Is Occupational Health Confidential? What Your Manager Will and Won't See
Being referred to occupational health can be worrying, especially if the reason is your mental health. Many people wonder whether what they say will go straight back to their manager, end up on their file, or be used against them. For NHS staff, where occupational health is often part of your own trust, those worries can feel even sharper.
The short answer is that your clinical information is confidential, but occupational health does write a report for your employer, and it helps to understand the difference. This guide explains what stays private, what your manager will see, and your rights along the way.
What stays private and what doesn't
Occupational health holds two kinds of information about you, and they are treated differently.
Your clinical record. This is what you discuss in the appointment: your symptoms, your medical history, any treatment, and the personal details behind them. This information is kept by the occupational health team, separately from your HR file, and it should not be passed to anyone outside the occupational health service without your written consent, except in rare circumstances such as a serious risk to you or others (Personnel Today). Many NHS occupational health services say the same in their own policies (Royal United Hospitals Bath).
The management report. If your manager referred you, they will usually ask specific questions, such as whether you are fit for work, whether any adjustments would help, and how long you might need. The clinician answers those questions in a report, using only the information needed to answer them. It gives functional advice, such as "would benefit from reduced hours for four weeks", rather than medical detail. You don't have to tell your manager your diagnosis.
Good practice is for the clinician to explain what they plan to say before the report is sent, and to give you a copy. If something in it worries you, say so at the time.
Your rights
- Consent. The clinician should explain why you have been referred and what will be shared, and ask for your consent before a report goes to your employer.
- Seeing the report. Most services will show you the report before it is released if you ask, and you can have a copy.
- Reports from your own doctors. If occupational health wants a report from your GP or specialist, they need your written consent. Under the Access to Medical Reports Act 1988, you can ask to see that report before it is sent, and ask for anything inaccurate to be corrected.
- Advice, not decisions. The service only advises. Your employer makes the decisions, including about adjustments, and has to act fairly and within the law.
Occupational health is not counselling
Occupational health can be helpful. It can recommend changes that make work manageable, support a phased return, and point you towards other services. But its job is to advise on your health in relation to your work, on behalf of your employer. It is not a confidential space to work through what is happening for you.
That is why some people choose to have counselling somewhere separate. Counselling with me is completely independent of your employer. I don't share anything with your employer, occupational health or your professional regulator without your agreement, unless there is a serious risk to you or someone else. If you work in the NHS, counselling for NHS staff looks at the different routes to support and where each falls short.
Frequently asked questions
Can occupational health access my medical records?
Not without your written consent. They may ask for a report from your GP or specialist, and you can see it before it is sent.
What will occupational health ask me?
Usually about your symptoms, how they affect your work, any treatment, and what might help. You can choose how much detail to give, but being open usually leads to more useful advice.
Can occupational health get me sacked?
No. It gives advice. Decisions about your job are made by your employer, who should take the advice into account fairly.
What if I disagree with the report?
Raise it with the clinician who wrote it, ideally before it is sent. You can ask for factual errors to be corrected.
Talking to someone
I'm a BACP registered counsellor offering person centred counselling and EMDR therapy in Nottingham and online. If you would like to ask whether I might be the right fit, you can get in touch before committing to anything.