Occupational Health Practice and Service Delivery
What this domain tests
This domain covers how occupational health services are designed, delivered and evaluated: pre-placement and periodic health surveillance, fitness-for-work assessment, rehabilitation and return-to-work, absence management, workplace risk assessment, health promotion, and the interface with HR, safety and primary care. Know the difference between health surveillance (a statutory, exposure-driven programme) and general health screening. Understand the purpose of a fitness assessment: to match the worker to the job, not to exclude people unnecessarily.
Concepts to hold
Be clear on the components of a good surveillance programme: defined population, validated test, action threshold, referral pathway, record keeping and review. Understand reasonable adjustments and the value of modified duties. Know that risk assessment follows a structured cycle (identify hazard, evaluate risk, control, record, review). Familiarise yourself with audit and quality improvement: standards, indicators, and the plan-do-study-act cycle.
Traps
Questions often present a manager requesting information and test whether you disclose only fitness conclusions, not clinical detail. Another trap is confusing surveillance with screening, or treating a surveillance result as a diagnosis. Watch for 'best first step' items: usually a risk assessment or a discussion with the worker, not immediate referral or exclusion. Finally, remember that absence management focuses on capability, not punishment.
Worked rule of thumb
Ask three questions for any service decision: who is the population, what is the outcome being measured, and what action follows a positive result? If no action pathway exists, the programme is not fit for purpose.
Example
A worker with controlled epilepsy in a safety-critical role: assess the specific task risks, consider adjustments, and document the reasoning rather than issuing a blanket unfit decision.