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Competency 2 – Good Clinical Care: Analyse and synthesise the interaction between clinical and medico-legal aspects of work and health

Objective: to understand and manage the legal and ethical implications of advice on suitability for work


Analyse and synthesise the interaction between clinical and medico-legal aspects of work and health

This can best be demonstrated by means of a case discussion.

Case: Cancer and return to work

Consider an individual who has been diagnosed with cancer and the implications this has to their employment. The number of patients who live for five years or more after diagnosis and treatment of cancer has increased substantially in recent decades. Many have a reasonable prospect of returning to work but do not do so. This can cause them to suffer serious financial and psychological difficulties.

For the purposes of this discussion we will assume that most of these survivors who were working in or away from home before their diagnosis wish to remain at work or return to work as soon as possible after treatment. Our aim is to decide what their doctors might do to assist them to minimise their absence.

Possible answers/points to raise:

What factors might impede return to work by a cancer survivor?

How might you and others contribute to high quality occupational rehabilitation for cancer survivors under your medical care?

What changes might have to be made at and around work to allow the patient to return?

Whatever reasonable changes the patient thinks necessary and which the employer is willing to provide. These might include:

Are there any legal requirements on the employer to make reasonable adjustments to such individuals?

Individuals with a diagnosis of cancer ( or multiple sclerosis or HIV/AIDS) are now covered by the Disability Discrimination Act (DDA) from the point of diagnosis and even if they do not have impaired day to day activities.

As such the employer has a legal duty to provide reasonable adjustments. This can include

Most workplaces have no occupational health staff. How might effective vocational rehabilitation be achieved in these circumstances?

What performance indicators might be useful in measuring the quality of your contribution to the management of return to work of cancer survivors?

Particular criteria to be met should be defined in respect of: