Deciding whether to refer concerns related to health

You may have concerns that someone’s physical or mental health is impacting (or could impact) their ability to provide safe care. Usually, these concerns can best be managed with your support, as an employer, to safely reduce any risk to people who use services.

You won’t need to make a referral if:

• the nurse, midwife or nursing associate has demonstrated good insight into the extent and effect of their condition
• the nurse, midwife or nursing associate is taking appropriate steps to access treatment and is following any advice from their health professionals
• occupational health (where available) is providing support through the employer
• the nurse, midwife or nursing associate is managing his or her practice appropriately, for example by taking sickness absence.

Referrals aren’t necessary when a nurse, midwife or nursing associate has a disability or long-term health condition but is able to practise with or without adjustments to support their practice. Equally, a nurse, midwife or nursing associate may be signed off as ‘unfit for work’ due to ill health, but this does not necessarily mean their fitness to practise is impaired.

You should make a referral when someone’s health condition presents a risk of harm to the public that you’re unable to manage, or a risk to public confidence in the profession.

This may be, for example, where someone has a long-term physical or mental health condition that is untreated (or unsuccessfully treated) and could affect their ability to provide safe care. Or it may be where the nurse, midwife or nursing associate has not acknowledged the health condition that’s affecting their practice.