Guidance for employers on statutory medical examinations and how to access HSE appointed or approved doctors

September 2011

1. What regulations require employers to ensure employees undertaking certain work activities with specified hazards have suitable medicals?

1. The Ionising Radiations Regulations 1999
2. The Control of Lead at Work Regulations 2002
3. The Control of Asbestos Regulations 2006
4. The Control of Substances Hazardous to Health Regulations 2002 (as amended)
5. The Work in Compressed Air Regulations 1996
6. The Diving at Work Regulations 1997

2. Who is responsible for making sure that employees have the relevant medicals?

The employer is responsible for ensuring their employees have the relevant medicals at the required intervals using the services of a Health and Safety Executive (HSE) Appointed Doctor (AD) or Approved Medical Examiner of Divers (AMED). ADs can be appointed under any of the regulations a-e above. AMEDs are approved specifically for the purposes of the Diving at Work Regulations 1997. Statutory medical examinations help ensure that the work undertaken by employees in relation to regulations a-f above, does not have an adverse effect on their health. The onus is on employers and the self-employed to find a suitable AD/AMED, if required.

3. How does HSE ensure there are appointed or approved doctors available to carry out these medicals?

In order to become appointed or approved, a doctor must demonstrate to HSE that they have suitable qualifications and experience, and have a detailed knowledge of the nature of the hazards and risks in relation to the work activities being undertaken for which statutory medical examinations are required.

Currently, there are approximately 600 ADs and AMEDs who can perform statutory medical examinations. These appointments and approvals enable employers to access competent advice and support in fulfilling their responsibilities under the regulations listed above. There must be a sufficient number of such suitably qualified doctors distributed geographically so employers and the self-employed can locate them when required.

4. What has changed?

In the past, HSE's practice was to consider all applications for appointment/approval on request. However, it has become increasingly onerous for HSE to meet the demand for new appointments and approvals, to continue auditing and monitoring existing ADs and AMEDs and therefore to resource the requirements to properly manage these processes. To more effectively manage existing ADs and AMEDs, HSE has streamlined its procedures. It is HSE's view that there are sufficient numbers of such doctors, geographically spread, to ensure employers and the self-employed have ready access to them. This is subject to periodic review.

As a result, HSE took the decision to implement a moratorium on new applications on 1 September 2010. The moratorium was highlighted in an e-newsletter published by the Society of Occupational Medicine with reminders and updates published on HSE's web pages for ADs and AMEDs. HSE also notified universities and other organisations that offer training to these doctors. The moratorium is subject to periodic review. However, HSE expects it to continue for some time.

5. How might this moratorium affect employers?

Following introduction of the moratorium, HSE will now only consider a new application from a doctor seeking an appointment/approval in exceptional circumstances. For example, where an employer cannot find an AD or AMED within a reasonable geographical area and this could compromise their ability to comply with the relevant regulations in respect of the requirement for medicals. In the first instance, employers and the self-employed should check whether there are existing ADs/AMEDs who can undertake the medicals (see Question 8).

There are Occupational Health Service (OHS) providers offering to conduct statutory medical examinations. Some employers may already have established a contract with such providers for a variety of services that may include medicals under the legislation outlined above. HSE will not appoint/approve new doctors where the OHS provider that an employer currently contracts with is unable to service their requirements (eg through an AD retiring, relocating or leaving the OHS). Any cost arising from an employer's efforts to source an alternative (initially checking whether existing ADs/AMEDs can undertake the work) is a business decision for that organisation.

6. What happens if an employer cannot find a suitable doctor to carry out medicals?

In the unlikely event that an employer cannot locate an AD or AMED in a reasonable geographical area after consulting the list of doctors provided by HSE (see Question 8), then HSE will consider a new appointment/approval to ensure the employer is able to comply with their legal obligations under the relevant regulations. HSE would normally expect a new application from a doctor seeking an appointment to include the name of the employer organisation that was unable to find an AD.

7. What else can employers do to ensure their organisation can continue to comply?

It may be appropriate for an employer to check that their current OHS provider (or any provider they intend to establish a contract with) has an existing AD/AMED. Alternatives include obtaining the services directly from an existing AD/AMED. Employers should also note that existing ADs can extend their appointment to include additional regulations (a-e in Question 1) as well as additional companies. The moratorium does not prevent this. Further details are available in HSE's AD web pages.

8. How do employers contact HSE to obtain a list of nearby doctors?

For a list of ADs, employers should contact the relevant HSE office. HSE is currently working towards making these details available on its website.

A list of AMEDs is available on HSE's diving website.