Under the Health and Safety at Work etc Act 1974, HSE’s Employment Medical Advisory Service (EMAS) has a wide range of duties and responsibilities. One of these is the periodic medical supervision of employees who work with specified hazards under certain conditions. These conditions are outlined in relevant regulations and where the nature of the work brings employees within those regulations, monitoring health is called ‘statutory medical surveillance’. This is synonymous with 'occupational health surveillance'.
HSE appoints registered medical practitioners to undertake statutory medical surveillance. This is done by issuing a Certificate of Appointment under the appropriate regulations. It authorises the appointed doctor to conduct medical surveillance under specified regulations for a stated period. Although appointed by HSE, appointed doctors are not employed by HSE. The company requiring statutory medical surveillance is responsible for agreeing conditions of service and payments with the appointed doctor.
Appointed doctors are accountable to HSE for the work they carry out. They work under the supervision of the HSE Senior Medical Inspector who issued the Certificate of Appointment.
As an appointed doctor, you are responsible for achieving and maintaining your own competence as required by the General Medical Council (GMC). In 2009, the GMC introduced a licence to practise. This is the first step towards introduction of a revalidation system to ensure doctors are fit to practise. It is important for HSE to have appropriate governance arrangements to monitor competence for the specific role of an appointed doctor.
The request for a doctor to be appointed under regulations is normally initiated by the employer duty holder to whom the regulations apply. In the first instance, the employer should consider using the services of a doctor already appointed for the relevant regulation. If such an appointed doctor is not available, the circumstances may require the assistance of another doctor (eg, a local GP or a doctor in their own occupational health service) who will need to apply to HSE for an appointment.
To apply for an appointment, all parts of form FODMS38AB (Further information must be provided when requesting extension of an appointment to include additional regulations and/or a new company - see Moratorium on new applications) must be completed. The form should be sent, with all the information requested in the 'General guidance for appointed doctors' to the HSE office that administers appointed doctor work for your area.
The application will be assessed by an HSE Medical Inspector. If appropriate, HSE will issue a Certificate of Appointment and a Schedule containing company details. Normally, the certificate is for one year in the first instance.
All appointments are subject to review before the certificate expires. In order for an HSE Medical Inspector to conduct a review, all the information requested in the 'General guidance for appointed doctors' as well as a Review of Appointment Declaration must be submitted to the HSE office dealing with your appointment. If appropriate, HSE will issue a new Certificate of Appointment for 1-5 years.
Under certain circumstances, the HSE Medical Inspector will conduct a face to face review visit with the appointed doctor. In considering the need for such a review visit, the following will be taken into account:
To provide medical surveillance for workers exposed to ionising radiation or work in compressed air, appointed doctors must undertake appropriate, separate training and maintain up to date knowledge.
The doctor must complete an initial one-day course followed by a one-day refresher course at least once every five years. The following organisations can provide suitable courses (inclusion in the list does not imply HSE approval or accreditation):
A doctor appointed to provide medical surveillance in relation to work in compressed air should have the same level of training as an HSE Approved Medical Examiner of Divers (AMED).
