  Please watch this short video the explains what you need to do.  Then use this link to begin your self-registration MyCohort link or copy this link to your browser https://nss.mycohort.cohort.hosting/account/login

If you don’t receive a registration email as part of the process then return to the login page, select Resent verification link and enter your email address.

- If you are within NES, SAS and HIS and this doesn’t work then contact the Occupational Health team by emailing nss.occupationalhealth@nhs.scot.

- If you are an employee of NSS or PHS and this doesn’t work then contact the Occupational Health team via Contact Us on HR Connect.

If you need to cancel and re-book your appointment then please watch this short video on how to book, view and cancel your appointment.

Please Note - as we use National Health Boards to deliver services this option may not be available at this time

For HIS, SAS and NES - Contact the Occupational Health team by emailing nss.occupationalhealth@nhs.scot.

For NSS and PHS - Contact the Occupational Health team via the Contact Us on HR Connect

You can do this yourself from the MyCohort login page, select Forgot password? You will need to enter your logon (email address) and follow the instructions on the email you receive.

For PHS and NSS - If your issue is not listed on the FAQ then log a call via the Contact Us on HR Connect. 

For HIS, NES and SAS - If your issue is not listed on the FAQ then please email nss.occupationalhealth@nhs.scot

The primary purpose of health assessment fitness for work is to make sure that an individual is fit to perform the tasks involved effectively and without risk to their own or others’ health and safety. 

It is not the intention to exclude a person from a job but to make any necessary reasonable modifications or adjustments to the job to allow the person to work efficiently and safely.

Why an assessment may be needed:

• the individual’s health condition may limit or prevent them from performing the job effectively (e.g. musculoskeletal conditions that limit ability)
• the individual’s condition may be made worse by the job
• the individual’s condition may make certain jobs and work environments unsafe to them personally (e.g. liability to sudden unconsciousness in a hazardous situation, risk of damage to the remaining eye in an individual with monocular vision)
• the individual’s condition may make it unsafe both for themselves and for others in some roles
• the individual’s condition may pose a risk to the community (e.g. infection transmitted by a food handler)

When an assessment may be needed:

Assessment of medical fitness may be needed for those who are:

• being recruited for the first time (depending on work exposures)
• being considered for transfer to a new job (depending on work exposures)
• returning to work after significant or prolonged illness or injury
• undergoing periodic review relating to specific requirements (e.g.health surveillance)
• being reviewed for possible retirement on grounds of ill-health

An assessment may be needed to help both the employer and the employee but should be directed at the job in question.  In all situations there is a legal requirement to consider ‘reasonable adjustment’ if the individual has a disability within the definition of the Equality Act 2010 and it is good practice to do so in any case.

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