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last updated:24/01/2012 @ 3:10 pm
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Competency 2 – Good Clinical Care: Be willing to listen to a patient’s views, aspirations and fears.

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


Be willing to listen to a patient’s views, aspirations and fears.

Good medical practice describes it as important to establish a patient-centred consultation. This incorporates the agendas of both the doctor and the patient.

A patient has a unique experience of their condition and normally includes the feelings, thoughts, concerns and effect on life that any sickness induces.

By listening to a patient’s views, aspirations and fears the following advantages can be achieved:

  • Support, understanding and building a relationship. Failing to understand the impact of the diagnosis of angina in 50 year old fireman whose livelihood is now threatened may well limit your effectiveness as a doctor. Your ability to help depends on your ability to diagnose effectively as well as understand your patient’s perspective and support through adversity.
  • Building rapport can aid diagnosis and management and make for effective and efficient interviews and provide useful groundwork for explanation and planning.

Understand the differing needs of employer and employee.


As an employer there are certain requirements that need to be satisfied when exploring an employee’s suitability for work. This is a legal requirement and is covered by The Management of Health and Safety at Work Regulations 1999 in which the duties of an employer are:

  • making your workplace safe and without risks to health
  • ensuring plant and machinery are safe and that safe systems of work are set and followed
  • ensuring articles and substances are moved, stored and used safely
  • providing adequate welfare facilities
  • giving your employees the information, instruction, training and supervision necessary for their health and safety

It is essential for employers when considering an employee’s suitability for work whether at pre-employment or following a period of sickness to ensure the following:

  • The individual is fit to perform the tasks required without risk to themselves or others’ health and safety.
  • An individual’s fitness should be interpreted in functional terms and in the context of the job requirements.
  • The employer has a duty to ensure as far as reasonably practicable the health, safety and welfare of all their employees.
  • Legal duties of reasonable adjustments and non discrimination in employment are imposed by the DDA.


As an employee possibly returning to work, or considering a post, the needs may be very different. Often, this is complex and governed by several factors:

  1. Biological factors i.e.: disease, ill health, functional ability
  2. Personal i.e.: Motivation to work or return to work, strongly held beliefs about work and health, resilience, or psychological well being.
  3. Social i.e.: financial, family commitments or demands