Occupational health: Common pitfalls for accountancy firms and how to avoid them
Occupational health (OH) can be a valuable tool when managing sickness absence, disability issues, workplace adjustments and performance concerns linked to health. However, many employers either fail to obtain OH advice when they should or misunderstand how that advice should be used.
For accountancy firms, these risks can be particularly acute. Long working hours, tight deadlines, client demands, regulatory pressures and increasingly blurred boundaries between home and office working can all contribute to physical and mental health issues among staff. We regularly advise professional services businesses on employment tribunal claims where health issues have allegedly not been handled appropriately.
This article highlights some of the most common pitfalls and the practical steps accountancy firms can take to avoid them.
1. Waiting too long before referring to occupational health
Many employers delay obtaining OH input until an employee has already been absent for several months or a dispute has arisen.
Managers may assume:
The employee will shortly recover
A GP fit note provides sufficient information
The employee will obtain their own diagnosis
OH should only be used for long-term absence
By the time OH is instructed, relationships may have deteriorated and important evidence may have been lost.
Employment tribunals will expect employers to understand and adjust for an employee's medical condition.
Delaying a referral can:
Prolong sickness absence
Delay practical support or a return to work
Increase the risk of disability discrimination claims
Leave the employer without sufficient medical evidence to make informed decisions
Consider an OH referral where:
Absence becomes recurrent
Absence exceeds four weeks
Mental health concerns or serious other condition are raised
Performance appears linked to health
The employee requests adjustments
The employee indicates they may have a serious condition or disability
Early intervention can often prevent a short-term issue becoming a long-term absence problem.
2. Treating the occupational health report as the final word
A surprisingly common misconception is that the OH ‘makes the decision’.
Managers sometimes say:
“Occupational health said they are not disabled.”
“We can go ahead and dismiss.”
Neither statement is correct.
OH provides a professional opinion based on the information available to it. Some assessments are conducted remotely, meaning the practitioner may never meet the employee in person.
The employer remains responsible for the decisions it makes and must be able to show that it acted reasonably. Ultimately, disability is a legal question rather than a purely medical one.
Employers remain responsible for:
Deciding whether adjustments are reasonable
Assessing capability to attend meetings and perform a role
Determining whether redeployment or dismissal may be appropriate
Considering whether an employee meets the definition of disabled under the Equality Act 2010
Use OH advice as one factor in decision-making.
Employers should also consider:
Fit notes, medical letters and any medical reports or records available
Discussions with the employee
The employer’s size and resources
Operational requirements
Legal obligations under the Equality Act 2010
The OH report should be discussed with the employee and considered alongside all other available evidence.
3. Asking the wrong questions
Employers often instruct OH using broad requests such as:
“Please advise on fitness for work.”
“Is the employee fit to perform the role?”
This rarely produces sufficiently detailed advice.
A vague referral often leads to vague recommendations.
Employers may be left without clear advice on:
Disability status
Likely recovery timescales
Recommended adjustments
Phased return arrangements
Future absence prognosis
Describe the employee’s role and key responsibilities and use tailored referral questions.
Examples include:
What is the nature of the employee's impairment?
Is there likely to be a substantial and long-term effect on normal day-to-day activities?
Are they likely to satisfy the Equality Act definition of disability?
What is the prognosis for recovery?
What adjustments would assist?
Is the employee fit to participate in meetings or disciplinary proceedings?
What steps could support a return to work?
In our experience, the quality of the referral questions often determines how useful the report will be.
4. Failing to consider reasonable adjustments properly
An OH report may recommend adjustments, but employers sometimes fail to implement them or reject them without adequate consultation.
In accountancy firms, common recommendations may include:
Homeworking
Auxiliary aids
Reduced working hours
Temporary reductions in workload
Flexible start and finish times
Failure to properly consider adjustments, or to engage with the employee about whether they would be effective, can create significant exposure under the Equality Act 2010.
Tribunals regularly scrutinise:
Whether adjustments were considered
Whether alternatives were explored
Whether discussions took place with the employee
Whether decisions were reasonable in all the circumstances
Create a documented adjustment assessment process.
For each recommendation:
Consider what is possible
Discuss the proposal with the employee
Record the reasons if it is rejected
Consider alternative adjustments
Review arrangements periodically
Employers do not have to implement every recommendation simply because OH has suggested it. However, there should always be a clear and documented reason for any decision not to do so.
5. Missing the link between performance, wellbeing and underlying health conditions
Some of the most difficult employment issues arise when a manager focuses on performance concerns without fully understanding the health factors that may be contributing to them.
In accountancy firms, these issues can present themselves in different ways, from stress and burnout during busy periods to the impact of menopause symptoms or neurodiverse conditions such as ADHD, autism, dyslexia and dyspraxia.
Concerns may include:
Missed deadlines
Billing performance
Client complaints
Reduced productivity
Examination failures for trainees
Managers may be tempted to move straight into a performance process without considering whether there is an underlying health issue.
If performance concerns are linked to a health condition, formal action may increase the risk of disability discrimination claims and may also damage employee relations.
Professional services firms often experience periods of intense pressure around:
Audit deadlines
Financial year-end periods
Tax return deadlines
Major transactions
Where it is foreseeable that work-related stress may affect an employee's serious health condition, employers may be expected to take reasonable steps to address the issue.
Practical measures may include:
Stress risk assessments
Workload reviews
Regular wellbeing discussions
Manager training
Employee assistance programmes
Clear escalation routes
Many accountancy firms employ talented individuals with:
ADHD
Autism spectrum conditions
Dyslexia
Dyspraxia
These issues may be viewed as performance concerns when adjustments and support would be more appropriate.
Possible adjustments may include:
Clear written instructions
Reduced distractions
Additional processing time
Software support
Adjusted supervision arrangements
Taking a supportive approach early can often help employees perform at their best while reducing legal risk for the employer.
Menopause is becoming an increasingly important workplace consideration, particularly within senior professional populations.
Symptoms may affect:
Concentration
Memory
Energy levels
Anxiety
Attendance
Employers should consider:
Menopause policies
Manager training
Obtaining OH input
Flexible working arrangements
Open dialogue with employees
6. Poor handling of long-term absence
Long-term absence cases can sometimes lose momentum, with review meetings becoming infrequent or decisions being repeatedly postponed. Others move too quickly towards dismissal without sufficient medical evidence.
Both approaches can create risk.
Employers are generally expected to follow a fair, medically informed and consultative process.
This includes:
Obtaining up-to-date medical evidence
Consulting with the employee
Considering adjustments
Exploring return-to-work options
Taking decisions only after a documented process
Establish a structured absence management process involving:
Regular welfare meetings
Updated OH reports
Reviews of adjustments
Consideration of alternative roles where appropriate
Careful documentation
7. Inadequate documentation
Managers often have conversations about health concerns but fail to record them.
If litigation arises several years later, the Employment Tribunal will focus heavily on documentary evidence. Without records, sensible decisions can be difficult to explain or justify.
Maintain clear records of:
OH referrals
Referral questions
Reports received
Meetings with employees
Adjustment discussions
Reasons for accepting or rejecting recommendations
Good documentation can be invaluable if decisions are challenged months or even years later.
Key takeaways for accountancy firms
In practice, the firms that manage OH issues most effectively tend to take a consistent and proactive approach:
Refer employees to OH early where health concerns may be affecting work
Ask focused questions that will help inform practical decisions
Look beyond the OH report and consider all available evidence
Approach performance concerns with an open mind, especially where health, menopause or disability issues may be relevant
Assess reasonable adjustments carefully and keep clear records of decision-making
Maintain regular reviews in long-term absence cases
Seek legal advice before dismissing an employee where health issues may be involved
Conclusion
OH works best when it forms part of a wider people strategy rather than being treated as a box-ticking exercise. For accountancy firms, early intervention, sensible questioning, meaningful consultation and careful record-keeping can make a significant difference to both employee outcomes and legal risk.
Employers that use OH proactively are generally in a much stronger position to support their people and make well-informed decisions when challenges arise. Every case will turn on its own facts, but taking advice early can often prevent issues escalating into formal disputes or tribunal claims.
The content of this page is a summary of the law in force at the date of publication and is not exhaustive, nor does it contain definitive advice. Specialist legal advice should be sought in relation to any queries that may arise.
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