Teacher with multiple sclerosis: adjustments versus ill-health retirement
A 47-year-old secondary school science teacher with relapsing–remitting multiple sclerosis has had worsening fatigue and right leg weakness over 6 months. She teaches 22 hours a week plus duties and has a 50-minute journey each way. She has fallen twice in the corridor and once dropped a tray of glass beakers, without injury. Her neurologist supports reduced hours. The head teacher asks whether she should be retired on ill-health grounds, and the HR manager says the school cannot afford cover for a part-time role. She wants to keep working.
1. How would you assess her fitness for work and what adjustments would you consider?
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- Assess function rather than diagnosis: mobility, balance, fatigue pattern through the day, manual handling, ability to supervise practicals, concentration and journey tolerance. Ask her what she finds hardest and what would help.
- Consider a phased timetable, reduced hours with protected breaks, ground-floor teaching rooms, timetable clustering to reduce stair use and travel between buildings, and avoidance of lone supervision of practicals until the falls are assessed.
- Refer to an occupational therapist or Access to Work for workplace assessment, equipment and possible travel support; involve the neurologist for a prognosis and treatment review.
- Treat the dropped beakers as a risk signal: carry out a temporary risk assessment and restrict practical work until her balance and fatigue are better controlled. This is a temporary restriction, not a permanent bar.
- Document the adjustments, review dates and the reasoning, and share only what is necessary with the school.
2. How would you respond to the head teacher's question about ill-health retirement and the HR manager's cost concern?
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- It is not the occupational physician's decision to retire her; your role is to provide evidence on capability, prognosis and the likely effect of adjustments. The decision rests with the employer and pension scheme.
- Apply the Equality Act 2010 framework: the employer must consider reasonable adjustments before any discriminatory decision. Cost can be relevant but is not a trump card; access to public funding and Access to Work should be explored.
- Advise that ill-health retirement should be considered only if adjustments and redeployment have been tried and her condition prevents her from doing the job, now or in the foreseeable future. She wishes to work, which is a strong factor.
- Provide a report distinguishing what she can do now, what she could do with adjustments, and what is likely to change. Avoid predicting the future beyond the evidence.
- Challenge the assumption that part-time cover is unaffordable by exploring job-share, redeployment or temporary cover; record the advice.
3. What would you do about the safety of students in her practical classes in the short term?
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- Carry out an immediate risk assessment focused on the tasks that have already caused incidents: carrying glassware, moving around the laboratory, and supervising pupils during practicals.
- Put temporary controls in place: no lone practical supervision, pre-prepared trays, trolley use, seated demonstration, and a designated colleague available if she feels unwell.
- Discuss the situation with her; a temporary restriction is preferable to removing her from teaching altogether and should be reviewed as her treatment and fatigue change.
- Record the risk assessment and review date. If her balance does not improve, consider temporary redeployment to theory teaching while maintaining her pay and conditions.
- Reassure the school that the aim is to keep her in work safely, not to force retirement.