Introduction
The impact of health conditions
Health conditions and disability
The role of occupational health
The role of risk assessments
Gendered health conditions
Menopause
Pregnancy
What should NASUWT Representatives do?
Further guidance
 

Introduction

This document is intended to give employment-related guidance to members who may be suffering from health conditions in the workplace. It is not intended to give medical advice and any non-employment-related concerns should be directed to the appropriate medical professional.

The impact of health conditions

The impact of a health condition on an individual can vary from minor to debilitating and it should be remembered that the same condition can have widely varying symptoms, both in terms of nature and severity, between individuals with the same condition.

Health conditions may be:

• acute or chronic;

• constant or relapsing remitting;

• improving or worsening over time; and

• recovery may or may not be expected.

For these reasons, every case must be treated individually on a case-by-case basis and generalisations should be avoided.

Health conditions and disability

Not every health condition will result in a disability. Under the Equality Act 2010, a person is disabled if they have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on their ability to do normal daily activities.

‘Substantial’ is more than minor or trivial. For example, it takes much longer than it usually would to complete a daily task like getting dressed, while ‘long-term’ means 12 months or more. A condition does not have to have existed for 12 months, but it should be reasonably expected to last 12 months or more.

Some conditions are automatically considered disabilities from the point of diagnosis - cancer, HIV infection and multiple sclerosis.

Under the Act, employers are required to make reasonable adjustments for people who are disabled. The exact nature of reasonable adjustments will depend on the individual circumstances, but it could include changes to the working environment, operation of policies, changes to terms and conditions, or flexible working.

Further information on the Equality Act can be found on our Equality Law in Great Britain page and on the Gov.uk page Equality Act 2010: Guidance.

The Equality Act does not apply in Northern Ireland, but the provisions of the Disability Discrimination Act 1995 mirror those of the Equality Act 2010 with regard to disabilities.

In addition, employers should approach disability from the social model, focusing on barriers and prejudice rather than the medical model which focuses on the impairment as the problem.

Further details on the social model of disability can be found in the TUC guidance Trade Unions and Disabled Members: Why the social model matters (pdf).

The role of occupational health

A referral to occupational health (OH) is usually a positive step and can be very useful in securing adaptions/reasonable adjustments.

An OH referral usually takes the form of an appointment with an OH professional, who will discuss the symptoms an individual is experiencing, how they are impacted by and impacting on work, and any adjustments that may be necessary.

The employee has the right to see the referral and the report and any discrepancies should be raised with the employer.

It should also be noted that members’ engagement with OH is protected by the Medical Records Act 1998 and, as a result, employers do not get access to their medical records that are shared with OH professionals.

The employer does not have to implement all the recommendations, but if they do not, further advice should be sought from NASUWT.

Further guidance on the role of OH can be found on the Acas page Using Occupational Health at Work.

The role of risk assessments

Under the Health and Safety at Work etc. Act 1974/Health and Safety at Work (Northern Ireland) Order 1978, an employer must do everything ‘reasonably practicable’ to ensure the health, safety and welfare of their employees.

In addition, under the Management of Health and Safety Regulations 1999/Management of Health and Safety at Work Regulations (Northern Ireland) 2000, an employer must carry out a risk assessment of any workplace hazards.

Risk assessments are generally either general - relating to the whole workplace/workforce - or specific - relating to an individual.

General risk assessments should be in place for all workplace hazards - these should be designed with control measures to eliminate/reduce risk to an acceptable level, i.e. they should be designed to prevent the workplace injuring/making people sick.

This should include physical hazards, such as slips and trips, and psychosocial hazards, such as stress. Individual risk assessments tend to be used to mitigate the impact of a particular hazard on an individual.

Whilst some health conditions can be caused by the workplace, especially stress, others will not be. However, if the workplace could exacerbate the condition, then a risk assessment may be in order.

Similarly, if side effects of medication taken for a condition could cause a hazard, then a risk assessment should be undertaken.

Any employee should be able to request a risk assessment and this should be undertaken in consultation with the employee and reviewed on an agreed basis.

Not every health condition will require a risk assessment.

Further advice on risk assessment can be found on our Risk Assessment Toolkit page.

Gendered health conditions

Gender is primarily cultural/social. Approaches to gender vary across cultures - some are more flexible, some more rigid.

Man/woman (boy/girl) are gendered descriptions. The physical sex attributes we are born with determine the gender we are assumed to have - they are assumed to be linked, but this isn’t always the case.

Non-binary people feel their gender identity cannot be defined within the margins of gender binary. Instead, they understand their gender in a way that goes beyond simply identifying as either a man or woman.

People who are intersex have genitals, chromosomes or reproductive organs that don’t fit into a male/female sex binary. Their genitals might not match their reproductive organs or they may have traits of both. Being intersex may be evident at birth, childhood, later in adulthood or never. Being intersex isn’t a disorder, disease or condition.

The term ‘cis’ is routinely used to describe someone whose gender identity corresponds to the sex they were assigned at birth.

NASUWT has provided advice and guidance on a number of health conditions, some of which are more likely to affect some people, or groups of people, more than others on Women’s Health And Wellbeing page.

NASUWT guidance includes:

• endometriosis;

• adenomyosis;

• fibroids; and

• menopause.

For example, endometriosis is extremely rare in those without a uterus/ovary. There is medical evidence to show that thyroid conditions are up to six times more likely in women, whilst only those with a prostate gland (such as men and trans women) suffer from prostate conditions.

Cis men are more likely to develop heart disease at a younger age, while women face increased risk after menopause. Trans people are also more likely to develop heart disease than cis people.

AHA Journals Circulation: Cardiovascular Quality and Outcomes

Employers should take account of gender-based health risks when compiling both general and individual risk assessments. These might include exploring temperature issues, access to toilets and workplace stress.

Where an individual has changed their gender identity with the NHS, this may have an impact on access to automated healthcare, including screening. Employers should be mindful when providing information or undertaking gendered health awareness-raising activities. These activities should be done in an inclusive way.

Menopause

The menopause is a natural part of ageing which usually occurs between 45 and 55 years of age. It occurs as a direct result of oestrogen levels declining.

In the UK, the average age to reach menopause is 51, although it can occur much earlier. For example, through medically induced menopause, e.g. hysterectomy.

Although the menopause itself is not a health condition, the symptoms of the menopause can be and it can also vary widely between women from very few or no symptoms to being completely debilitating.

Likewise, whilst menopause is not a disability itself, the symptoms can reach the threshold for a disability as described above.

Most people experiencing menopause will have some or all of the symptoms at some point in their lives and NASUWT believes that, as teaching is a predominately female profession, addressing the menopause should be a high priority in all workplaces.

Further detailed guidance on the menopause can be found on our Women’s Health and Wellbeing page.

Pregnancy

Pregnancy is not itself an illness. Pregnancy can, however, lead to a number of health conditions that have an impact in the workplace.

Employers are required by law to undertake and regularly review a risk assessment for all pregnant/breastfeeding workers.

NASUWT has extensive guidance on pregnancy which can be found on our Maternity Leave for Teachers and Valuing Maternity pages.

What should NASUWT Representatives do?

NASUWT Representatives should work with schools and employers to ensure they have in place all the necessary risk assessments and policies, such as stress/wellbeing, menopause, and absence management.

Health and Safety Representatives can request data around staff absence, which ideally should be interrogated at the school/employer health and safety committee For further information, please see our guidance on 'Health and Safety Committees' on our Health and Safety page.

Policy checklists for a variety of policies can also be found on the NASUWT web page Reps Resources, including Managing Sickness Absence.

Further guidance

Any member experiencing issues with health conditions that their school/employer has not addressed or any member entering a formal process should contact NASUWT for further advice.