Background
This section explains the role of the appointed doctor and the appointment process.
HSE appoints registered and licensed medical practitioners to undertake statutory medical surveillance. Under certain regulations employers have a duty to ensure workers are placed under medical surveillance by an appointed doctor.
The doctor's role is to inform employees of early signs of potential health problems caused by the work they are doing, advise them on whether further exposure to the particular hazard is appropriate and make the employer aware of any emerging issues so they can review their risk assessment and ensure risks to their employees' health are properly controlled. HSE appoints doctors by issuing a Certificate of Appointment covering one or more regulations, valid for a stated period.
Appointed doctors are accountable to HSE for the work they carry out. As a condition of appointment they undertake to adhere to standards set by HSE in regulation specific guidance for appointed doctors.
Appointment process
To be appointed by HSE to become an appointed doctor you will need to meet the following requirements:
- You must be registered with the General Medical Council (GMC) and hold a licence to practise and be fully engaged with GMC revalidation. As part of your revalidation you should ensure your appointed doctor work is considered during your annual appraisals.
- You must:
- have a qualification in occupational medicine (minimum diploma)
- appropriate training for the regulations under which you have been appointed
- maintain and improve your standards by continual professional development as required by the GMC
- You require a comprehensive understanding of:
- The appointed doctor web pages
- The guidelines for appointed doctors conducting medical surveillance specific to the regulations under which you are appointed
- the Approved Code of Practice relevant to the regulations under which you are appointed
- ebulletins for Appointed Doctors sent out periodically by HSE
- You need access to appropriate facilities and equipment for conducting medical examinations. This includes:
- a safe environment for conducting examinations
- an environment which safeguards the privacy of the worker during the examination
- appropriate equipment for conducting examinations which is maintained and calibrated in accordance with the manufacturers' instructions
- suitable furnishings for conducting examinations
- acceptable levels of hygiene
- adequate heating and ventilation
- hand washing facilities
- While you must retain overall responsibility for statutory medical examinations some elements may be delegated to nurses or occupational health technicians. However, you must ensure that the nurse or occupational health technician is suitably trained and competent. You should still see the worker and where relevant assess their fitness to continue work as guided by the relevant regulations, Approved Code of Practice and guidance.
- Where practical, you should visit the workplace to familiarise yourself with the activities to which the regulations apply, the conditions in the workplace and the workers under medical surveillance.
- You must respond promptly to requests from HSE for information on your activities as an appointed doctor and promptly inform HSE of any changes in contact details. If HSE is unable to contact you, your appointment may be withdrawn.
- You must keep an up to date list of the companies and self-employed workers for whom you provide appointed doctor services.
- You should aim to undertake at least five statutory medicals a year for each regulation under which you are appointed. If your annual return indicates you have not performed any medicals over a 12-month period, HSE may withdraw your appointment.
The following statement is being published to meet the requirements of the Professional Qualifications Act 2022 (PQ Act). Under section 8 of the PQ Act regulators in the UK are required to publish certain information about requirements to practise the profession:
Any person wishing to practise the profession of Appointed Doctor under the Ionising Radiation Regulations 2017 must hold qualifications and experience that complies with HSEs appointment process. There is no application process within the scope of Sections 8(2)(b) or 8(2)(c).
Training
To provide medical surveillance for workers exposed to ionising radiation or work in compressed air, appointed doctors must undertake specific training and maintain up to date knowledge. Completion of an initial training course in itself does not guarantee that HSE will either grant an appointment or renew an appointment.
Ionising Radiation
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):
Healthy Working Lives Group
University of Glasgow
1 Lilybank Gardens
Glasgow
G12 8RZ
Tel: 0141 330 3559/3719
email: [email protected]
TP Health
Dr Jonathan Peters CMO AWE
First Floor Rickyard Barn
Pury Hill Business Park
Nr Alderton
Towcester
Northamptonshire
NN12 7LS
email: [email protected]
0118 9826437
Work in compressed air
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).
How to apply for an appointment
You should only apply for appointment if you fully meet our criteria and there is a demand for your services, if appointed.
To apply for an appointment, you should complete application form FODMS38 and provide HSE with the following information (Incomplete applications will be rejected):
- documentary evidence of satisfactory completion of your last annual appraisal, containing your name as appraisee, name of appraiser, signature of appraiser (or electronic confirmation) and date of appraisal
- a copy of the certificate of your highest qualification in Occupational Medicine (minimum of Diploma)
- for an appointment under the Ionising Radiations Regulations, a copy of your ionising radiation training certificate
- for an appointment under the Work in Compressed Air Regulations, evidence of specialist knowledge in hyperbaric medicine
The application form and the additional information requested should be sent by email to: [email protected] and marked New Applicant.
If satisfactory, HSE will issue you with a Certificate of Appointment for one year in the first instance. You should note the certificate is issued to you as an individual doctor and cannot be transferred to another doctor. You are responsible for ensuring you do not undertake medicals beyond the expiry date on your certificate unless issued with a new certificate.
How to renew your certificate of appointment
When HSE notifies you that your Certificate of Appointment is due for renewal we will check you continue to be registered with the GMC and hold a licence to practise. You should complete the renewal form FODMS38R, the Appointed Doctor Audit Form and provide the following information:
- documentary evidence of satisfactory completion of your last annual appraisal, containing your name as appraisee, name of appraiser, signature of appraiser (or electronic confirmation) and date of appraisal
- for an appointment under the Ionising Radiations Regulations, a copy of your current ionising radiation training certificate
- for an appointment under the Work in Compressed Air Regulations, evidence of up to date specialist knowledge in hyperbaric medicine
HSE will not renew your appointment if you provide incomplete information. For example where appointment is subject to holding a current training certificate, it will not be renewed until HSE is in receipt of a copy of that certificate. Therefore if your appointment requires specialist training you are responsible for arranging that training takes place before your appointment is due for renewal. In these circumstances, once your appointment has expired you will no longer be appointed by HSE and therefore, you will not be able to undertake statutory medicals under the regulations for which you were appointed.
If satisfactory, HSE will renew your Certificate of Appointment, normally for five years. You are responsible for ensuring you do not undertake medicals beyond the expiry date on your certificate.
Reviewing performance
HSE takes a risk based approach to performance reviews, depending on the regulations under which a doctor is appointed. Consequently, while any appointed doctor could be subject to review not all appointed doctors whose appointments are due for renewal will undergo a performance review at the same time. If selected for review, you will be assessed against standards based on the regulation-specific guidance for appointed doctors.
Following assessment of your renewal papers, HSE will notify you if it wishes to review your performance as an Appointed Doctor by evaluating medical records from your most recent cases. You will need to provide medical records for at least three workers (copies only, do not send originals), under the regulations HSE wishes to review, including both male and female workers if available. To review your work under the Control of Lead at Work Regulations, one of the medical records should be for the employee with the highest blood lead level you have recorded.
In submitting records you should anonymise them by removing or redacting the employee's name and address but still retain their gender and date of birth. If you submit records by post you should mark them 'Medical in Confidence'. HSE will destroy the records on completion of the review.
Following the review, an HSE Medical Adviser will write to you, indicating whether the outcome was satisfactory or if minor or major improvements are required, setting out any remedial action considered necessary. In exceptional cases, remedial action may include face to face review, usually at an HSE office. Once you have addressed any remedial action that may be necessary, HSE will renew your Certificate of Appointment, normally for five years. If serious compliance problems are identified, HSE may decide not to renew your certificate or to issue a certificate of short duration, for no longer than one year.
Extending an appointment
Established appointed doctors can extend their appointment to cover additional regulations by completing form FODMS38 and submitting it to HSE. If appropriate, HSE will issue you with an amended Certificate of Appointment.
HSE no longer issues Schedules or requires doctors to submit new FODMS38 forms when you take up work for new companies or self-employed workers. However, HSE still requires you to maintain an up to date list of the companies and self-employed workers for whom you provide appointed doctor services.
Arranging cover for absence
If you require temporary cover because of maternity leave or other protracted absence, another HSE appointed doctor may be required to ensure continuity of medical surveillance until you can resume your duties. You should discuss this matter with the duty holder so that they can ensure that another HSE Appointed Doctor will be available in your absence. A list of appointed doctors can be found on our website.
How to appeal
You may appeal against a decision:
- not to issue you with a Certificate of Appointment
- to revoke your Certificate of Appointment
If you wish to appeal, you must submit your request within 28 days of receiving formal notice of the decision. You should provide documentary evidence in support of the appeal and send the request in an email to [email protected]. The email should be marked 'Appeal' and cite your PIN Number.
The original decision made will remain in place until the outcome of any appeals process.
Ahead of an appeal you may wish to discuss the initial outcome with HSE's Principal Medical Adviser or a member of their team to understand the issues raised and any actions that need to be taken.
The appeal panel
The panel will comprise of:
- HSE's Chief Medical Adviser
- The Senior Civil Servant (SCS) responsible for HSE's appointed doctor scheme (chair)
- An independent member
The members of the panel will not have been involved in making the original decision. The panel is chaired by the member of the SCS responsible for the scheme. The purpose of the panel is to ensure the appointed doctor appointment and renewal process has been followed, taking into account any technical advice relevant to the case.
The appeal process
The appeal is a paper based review conducted by the panel. The review will consider the previous decision made and the evidence to support that decision. The panel will reject the appeal if it is without merit.
- HSE will aim to convene the panel within 15 working days after receipt of the appeal request or as soon as reasonably practicable thereafter. The appellant will be informed of the date of the panel once it is set.
- The documentary evidence provided by the appellant in support of the appeal will be provided to the panel.
- If additional information is required from the appellant they will be informed by email and provided with a date by which the additional information must be submitted.
Appeal outcome
The appellant will then be notified of the outcome as soon as is reasonably practicable following the meeting and conclusion of the panel. The decision will contain the reasons for the outcome of the appeal.
Complaints
If there is a verbal complaint made about your work as an appointed doctor, HSE will request written confirmation. To investigate a formal, written complaint, HSE will ask you to provide written comments in response. Alternatively, an HSE Medical Adviser may visit you to gather evidence on which to base their judgement.